Peanut ball under förlossning

Peanut ball during labor

The text has been produced to spread tips and knowledge. The information does not consider the advice and knowledge of your doctor or midwife. If you have medical questions/problems or are unsure what applies to you, contact your doctor/midwife. 

This is a big post so use the headings to find the right information. 

What is a peanut ball?

A peanut ball, or ball in Swedish, is basically the same thing as a pilates ball but with the shape of a peanut. 

Peanut balls have become very popular birthing tools to help the baby take optimal positions in the pelvis. 

They also work well for those who have chosen an epidural as mobility is usually reduced, with a Peanut ball the possibility of movement increases.

The Peanut ball is also nice to use as a softer support if you want to raise one of your legs during contractions instead of the bed's leg support in the delivery ward.

What can a peanut ball help with during labor?

A randomized controlled trial was conducted to determine if the use of a Peanut ball reduced the length of labor and increased the number of vaginal births. 

Women who used the peanut ball compared to those who did not had:

  • 29 minutes shorter latency phase
  • 11 minutes shorter active phase
  • Lower number of caesareans

The Peanut ball is a potentially successful aid to promote labor and vaginal birth (especially for those with an epidural). 


  • Reduced pain (movement reduces pain, which the peanut ball helps with)
  • The fallopian tubes open faster
  • Opens up the pelvis
  • Shortened labor length
  • Reduces the risk of caesarean section
  • Reduces the risk of other interventions

Some contraindications

Always consult your midwife/doctor and follow their advice!

  • Broken hip
  • Broken pelvis
  • Broken symphysis
  • Deep vein thrombosis
  • Maintain good body mechanics (spec with epidural)
  • If it hurts, change position or cancel

Care advice


Use an electric air pump with a narrow spout to inflate your peanut ball, just like you would inflate a pilates ball. Alternatively, you can use the manual pump that comes with the peanut balls we sell. 


Clean the ball after each use with DAX, Colloidal Silver or Dettol antibacterial surface cleaning wipes (perfect to keep in your bag!).

Recommendation is to have some kind of protection on the ball when it is used, for example incontinence protection , pillowcase/duvet sheet or sew your own cover. Something that protects the ball between uses. 

Keep in mind that blood stains are difficult to remove.

How to choose the right size?

One size does not fit all, therefore it is important to get a peanut ball adapted to your height. If you are a doula, midwife or other birth worker, it is a good idea to have several different sizes available.

The different positions can also affect the type of size you need. Keep in mind that the size of the ball varies greatly depending on the amount of air.

If you only have a too small ball at hand, you can make the ball "thicker" by using a pillow under the leg in certain positions. And conversely, if you have a slightly too big ball, you can let some air out.

General size guide :

  • SMALL 40 cm - Recommended for mothers under 160 cm, i.e. shorter and short legs
  • MEDIUM 50 cm - Recommended for mothers who are over 160 cm to 168 cm, i.e. medium length. (This is the most common size).
  • LARGE 60 cm - Recommended for mothers who are over 170 or taller.
  • X-LARGE 70 cm - Only used for sitting on.

The baby in the pelvis

Want to explain some of the baby's work and the journey down through the pelvis. 

The baby pulls its chin towards the chest and rotates downwards, which facilitates birth through the cervix, pelvis and vagina.

If the head is large, the baby can stay for a while in certain positions to allow the head to be shaped according to the pelvis and then slide on. This is common and can, for example, sometimes be seen in newborn babies whose heads are "oblong". This goes back after about 1-2 days after birth.

When the baby pushes down, people talk about different "stations" for where the baby's head is in the pelvis. This is calculated in cm and varies from -4 to +4 (sometimes also -5 to +5). Zero (0) is the center of the pelvis. So if the baby's head is -3, it means it is 3 cm above the center of the pelvis.

When the baby passes a part in the pelvis called the spine (also called the spine thorns or the spinal protrusions), you may experience nausea and vomiting. This is nothing strange but a normal reaction as it is the narrowest part of the pelvis. Although this can be experienced as difficult, it is also an indication of where the baby is. Healthcare professionals usually talk about over or past the spine tags. 


Try different positions, but try to move at least every 20-60 minutes to maintain good circulation and continued progress. There is no exact knowledge behind all the different positions - as I said, movement is key. Below is a compilation of the positions from several different sources.

When you buy a peanut ball from us, you get a pdf with the illustrations and instructions below!

There are many different positions (with many different names) to take with the peanut ball, described below:

  • Flying cowgirl
  • Semi sitting
    - Semi sitting lunge
    - Semi sitting lotus
  • Tuck position
    - Tuck position with pillow
  • Sims variation 
  • Side lying 
  • Forward leaning
  • Fire hydrant
  • Pushing
  • Straddling 

Small variations in different positions make a big difference!

Length of time in each position is around 20-40 minutes, then you have to switch sides and do the same there. 

