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Having a Ball

Using Birth Balls to Ease Labor
By Kelly Burgess

During labor it may seem as if you wouldn't want to be sitting on something that's as roly poly as you are, but birth balls are a favorite tool for those who teach and promote natural relief during labor and delivery. Birth balls are so versatile they can even be used during pregnancy to prepare for the demands of childbirth and post-partum as support for a sore body.

Birth balls are increasingly becoming a fixture in hospitals, birth centers and home births. They allow the mother to have the freedom to shift her weight and support her pelvic region for greater comfort during labor. They also facilitate fetal descent in cases where labor may not otherwise be progressing. In an age when the old ideas of what a woman should be doing during labor are being replaced with ideas of care and comfort, the birth ball is an important accessory for any expectant mother.

Staying Up for Labor
A few years ago, the Cochrane Collaboration, an international not-for-profit organization that provides information about the effects of health care, reviewed studies of maternal position during the second stage of labor. It discovered that sitting up or lying on one's side were far superior laboring positions than lying on the back.

Birth balls are one of the best tools for facilitating this upright position, according to Connie Livingston, a registered nurse, Lamaze-certified childbirth educator, doula and administrator of BirthSource.com, a site devoted to prenatal education. "There's a lot of research right now on the importance of upright positioning during labor," says Livingston. "Staying in the upright position allows gravity to help with the birth and improves effacing and dilating. The beauty of the birth ball is that it can also support a woman if she wants to try different positions."

Livingston, who always recommends birth balls to her patients, says they are particularly helpful if the baby is ascynclitic, or coming down the birth canal in a slightly crooked position. Often, this position can lead to failure to progress, but using the birth ball can help open the pelvis and give the baby space to correct itself.

Furthermore, the birth ball supports a laboring mother in a variety of positions as she progresses in labor and increasingly needs to move around, says Ann Douglas, author of The Mother of All Pregnancy Books: The Ultimate Guide to Conception, Birth, and Everything in Between (Wiley, 2002).

"A birth ball allows you to find a really comfortable position to labor," says Douglas. "You can sit on them or lean over them and support your torso. It allows you to move around but gives you support."

Janet Douglas* was so comfortable laboring on the birth ball that she would have given birth on it if the doctors hadn't objected. Her only regret was that she hadn't used it for her first two births.

"When I used the birth ball, it was back in 1997, and it was used so rarely that it wasn't even ready to go when I got to the hospital," says Janet Douglas. "I had to stand and wait while they sanitized this big, awkward thing. But it was so comfortable I hardly felt like I was in labor until they made me move to the bed."

Preparing for Birth
While they may be called "birth" balls, what these balls really are is professional-grade physical therapy balls. Inflatable balls used for birth support should be slow-deflating (so Mom doesn't end up on her bottom if it were to puncture), latex free (because many people are allergic to latex and don't even know it) and weight tested to support up to 600 pounds.

Livingston says these balls came into the birth arena in the early 1980s, but she cautions both expectant parents and professionals to be careful about using balls provided by some hospitals that may date back that far. While midwife centers tend to be more up to date on this type of labor support, many hospitals are just now coming into the more natural way of laboring and may have old physical therapy balls that they are still using as birth balls. These balls may not be professional grade and may not be suitable to use as birth balls.

If you're thinking about purchasing your own birth ball, find one that is sold as a birth ball – those found at discount or toy stores are not as safe as approved balls. It may be worth a couple's while to purchase their own – especially if they're planning on having more than one child. They generally cost less than $30, and, in addition to support during labor, they can be used during pregnancy to help prepare the body for giving birth.

"We don't do a lot of squatting like people in other cultures," says Douglas. "This can make it really difficult for a woman in labor if she really wants to squat, which is a comfortable laboring position, but her legs can't take the strain."

The birth ball can be used during pregnancy to practice those squats. Having regular access to a birth ball also enables the partner to practice holding and stabilizing the ball so he's not learning as he goes along while his partner is in labor.

It can even be used post-partum, providing gentle support to a sore bottom. Also, babies love the bouncing motion that Mom can make on the birth ball.

Types of Birth Balls
There are several different sizes of birth balls. The size you need depends on your height. Livingston recommends the following:

Height – Ball Size

Less than 5'2" – 53 centimeters round

5'2" to 5'8" – 65 centimeters round

More than 5'8" – 75 centimeters round

Birth balls also come in oval shapes. Known as egg balls, these more stable balls may just represent the future of birth balls. Mothers tend to feel more comfortable on them, and their shape encourages a deep squat, which helps open up the pelvis.

Livingston notes that birth balls, whether oval or round, should always be used with a "spotter," as pregnant women are often not well-balanced. Birth ball bases are available if a spotter is not always convenient.

*Name changed to protect privacy.

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