The Effect of Peanut Ball Use on the Labour Process and Maternal-Neonatal Outcomes in Parturient Women With High Maternal Body Mass Index: A Randomized Controlled Trial.

Only 59 women completed the trial (29 intervention, 30 control), fewer than the 35 per group planned, so the labour duration result may have limited power to detect differences in the primary duration outcome. The trial was single centre and did not blind participants or the researcher, and pain and satisfaction were collected by the researcher who delivered the intervention. All women had an episiotomy, so the study cannot show whether peanut ball positioning changes perineal trauma when episiotomy is not routine. Women did not receive pharmacologic analgesia, so the results may not apply to labour with epidural or other analgesia. Adverse events such as falls or near-falls were not monitored with a formal checklist, although participants were supervised. Some participants left before analysis because of emergency caesarean sections or withdrawal, and caesarean sections before active labour were excluded.

The authors report no funding and no conflicts of interest.

Do not conclude that peanut ball positioning shortens labour or improves neonatal outcomes. The active phase duration was not significantly different, and neonatal measures were also not significantly different. The positive findings were pain and birth satisfaction in a small, unblinded trial where all participants had an episiotomy.