The effects of peanut ball use on labor pain, labor duration, anxiety, and maternal satisfaction in primiparous women: a randomized controlled trial

This study aimed to evaluate the effects of peanut ball use during labor on labor pain, labor duration, anxiety levels, and maternal satisfaction in primiparous women. This randomized controlled trial was conducted between January 30, 2025, and May 1, 2025, in the maternity unit of a tertiary referral hospital in southeastern Türkiye. A total of 114 primiparous women were randomized (57 per group); four discontinued participation after randomization, and 110 women were included in the final per-protocol analysis (55 per group). The intervention group received peanut-ball application during the first stage of labor, whereas the control group received standard care. Data were collected using the Personal Information Form, Visual Analog Scale (VAS), State Anxiety Inventory (SAI), and Maternal Satisfaction Assessment Scale for Normal Birth (MSASNB). Repeated VAS and SAI measurements were analyzed using generalized estimating equations, while labor duration and maternal satisfaction were analyzed using covariate-adjusted analysis of covariance. Bonferroni adjustment was applied to time-specific pairwise comparisons of repeated VAS and SAI measurements; no global multiplicity adjustment was applied across the four outcome domains. Statistical significance was set at p < 0.05. Significant group-by-time interactions were observed for labor pain and state anxiety. After covariate adjustment and Bonferroni correction, VAS scores were lower in the intervention group at T1, T3, and T5, whereas the between-group differences at T2 and T4 were not statistically significant. Adjusted SAI scores were lower in the intervention group at both post-intervention and postpartum follow-up assessments (all p < 0.001). The adjusted durations of the active and transition phases were shorter, and the adjusted mean maternal satisfaction score was higher, in the intervention group (all p < 0.001). Peanut-ball use as an adjunct to routine intrapartum care was associated with lower labor pain and anxiety, shorter labor duration, and greater maternal satisfaction. Given the baseline imbalances and methodological limitations, these findings should be confirmed in adequately powered multicenter randomized controlled trials. NCT06804577, (registration date 20250127)