Peanut Ball and Epidurals (Tips for Doulas)

You’ve probably seen a yoga or “birth ball” – they come in a variety of sizes (usually 55cm up through 75cms) and can be purchased at Target for under $10. They’re fantastic for assisting in various positions in pregnancy and labor. A peanut ball is similar but instead of being round it’s squished flat and longer – like a peanut!

One study found that putting a peanut ball between a mother’s legs when she had an epidural opened up her pelvis and had significant results:

The results were compelling. Those who used the ball decreased the first stage of labor by nearly 90 minutes and the second stage by 23 minutes compared with a control group that did not use the ball.

The real payoff came through lower C-section rates. The C-section rate for the group of women who used the ball was 13 percentage points less than for the group that did not use the peanut ball.

Your hospital may not have a peanut ball but it’s an inexpensive investment that may have priceless benefits! You can purchase one at Walmart or Target in their exercise section near the yoga balls and they are around $20. Moms, if you know you plan to have an epidural then go order a peanut ball!

Read more: Article here.

www.BetterBirthDoula.orgThis is the side lying position demonstrated, sorry for the lovely iPhone picture of me. While this looks like a somewhat awkward position, it’s actually really comfortable!

Update: For moms not having an epidural the peanut ball can still be beneficial in labor. If you’re side lying the peanut ball can help keep mom’s pelvis open and help her feel more comfortable. I now keep the peanut ball in my car for all births and bring it in if needed.

Update II: I used the peanut ball at a hospital birth and it was GREAT! The nurses were curious and I explained more and they thought it was a fabulous way to help moms with positioning while laboring on their side. I got some funny looks walking into the hospital with it but once I explained you could see their expressions change with understanding and, “OH, that’s a great idea!”

Update III: The peanut ball has also been handy if mom is on the bed on all fours and her arms are tired. It’s a good height to cover with a blanket or towel and let her rest her upper torso on, instead of hurting her wrists.

Update IV: Andrea wrote a wonderful and thorough article about the use of peanut balls and you can read it here. She also includes several images of different positions you can use which are much better than my snapshot above. :)

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25 Responses to Peanut Ball and Epidurals (Tips for Doulas)

  1. hanna says:

    Love all your info. just starting off as a doula and already want to get a peanut ball for clients! great clip, thanks for sharing.

  2. That reminds me tha I need to stop at Target in the morning on my way to a prenatal with a momma I am serving!

  3. candice says:

    I plan on having an epidural again this time and will definitely let you know what the difference is with the ball, i don’t have a doula :(

    so will be doing it on my own but the video is incredibly helpful as well as images i have seen with demonstrations on your back inclined with ball underneath one leg at a time.

    • heidi says:

      I would love to hear your experience with it! For moms laboring with or without an epidural I’ve received positive feedback.

  4. Alice says:

    What size peanut ball do you suggest?

    • heidi says:

      I purchased locally but through the Amazon link the orange 50cm one is closest in size. I’ve heard 55cm or smaller, under 20″ high is best. I believe mine is around 18″ high.

  5. L&DRN says:

    We LOVE the peanut ball at our hospital! We use it so often that have a protocol and policy for it’s use! We all get silly looks from patients and their families as well but when it works the proof is in the pudding! Great read! Keep up the good work!

    • heidi says:

      I love to hear that! And I’m curious about what the policies and protocols are for it, if you don’t mind sharing? :)

    • Would you consider sharing your Policy with us we are just starting a research project and small test of change utilizing the peanut ball. We would be ever so greatful.

      • Heidi Thaden-Pierce says:

        Tess, I’m not sure what you mean by policy re: the peanut ball? The video demonstrates some of the positions and I use it in any labor when mom is laying down on her side, so long as it feels good to her.

  6. Chelsea says:

    I use the round balls a lot when I’m at a birth. In general, do you think the peanut shape or the round is better? Thanks! :)

    • heidi says:

      They are such different uses that it’s hard for me to say. One of my hospitals in town has birth balls, the other does not (and neither carry the peanut yet.) A local midwife at our birth center says she uses the peanut ball as much as the birth ball, and I think it’s worth having both even if they do take up lots of space. :) If you don’t have a peanut ball at the hospital you can improvise by setting a pillow on the hospital bed table and raising it just a bit to elevate the mom’s leg. You can also pull out the stirrup (if the nurses don’t mind and show you how!) and use that to help raise the mom’s leg while she’s laying on her side. It would be trickier to come up with an alternative to the birth ball (I can’t think of one!) so that would probably be my basic, but I really do love the peanut ball as well.

  7. Sara says:

    I didn’t have a peanut ball at my first child’s birth, but the nurse laid me on my side and put my top leg in a stirrup (so a very similar position as your picture above – I did get an epidural). I went from 5cm to 10 in half an hour. I’m a doula now and will definitely get one of these. Thanks for the reminder!

