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IRCT20260805070545N1 IRCT 2026-08-27 Ahvaz University of Medical Sciences Effect of second stage of labor management program on pelvic floor muscle Design, Implementation, and Evaluation of the Impact of a Second-Stage Labor Management Program on Pelvic Floor Muscle Health: A Mixed-Methods Evaluation Design 2026-09-06 anticipated 420 Recruiting https://irct.ir/trial/92492 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: Midwives are divided into two intervention and control groups with a 1:1 allocation ratio using stratified randomization based on the variable of work experience (less than 5 years and 5 years or more). The randomization sequence is generated by an independent person from the research team using a random number table. The final allocation is kept in opaque, sealed, and numbered envelopes and is known only to the independent person until the results are announced. N/A Pelvic floor disorders after vaginal delivery. Intervention 1: Intervention group: Participants in the intervention group will receive a Second Stage of Labor Management Program designed to protect pelvic floor muscle health during childbirth. The program will be implemented by trained midwives and includes evidence-based interventions during the second stage of labor, such as guidance on spontaneous pushing, appropriate maternal birthing positions, controlled breathing techniques, perineal support, controlled delivery of the fetal head, and other standardized practices aimed at reducing pelvic floor muscle strain and birth-related pelvic floor injury. Intervention 2: Control group: Participants in the control group will receive routine intrapartum care according to the standard clinical protocols of the study setting. Labor and birth management will be conducted by the attending healthcare providers without implementation of the structured Second Stage of Labor Management Program. Yes - There is a plan to make this available What will be shared: The documentation will be published as articles on scientific websites. When: Access period begins 6 months after the publication of results. To whom: Researchers at academic and scientific institutions, students, and midwives working in public and private centers. Conditions: For the purpose of conducting further research or applying the results in clinical settings or scientific documentation. Where to obtain: Articles published on domestic and international scientific and research websites will be accessible. How to obtain: Scientific articles based on research findings are eligible for publication in journals following rigorous peer review. Comments:
public Hadis Bahmaei
Iran, Ahvaz, Golestan Highway, Ahvaz Jundishapur University
Ahvaz Iran (Islamic Republic of) ۶۱۳۵۷۱۵۷۹۴ +98 61 3314 0000 hadisbahmaei8894@gmail.com Ahvaz University of Medical Sciences scientific Hadis Bahmaei
Iran, Ahvaz, Golestan Highway, Ahvaz Jundishapur University
رامهرمز Iran (Islamic Republic of) ۶۱۳۵۷۱۵۷۹۴ +98 61 3314 0000 hadisbahmaei8894@gmail.com Ahvaz University of Medical Sciences Iran (Islamic Republic of) Willingness to participate in the study Maternal age between 18 and 45 years Singleton live fetus Cephalic fetal presentation Low-risk pregnancy Gestational age between 37 and 41 weeks of pregnancy 18 years 45 years Female Attendance at more than four childbirth preparation classes Performing perineal massage during pregnancy Presence of a birth companion (professional labor support midwife/doula or a family member) high-risk pregnancy Presence of contraindications to vaginal birth Presence of maternal medical conditions documented in the medical record Treatment - Other N/A Intervention group: Participants in the intervention group will receive a Second Stage of Labor Management Program designed to protect pelvic floor muscle health during childbirth. The program will be implemented by trained midwives and includes evidence-based interventions during the second stage of labor, such as guidance on spontaneous pushing, appropriate maternal birthing positions, controlled breathing techniques, perineal support, controlled delivery of the fetal head, and other standardized practices aimed at reducing pelvic floor muscle strain and birth-related pelvic floor injury. Control group: Participants in the control group will receive routine intrapartum care according to the standard clinical protocols of the study setting. Labor and birth management will be conducted by the attending healthcare providers without implementation of the structured Second Stage of Labor Management Program. Pelvic floor muscle strength. Timepoint: 8–12 weeks postpartum. Method of measurement: Pelvic floor muscle strength will be assessed using the Modified Oxford Scale (MOS) through standardized digital vaginal examination performed by trained assessors. The MOS is a validated 6-point grading system ranging from 0 (no palpable contraction) to 5 (strong contraction). Ahvaz University of Medical Sciences Approved 2026-08-15 Vice Chancellor for Research and Technology, Ahvaz Jundishapur University of Medical Sciences Ground Floor, Vice Chancellor for Research and Technology, Ahvaz Jundishapur University of Medical Sciences, University Campus, Ahvaz, Khuzestan, Iran رامهرمز Khouzestan Iran (Islamic Republic of)