Effectiveness of Birthing Ball

upon Labor Pain and coping in

Primi gravid Women
Dr. Latha Venkatesan

Principal, Apollo College of Nursing

Chennai, India
Labor Pain & Birthing Ball
 Statement of the problem

An Experimental Study to Assess the Effectiveness

of Birthing ball upon Labor pain and Coping during
First Stage of Labor in Primi parturient Women at
Andhra Mahila Sabha Hospital, Chennai.
 Objectives of the study

1. To assess the level of labor pain, coping and feto-maternal

parameters during the first stage of labor before and after use
of birthing ball among the control and experimental group of
Primi parturient women.

2. To assess the effectiveness of birthing ball by comparing the

level of pain, coping and feto-maternal parameters during first
stage of labor before and after use of birthing ball among the
control and experimental group of Primi parturient women.
 Contd…

3. To determine the level of satisfaction upon use of birthing ball in

experimental group of Primi parturient women.

4. To find out the association between the demographic variables

and the level of labor pain and coping in control and experimental
group of Primi gravid women before and after the use of birthing
ball.

4. To find out the association between the Obstetric variables and

the level of labor pain and coping in control and experimental group
of Primi gravid women before and after the use of birthing ball.
 Operational Definitions

Effectiveness
•The outcome of the birthing ball
as measured in terms of the level
of labor pain and feto maternal
parameters of Primi parturient
Women before and after use of
birthing ball.
 Birthing ball

It is a large air filled rubber ball (about 60

cm in diameter) made up of extra tough non
slip burst proof PVC that is easily wiped and
clean. The women will be sitting over the
birthing ball after 2cm of cervical dilatation
in a sitting position for 15 minutes in an
interval of 2cm, 4cm, and 6cm of cervical
dilatation
 Cont..

Labor Pain

In this study, it was the pain experienced by the Women during the
first stage of labor as measured by numeric pain rating scale

First stage of labor

In this study, it refers from the starting of true uterine contractions

to till full cervical dilatation of the cervix. Approximately the
duration of this period for Primi Parturient woman is 12 hours.
Feto-maternal Parameters
• The parameters which are measured by the
researcher through modified WHO partograph
namely fetal heart rate, maternal blood pressure,
duration and frequency of uterine contraction per
ten minutes and cervical dilatation

Primi Parturient Women

• In this study, it refers to the Women who is going
to deliver the baby for first time between the age
of 18-35 with gestational age of37-42 weeks are
in the first stage of labour
Cont

Level of satisfaction
•In the study level of satisfaction is a
feeling of gratification attained or
achieved by birthing ball in Primi
parturient women as measured by
rating scale prepared by researcher
 Hypothesis
H01There will be no significant difference in the level of pain, coping
and feto-maternal parameters during first stage of labor before and
after use of birthing ball in the control and experimental group of
Primi parturient women.

H02 There will be no significant association between the selected

demographic variables and level of labor pain and coping before and
after use of birthing ball in the control and experimental group of
Primi parturient women.

H03 There will be no significant association between the selected

obstetric variables and level of pain and coping before and after use
of birthing ball in the control and experimental group of Primi
parturient women.
 Research methodology

Experimental approach
Research design: Time series with multiple Institution of
treatment
R O1 X O2, O3 X O4, O5 X O6

R O1 - O2, O3 - O4, O5 - O
O1,O3,O5: Assessment before use of birthing
ball at 2cm, 4cm, 6cm of cervical dilatation
X : Administration of birthing ball
O2, O4,O6: Assessment after use of birthing ball at
2cm, 4cm, 6cm of cervical dilatation
Sample size – 60 patients ( 30-
control & 30-experimental)

Sampling technique –
Systematic Random Sampling
Technique.
 Inclusion criteriaSamplingExclusion
criteria criteria
Women with second and third stage
Women with first stage of labor of labour

Women available during the time

of data collection Women induced with Cervi prime gel

Who were willing to participate in

the study
Between age of 18-35 years
Women with in the gestational
age of 37-40 weeks
With the cervical dilatation of 2
cm – 6 cm
Women who adopted any other non
pharmacological method
Women who are posted for Lower
segmental caesarean section
Women with underline diseases such
as pregnancy induced hypertension,
diabetes mellitus
 Study Instruments
Demographic Variable Proforma.
Obstetrical Variable Proforma.
Modified pain intensity scale
Pain coping scale
Modified WHO Partograph
Rating scale on satisfaction of birthing ball
 Data Collection Procedure

