{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:09:11Z","timestamp":1759190951772,"version":"3.44.0"},"reference-count":90,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T00:00:00Z","timestamp":1758931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: Women\u2019s vocalization during labor can be highly influenced by the attitudes and practices of nurse midwives. This study analyzed the perspectives of nurse midwives regarding women\u2019s vocalization in the first and second stages of labor (n = 16). Methods: Descriptive study using semi-structured interviews analyzed through lexical analysis with IraMuTeQ software. Data collection took place between February and April 2024. Results: The analysis revealed six thematic classes: \u201cAttitude toward vocalization\u201d, \u201cSignificance of women\u2019s self-image\u201d, \u201cResistance and acceptance of vocalization\u201d, \u201cControl and inhibition of vocalization\u201d, \u201cAdvantages and disadvantages of vocalization\u201d, and \u201cUsefulness of vocalization in caregiving\u201d. Conclusions: There are different attitudes among nurse midwives toward women\u2019s vocalization, ranging from respect to paternalistic control. Practical implications include the urgent need for curricular modules on vocalization in midwifery training programs and the deconstruction of biases that silence women\u2019s voices during childbirth.<\/jats:p>","DOI":"10.3390\/healthcare13192451","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T10:49:34Z","timestamp":1759142974000},"page":"2451","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurse Midwives\u2019 Perspectives on Women\u2019s Vocalization During the First and Second Stages of Labor: A Qualitative Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3456-544X","authenticated-orcid":false,"given":"Isabel Rute","family":"Pereira","sequence":"first","affiliation":[{"name":"Nursing Department, University of \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"Maternal Health and Obstetrics Department, Unidade Local de Sa\u00fade do Alto Alentejo, 7300-853 Portalegre, Portugal"},{"name":"Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0028-2664","authenticated-orcid":false,"given":"Margarida","family":"Sim-Sim","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Centre (CHRC), S\u00e3o Jo\u00e3o de Deus School of Nursing, University of \u00c9vora, 7004-516 \u00c9vora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2899-8768","authenticated-orcid":false,"given":"Maria Ot\u00edlia","family":"Zang\u00e3o","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Centre (CHRC), S\u00e3o Jo\u00e3o de Deus School of Nursing, University of \u00c9vora, 7004-516 \u00c9vora, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,27]]},"reference":[{"key":"ref_1","first-page":"380","article-title":"The evolution of midwifery","volume":"146","author":"Rabinerson","year":"2007","journal-title":"Harefuah"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e409","DOI":"10.1016\/j.wombi.2021.10.009","article-title":"Looking Back Moving Forward: The History of Midwifery in Western Australia","volume":"35","author":"Davison","year":"2022","journal-title":"Women Birth"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1177\/10436596221098975","article-title":"A History of the Midwifery Profession in the Republic of Croatia","volume":"33","author":"Malnar","year":"2022","journal-title":"J. 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