Evidence-based intrapartum supportive care in Turkiye: A randomized controlled trial

Abstract

Background The integration of evidence-based supportive care practices into intrapartum care is increasingly emphasized in international guidelines, as such practices are considered fundamental to ensuring safe, respectful, and woman-centered maternity services. Despite growing awareness, supportive practices remain under-implemented in clinical settings. Therefore, this study aimed at investigating the effect of supportive care provided in line with evidence-based practices during the intrapartum period. Methods The study has a randomized controlled intervention design, in which participants were randomly allocated to the intervention or control group. This study was conducted in a public hospital, a province in Balıkesir, Türkiye. The study sample comprised (n=104) pregnant women assigned to the intervention (n=52) and control (n=52) groups. Participants were matched for age, education level, body mass index, the number of births and pregnancies, and participation in prenatal preparation classes. During the intrapartum period, the participants in the intervention and control groups were given supportive care and routine care, respectively. The Descriptive Characteristics of Women Questionnaire, State Anxiety Inventory (SAI), Visual Analogue Scale (VAS), pain diagram, and labor and postpartum evaluation form were used to collect the data. Data were analyzed using SPSS version 26.0. Group comparisons were performed using chi-square and Fisher’s exact test for categorical variables and Student’s t-test for continuous variables showing a normal distribution. Intra-group comparisons were performed using paired t-tests, and repeated measures were analyzed using analysis of variance with Bonferroni post hoc correction. Effect sizes were calculated using Cohen’s d. In the analysis of the data, Student’s t-test, paired t-test, repeated measures of ANOVA (post hoc: Bonferroni) and Cohen’s d were used. Results The participants in the intervention group tended to have lower mean VAS and SAI in the latent, active and transition phases after they received supportive care. The duration of labor was shorter with the intervention compared to the control group (9.2±5.4 h vs. 12.6±6.8 h, p=.005). The perceived difficulty of labor was also lower with the intervetion (7.8±2.0 vs. 9.4±1.2, p<.001). Maternal satisfaction scores were higher with the intervention compared to the control group (9.9±0.2 vs. 7.2±1.6, p<.001). Conclusion The research found that pregnant women who received supportive care during labor, tended to have lower perceived labor pain and state anxiety levels, shorter labor duration, and lower perceived difficulty during labor compared to those who received standard care. Additionally, the postpartum maternal satisfaction scores tended to be higher in the intervention group. Future research should focus on longitudinal studies evaluating the effects of supportive care provided during the intrapartum period on the postpartum well-being of mothers and the breastfeeding process. Trial and protocol registration This randomized controlled trial was retrospectively registered at ClinicalTrials.gov (NCT06024811) on July 25, 2023. Reporting method Study methods and results reported in adherence to the CONSORT Statement.