Integrated Intrapartum Supportive Care and Pushing Strategies in Women Receiving Low-Dose Epidural Analgesia

NCT07663500 | Recruiting

• 1 other identifier: 2024E02
• Study Type: interventional
• Target: 159
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective, three-arm, non-randomized quasi-experimental study aims to evaluate integrated intrapartum supportive care combined with different pushing strategies among women at 37-42 weeks of gestation who receive low-dose epidural analgesia. Participants receive integrated intrapartum supportive care combined with spontaneous pushing, integrated intrapartum supportive care combined with immediate pushing, or routine intrapartum care combined with immediate pushing. The primary outcomes are the durations of the first and second stages of labor. Secondary outcomes include mode of birth, obstetric interventions, maternal outcomes, and neonatal outcomes.

Conditions

Labor, Obstetric; Epidural Analgesia, Obstetric; Labor Duration

Keywords

Integrated intrapartum supportive care; Spontaneous pushing; Immediate pushing; Low-dose epidural analgesia; Maternal mobility; Labor progression

Outcome Measures

Primary Outcomes (1)

• Duration of the first and second stages of labor

  The duration of the first stage of labor is defined as the time interval from the onset of active labor-marked by regular, painful uterine contractions and cervical dilation of ≥6 cm-until full cervical dilation (10 cm). The duration of the second stage of labor is defined as the time from full cervical dilation to the complete delivery of the fetus. Labor durations will be recorded in minutes based on partograph entries and electronic medical records, with all timings verified by attending midwives or obstetric care providers to ensure accuracy.

  From the onset of active labor to the delivery of the fetus.

Secondary Outcomes (3)

• Caesarean Section Rate

  During labor and delivery

• Instrumental Vaginal Delivery Rate

  During delivery

• Augmentation Rate

  During labor

Study Arms (3)

Integrated Care with Spontaneous Pushing

EXPERIMENTAL

Integrated Care with Spontaneous Pushing Group

Behavioral: Integrated Care with Spontaneous Pushing Group

Integrated Care with Immediate Pushing

EXPERIMENTAL

Integrated Care with Immediate Pushing Group

Behavioral: Integrated Care with Immediate Pushing

Standard Routine Care

ACTIVE COMPARATOR

Standard Routine Care

Behavioral: Standard Routine Care

Interventions

Integrated Care with Immediate Pushing BEHAVIORAL

Integrated Care with Immediate Pushing Group: Participants receive an integrated intrapartum care package that includes continuous labor support and active birth positioning. Once full cervical dilation is achieved, participants are instructed to begin pushing immediately, regardless of the presence or absence of an urge to push. This directive approach to second-stage labor is guided by midwives or obstetric staff.

Integrated Care with Immediate Pushing

Integrated Care with Spontaneous Pushing Group BEHAVIORAL

Participants receive the integrated intrapartum supportive care program during the first stage of labor. During the second stage, participants are encouraged to begin pushing in response to their spontaneous urge to push rather than routinely initiating pushing immediately after full cervical dilation. The pushing strategy is implemented by the attending clinical care team according to the predefined group protocol.

Integrated Care with Spontaneous Pushing

Standard Routine Care BEHAVIORAL

Participants receive routine intrapartum care according to institutional clinical practice. Supportive measures and position changes may be provided according to maternal needs and clinical judgment, but participants do not receive the structured multicomponent integrated intrapartum supportive care program. During the second stage of labor, pushing begins after full cervical dilation according to the attending clinical team's immediate pushing practice.

Standard Routine Care

Eligibility Criteria

• Age: 18 Years+
• Gender Eligibility Details: Only biological females who are pregnancy at 37-42 week will be eligible to participate in this study.
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

Sponsors & Collaborators

• National Taipei University of Nursing and Health Sciences: lead

Study Sites (1)

Taiwan Adventist Hospital

Taipei, 10556, Taiwan

RECRUITING

Study Officials

• Wan-Lin Pan, PhD

  National Taipei University of Nursing and Health Sciences

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Wan-Lin Pan, PhD

CONTACT

+886-2-2822-7101 ext. 7101; wanlimp@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: June 17, 2026
• First Posted: June 23, 2026
• Study Start: June 10, 2025
• Primary Completion: July 31, 2026
• Study Completion: July 31, 2026
• Last Updated: June 23, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)