Birth ball for pregnant women in labour research protocol: a multi-centre randomised controlled trial

The effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction: a randomized controlled study

PURPOSE

This study aimed to examine the effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction.

METHODS

The study used a randomized controlled trial design. All 120 primiparous pregnant women were randomly assigned to the intervention (IG) and control groups (CG). After the cervical dilatation reached 4 cm, the pregnant women in the IG performed birth ball exercises, adhering to the birth ball guide created by the researcher. No intervention was made in the control group other than standard midwifery care practices.

RESULTS

The labor pain level between the groups (VAS 1-when cervical dilatation was 4 cm) was similar to each other. The labor pain level (VAS 2- when cervical dilatation was 9 cm) scores of the women in the IG were significantly lower than those in the CG (p < 0.05). The time between the active phase of labor until dilatation is complete and the time until the baby's head comes out after full dilatation was found to be statistically significantly shorter in the IG compared to the CG (p < 0.05). Childbirth comfort and satisfaction mean scores between the groups were found to be statistically insignificant (p >  0.05).

CONCLUSION

As a result of the study, it was determined that the birth ball exercise significantly reduced labor pain and labor time. We recommend that the birth ball exercise be applied to all low-risk pregnant women because it helps fetal descent and cervical dilatation, and shortens labor pain and delivery time.

The effect of using birth ball and squatting position during labor on pain, duration, and satisfaction: A randomized controlled trial

AIM

The aim of this study is to assess the effect of using a birth ball and squatting position during labor on labor pain, duration of labor, and satisfaction.

METHODS

This study is a randomized controlled experimental trial. It was conducted in the delivery unit of Başakşehir Çam and Sakura City Hospital. The study sample consisted of a total of 159 women, 53 in the birth ball application room, 53 in the squatting position group, and 53 in the control group. The "Information Form," "Visual Analog Scale," "Partograph," and "Maternal Satisfaction Assessment at Delivery Scale-Normal Birth" were used in the data collection. Data were analyzed using analysis of variance, Pearson's Chi-square test, Pillai's trace test.

RESULTS

The present study revealed that the pain perception level was lower in the birth ball and squatting position groups compared to the control group, and there was a statistically significant difference between them (p < .05). The duration of the first and second stages of labor and the total duration of labor decreased in the birth ball and squatting position groups (p < .05). The difference was statistically significant in comparing the level of satisfaction (p < .05). It was found that the highest satisfaction was in the birth ball group.

CONCLUSION

Using a birth ball and squatting position during labor are effective methods of reducing labor pain, shortening the duration of labor, and increasing the level of satisfaction. There is a need for more studies on the effects of the birth ball and squatting position.

CLINICALTRIALS

gov Identifier: NCT05360823.

The Effect of Birthing Ball Exercises on Labor Pain and Labor Outcome Among Primigraviade Parturient Mothers at a Tertiary Care Hospital

INTRODUCTION

Every woman has the right to respectful and empathetic care during childbirth that addresses her needs for pain management, and allows her the liberty to make it a memorable experience. This study aimed to assess the effect of birthing ball exercises on labor pain and labor outcome among primigravidae parturients at a tertiary care hospital.

METHOD

A quasi-experimental design was used. A total of 60 primigravidae with 30 each in the control and experiment groups were selected by consecutive sampling. Primigravidae in the experiment group underwent two sessions of 20 minutes of birthing ball exercises at a subsequent gap of one hour during their active phase of labor (>4 cm cervical dilation). Primigravidae in the control group received routine standard care that included continuous observation and monitoring of vital signs and progress of labor. The visual analog scale (VAS) score was assessed in the transition phase (cervical dilation 8 cm to 10cm) and labor outcomes were assessed after delivery in both groups.

RESULT

The experiment group had significantly better labor outcomes in terms of labor pain, cervical dilatation, and duration of labor compared to the primigravidae in the control group (p<0.05). In addition, the majority of mothers in the experiment group (86.7 %) underwent vaginal delivery with episiotomy compared to the control group (53.3%). Findings also revealed a statistically significant difference in the newborns of both groups regarding appearance, pulse, grimace, activity, and respiration (APGAR) score, crying immediately after birth, and admission to the neonatal intensive care unit (NICU) at p<0.05.

