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The Miracle of Peanut Balls

So my dear friend Coza, an L&D RN as well as a previous client of mine, has become a fan of the peanut ball. When she initially told me about them, I was baffled, not having a clue what she was talking about. Boy, did I get an education!

A peanut ball (PB) is like a birth ball, but shaped like a peanut. It comes in a variety of sizes, just like birth balls and can be used like one… in fact, several doulas use it instead of birth balls since they are more stable with a woman sitting on them.

But sitting on the ball isn’t what Coza was raving about. It was that, in the hospital she works in, they have lowered the cesarean rate considerably. Apparently, the news is leaking out about PBs and I’m learning creative doulas have manufactured their own “peanut” for women to utilize during their labors, using pillows and even the bedside table!

So what do you do with this fantastic peanut and how does it lower cesarean rates?

When women have an epidural, they are confined to bed and are pretty immobile. As we know, the baby’s head likes to be jiggled around in order to get into the pelvis in the correct position to be born. When a woman is mobile, she and the baby “dance” to facilitate the optimal fetal positioning. In bed, not possible. The peanut, while not wiggling mom around or anything, can be placed between her legs in a way to open the pelvis so dramatically as to allow the baby to get into his or her best position to be born.

Coza said this yesterday:

“So a bit ago I posted a thingy about peanut balls for the epidural crowd. Let me just say that we at Holy Family (in WA State) are firm believers in the power if the peanut! We are seeing labors shortened right and left. Women who stall flying to complete when that ball is shoved between their legs! Babies not coming down that are suddenly 'oh please don't sneeze or your nurse is catching your baby.' We peanut balls!”

Last year, Jill, of Unnecesarean, wrote about PBs in “Peanut Balls and VBAC Bans,” highlighting Banner Health’s new commitment to the peanut in all of their Arizona hospitals. The article Jill quoted from the Arizona Republic (“’Peanut Ball’ reducing C-section rate” said:

“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.”

I was sent to a study that was done on PBs – “Use of a Labor Ball to Decrease the Length of Labor in Patients Who Receive an Epidural” and the Conclusion was:

“The use of the PB during labor for patients with an epidural significantly reduced the length of labor without adverse neonatal outcomes.”

What birth junkie wouldn’t be thrilled with such a low-tech way to help women have shorter labors and avoid a cesarean?

But how do you work with this thing? Where is it placed? And how can someone without a peanut mimic the position?

I was sent to this video on YouTube, but still don’t find as much about positioning as I’d like. My nurse-friend Coza gave me a graphic example of how to utilize the PB. Let me summarize here:

If the woman is on her side (and of course the bed will be somewhat elevated since you don’t want her flat), you bend both knees and push the PB as deep into her crotch as possible. Each woman will be able to have it at different depths depending on her thighs, but as far as you can is where the PB goes. Then, so the PB does tilt or fall out, roll up a towel and prop the end that pokes out of the back side of the woman; you want the ball parallel to the floor.

If mom is sitting more upright on her back (semi-Fowler’s position), alternate each leg and put the PB under one knee, the middle part right under the knee. Coza says this mimics lunges. She doesn’t say how often to change legs, but I can see every 20-30 minutes being a good time frame to have each leg open. (It’s what we do when we flip a mom side to side with her leg lunging on the bed, so makes sense it would be similar.)

Coza also says if she has a mom that can move to the position, she has them on all fours, leaning over the ball and rocking back and forth. She said this is so much easier for moms than doing it with a ball.

As you all use them, please let me know how they work for you.

Peanut Balls for everyone!

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Reader Comments (9)

Peanut balls get us in this mess, and now they get us out of it!! Hooray for peanut balls! Haha

May 11, 2012 | Unregistered CommenterTara

So I had an interview at a Women's Center the other day (first RN job since graduating with BSN 2 years ago and having baby- woo hoo!) and we talked about peanut balls. They have one and have only been using it to sit on. I mentioned the recent discussion on your page and about using it positionaly with women who have epidurals and the nurse manager had not heard of this. Any brave souls out there want to take some photos to further illustrate and share them with Barb to post? I think I nailed the job interview and want to come in prepared. :)

May 11, 2012 | Unregistered CommenterKim

Sounds very promising! Do you know what size the peanut balls should be to fit most moms? It looks like they come in several different sizes.

May 11, 2012 | Unregistered CommenterAnne Campbell

Cool, definitely worth a shot with an epidural in situ. Might buy one for my unit as a leaving present :) it's a very small study of 200 women, does anyone reading this know if there are any other studies either underway or published?

May 12, 2012 | Unregistered CommenterEllie

I don't know the size... will ask Coza what size her unit uses.

Don't know of any other studies, but anecdotally, have heard from many nurses already that they LOVE them and are as much a fan of them as Coza... who keeps singing, "Praise the Peanut!" She said one of the nurses made buttons for the unit that says, "Praise the Peanut!" I'll ask again, but the c/s rate has plummeted on her unit as well. Last I heard, I think she said they had a 17% c/s rate? I'll check to make sure.

May 12, 2012 | Registered CommenterNavelgazing Midwife

Excellent - I shared this on my facebook page! As a doula, I am going to purchase a peanut ball for myself and to donate to the local hospital. I am anxiously awaiting the size as well. Do you think the oval balls are similar enough to have the same effect?

May 12, 2012 | Unregistered CommenterKatrina

I'm a doula in Phoenix, AZ, and support moms at Banner Health hospitals. The peanut balls ARE great. They are a wonderful option for moms who chose epidurals. I've also used them with unmedicated moms in the hands and knees position. They can "hug" the PB when the birth ball feels too big.

June 30, 2012 | Unregistered CommenterLakisa Muhammad

I am also really interested in what size is best. I am attempting a VBAC and, while I prefer unmedicated, I want to be prepared for anything this time. I am 5'6" if that makes a difference.

July 4, 2012 | Unregistered CommenterDiana

55 cm. seems to be the consensus.

July 4, 2012 | Registered CommenterNavelgazing Midwife

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