First Advisor

Dunemn, Kathleen

Date Created


Embargo Date



The high rate of cesarean section deliveries in the United States is greatly concerning for the health of our laboring women and their babies. Many physical, emotional, and financial risks are linked to this surgical procedure. This author felt the labor care model has been narrowed in many instances, creating an atmosphere where laboring women become fixed in a cycle of medical actions mostly due to continuous electronic fetal monitoring. Labor and delivery activities can be viewed as compulsory and integral pieces of care but in themselves are not always required. Methods to minimize unnecessary cesarean deliveries are being explored, especially interventions that improve pelvic opening, thus allowing the fetus to traverse the birth canal. The peanut ball is one such innovative intervention being offered in labor management in the past few years. Educational methods for utilization of the peanut ball vary and might be lacking among labor attendants. The intention of this project was to develop a clinical practice guideline for use of the peanut ball for those patients in labor to assist with opening the pelvis to facilitate fetal rotation, thereby shortening labors and ultimately reducing the rate of cesarean deliveries. To improve the efficacy of use, a retrospective analysis of articles on laboring women was performed to obtain statistical data of value for this project. Surveys distributed to experts in the care of laboring women were issued in two waves. They were collected and evaluated to determine education points necessary for inclusion in the guideline. The PICOT for the project with plans for a future research project was, “In pregnant women, how does the use of the peanut ball compared to no use of the peanut ball influence the rate of cesarean section during labor and delivery? Once the guideline was developed, an accompanying education document was created along with a pelvic positioning visual sheet. A succinct step-by-step instructional sheet explaining proper implementation of the guideline along with a policy template were created. Through development of the guideline, it was desired to facilitate a successful vaginal delivery, shorten labor times, decrease the discomfort of the woman, and promote satisfaction with her experience. By accomplishing these goals, it was projected a reduction in the cesarean rate would also be present. A research project could occur with the guideline and would be an undertaking of the organization. If a research project is completed, a data collection and analysis could be carried out to determine whether the expected objectives were met and continued use of the guideline would be beneficial for laboring women within the institution and whether the guideline could be disseminated to outside organizations. This research area could provide the catalyst to increase awareness and restructure the rigid, task-oriented processes currently being noted in labor care.


Cesarean section; Labor and delivery; Obstetrics


132 pages

Rights Statement