CONCLUSION

There are a variety of discomforts that a woman experiences during labor. Reducing these discomforts is an important part of good nursing care. Non-pharmacologic methods like birthing ball exercises help decrease these discomforts by reducing labor pain and improving maternal and neonatal outcomes.

Effectiveness of Jacobson Relaxation and Lamaze Breathing Techniques in the Management of Pain and Stress During Labor: An Experimental Study

Background and objective The mother's ability to tolerate labor discomfort has an impact on how the labor progresses. Good pain management will boost mothers' ability to labor collaboratively and will shorten the time it takes for the uterus to open completely. Many women prefer not to use pharmaceutical or invasive pain relief during labor, which may have contributed to the popularity of complementary pain relief approaches. This study aimed to assess the effectiveness of the Jacobson relaxation technique and Lamaze breathing technique in the management of pain and stress during labor. Methods Thirty-six women aged between 25 and 35 years were randomly assigned to two groups for the purpose of this study. Group A received the Jacobson relaxation technique while Group B received the Lamaze breathing technique for four weeks. The patients were instructed to practice breathing techniques at the time of labor. The outcomes measure included the Numerical pain Rating Scale (NPRS) and Perceived Stress Scale (PSS), which would be measured before and after the delivery. Results The subjects showed improved labor pain and anxiety following the physiotherapy intervention. The results were found to be statistically significant (p<0.05). Conclusion Based on our findings, physiotherapy intervention plays an integral role in the multidisciplinary approach to relieving labor pain and helping patients have a normal vaginal delivery.

The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor

Background: Long duration of labor increases the pain that a mother experiences. Several non-pharmacological methods, such as pelvic rocking exercises and SP6 acupressure, have been discovered to reduce pain and accelerate labor duration. It needs to be clarified which of the two methods is more effective.Purpose: This study aimed to assess the effectiveness of pelvic rocking exercise with a birth ball and SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor.Methods: This study used a quasi-experimental design involving 64 mothers in the first stage of normal delivery who were recruited using propensity score matching sampling. The participants were divided into two intervention groups (the pelvic rocking exercise with a birth ball and SP6 acupressure). Each respondent in the two intervention groups was monitored for progress of labor during the active phase in the first stage using a partograph starting from cervical dilatation of 4 cm to 10 cm. The duration of the second stage was assessed by calculating the length of time from cervical dilatation of 10 cm to the delivery of the entire baby. The Mann-Whitney U test was performed to assess the difference between the two interventions in the two stages of labor assessed.Results: There was a difference in the duration of labor in the first stage (p=0.00) and the second stage (p=0.001) between the groups given the pelvic rocking exercise with a birth ball and the SP6 acupressure. The pelvic rocking exercise with a birth ball was found to be more effective in shortening the duration of the active phase in the first stage (Mean rank=19.83) and the second stage of labor (Mean rank=24.56) compared to SP6 acupressure (Mean rank of the first stage=45.17 and Mean rank of the second stage=40.44).Conclusion: The pelvic rocking exercise was found to be more effective compared to SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor. Pelvic rocking exercise can be implemented to help accelerate labor duration so that mothers can feel more comfortable during the labor.

The effect of delivery ball and warm shower on the childbirth experience of nulliparous women: a randomized controlled clinical trial

INTRODUCTION

Childbirth is a unique experience that affects women's life. Midwives can play an effective role in creating positive birth experiences for women using non-pharmacological and supportive methods. Accordingly, this study aims to determine the effect of delivery balls and warm showers on childbirth experiences of primiparous women.

METHODS

This clinical trial was conducted on primiparous pregnant women who referred to the Motazedi Hospital in Kermanshah, Iran. Sampling was done from eligible individuals by a continuous method, and pregnant women were assigned to the three groups of delivery balls plus warm showers or A (n = 35), delivery balls or B (n = 35), and control or C (n = 35). The use of the ball at the dilation of 4 cm was similar in the two groups of A and B, but the first group used a warm shower at the dilatation of 7 cm as well. The control group also received routine delivery care. Besides, demographic information forms consisting of the pregnancy history and some information about the mother and her infant were completed. Additionally, childbirth experience questionnaires (CEQ) were completed by the women two hours after childbirth. The analysis of intervention effects was performed as per-protocol analysis.

