Brief Summary
The goal of this clinical trial is to evaluate whether scheduled maternal position changes using a peanut birthing ball improve labor outcomes in low-risk, primiparous women receiving epidural analgesia during labor. The main questions it aims to answer are:
Does scheduled maternal positioning with a peanut ball reduce the duration of the first and second stages of labor?
Does scheduled maternal positioning with a peanut ball influence mode of delivery and maternal and neonatal outcomes?
This non-invasive randomized controlled trial will be conducted at the Women's Wellness and Research Center in Qatar. Participants will be randomly assigned to either an intervention group receiving scheduled maternal position changes using a peanut birthing ball or a control group receiving standard intrapartum care without peanut ball use. Researchers will compare outcomes between the two groups to determine whether structured positioning with a peanut ball improves labor progression and delivery outcomes in women receiving epidural analgesia.
Participants in the intervention group will undergo scheduled position changes throughout labor using a peanut birthing ball, including left lateral, right lateral, semi-sitting, and Taylor positions, under the supervision of trained nursing and midwifery staff. Participants in the control group will receive routine intrapartum care following epidural analgesia without the use of a peanut ball or a structured positioning schedule.
Primary maternal outcomes include duration of the first and second stages of labor, mode of delivery, estimated blood loss, postpartum hemorrhage, use of oxytocin augmentation, degree of perineal trauma, and hospitalization cost. Neonatal outcomes include Apgar scores at 5 and 10 minutes, NICU admission, birth-related injuries, and umbilical cord blood pH. Findings from this study are expected to support evidence-based intrapartum care practices and inform clinical protocols for women receiving epidural analgesia.
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.
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