Effect of Birth Ball Exercise on Labor Progress During the Active Phase of Labor Assessed by Intrapartum Ultrasound

NCT07889700 | Completed

• 1 other identifier: BIRTH BALL-INTRAPARTUM USG
• Study Type: interventional
• Target: 77
• Locations: 1 country
• Sites: 1

Brief Summary

The active phase of labor is a critical period for the progress of labor and maternal comfort. Non-pharmacological interventions such as birth ball exercises are frequently used to support labor progress and maternal mobility. Birth ball exercises may facilitate fetal descent, improve maternal pelvic mobility, and potentially shorten labor duration. Intrapartum ultrasound has recently emerged as an objective method for assessing labor progress and fetal head position. Compared with digital vaginal examination, intrapartum ultrasound provides more reliable and reproducible measurements. The aim of this study is to evaluate the effect of birth ball exercises performed during the active phase of labor on labor progress using intrapartum ultrasound. The findings of this study may contribute to understanding the potential benefits of birth ball exercises in supporting physiological labor.

Conditions

Labor; Labor Progress

Keywords

Birth Ball; Intrapartum Ultrasound; Active Phase of Labor; Labor Progress

Outcome Measures

Primary Outcomes (5)

• Angle of Progression (AoP) during the active phase of labor

  Angle of progression (AoP) was measured by transperineal intrapartum ultrasound. AoP was defined as the angle between the long axis of the pubic symphysis and a line drawn from the inferior edge of the pubic symphysis tangentially to the most distal point of the fetal skull. Measurements were obtained at 6 cm and 10 cm cervical dilation. AoP was expressed in degrees, with higher values indicating greater fetal head descent.

  At 6 cm and 10 cm cervical dilation during the active phase of labor

• Head-Perineum Distance (HPD) during the active phase of labor

  Head-perineum distance (HPD) was measured by transperineal intrapartum ultrasound. HPD was defined as the shortest distance between the perineal skin surface and the outer bony limit of the fetal skull. Measurements were obtained at 6 cm and 10 cm cervical dilation. Lower HPD values indicate greater fetal head descent. HPD was expressed in centimeters.

  At 6 cm and 10 cm cervical dilation during the active phase of labor

• Progression Distance (PD) during the active phase of labor

  Progression distance (PD) was measured by transperineal intrapartum ultrasound. PD was defined as the distance between the infrapubic line and the most distal point of the fetal skull. Measurements were obtained at 6 cm and 10 cm cervical dilation, and changes in PD reflected fetal head progression through the birth canal. PD was expressed in centimeters.

  At 6 cm and 10 cm cervical dilation during the active phase of labor

• Fetal Head Direction (HD) during the active phase of labor

  Fetal head direction (HD) was assessed by transperineal intrapartum ultrasound according to the orientation of the fetal head within the maternal pelvis. Head direction was categorized as downward, horizontal, or upward. Assessments were performed at 6 cm and 10 cm cervical dilation. The outcome measure was reported categorically as downward, horizontal, or upward.

  At 6 cm and 10 cm cervical dilation during the active phase of labor

• Fetal Head Position during the active phase of labor

  Fetal head position was assessed by intrapartum ultrasound according to the orientation of the fetal occiput within the maternal pelvis. Fetal head position was categorized as occiput anterior, occiput transverse, or occiput posterior. Assessments were performed at 6 cm and 10 cm cervical dilation. The outcome measure was reported categorically as occiput anterior, occiput transverse, or occiput posterior.

  At 6 cm and 10 cm cervical dilation during the active phase of labor

Secondary Outcomes (2)

• Duration of the active phase of labor

  During labor

• Mode of delivery

  At delivery

Study Arms (2)

Birth Ball Exercise Group

EXPERIMENTAL

Pregnant women in the active phase of labor will perform birth ball exercises under supervision.

Behavioral: Birth Ball Exercise

Control Group

NO INTERVENTION

Participants will receive routine labor management without birth ball exercises.

Interventions

Birth Ball Exercise BEHAVIORAL

Birth ball exercises performed during the active phase of labor to facilitate labor progress.

Birth Ball Exercise Group

Eligibility Criteria

• Age: 18 Years - 35 Years
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Pregnant women aged 18-35 years
• Nulliparous women
• Singleton pregnancy
• Cephalic presentation
• Gestational age between 38 and 40 weeks
• Expected vaginal delivery
• Cervical dilation ≥6 cm (active phase of labor)
• Ability to perform birth ball exercises
• Ability to provide informed consent

You may not qualify if:

• Multiple pregnancy
• Non-cephalic presentation
• Previous uterine surgery
• Obstetric risk factors
• Obstetric complications during labor (e.g., vaginal bleeding, fetal distress)
• Gestational age \<37 weeks at admission
• Alcohol or substance abuse
• Inability to perform birth ball exercises

Sponsors & Collaborators

• Sakarya University: lead

Study Sites (1)

(Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi) Department of Obstetrics and Gynecology

Sakarya, 54000, Turkey (Türkiye)

Location

Study Officials

• Hilal Uslu Yuvacı, MD

  (Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi) Department of Obstetrics and Gynecology

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will be randomly assigned to either a birth ball exercise group or a control group during the active phase of labor.

Study Record Dates

• First Submitted: May 4, 2026
• First Posted: October 22, 2026
• Study Start: November 2, 2025
• Primary Completion: July 16, 2026
• Study Completion: September 1, 2026
• Last Updated: October 22, 2026

Record last verified: 2026-10

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)