    • heidi says:

      I’ve heard nurses and midwives refer to that position as the pretzel or chicken leg – and it can really work well!!

  8. Gina says:

    I am an L&D nurse and I swear by the peanut ball. Our hospital has two of them, and we are getting more. They are especially great when trying to get an OP baby to turn. I found that if you get mom in side-lying (SUPER side-lying…almost like corkscrew) and do 20-30 minutes on each side, it really gets that baby to turn. Works best when mom has an epidural, but it does work without one. Its just that if ne doesnt have an epidural, they are typically more active in labor anyway.

    • heidi says:

      That makes me so happy to hear of hospitals having a peanut ball! The midwives at the birth center where I work love them, too, but we’re still working on the hospital to carry them. :)

  9. Mari says:

    Please check back with your new moms 6 months after giving birth! My daughter used a birthing peanut and all the hospital staff was amazed that her baby was born after only 2 pushes… but over the next few months, she had 2 major surgeries and another hospitalization to repair all the damage done to her tailbone and organs. I think babies needs more time to transition during the birthing process. Our bodies aren’t built to shoot babies out so quickly. Think about it, she almost lost the use of her right leg and needed emergency neurosurgery. I’d go with a little bit longer labor -heck, even a C-Section beats what she’s gone through. She couldn’t even pick up her baby for 3 months – and the scars are not cute little bikini scars either. Please think about it!!

    • heidi says:

      Mari, I’m sorry to hear that about your daughter’s complications! I check in with moms throughout their first year and none have experienced any complications after the peanut ball use – though none of them birthed in only two pushes either! :) I’ve had some moms push out babies that fast though they had quick labors and never used the ball. Those using the peanut ball have not had it in place for more than 30 mores (we change positions at least every half hour) and most of them did not have an epidural in place, so if anything felt “off” they were able to adjust or move the ball. It’s usually been with moms just resting a bit then getting back up to move around. I will keep in mind what you shared – thank you!

      • Mari says:

        Thank you for your reply, Heidi, I appreciate it!

        • Julie says:

          Mari, I’m so sorry about your daughter’s injuries… I know that was so difficult and painful, emotionally and physically. (Bless her heart and yours, too!) I’ve been a birth instructor and labor assistant for almost 30 years, and in my experience, it sounds like there was possibly another factor to your daughter’s injury that was unrelated to the peanut ball or to the fast pushing stage.

          I’ve had a number of women have babies born in just a couple of fast pushes, and all five of my babies were born with very fast pushing stages (two were born with one push), and neither I nor the ladies I’ve helped suffered a birth injury. I’ve also been at a number of births where the peanut ball was used and the pushing stage was an average length.

          The peanut ball is a great tool to use in positioning women in labor, but it does not create a fast pushing stage all by itself (in my experience). There are a number of factors that affect how fast or slow the pushing stage is, including the position of the baby’s head, how fast or slow the head molding process takes place, what pelvic station the baby is at prior to complete dilation and the mother’s position, among other things. A very fast pushing stage and a very long pushing stage can both be within parameters of a normal, healthy birth process.

          I am really sorry your daughter suffered such a difficult injury and painful recovery. :( I know that was not expected and it had to be so hard for you to see your daughter go through so much. Over the years, I’ve heard of fast birth experiences pointed out as the cause of various birth injuries, but there is most often another factor. Many fast births do not result in any injury at all. I sincerely hope she is healing well….

    • Sandy Hess says:

      I am sorry to hear of your child’s birth injuries. I had some internal injuries with the birth of my third child, thankfully not requiring surgery. It did require about 9 months of healing before the pain disappeared. My grandaughter pushed out baby #1 in two pushes and baby #2 in three pushes. No injuries. I had a large baby which caused my problem, I think (almost 10 pounds). My grand kids were around 7.5 to 8 pounds. No peanut balls were used. Sometimes it’s hard to explain what happened. I hope your daughter is doing well. This must have been difficult for her and all of her family.

  10. Jena says:

    I didn’t get an epidural and this birthing peanut helped me as well. I was stuck at a 7 and they gave me this and my son was born within minutes. So I believe it works with or without an epidural!

  11. SandyHess says:

    May I have permission to use your photo of the nurse demonstrating the use of a peanut ball on my blog? I will be happy to give credit to you. Just tell me how you would like it stated.

    • Heidi Thaden-Pierce says:

      Sandy, that’s actually just a screenshot from the video (which I realize I probably should recreate my own image since that one isn’t my work!) I don’t own the video but you can embed it/share it on your own website. Thanks for checking! (I’ll try to get a similar image up and you’re very welcome to use it, too.)

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