Peanut ball for labour: what you need to know

You're past 36 weeks, the hospital bag is half packed, and someone at antenatal class mentioned a peanut ball. Not the birthing ball you've been bouncing on since 30 weeks. The other one, the one that goes between your knees in bed.

Here's what it's for, how to use it with and without an epidural, and what we've stopped claiming about it. The positions are the useful part, so they're most of the page.

Key facts

• Our labour peanut ball is one size, 50cm, and inflation matters more than size: firm enough to hold your top leg up, not so hard it feels rigid.
• The NHS says if labour starts during the day, stay upright and gently active, which helps your baby move down into your pelvis and helps your cervix dilate.
• Positions the NHS lists for labour: sit, lie on your side, stand, kneel or squat, and kneeling on all fours if your back is aching.
• After an epidural your legs may feel numb or weaker than usual, the NHS says, which is when a ball between the knees does the holding.
• Inflate it in stages well before your due date, and check your unit's policy on bringing your own equipment.

What a peanut ball does in labour

The name is the shape: two rounded ends and a narrower middle, so it sits between your knees without rolling out. Lying on your side with the ball between your legs holds your top leg up and out, which keeps your pelvis open while the rest of you rests.

That's the whole job, and it's a bigger one than it sounds.

A birthing ball is for sitting upright and moving your hips. A peanut ball is for lying down. They do different jobs at different stages, which is why plenty of people take both to hospital rather than choosing between them. Midwives use peanut balls for exactly this reason, and having your own means you're not waiting for the unit's one to come free.

What the NHS says about positions in labour

The NHS advice on positions is short. Walk around or get into whatever position feels comfortable: sit, lie on your side, stand, kneel or squat. If your back is aching, kneeling on all fours may help. That's the stages of labour page, and it's worth a read before the day.

If labour starts during the day, the NHS says stay upright and gently active, because it helps your baby move down into your pelvis and helps your cervix dilate. If it starts at night, sleep if you can. Keeping moving is also on the NHS list of things that help with pain.

The peanut ball is the "lie on your side" part of that list, for the stretches when upright isn't possible or you've run out of steam.

How to use a peanut ball in labour

Three positions cover most of it. Your midwife may have others; theirs win.

Side lying

Lie on your side in bed, put the ball between your thighs and let your legs rest round it, with a slight bend in your knees. Your top leg is held up and out, your pelvis stays open, and you can doze. This is the one to start with.

Side lying, knees tucked

Same position, then bring your knees up towards your chest so you're in a lying down squat. It opens the pelvis further than the straight version. Use pillows behind your back so you're not holding yourself there.

The flying cowgirl

Daft name, useful position. Lie on your side with the biggest part of the ball between your knees and your ankles resting round the far end, then push your ankles back behind you so your body makes a backwards C. Change sides every 30 minutes or so, and let your midwife help you turn if you've had an epidural.

Whichever you're in, swap sides every 20 to 60 minutes, or when your midwife suggests. The ball works because you keep changing, not because you lie still.

Knees apart or knees together

Midwives talk about opening the top of the pelvis and opening the bottom of it, and the ball does either depending on where you put it. Knees apart, feet closer together, opens the top of the pelvis, which is the shape for helping your baby's head drop in. That's the ball between the knees, as in the side lying positions above.

Knees together, ankles apart, opens the bottom of the pelvis, which is the shape for later on, when your baby is coming through. That's the ball lower down, between your ankles or calves, with your knees resting together. Your midwife will tell you which they want, and when.

Peanut ball positions with an epidural

This is where the ball earns its keep. After an epidural your chest, tummy and legs may feel numb and your legs may not feel as strong as usual, the NHS says, and unless your unit does mobile epidurals you'll be in bed. Lying still is exactly when labour tends to slow, and it's what the ball is for.

All three positions above work with an epidural, with two changes. Your midwife or partner moves the ball and turns you, because your legs won't do it reliably, and you swap sides on the clock, roughly every half hour, rather than waiting until you feel like moving.

What size peanut ball for labour

One size, 50cm, covers most people for labour use. Too big and it stresses the hips; too small and it doesn't hold your leg up enough to keep the pelvis open. What matters more is how much air is in it: firm enough to hold your top leg up without collapsing, but not so hard it feels rigid between your knees.

Peanut ball pregnancy positions before labour

Before labour there are two uses. Between your knees when you sleep on your side, it takes the twist out of your hips and lower back in the last weeks. Kneeling and leaning forward over it, arms across the top, is the other one, and a good way to get off the sofa in the evening.

If you're trying to help your baby into a good position for birth, that's a topic of its own, and the ball is one small part of it. Our piece on getting your baby into position covers it, and the birthing ball exercises do more of that work than the peanut ball does.

What's in it for you, honestly

The old version of this page listed nine benefits, from shorter labour to fewer c-sections, with two studies and minutes attached. They're gone. The studies were small and measured different things, and a number on a blog isn't something to plan a birth around.

What we'll stand behind: it keeps your pelvis open while you rest, it gives you a way to keep changing position when you can't get up, and it's comfortable in a way a pillow between the knees isn't, because it doesn't squash flat. Whether it shortens your labour is something no one can promise you, us included. Ask your midwife what their unit has seen.

Using the peanut ball after the birth

It doesn't retire when the baby arrives. Between your knees while you sleep on your side is genuinely comfortable in the weeks after birth, when your hips are still settling. Side lying to feed, with the ball holding your top leg, takes the strain off your back. Later on, some people use it as a support for physio exercises.

Go at your own pace with any of that. If you've had a c-section or stitches, anything that pulls at the wound is your signal to stop and ask your midwife.

Inflating it before the day

Do this well before your due date, not when contractions have started. Let the ball reach room temperature first, inflate it in stages, leave it overnight to relax, then top it up the next day.

Slow is normal; it isn't you doing it wrong.

Then it lives in the car with the hospital bag, already inflated. If you'd rather not use the foot pump, our electric pump fits the peanut balls. Check with your midwife or birth centre about their policy on bringing your own equipment, and do it at an appointment rather than at the door.

Questions we get asked

How do you use a peanut ball in labour?

Lie on your side with the ball between your knees, legs resting round it, and rest. Swap sides every 20 to 60 minutes or when your midwife suggests. Bring your knees up for a deeper squat, or push your ankles back behind you for the flying cowgirl, and leave the choice of position to whoever is looking after you.

What peanut ball positions work with an epidural?

The side lying ones. Your legs may feel numb or weak after an epidural, the NHS says, so your midwife or partner places the ball and turns you, and you change sides on the clock, roughly every half hour, rather than waiting until you feel like moving.

Can I take my own peanut ball into hospital?

Usually, and it's worth asking at an antenatal appointment rather than assuming. Units vary on their own equipment and on what you can bring; the midwife will tell you. Inflate it at home, put it in the car with the bag, and tell the midwife you've brought it when you arrive.

Is a peanut ball the same as a birthing ball?

No. A birthing ball is round, and for sitting upright and moving your hips. A peanut ball is for lying down, holding your legs apart while you rest. Different jobs, different stages, and plenty of people take both.

Next step: the peanut ball goes in the car with the bag, and the birthing ball does the upright half of the job before it.