How to Use a Peanut Ball During Labour

Vera Kevic and Mira Kevic, Birth/Postpartum Doulas and Childbirth Educators

Hello, my name is Vera Kevic and I am a birth and postpartum doula and a childbirth educator with Oona here in Toronto. A doula is a non-medical support person who attends people during their pregnancy, during their labour and their birth, and in the immediate period known as the postpartum time as new parents are transitioning into life with newborn. We use noninvasive tools and tricks to help people get comfortable – this is one of them – it’s a peanut ball. And keep watching, my doula partner, Mira and I are going to demonstrate a few ways that you can utilize this tool in your pregnancy and during your labor to help you have a smoother, more comfortable time, keep watching.

Hi, we are Mira and Vera Kevic, we are birth doulas and labour doulas and we want to talk to you today about the peanut ball. That’s what this is right here. And working with folks in labour, and giving birth, we know that body position during labour both in active times and in times of rest are very important for how your labor progresses. And the peanut ball is a really great tool for some of the more restful positions. We want to go through how you can use a peanut ball when you’re labouring at home to make yourself comfortable. And also, once you’re at the hospital if your birth has become medicalized there are ways that the peanut can help you there as well. We’re going to go through some of those ways that you can use the peanut to make your labor efficient and have your baby in the best position for your birth.

This is our peanut ball, they come in different sizes. It feels like a yoga exercise ball. It’s got a rubbery exterior, they are filled with air so you’re going to need some way to pump it up. And it has this sort of rubbery silicone feeling coating on it and first we’re going to go through some of the ways that we can use it at home because there are different exercises based on whether you’re feeling restful or you want your labour to progress to the next step. So we’re going to go over what the different positions are when you’ve got the peanut in the bed with you.

So when you’re lying in a bed with a peanut there are three different ways that you can position your body to make the peanut be comfortable for you. So if you are ready to have a rest, and you want to have a sleep, it can be difficult to lie down in labor in a position in the bed lying down ’cause there’s a lot of pressure on your pelvic floor. So the way that we can get rid of that pressure on the pelvic floor is if we open the leg up and we drape it down over the peanut. Now the pelvis is open, the knees are apart. We’ve taken a lot of that pressure off of the pelvic floor and we’re in a restful position for rest. We can take some more pillows if we like and put them at the small of the back. We can take another one and put it underneath our belly. And then we can have a delightful two-minute snooze in between our surges and in that two-minute snooze, you’re going to store up so much energy for the rest of the journey. So this is a nice restful position and this is if you are feeling like you want to have a little break. This is great to give your knees a break, your hips a break, your back a break, because often labor positions can be very hard on the knees, pelvis and back. And it’s important to rest those because they’re working hard and they’re going to do more work as our labor progresses.

Now if we want a break from the back, maybe we’re feeling our surges in the back a little bit or this position is less comfy, what we can do is we can configure this to be more on our side. We’re just going to take this leg and we’re going to drape it over the other leg. So now we have even more extreme opening of the pelvis and the knees, but we’re in more of a side position. So again, we can wedge in some more pillows. We can put another one under our belly here, we can even hug that one a little bit, might feel nice. And we’ve got another restful position.

This is also great for support people to be able to apply some counter pressure at the lower back to feel nice during those surges, apply some light comforting touch to our pregnant person and make the make sure that they feel cared for and safe. Now one more trick we can have lying down with this peanut is say you want things to move and you’re a practitioner or a coach or someone has suggested you try something called the miles circuit. We also just like these sort of extreme positions for labor. We can go into the most extreme stretch. And some of you actually might know this position called the rescue position from different sorts of CPR classes. But now we’ve got the most extreme separation of opening of the pelvis, separating of the knees and now we can keep going with our hugging pillows which feel really nice and we can wedge some more things at the back here because you want as few muscles engaged for your laboring person while they’re in these positions. The point of them is to store up some energy to keep your labor progressing in a very conducive position to baby dropping lower in the pelvis and your cervix opening. But you need to be restful. So what I like to say is “no bones”. Are you no bones?

– No bones, it’s so good.

– And then when someone has relaxed all their muscles they’re going to sleep and then they’re going to wake up and they’re going to be ready for the next step. Now to see those positions from a different angle that gives you better idea of what the legs are doing, here’s that restful back-lying position again. Both legs are bent. We’re still not using any muscles to support ourselves. We’ve got our pillows wedged and this is our back comfy lying sleep position. Now when Vera moves into the side lying comfy position we’ll see what changes is that the top knee now is going over the bottom knee. So both legs are still bent. We’ve still got our wedges, but now we’re more to the side and we’re giving our lower back a little bit even more of a break than with that last position. So the differences between these two is just going to be your labouring person’s comfort or your comfort if you’re the laboring person and which you find to be best. They also count as two different positions. So if you’re feeling really nice in a laying down position and it’s suggested you try something new, go from back to side and see if that makes you feel things a little differently.

