What question did this study set out to answer?

This research aims to evaluate the impact of birthing balls and peanut balls on labor pain, labor duration, and delivery mode.

April 3, 2026Open Access

Birthing balls and peanut balls for labor pain, delivery duration, and mode of delivery: a meta-analysis of randomized controlled trials

Key Points

This research aims to evaluate the impact of birthing balls and peanut balls on labor pain, labor duration, and delivery mode.
Conducted a systematic review and meta-analysis of randomized controlled trials
Searched multiple databases including Cochrane Library and MEDLINE
Included trials focused on pregnant women with singleton and cephalic fetuses
Compared outcomes of birthing or peanut balls versus no ball use
Birthing balls significantly reduced labor pain by an average of 1.81 points
Shortened first stage of labor by 0.86 standard deviations and second stage by 17 minutes
Reduced cesarean delivery incidence by about 49%
Peanut balls shortened the first stage of labor by 0.85 standard deviations and second stage by nearly 11 minutes

Abstract

Background To determine the effects of birthing balls and peanut balls on labor pain, duration of labor, and mode of delivery. Methods In this systematic review and meta-analysis, Cochrane Library, EMBASE, MEDLINE ( via PubMed), Scopus, and Web of Science were searched from their inception to December 25, 2024, with an updated search performed on November 10, 2025. Included studies were randomized controlled trials written in English that investigated the efficacy of birthing balls or peanut balls compared to no birthing balls or peanut balls in pregnant women with a singleton and cephalic fetus. Conference abstract, editorial, review, dissertation, thesis, and non-randomized controlled trials were excluded. Primary outcomes were labor pain and duration of labor, while the secondary outcome was mode of delivery. Results A total of 23 studies involving 3,192 participants were included. Relative to no birthing balls, birthing balls significantly alleviated labor pain (MD: −1.81; 95% CI −2.38 to −1.23), shortened the duration of the first (SMD: −0.86; −1.26 to −0.45) and second (MD: −17.00 min; −26.54 to −7.46) stages of labor, and reduced the incidence of cesarean delivery (RR: 0.51; 0.37 to 0.71). Peanut balls significantly shortened the duration of the first (SMD: −0.85; −1.25 to −0.46) and second (MD: −10.90 min; −21.11 to −0.70) stages of labor, compared to no peanut balls. No other significant results were observed. Some concerns were raised and the overall quality ranged from moderate to low. Conclusions Based on low- to moderate-quality evidence, birthing balls appear to be a potentially effective tool and may be considered by nurses and midwives to help alleviate labor pain and shorten the duration of the first and second stages of labor, thereby potentially reducing the likelihood of cesarean delivery. Low-quality evidence suggests that peanut balls could help shorten the duration of the first and second stages of labor. More well-designed studies are needed to verify the true and comparative effects of birthing and peanut balls.

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