Published Paper Details:

Background: The use of peanut balls among women receiving epidural analgesia during labour has increased in recent years. Preliminary randomized controlled trials conducted internationally have demonstrated clinically and statistically significant findings related to labour progress and maternal and fetal outcomes. However, limited evidence is available regarding the feasibility of implementing scheduled peanut ball positioning protocols within the Women's Wellness and Research Center (WWRC), Qatar. Aim: This pilot study aimed to evaluate the feasibility of conducting a randomized controlled trial assessing the impact of scheduled peanut ball positioning on labour outcomes among primiparous women receiving epidural analgesia. Methods: A pilot randomized controlled trial was conducted in the Labour and Delivery Unit at the Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar. Primiparous women in active labour receiving epidural analgesia were screened for eligibility and randomized into intervention and control groups. The intervention group received scheduled positioning with a peanut ball using predefined maternal positions throughout labour, while the control group received routine labour care. Feasibility outcomes included recruitment rate, participant adherence, acceptability of the intervention, randomization process, and completeness of data collection procedures. Maternal and neonatal outcomes were also preliminarily explored. Results: The pilot study demonstrated that recruitment, randomization, intervention implementation, and outcome data collection were feasible within the WWRC labour room setting. Participants tolerated the scheduled positioning protocol well, and adherence to position changes was achievable during labour management. Preliminary observations suggested potential benefits related to labour progression and maternal comfort; however, the pilot study was not powered to determine statistical significance for clinical outcomes. Conclusion: The findings support the feasibility of conducting a future fully powered randomized controlled trial evaluating scheduled peanut ball positioning among primiparous women receiving epidural analgesia in Qatar. The pilot study provided valuable insight into operational processes, participant compliance, and implementation strategies necessary for the definitive trial.