A group of 60primi parturient women (30 in each group) were

selected by systematic sampling method and consent was
obtained from participants

Yoga mat has been placed on the floor over that birthing ball
has been kept. Then the mother was made to sit over the
ball. The researcher held the mother and started initially with
breathing techniques for 1 to 10 counts after that the fro and
through movement has been provided with the gentle back
massage.
 Cont,,

Birthing ball was provided for 15 minutes in the interval of cervical

dilation of 2cm, 4cm, and 6cm for experimental group of Primi
parturient women.

The pain level, coping level and feto maternal parameters were
assessed after intervention and with the cervical dilatation of 2cm,
4cm, and 6cm for both groups with the same tools.

The level of satisfaction on use of birthing ball was assessed in the

experimental group of Primi parturient women using rating scale
after delivery.
RESULTS
Demographic Variables in Control and
Experimental Group of Primi parturient
Women During First Stage of Labor
• All the women were home makers (100%,100%) ,
didn’t received any previous knowledge regarding
birthing ball (100%,100%) and majority of the
women were homogenously distributed between
the age group of 21-25years (70%,60%) had
completed their secondary education (60%,70%)
with monthly income of 5000-7000 rupees
(70%,50%) and living in urban (50%,60%) in the
control and experimental group respectively.
 • All the women attended more than 8
ante natal visits (100%,100%)
• None received any pain management
Frequency and during labour (100%,100%)
Percentage • Majority of them were in the gestational
Distribution of age of 39-40 weeks (70%,70%)
Obstetric Variables • No fetal and maternal complications
in Control and during labour (100%,100%)
Experimental • Had normal vaginal delivery (70%,90%)
Group of Primi • Duration of first stage labour was 9-10
parturient Women hours (60%,70%)
during First Stage • Duration of second stage of labour was
of Labor. 15-20 minutes (70%,90%)
• Normal APGAR score of the new born
(100%,100%) in control and
experimental group respectively.
 Comparison of Mean and Standard Deviation of Level of
Labor Pain Before and After use of birthing ball in Control
and Experimental Group of Primi parturient Women.
Before therapy ‘t’ After therapy ‘t’ value
Level of labour N = 30 value N = 30
pain

Control group 5.5 0.44 5.8 0.63

0.50 6.7
Experimental group 6.1 0.5 5 0.6

fff
 Comparison of Mean and Standard Deviation of Level of Coping
Before and After use of birthing ball in Control and
Experimental Group of Primi parturient Women
Level of coping Before therapy ‘t’ After therapy ‘t’ value
N = 30 value N = 30

Control group
4.2 0.84 2 0.87

Experimental 0.91 5.6

3.3 0.60 4.3 0.69
group

fff
 Association between the Selected Demographic
Variables and Level of Labor Pain and Coping Before
and after use of Birthing ball in Control and
Experimental Group of Primi parturient Women
• There was no significant association between
the level of labor pain and coping with the
selected demographic variables of the
control and experimental group of Primi
parturient women. Hence null hypothesis H01
& H02 were retained.
 Association between the Selected Obstetric
Variables and Level of Labor Pain and Coping Before
and after use of birthing ball in Control and
Experimental Group of Primi parturient Women
• There was no significant association between
the selected Obstetric variables and the level
of labor pain and coping in Control and
experimental group of Primi gravid women
Hence the null hypothesis H03 & H04 were
retained.
 Recommendations ..
The same study can be conducted with larger number of
samples.

A comparison can be made between Primi and Multi gravid.

A comparison can be made with different stages of labor.

The same study can be conducted at different settings.

A comparison can be made between different types of

alternative and complementary therapies.
Conclusion..
This study shows that use of
birthing ball was effective in
reducing the labour pain
perception and improving the
coping level. The experimental
group of women who received
birthing ball had decreased
pain perception and was highly
satisfied with the therapy. The
birthing ball is a non – invasive
procedure and has no adverse
effects on the mother and the
fetus and hence the midwives
could be encouraged to use this
as a pain relief method during
labour.
THANK YOU