Scheduled peanut birthing-ball positioning for labor in first-time mothers with an epidural
Determine the Impact of Scheduled Positioning With a Peanutball on Labor Outcomes Among Primiparous Women Under Epidural Analgesia: A Non-Invasive Randomized Controlled Trial
We will try scheduled position changes using a peanut birthing ball to see if it shortens the first and second stages of labor and improves delivery outcomes for first-time mothers who have an epidural.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 110 (estimated) |
| Ages | 16 Years to 55 Years |
| Sex | Female |
| Sponsor | Hamad Medical Corporation Industry-sponsored |
| Locations | 1 site (Doha, Baladiyat ad Dawhah) |
| Trial ID | NCT07333209 on ClinicalTrials.gov |
What this trial studies
This randomized, non-invasive trial at the Women's Wellness and Research Center in Doha will enroll term, primiparous women with singleton pregnancies who receive epidural analgesia in active labor. Participants will be randomly assigned to scheduled maternal position changes using a peanut birthing ball or to standard intrapartum care without the ball. The primary outcomes include duration of the first and second stages of labor, with secondary outcomes capturing mode of delivery and selected maternal and neonatal outcomes. Group comparisons will determine whether structured peanut-ball positioning improves labor progression and birth outcomes.
Who should consider this trial
Good fit: Term (37+0 to 41+6 weeks) primiparous women with a singleton pregnancy who are in active labor at WWRC, have received an epidural, expect a vaginal birth, speak Arabic or English, and can give written consent.
Not a fit: Women with contraindications to vaginal birth, non-progressing labor requiring immediate intervention, severe pre-eclampsia/eclampsia, those not receiving an epidural, multiparous women, or those unable to use the birthing ball are unlikely to benefit from this intervention.
Why it matters
Potential benefit: If successful, scheduled peanut-ball positioning could shorten labor and reduce the need for instrumental or cesarean delivery, improving short-term outcomes for mother and baby.
How similar studies have performed: Prior randomized and observational studies in women with epidurals have suggested peanut-ball positioning can reduce labor duration and increase vaginal birth rates, but results have been inconsistent and not definitive.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:Inclusion Criteria: To be eligible for participation, women must meet all the following criteria: * Primiparous (first pregnancy resulting in a live birth or stillbirth after 20 weeks of gestation). * Singleton at gestation. * Gestational age of the term (37 weeks 0 days to 41 weeks 6 days). * Admitted to the Labor and Delivery Unit at WWRC in active labor. * Received epidural analgesia for labor pain management. * Expected to have a vaginal delivery (e.g., no contraindications for vaginal birth identified at the time of recruitment). * Able to understand and communicate in Arabic or English. * Provide written informed consent. Exclusion Criteria:The birthing ball should NOT be used in any of the following conditions: 1. Obstetric Contraindications (Maternal) * Any situation where vaginal birth is not appropriate (e.g., absolute indication for cesarean section) * Non-progress of labor requiring immediate intervention * Severe pre-eclampsia/eclampsia * Active vaginal bleeding of unknown cause * Placenta previa (major) or vasa previa * Placental abruption (suspected or confirmed) * Preterm labor with medical contraindication to ambulation or mobility * Ruptured membranes with unstable fetal head (high station) → Risk of cord prolapse * Severe maternal exhaustion requiring bed rest * Maternal hemodynamic instability 2. Fetal Contraindications * Non-reassuring fetal heart rate requiring continuous monitoring (Category II-III tracings) * Malpresentation requiring immediate obstetric intervention (e.g., transverse lie) * Suspected macrosomia with mechanical obstruction concerns (e.g., cephalopelvic disproportion) * Multiple gestation with instability or complications 3. Orthopedic / Musculoskeletal Contraindications * Any condition that prevents safe sitting, balancing, or weight-bearing, such as: Severe hips, leg, knee, or pelvic injuries * Significant arthritis of the lower limbs or pelvis * Recent joint surgery (hip/knee replacement, pelvic repair) * Neuromuscular disorders affecting balance (e.g., severe neuropathy) * Severe sciatica limiting mobility * Poor trunk control or inability to maintain safe seated posture 4. High-Risk Pregnancy Conditions * Use of birthing balls is contraindicated if pregnancy is classified as high-risk, including Uncontrolled gestational diabetes and Uncontrolled hypertension * Intrauterine growth restriction with required continuous monitoring * Polyhydramnios or severe oligohydramnios (risk of cord compression/instability) * Preterm premature rupture of membranes (PPROM) * History of preterm birth with current instability * Any condition requiring bed rest or reduced mobility 5. Safety / Environmental Contraindications * Patients are unable to follow instructions or unsteady balance * No trained staff available to supervise during labor use Unstable or improperly sized birthing ball
Where this trial is running
Doha, Baladiyat ad Dawhah
- Women's Wellness and research center — Doha, Baladiyat ad Dawhah, Qatar (Recruiting)
Study contacts
- Principal investigator: Parveen Nather — Hamad Medical Corporation
- Study coordinator: Parveen N Nather, Master's in nursing
- Email: pnather@hamad.qa
- Phone: 00974-77641213
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.