Real-Time Imaging as Visual Biofeedback in Active Second Stage of Labor Among Nulliparas: A Randomized Controlled Trial

( Am J Obstet Gynecol . 2023;229(4):443.e1–443.e9. doi:10.1016/j.ajog.2023.04.049) Extended second-stage labor heightens the chances of severe perineal tears, postpartum bleeding, operative deliveries, and low Apgar scores, especially among first-time mothers. Maternal exertion during this stage aids the natural expulsion of the fetus. Biofeedback, a mind-body technique, empowers individuals to regulate their bodily functions for holistic well-being. Utilizing mirrors or monitors for real-time visual feedback enhances self-awareness. In a previous study, 88.5% of women who used a mirror during the second stage of labor felt that it motivated them to push, albeit with some clarity limitations. Similarly, in 2 additional small studies, visual aids like cameras or ultrasound shorten the second stage by inspiring effective pushing. The current study aimed to compare real-time introitus visualization (InV) against maternal face (MF) viewing (control) during pushing in first-time mothers, assessing its impact on delivery time and maternal satisfaction.