Extra tip - In most positions during birth, you can bring your knees together and your feet out. This also increases the space in the pelvis.

Flying cowgirl 

Baby station: High up, above 0 (eg -2. -3)
Labour: Early/latency phase

  1. Lie straight on one side with the ball between your knees.
  2. Keep a straight line from your torso, to your thighs to your knees and pull your legs "behind you" (imagine what a cowboy looks like riding a wild horse 🤣 )
  3. The feet should preferably be parallel.
  4. You should be able to relax in the position so roll up with pillows around if you need support.
  5. Hold this position for about 20-40 minutes, then do the same on the other side.

Semi sitting 

Baby's station: Middle/high, so 0 or -2,-3.
Labour: Early/latent phase or active phase.

Can also be performed when baby is not in an optimal position.

  1. Sit in a comfortable position.
  2. Place one leg over the peanut.
  3. Let the peanut be as close to your hip as possible.
  4. Does the ball roll away? Support with pillows/towels in front as a stop.
  5. Hold this position for about 30-40 minutes, do the same on the other side. 

Can be made into a Semi sitting lunge by rolling the ball back and forth under the leg.

Or turn it into a Semi sitting Lotus - Place both feet on the peanut so that they meet, similar to sitting in the lotus position. Good in the early phase when the woman wants to rest.

Tuck position

Baby's station: Middle, 0
Childbirth: Active phase

Position can also be good to cross.

Lie in the same position as Side lying but pull the ball up towards your face as if you were to hug the peanut from the side with both arms and legs over/around the ball.

Tuck position with pillow 

Baby's station: 0, +1,+2
Childbirth: Towards the end, 9-10 cm

Help the baby down through the pelvis, opening up the lowest part of the pelvis.

Key - the leg should be raised high, use a pillow, towel.

  1. Place the peanut between the legs.
  2. Elevate the upper foot using a pillow/towel (the key is the elevation of the leg)
  3. Lie down for about 30-40 minutes, then switch to the other side.

Sims variation

Childbirth: It's going slowly

  1. Lie on your side with the peanut lying in front of you.
  2. Place your upper leg on the peanut, making sure the ball supports your knee and ankle.
  3. Twist yourself forward - lean your shoulders and hips forward.
  4. In this position you can rock back and forth, lots of movement.
  5. Do for 20-40 min and then do the same on the other side.
  6. Support with pillows.

The position provides the opportunity for a support person/partner to give a hip and bum massage.

Side lying

Baby's position: Baby starts to come down.
Labor: Active phase - bring the baby down through the pelvis.

Can be done in all parts during childbirth.

Good position if you need/want to rest or after receiving an epidural. Opens up the pelvis.

Goal - keep shoulders and hips in a parallel straight line.

Size: Usually requires a larger peanut ball.

  1. Lie on your side with the peanut between your legs, the ball should be horizontal.
  2. Keep your legs slightly bent, but low under you.
  3. Place a pillow under the front part of the peanut so that it does not swing back and forth, or alternatively take support from the leg support found on the delivery beds.
  4. Lie in this position for 20-40 min, then do the same on the other side.

Forward leaning

Baby's position: High,  -2
Childbirth: Good for breech or if baby is high and needs to rotate down.

Rest without eda or if you got eda perform the position with help .

  1. The aim is to achieve a "stair step" form of the substrate and for the position. Lower the foot end of the bed to help gravity. Alt do it on the floor with the peanut on a sofa, have a mattress for the knees on the floor.
  2. Place the peanut on the top of the bed/sofa.
  3. Stand with your knees on the lower part of the bed/floor.
  4. Lean your upper body into the narrow part (middle) of the peanut (gives more room for your stomach).
  5. Rock or rock your hips.

Remember - knees together, feet out. 

Fire hydrant 

This position can help your baby rotate as it moves through the birth canal. Can be done with or without an epidural.

  1. Stand on all fours, in bed (lower the bed) or on the floor.
  2. Raise one of your legs so that they rest on top of the peanut (think "peeing the skin").
  3. Ensure that the ball does not roll away by supporting the edge of the bed/pillows.
  4. Change sides every 20-30 min.

To get extra support, you can lean against/on a peanut ball in front of you or take support from pillows or a sack.


  1. Mimic a deep squat/crouch In bed on your side.
  2. Put your legs and arms around the peanut, like a hug with your whole body.
  3. Between cramps, the woman can rest on the ball.
  4. Support with pillows behind the woman so she has support and lies comfortably.

Straddling position

Childbirth: Anytime. 

Rocking/bouncing on the ball can relieve discomfort as it tends to push against the perineal area.

  1. This is done on the floor , on the largest peanut ball 70cm.
  2. To avoid a fall accident, hold on to something such as the end of the bed or a rope, rebozo. 
  3. Sit straddling the ball and swing/bounce gently.

Tips on Youtube clips: 

You are very welcome to share your own experiences if you used a peanut ball during childbirth.

Good luck!

Big hug,

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