The environment of the labor room may influence how women experience childbirth. Light levels, in particular, may affect comfort, stress, and the course of labor. However, there is limited high-quality evidence on whether keeping the labor room lighting dim has measurable benefits for mothers. This study aims to evaluate the effects of dim light exposure during active labor on pain, anxiety, and labor progress. Pregnant women who are in active labor at term will be randomly assigned to one of two groups. One group will give birth in a room with dim lighting (50-80 lux), while the other group will receive standard room lighting as part of routine care. Pain and anxiety levels will be measured at specific time points during labor using standard assessment scales. Information about labor duration, use of labor medications, mode of delivery, and newborn outcomes will also be collected. The dim light intervention does not interfere with routine obstetric care and does not pose additional risk to the mother or baby. If needed for clinical reasons, room lighting can be increased immediately. The results of this study may help determine whether a simple change in the birth environment can improve maternal comfort and labor outcomes.
This study is a single-center, parallel-group randomized controlled trial designed to evaluate the effects of dim light exposure during active labor on maternal pain, anxiety, and labor progress. The trial is conducted in a university hospital labor ward and includes term pregnant women in active labor. Eligible participants are women aged 18-45 years with a singleton, vertex-presenting pregnancy at ≥37 weeks of gestation who are in active labor. Participants are allocated to one of two study groups according to a predefined randomization scheme. To minimize contamination between groups, cluster randomization by delivery room and week is applied. In the intervention group, labor room lighting is adjusted to a dim light environment with an illumination level maintained between 50 and 80 lux, using warm white or amber light sources. Light intensity is monitored at regular intervals using a lux meter. In the control group, routine labor room lighting conditions are maintained in accordance with standard clinical practice. Pain intensity and anxiety levels are assessed at predefined time points during labor using validated measurement tools. Labor progress and obstetric outcomes, including use of labor augmentation, duration of labor stages, mode of delivery, and neonatal outcomes, are recorded from clinical charts. The primary outcome is derived from changes in pain intensity over time during labor. Secondary outcomes include anxiety levels, labor characteristics, and maternal and neonatal clinical outcomes. The dim light intervention is non-invasive and does not interfere with routine obstetric care. For clinical or safety reasons, room lighting can be increased immediately at any time at the discretion of the clinical team. All participants receive standard intrapartum care according to institutional protocols. Study data are collected prospectively and stored in an anonymized format to ensure participant confidentiality. The study is conducted in accordance with ethical principles and has received approval from the relevant institutional ethics committee.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
Adjustment of labor room illumination to a target range of 50-80 lux during active labor, with monitoring using a lux meter; lighting can be increased at any time for clinical reasons.
Standard labor room lighting conditions maintained according to routine clinical practice, without modification of illumination levels.
Niğde Ömer Halisdemir University Hospital
Niğde, Niğde Province, Turkey (Türkiye)
RECRUITINGPain intensity over time (VAS-AUC, 0-120 minutes)
Pain intensity will be assessed using a 0-10 Visual Analog Scale (VAS) at baseline (0 minutes), 60 minutes, and 120 minutes after allocation. The area under the curve (AUC) for VAS from 0 to 120 minutes will be calculated as the primary outcome.
Time frame: From baseline to 120 minutes during active labor
Anxiety level (STAI-S change)
State anxiety will be assessed using the State-Trait Anxiety Inventory - State Anxiety Scale (STAI-S) at baseline (prior to intervention/exposure) and at 90 minutes during active labor. The STAI-S consists of 20 items, with total scores ranging from 20 to 80. Higher STAI-S scores indicate greater state anxiety (worse outcome). The primary analysis will use the change score (90-minute STAI-S minus baseline STAI-S); negative values indicate a reduction in anxiety.
Time frame: From baseline to 90 minutes during active labor
Oxytocin use (initiation rate and total dose)
Proportion of participants who receive oxytocin augmentation and the total oxytocin dose administered during labor will be recorded from clinical charts.
Time frame: During labor until delivery
Duration of active phase of labor
Time from enrollment during active labor to full cervical dilation will be recorded.
Time frame: From enrollment to full dilation
Duration of second stage of labor
Time from full cervical dilation to delivery will be recorded.
Time frame: From full dilation to delivery
Mode of delivery
Vaginal delivery (spontaneous/assisted) and cesarean delivery will be recorded.
Time frame: At delivery
Estimated blood loss
Estimated maternal blood loss at delivery will be recorded from clinical records.
Time frame: At delivery / immediate postpartum
Neonatal outcomes (Apgar scores)
Neonatal well-being will be assessed using the Apgar scoring system at 1 and 5 minutes after birth. The Apgar score ranges from 0 to 10, based on five components (heart rate, respiratory effort, muscle tone, reflex irritability, and skin color). Higher Apgar scores indicate better neonatal condition (better outcome). Apgar scores at 1 and 5 minutes will be recorded and analyzed descriptively.
Time frame: 1 and 5 minutes after birth
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