Impact of Using a Mirror in the Second Stage of Labor on Childbirth Duration and Experience
Phase: NA
Conditions: Labor Stage, Second
Sponsor: Kocaeli University

 
 
 
Impact of Using a Mirror in the Second Stage of Labor on Childbirth Duration and 
Experience: A Randomized Controlled Trial 
 
 
 
NCT Number: NCT06648161 
Document Date: January 14, 2025 
 
 
 

STUDY PROTOCOL AND STATISTICAL ANALYSIS PLAN 
1. Title of the Study 
Impact of Using a Mirror in the Second Stage of Labor on Childbirth Duration and Experience: 
A Randomized Controlled Trial 
2. Background and Rationale 
Childbirth is a critical period for maternal health. The second stage of labor, from full cervical 
dilation to birth, is particularly demanding. Recent studies suggest that visual biofeedback (e.g., 
using a labor mirror) may improve maternal control, reduce fear, and shorten labor. However, 
there is limited empirical evidence from randomized controlled trials, especially in the Turkish 
context. 
3. Study Objectives and Hypotheses 
Aims:  
-To assess the impact of labor mirror use on the duration of the second stage of labor. 
-To evaluate the effect of labor mirror use on maternal birth experience. 
Hypotheses: 
H0-1: There is no difference in second-stage labor duration between the mirror and control 
groups. 
H1-1: There is a significant difference in second-stage labor duration between the groups. 
H0-2: There is no difference in Childbirth Experience Questionnaire (CEQ) scores between the 
mirror and control groups. 
H1-2: There is a significant difference in CEQ scores between the groups. 
4. Study Design 
Randomized controlled, non-blinded, parallel-group design. 
5. Study Setting and Timeline 
Site: Kocaeli Darica Farabi Training and Research Hospital, Turkey 
Study Period: February 2023 – July 2024 

6. Participants 
Inclusion Criteria: 
• Aged ≥18 years 
• Gestational week 38–42 
• Low-risk, healthy singleton pregnancy 
• Literate in Turkish 
Exclusion Criteria: 
• Preterm labor, epidural, fetal complications, meconium-stained fluid 
• Assisted deliveries (e.g., forceps, vacuum) 
• Withdrawal from mirror use or complications in second stage 
7. Sample Size and Randomization 
Using G*Power (v3.1.9.2) based on Palompon et al. (2011), effect size=1.93, power=0.99, 
α=0.05: 
Total: 122 participants (61 per group) 
Random Allocation Software was used. 
8. Interventions 
Intervention Group: Participants were informed and consented. A perineal mirror was fixed 
to the delivery bed during the second stage of labor, allowing women to visualize fetal descent. 
Control Group: Received standard care with no mirror. 
Outcome Measures 
Primary Outcome: 
Duration of second stage of labor (in minutes) 
Secondary Outcome: 
Maternal childbirth experience using the Childbirth Experience Questionnaire (CEQ) 
10. Data Collection Tools 
Personal Information Form 

CEQ (validated Turkish version) 
Opinion Form on Labor Mirror Use 
11. Statistical Analysis Plan 
Descriptive statistics (mean, SD, frequencies) 
Shapiro-Wilk test for normality 
Mann-Whitney U test for group comparisons 
Pearson Chi-Square for categorical variables 
p-value <0.05 considered statistically significant 
Software: IBM SPSS Statistics v20 
12. Ethical Considerations 
Approval: Kocaeli Derince Training and Research Hospital Ethics Committee (2023-13) 
Written informed consent obtained 
Data anonymized 
Compliance with Declaration of Helsinki 
13. Data Sharing Statement 
Data is available from the corresponding author upon reasonable request. 
Prepared by: 
Dr. Suzi Özdemir, RM, PhDKocaeli University, Faculty of Health Sciences, Midwifery 
Department 
suzi.ozdemir@kocaeli.edu.tr