How birth position affects pelvic floor strength and perineal pain in first-time mothers
The Effect of Birth Positions on Pelvic Floor Muscle Strength, Severity, and Quality of Perineal Pain in Primiparous Pregnant Women: A Randomized Controlled Trial
We will try delivering in a semi‑sitting (semi‑Fowler) position instead of the usual lithotomy position to see if it improves pelvic floor muscle strength and reduces perineal pain for first‑time, term pregnant women.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 70 (estimated) |
| Ages | 18 Years to 35 Years |
| Sex | Female |
| Sponsor | Ege University Academic / other |
| Locations | 1 site (Izmir) |
| Trial ID | NCT07243522 on ClinicalTrials.gov |
What this trial studies
This randomized controlled trial will enroll 70 primiparous women at term at Bakırçay University Çiğli Training and Research Hospital in İzmir. Participants will be randomly assigned to deliver in a semi‑sitting (semi‑Fowler) position or the hospital's standard lithotomy position, with data collected on admission, at 8–10 cm cervical dilation, and within 24 hours after delivery. Primary outcomes include pelvic floor muscle strength and the severity and nature of perineal pain; strict inclusion and exclusion criteria focus the sample on low‑risk, singleton, cephalic pregnancies. The study is planned to run for about one year following ethics approval.
Who should consider this trial
Good fit: Ideal candidates are low‑risk, first‑time pregnant women aged 18–35 at 37–42 weeks with a single cephalic fetus, estimated fetal weight 2,500–4,000 g, BMI under 30, able to speak Turkish, and planning a vaginal birth.
Not a fit: Women with non‑cephalic presentation, significant chronic disease or obstetric risk factors, prior pelvic or prolapse surgery, suspected fetal/maternal complications, or those requiring cesarean delivery are unlikely to receive benefit from this intervention.
Why it matters
Potential benefit: If successful, delivering in a semi‑sitting position could help preserve pelvic floor strength, reduce perineal pain after birth, and improve early postpartum recovery for first‑time mothers.
How similar studies have performed: WHO guidance supports freedom of movement and upright positions and some prior studies show favorable effects of upright positions on labor outcomes, but evidence specifically on pelvic floor strength and perineal pain in primiparas is limited and mixed.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Being between 18 and 35 years of age * Being primiparous * Being at term (37-42 weeks) * Being in the latent phase of the first stage of labor * Being in the vertex position, having a single, live fetus * Having an estimated fetal weight between 2500 and 4000 grams * Having a maternal Body Mass Index \<30 * Pregnant women who are expected to give birth vaginally * Ability to understand and speak Turkish * Volunteer to participate in the study Exclusion Criteria: * Non-cephalic presentation * Chronic diseases (heart disease, epilepsy, hypertension, hypothyroidism, diabetes, and kidney disease, etc.) * Risk of obstetric complications (gestational hypertension, cephalopelvic disproportion, antepartum hemorrhage, intrauterine growth restriction, premature rupture of membranes, etc.) * History of pelvic surgery * History of prolapse surgery * History of collagen disorder * Severe anemia * Presence of genital tract infection * Abnormalities of the vulva (presence of vulvar edema, scarring, etc.) * Application of fundal pressure * Interventional delivery (use of forceps/vacuum during the second stage, etc.) * Cesarean section * Fetal (risk/presence of congenital malformations, estimated fetal weight \<2500 g or \>4000 g)
Where this trial is running
Izmir
- Izmir Bakircay University Cigli Training and Research Hospital — Izmir, Turkey (Türkiye) (Recruiting)
Study contacts
- Study coordinator: Emine Demir, Research Assistant
- Email: demiremine0146@gmail.com
- Phone: +90 232 311 83 00
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.