Now finally, in this lying down we have the extreme stretch mile circuit rescue position and now you see we’ve moved that top leg all the way over to just out from in front of the body and that under leg is straight all the way down opening up that pelvis as wide as it will go and we’re still in a restful position. We can let go, get yourself in all your comfiness so that you can go no bones and relax your muscles and be restful while your labor progresses.

So now we’re going to talk about what happens when you are at the hospital for your birth. So for instance, Mira now is in a hospital bed in a reclined position on an epidural which means this is her position for the duration of her labor. So typically with an epidural in a hospital bed, you are on your back with a wedge underneath one side or another. So you’re stuck on your back unless you get to go a little bit to one side or a little bit to the other side. But beyond that, it can get a little stiff for the body. It can get a little extra numb in the legs and it can cause different parts of pinching that can affect baby’s heart rate, pinch their cord and just upset them.

Anyone who’s been in the hospital room during a medicalized birth will hear, “Oh baby didn’t like that position, we need to try a different one.” So what the peanut can do is diversify your positions and also these positions with the peanut will take pressure off of certain parts, which will keep your labor flowing and also keep your baby maybe more happy. So we’re lying on our back with a wedge and the first thing that we’re going to do is similar to what we’ve seen from at home, but we’re just going to open up the pelvis. We’re going to bring one leg up and we’re going to drop it over the peanut. Are you using any muscles?


There we go, so we’re flopped, we’re at still, you might need help to have your legs put into this position, depending on the numbness level from the epidural but our pelvis is open, our knees are apart. There’s going to be some pressure taken off of the pelvis and the low back where you’ve got some nerves there that could cause some deceleration. Then maybe if we’ve got our blood not moving nicely and our wedge is still there, this can be changed from side to side, depending on what we want to do for labor progress and have position changes and also what the nurses are recommending when they come in and request a position change.

So this is how we can just be comfy on an epidural in a hospital bed. Now maybe your legs are getting a little too numb from the epidural, what we can do is we can bring both legs up on this peanut. You’re going to need some help if your legs are numb and then you’re still going to have your wedge. You can’t be completely flat on your back but your legs are going to be up a little bit. You’re going to drain some of the epidural from your legs so your legs won’t be quite so numb. You can give your toes a little wiggle and hold your legs up a little bit better when it’s time to push. But we’ve got some more diversity and movement there as well.

Now, these extreme sideline positions can be tried in the hospital bed. You don’t have quite as much bed so it is better to be sort of more in this lying position but it’s going to keep your pelvis open which is going to help your labor progress, again, we’re making room for baby to slide down into the pelvis and we’re keeping the medicine moving through the body a little bit more as opposed to pooling in certain places. Finally, we want to show you how to get the most comfort out of your peanut ball because there are some other ways that we can use it other than between the legs and there are ways we can make it even more comfortable.

Now, this doesn’t necessarily feel so nice on the skin up till now, Vera’s just shown you pants legs on the ball. But if you’re putting bare skin, if you’re in labor without pants on or in something more gown-like, you may want to cover it with some sort of fabric here. I’m using a nice doulas on bikes receiving blanket. But any sort of pillowcase, big pillowcase, if you’re at the hospital, you can use a hospital gown. Those have the string so you can tie it nicely around the peanut so it stays there.

But this way, see, Vera is able to recline, if someone’s feeling their surges in their back it feels really nice to be in a forward leaning position. Even an extreme forward lean position will help get baby into optimal positioning for birth. You can have your back open for someone to provide physical comfort to you during your surges, and you’re now getting your baby into a great position. So the peanut can work well like that. If you’re also still in a very mobile place in your labor wanting to get some pressure off of your pelvic floor but sitting on the peanut either maybe you don’t have a yoga ball and it doesn’t feel as, or it’s too big for you. You can even sit on the peanut like an exercise ball to get your pelvis open and to take some pressure off of your hip.

So this is, you know, still going to have some knees. Your knees are still going to need to be in a good shape. But again, this opens up the back for people to be able to provide some physical comfort on the back, some touch. You can have someone that you lean on and have a slow dance with, but there are lots of ways to use your peanut ball in labor and during birth to make things go more smoothly. Position changes are very important and when you can diversify your positions and make those positions restful and not as reliant on your joints and your muscles then your labor is going to progress nicely and comfortably and you get to bring your baby into the world in a safe way.

Thanks for watching.

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