Effects of Body Movement by Birth Ball Program on Labor Pain and Active Phase Duration among Primiparous Parturients

Main Article Content

Lamai Wongsason
Siriwan Sangin
Wantana Suppaseemanont


            Labor pain in the first stage of labor causes discomfort and suffering for women, especially in primiparous parturients. This comparative experimental design, two group pretest-posttest design aimed to determine the effects of body movement by birth ball program on labor pain and duration of active phase among primiparous parturients. Sample consisted of 62 primiparous parturients who delivering in the delivery room at Somdej Phranangchaosirikit Hospital. They were selected by convenience sampling and then were assigned by simple computerized randomization to either an experimental (n = 32) or a control group (n = 30). The experimental group received both body movements by birth ball program and routine care, while the control group received routine care only. Data collection tools included a demographic and obstetric record and a visual analogue scale for pain. Data were analyzed by using descriptive statistics and independent t-test.
            Results revealed that the experimental group had mean score of labor pain in phase of maximum slope and transitional phase significantly lower than those in the control group (t41.85 = 8.50, p < .001; t43.11 = 9.75, p < .001, respectively). As well as, the experiment group had mean score of duration of active labor significantly shorter than those in the control group 134.42 minutes (t60 = 5.06, p < .001).
            This study confirmed that body movement by birth ball program had lower labor pain and shorter duration of active labor. Therefore, midwives should be used this program as a guideline for caring parturients in order to help them safely and soundly pass through the delivery period.


Download data is not yet available.

Article Details

Research Article


1.Lowdermilk DL, Perry SE. Maternity nursing. 7th ed. St Louis, MO: Mosby; 2006.

2.Suppasri P. Nursing in the delivery period. 2nd ed. Bangkok: National Assembly Library of Thailand; 2008. (in Thai).

3.Melzack R, Wall PD. Pain management. China: Churchill Livingstone; 2003.

4.Read DG. Childbirth without fear: the principle and practice of natural childbirth. 4th ed. London: Printer & Martin; 2005.

5.Lowe NK. The nature of labor pain. Am J Obstet Gynecol 2002;186(5 suppl nature):S16-24.

6.Phumdoung S. Non-pharmacological management of labor pain. 11th ed. Songkla: Faculty of Nursing, Prince of Songkla University; 2010. (in Thai).

7.Stables D. Physiology in childbearing. 2nd ed. China: Elsevier; 2005.

8.Phumdoung S. Model of care for women during labor. Songkla Med J 2005;24(1):59-63. (in Thai).

9.Sosa CG, Balaguer E, Alonso JG, Panizza R, Laborde A, Berrondo C. Mepenidine for dystocia during the first stage of labour: A randomized controlled trial. Am J Obstet Gynecol 2004;191(4):1212-8.

10.Gorrie TM, Mckinney ES, Murray SS. Foundations of maternal-newborn nursing. 3rd ed. Philadelphia: W.B. Saunder; 2002.

11.Poonperm R, Rawangko U, Doundee K. Effect of warm compression on anterior abdominal wall to reduce Labor pain and duration of active phase of labor among primiparous mothers. Journal of The Royal Thai Army Nurses 2013;14(3):67-76. (in Thai).

12.Klaikham T, Yusamran C, Thananowan N, Phahuwatanakorn W. Effects of massage and hot compress on labor pain and pain coping behavior in primigravidas. J Nurs Sci 2013;31(2):39-47. (in Thai).

13.Sutthiwanichsak U. The effect of music therapy and positioning in the first stage of labour on labour pain, anxiety, stage of labour, and childbirth experience in primiparous laboring women. [Master’s thesis, Faculty of Nursing]. Mahidol University; 2008. (in Thai).

14.Taavoni S, Abdolahaian S, Haghani H, Neysani L. Effect of birth ball on pain severity during the active phase of physiologic labor. J Midwifery Womens Health 2011;13(1):25-31.

15.Gau ML, Ching CY, Tian SH, Lin KC. Effect of birth ball exercise on pain and self-efficacy during childbirth: a randomized controlled trial in Taiwan. Midwifery 2011;27(6):e293-300.

16.Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965;150(699):971-9.

17.Silva LM, Oliveira JV, Silva BD, Alvarenga MB. Using the swiss ball in labor. Acta paul enferm 2011;24(5):656-62.

18.Hau WL, Tsang SL, Kwan W, Man L, Lam KY, Ho LF, et al. The use of birth ball as a method of pain management in labour. Hong Kong J Gynaecol Obstet Midwifery 2012;12(1):63-8.

19.Perez P. Teaching tip-the birth ball. Genesis: Los Angeles; 2001. p.1-5.

20.Bernars HW. Psychology of learning and teaching. U.S.A.: McGraw–Hill; 1972.

21.Kulaneejitmatee T. Pain and pain management during labor. Association of Private Higher Education Institutions of Thailand Journal 2017:6(2);158-65. (in Thai).

22.Thato R. Nursing research: concept to application. Bangkok: Chulalongkorn University Press; 2009. (in Thai).

23.Revill SI, Robinson JO, Rosen M, Hogg MI. The reliability of a linear analogue for evaluating pain. Anesthesia 1976;31(9):1191–8.

24.Makvandi S, Latifnejad RR, Sadeghi R, Karimi L. Effect of birth ball on labor pain relief: a systematic review and meta-analysis. J Obstet Gynaecol Res 2015;41(11):1679-86.

25.Leung RW, Li JF, Leung MK, Fung BK, Fung LC, Tai SM, et al. Efficacy of birth ball exercises on labour pain management. Hong Kong Med J 2013;19(5):393-9.

26.Liu YC. Effect of an upright position during labor. Am J Nurs 1974;74(12):2202-5.

27.Noble E. Controversies in maternal effort during labor and delivery. J Nurse Midwifery 1981;26(3):13-22.

28.Lawrence A, Lewis L, Hofmeyr GJ, Styles C. Maternal positions and mobility during first stage of labour. Cochrane Database Syst Rev 2013. [Internet]. [cited 2015 January 10]. Available from: https://www.cochrne.org/reviews/en/aboo3934.html.

29.Simpson KK, Cheehan PA. Perinatal nursing. New York: Lippincott-Raven Publishing; 1996.

30.Perez P. Birth ball: use of physical therapy balls in maternity care. Johnson VT: Cutting Edge Press; 2000.