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///2018 Abstract Details
2018 Abstract Details2019-08-02T15:57:01-05:00

Do Peanut-Shaped Birthing Balls Reduce the Length of Labor in Patients with Epidural Analgesia?

Abstract Number: T4B-1
Abstract Type: Original Research

Mariam M. Batakji MD1 ; Robert D D'Angelo professor/obstetric anesthesia director 2; lynnette C Harris bachelor of science in nursing 3

Background: In 2015, 32.0% of women in the US had cesarean delivery (C/D).1 Because C/D increases risk compared to vaginal delivery, there is interest in reducing the national rate. A recent nursing report suggests that the use of a peanut-shaped birthing ball (PB) during labor reduces labor duration by 113min and the C/D rate from 23.7 to 10.3%, presumably by widening the pelvic diameter.2 The public health benefits would be significant if the use of a simple prop could reduce national C/D rates. However, because labor and delivery is dependent on many variables other than knee position and pelvic diameter, it was hypothesized that the use of the PB placed between the knees during labor will not significantly affect the labor duration or mode of delivery.

Method: After IRB approval and informed consent, 101 healthy nulliparous parturients were randomized to either place a 45cm PB between their knees in the semi-reclined or semi-prone position until 10cm cervical dilation or labor without the PB. Inclusion: >18 years, English speaking, successful CSE, ≤ 5cm dilation at time of CSE. Cervical exam done within 15min of CSE and every 4 hrs until complete dilation. Patients were repositioned hourly. T-test and Fisher’s exact were used as appropriate.

Results: Of 101 patients, 81 completed the study and 20 were excluded: 6 in PB group requested to stop its use, 6 controls wanted to use the PB, 2 no CSF, 2 Foley Bulb in use, 2 were > 5cm at request, 1 wet tap, 1 C/D prior to request. Except for patients’ height, all results were similar between groups (see table).

Discussion: PB use during labor had no effect on cervical dilation rate, length of labor or mode of delivery, even when the patients that dropped out were included in the analysis. The current findings may have differed from the previous report because enrollment criteria were strictly controlled and cervical dilation was monitored frequently. Although unlikely a simple maneuver like knee positioning during labor could affect factors like the hormonal influences on uterine contraction frequency and strength, cervical dilation, and fetal head position, it would have been interesting to report that a low-cost prop improved outcome. However, because no adverse effects of PB were observed other than mild discomfort, patients that would like to use the prop during labor can do so without harm.

1. Births final data for 2015. CDC NCHS NVSS 2017; 66: #1; 2. Jr Perinatal Education 2015; 24: 16-24.

SOAP 2018