Improving labour progression among women with epidural anesthesia following use of a birthing ball: a review of recent literature.
Nicholas Suraci, Christina Carr, Jacquelin Peck...
https://pubmed.ncbi.nlm.nih.gov/31476927Actively Recruiting
Phase Not Applicable
Age: 16Years - 55Years
FEMALE
ID07333209
Impact of Scheduled Positioning Using a Peanut Birthing Ball on Labor Outcomes Among First-Time Mothers Receiving Epidural Analgesia: A Randomized Controlled Trial
Led by Hamad Medical Corporation · Updated on 2026-01-12
110
Participants Needed
1
Research Sites
8 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are evaluating whether using a peanut birthing ball with scheduled maternal position changes during labor can improve outcomes for first-time mothers receiving epidural analgesia. The study aims to determine if this approach can reduce the duration of the first and second stages of labor and affect the mode of delivery as well as maternal and newborn health. This is a non-invasive, randomized controlled trial conducted at the Women's Wellness and Research Center in Qatar. Participants will be randomly assigned to one of two groups. The intervention group will receive scheduled position changes using a peanut birthing ball placed between the legs, with positions including left lateral, right lateral, semi-sitting, and Taylor positions, changed every 30-60 minutes under staff supervision. The control group will receive standard labor care without the use of the peanut ball or structured position changes. During the study, participants will be closely monitored with continuous fetal and maternal assessments. Researchers will record labor duration, delivery type, oxytocin use, blood loss, perineal trauma, and hospital costs. Newborn assessments will include Apgar scores, NICU admission, birth injuries, and umbilical cord blood pH. Data will be collected in real time and analyzed to compare outcomes between groups, aiming to inform best practices for labor care with epidural analgesia.
CONDITIONS
Brief Title
Scheduled Positioning With a Peanutball(SPP) on Labor Outcomes Among Primiparous Women Under Epidural Analgesia
Who Can Participate
Age: 16Years - 55Years
FEMALE
Eligibility Criteria
You may qualify if you...
- Primiparous women (first pregnancy resulting in live birth or stillbirth after 20 weeks gestation)
- Singleton pregnancy at term (37 weeks 0 days to 41 weeks 6 days)
- Admitted to Labor and Delivery Unit in active labor
- Received epidural analgesia for labor pain
- Expected to have vaginal delivery with no contraindications
- Able to understand and communicate in Arabic or English
- Provide written informed consent
You will not qualify if you...
- Any condition where vaginal birth is not appropriate (e.g., absolute cesarean indication)
- Non-progressive labor needing immediate intervention
- Severe pre-eclampsia or eclampsia
- Active vaginal bleeding of unknown cause
- Major placenta previa or vasa previa
- Suspected or confirmed placental abruption
- Preterm labor with mobility contraindications
- Ruptured membranes with unstable fetal head (risk of cord prolapse)
- Severe maternal exhaustion requiring bed rest
- Maternal hemodynamic instability
- Non-reassuring fetal heart rate needing continuous monitoring
- Malpresentation requiring urgent intervention (e.g., transverse lie)
- Suspected fetal macrosomia with mechanical obstruction concerns
- Multiple gestation with complications
- Severe orthopedic or musculoskeletal conditions preventing safe sitting or balance
- High-risk pregnancy conditions such as uncontrolled gestational diabetes or hypertension
- Conditions requiring continuous monitoring or restricted mobility
- Inability to follow instructions or unsteady balance
- Lack of trained staff for supervision during labor use
- Use of unstable or improperly sized birthing ball
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Labor with Scheduled Positioning Using a Peanut Ball
Duration - Duration of labor (approximately 12 to 19 hours)
Participants receive epidural analgesia during labor and are positioned at scheduled intervals using a peanut birthing ball to support labor progress and maternal comfort. Positions include left lateral, right lateral, semi-sitting, and Taylor positions, supervised by trained staff.
Continuous in-hospital monitoring during labor
Standard Labor Care
Duration - Duration of labor (approximately 12 to 19 hours)
Participants receive standard intrapartum care with epidural analgesia without scheduled positioning or peanut ball use.
Continuous in-hospital monitoring during labor
Post-Delivery Observation
Duration - Up to 3 hours after delivery
Participants and newborns are observed after delivery to monitor outcomes including postpartum hemorrhage, perineal trauma, Apgar scores, and neonatal intensive care admission.
1 to 2 visits (in-hospital)
Trial Site Locations
Total: 1 location
1
Women's Wellness and research center
Doha, Baladiyat ad Dawhah, Qatar, 3050
Actively Recruiting
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Research Team
P
Parveen N Nather, Master's in nursing
D
Dr.Ananth Nazarene, PHD in Nursing
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
SUPPORTIVE_CARE
Number of Arms
2
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Published Research Related To This Trial
Using a peanut ball during labour versus not using a peanut ball during labour for women using an epidural: study protocol for a randomised controlled pilot study.
Virginia Stulz, David Campbell, Biing Yin...
https://pubmed.ncbi.nlm.nih.gov/30305919Effects of Labor Epidural Analgesia on Short Term Neonatal Morbidity.
Khalil Mohd Salameh, Vellamgot Anvar Paraparambil, Abedin Sarfrazul...
https://pubmed.ncbi.nlm.nih.gov/32099485Effectiveness of a peanut ball device during labour on maternal and neonatal outcomes: protocol for a randomised controlled trial.
Pratibha Kamath, Muralidhar Pai, Revathi Shenoy...
https://pubmed.ncbi.nlm.nih.gov/36531256Effects of peanut ball use on perceived labor pain, fatigue, and mother's perception of childbirth: a randomized controlled trial.
Hacer Alan Dikmen, İlknur Münevver Gönenç, Ayşe Nur Ataş
https://pubmed.ncbi.nlm.nih.gov/39103620Influence of Laboring People's Mobility and Positional Changes on Birth Outcomes in Low-Dose Epidural Analgesia Labor: A Systematic Review with Meta-Analysis.
Maite de Verastegui-Martín, Ana de Paz-Fresneda, José Antonio Jiménez-Barbero...
https://pubmed.ncbi.nlm.nih.gov/36504479Effectiveness of the peanut ball use for women with epidural analgesia in labour: a systematic review and meta-analysis.
Alexandre Delgado, Leila Katz, Renato S Melo...
https://pubmed.ncbi.nlm.nih.gov/34996318Peanut Ball Utilization Protocols in Women During Labour and Delivery: An Integrative Review.
Maria Evilene Macena de Almeida, Samara Sousa Mendes, Natália Maria de Vasconcelos Oliveira...
https://pubmed.ncbi.nlm.nih.gov/37473916Modern labor epidural analgesia: implications for labor outcomes and maternal-fetal health.
Elliott C Callahan, Won Lee, Pedram Aleshi...
https://pubmed.ncbi.nlm.nih.gov/37164496