Abstract
BACKGROUND: Therapeutic exercises with the peanut ball may support the progress of vaginal birth. OBJECTIVE: To evaluate the effectiveness of a physical therapy program using peanut ball positioning during the first stage of labor on maternal and neonatal outcomes. METHODS: Randomized clinical trial involving women aged 18-40 years, in the first stage of active labor with low-risk pregnancies and singleton cephalic presentations. Participants were allocated to using 126 black, opaque, sealed, and sequentially numbered envelopes. Randomization was based on a computer-generated list. The intervention group used peanut ball positions, while the control group received standard care. Maternal fatigue was measured by the Maternal Perception of Fatigue in Labor Questionnaire (MCFQ), and maternal anxiety was measured by the State-Trait Anxiety Inventory (STAI). RESULTS: Compared with the control group, positioning with the peanut ball reduced maternal fatigue by 4.15 points (95% confidence interval [CI]: -7.08 - -1.23), total labor duration by 188.2 min (95% CI: -208.8 - -95.6), and maternal anxiety by 3.56 points (95% CI: -5.69 - -1.43). It increased the incidence of vaginal birth (RR: 1.73, 95% CI: 1.09 - 2.28, Number needed to treat: 12). CONCLUSIONS: A physical therapy program using peanut ball positioning reduces labor time, increases vaginal birth rates, and reduces caesarean section rates. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC): RBR-7z7f5s. Registered on 11 February 2020.