Pushing Using Real-time Sonographic Ultrasound Education

"The pushing training program consists of a two-hour in-person session, structured as follows:~* 30 minutes of theoretical instruction, covering the physiological mechanisms of labor, the role of the levator ani muscle (LAM) during pushing, and optimal pushing techniques.~* 30 minutes of practical exercises, during which women will be guided through breathing techniques, pushing strategies, and perineal relaxation.~Women randomized to the ultrasound-guided pushing training group will receive additional transperineal ultrasound (TPU) evaluations during practical exercises, performed by a midwife trained in ultrasound imaging. These assessments will ensure effective LAM relaxation during pushing practices and provide real-time visual feedback to optimize muscle coordination."

"The pushing training program consists of a two-hour in-person session, structured as follows:~* 30 minutes of theoretical instruction, covering the physiological mechanisms of labor, the role of the levator ani muscle (LAM) during pushing, and optimal pushing techniques.~* 30 minutes of practical exercises, during which women will be guided through breathing techniques, pushing strategies, and perineal relaxation."