RESULTS

There was a statistically significant difference in the mean score of the childbirth experience between the two groups of A and C (p = 0.001) after the intervention as well as between the groups of B and C (p = 0.001).

CONCLUSION

The use of delivery balls and warm showers was effective in creating a positive childbirth experience. To create a positive childbirth experience in mothers, the use of both interventions (delivery balls and warm showers) is recommended.

TRIAL REGISTRATION

TCTR 20200408002 . Prospectively registered on March 21, 2020.

The Effect of Combination of Pelvic Rocking Exercise and Back Massage to Pain and Duration of Labor in Primigravidae

Background The combination of pelvic rocking exercise using a birth ball and back massage as non-pharmacological therapy needs to be investigated in relation to reducing pain and labor duration in primigravida mothers.   Aim This study aims to determine the effect of a combination of pelvic rocking exercise using a birth ball and back massage on pain and labor duration in primigravida mothers.    Methods The design of this study was quasy Experiment with the approach of non-equivalent control group 's. The research sample was 160 primigravida maternity mothers. The sample in the treatment group was given pelvic rocking intervention using a birth ball and back massage and the sample in the control group was given standard labor care such as touch, and taught labor positions that were in an upright position, providing encouragement and counseling. This research conducted in July–December 2020.    Results Provided evidence that pelvic rocking using a birth ball and back massage offers safe, non-invasive treatment for pain management and duration during labor.   Conclusion The results of this study provide an understanding that there is a significant effect of the combination of pelvic rocking exercise and back massage on pain and duration of labor in primigravida mothers.  

Birthing ball on promoting cervical ripening and its influence on the labor process and the neonatal blood gas index

BACKGROUND

Term pregnancy-induced labor refers to the use of artificial methods to induce uterine contractions and terminate pregnancy after 37 wk. It is a common method to prevent overdue pregnancy and to deal with high-risk pregnancies. In addition, it can alleviate maternal complications and cause the fetus to leave the adverse intrauterine environment early, which is beneficial to the outcome of pregnancy.

AIM

To explore the effect of a birthing ball on labor by inducing cervical ripening and its influence on labor and the neonatal blood gas index.

METHODS

Twenty-two women who were scheduled to undergo labor induction and delivery in the obstetrics department of our hospital were randomly divided into two groups: the delivery ball group (childbirth ball combined with COOK balloon induction) and the conventional group (COOK balloon induction alone). The cervical Bishop score before and after intervention, duration of labor at each stage, mode of delivery, neonatal umbilical venous blood pH, oxygen partial pressure (PO₂), carbon dioxide partial pressure (PCO₂), and the 1-min Apgar score were recorded.

RESULTS

After the intervention, the cervical Bishop score of the delivery ball group (7.84 ± 1.52) was significantly higher than that of the conventional group (7.32 ± 1.29) (P < 0.05), and the cervical Bishop scores of the two groups after intervention were significantly higher than those before intervention (P < 0.05). After the intervention, the first stage of labor (510.9 ± 98.7 min), the second stage of labor (43.0 ± 8.5 min), and the total duration of labor (560.0 ± 120.9 min) in the delivery ball group were lower than those in the routine group, with a first stage of labor of 602.1 ± 133.2 min, a second stage of labor of 48.4 ± 9.1 min, and a total duration of labor of 656.8 ± 148.5 min (P < 0.05). There was no significant difference in the time of the third stage of labor between the two groups (P > 0.05). There was no significant difference in the pH, PO₂, and PCO₂ values of newborns between the delivery ball group and the conventional group (P > 0.05). The 1-min Apgar score of the delivery ball group was higher than that of the conventional group (9.10 ± 0.38 points vs 8.94 ± 0.31 points, P < 0.05). The natural delivery rate of the delivery ball group was higher than that of the conventional group (91.00% vs 78.00%, P < 0.05).

CONCLUSION

The use of a birthing ball combined with a COOK balloon for inducing labor has a better effect on promoting cervical ripening, shortening the time of labor, and improving the Apgar score of newborns.