Brief Summary The goal of this clinical trial is to evaluate whether scheduled maternal position changes using a peanut birthing ball improve labor outcomes in low-risk, primiparous women receiving epidural analgesia during labor. The main questions it aims to answer are: Does scheduled maternal positioning with a peanut ball reduce the duration of the first and second stages of labor? Does scheduled maternal positioning with a peanut ball influence mode of delivery and maternal and neonatal outcomes? This non-invasive randomized controlled trial will be conducted at the Women's Wellness and Research Center in Qatar. Participants will be randomly assigned to either an intervention group receiving scheduled maternal position changes using a peanut birthing ball or a control group receiving standard intrapartum care without peanut ball use. Researchers will compare outcomes between the two groups to determine whether structured positioning with a peanut ball improves labor progression and delivery outcomes in women receiving epidural analgesia. Participants in the intervention group will undergo scheduled position changes throughout labor using a peanut birthing ball, including left lateral, right lateral, semi-sitting, and Taylor positions, under the supervision of trained nursing and midwifery staff. Participants in the control group will receive routine intrapartum care following epidural analgesia without the use of a peanut ball or a structured positioning schedule. Primary maternal outcomes include duration of the first and second stages of labor, mode of delivery, estimated blood loss, postpartum hemorrhage, use of oxytocin augmentation, degree of perineal trauma, and hospitalization cost. Neonatal outcomes include Apgar scores at 5 and 10 minutes, NICU admission, birth-related injuries, and umbilical cord blood pH. Findings from this study are expected to support evidence-based intrapartum care practices and inform clinical protocols for women receiving epidural analgesia.
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Duration of First Stage of Labor
Timeframe: 12hours to 16 hours
Duration of Second Stage of Labor
Timeframe: 2 Hours to 3 Hours
Mode of Delivery
Timeframe: At delivery
Use of Oxytocin Augmentation
Timeframe: During labor
Postpartum Hemorrhage
Timeframe: 3 hours after delivery
Degree of Perineal Trauma
Timeframe: at time of delivery
Hospitalization Cost
Timeframe: From admission to discharge
APGAR Score
Timeframe: The Apgar Score is a standardized newborn assessment scale ranging from 0 to 10, with higher scores indicating better neonatal status, assessed at 5 and 10 minutes after delivery.
NICU Admission
Timeframe: 2 hours after delivery
Newborn Birth Injuries
Timeframe: 2 hours from delivery