In 2011, one in three women in the United States gave birth by cesarean delivery (The American Congress of Obstetricians and Gynecologists, 2015). During the laboring process, it is a common occurrence for women to remain immobile (Zwelling, 2010). Obstetrical interventions such as, fetal monitoring, oxytocin inductions, and epidural anesthesia can interfere with a patient’s mobility and position changes (Zwelling, 2010). When laboring mothers remain immobile, it decreases the fetus’ ability to flex, engage into the pelvis, rotate into position and descend (Zwelling, 2010). Studies have found that women who were positioned in upright positions as compared to women who remained in flat or recumbent positions benefited with a shorter first stage of labor by an average of 66.48 minutes (Zwelling, 2010).
One of the most common reasons for a cesarean section is "arrest of labor" also known as failure to progress or midpelvic arrest. It is estimated that between 2002 and 2008, 10% of first-time mothers had cesarean sections for failure to progress (Boyle, Reddy et al. 2013). Of that 10 %, 40% had cesarean sections before they had even reached 5 cm dilation (Boyle, Reddy et al. 2013). Safely reducing the rate of primary cesarean sections will require different approaches (The American Congress of Obstetricians and Gynecologists, 2015). The American Congress of Obstetricians and Gynecologists (ACOG) suggests increasing a women’s access to nonmedical interventions during labor (The American Congress of Obstetricians and Gynecologists, 2015).
Most birthing balls can facilitate a more normal labor progression for ambulatory laboring women. However, when a patient is immobile, due to medical circumstances, initiating the use of a peanut ball might promote positive labor outcomes as well as hopefully reduce the duration of the delivery process. This double birth ball, connected in the middle mimicking a large peanut, is low-risk and a low-cost nursing intervention (Tussey et al., 2015). A randomized, controlled study was conducted to determine whether the use of a “peanut ball” decreased the length of labor and increased the rate of vaginal birth (Tussey et al., 2015). Using the peanut ball promotes spinal flexion, thus increasing the utero-spinal angle (Tussey et al., 2015). This widening of the pelvic diameter subsequently assists in facilitating occiput posterior rotation to a more favorable position for delivery (Tussey et al., 2015). Since there is a lack of evidence-based research on this new intervention the use of the peanut ball affirms the need for further research.