Email this article 
The Combined Effect of Birthing Ball Therapy and Birthing Yoga on Maternal Outcomes in Normal Delivery
Abstract
Childbirth is a physiological process that can be accompanied by pain, anxiety, and varying duration of labor. When pain is not managed well, with high anxiety and too long labor duration, it can increase the risk of complications for the mother and baby, resulting in an increased risk of labor with medical procedures and labor trauma for the mother. One of the complementary therapies that can overcome these problems is the use of birthing balls and labor yoga. The purpose of this study was to analyze the effect of the combination of birthing balls and labor yoga on labor outcomes (labor pain, anxiety levels and labor duration). The research method used was Quashi Experiment with a Non-Equivalent Pretest-Posttest Control Group Design. The research subjects were mothers giving birth in the delivery room of RSIA Siti Khadijah, Gorontalo City with a purposive sampling technique based on inclusion and exclusion criteria, so that the total sample obtained was 50 mothers giving birth consisting of 25 respondents in the intervention group and 25 respondents in the control group. Data analysis used the T Test on the variables of Labor Pain and Anxiety Level and the Man-Whitney Test on the variable of labor duration. The results of this study indicate that the combination of birthing ball and birthing yoga has a distinct impact on labor outcomes. The greatest impact was seen on the psychological aspect, with a significant reduction in anxiety (p < 0.01), while the effects on labor pain and duration were more clinical-descriptive in nature without statistical significance (p > 0.05). Therefore, it can be concluded that the combination of birthing ball and birthing yoga predominantly affects the psychological aspect, while still contributing to expediting labor progress descriptively.
Keywords
Full Text:
PDFReferences
Abera, M., Hanlon, C., Daniel, B., Tesfaye, M., Workicho, A., Girma, T., Wibaek, R., Andersen, G. S., Fewtrell, M., Filteau, S., & Wells, J. C. K. (2024). Effects of relaxation interventions during pregnancy on maternal mental health, and pregnancy and newborn outcomes: A systematic review and meta-analysis. PloS One, 19(1), e0278432. https://doi.org/10.1371/journal.pone.0278432
Ahmadpour, P., Faroughi, F., & Mirghafourvand, M. (2023). The relationship of childbirth experience with postpartum depression and anxiety: A cross-sectional study. BMC Psychology, 11(1), 1–9. https://doi.org/10.1186/s40359-023-01105-6
Alizadeh Pahlavani, H. (2024). Possible role of exercise therapy on depression: Effector neurotransmitters as key players. Behavioural Brain Research, 459, 114791. https://doi.org/10.1016/j.bbr.2023.114791
Aslanta?, B. N., & Çankaya, S. (2024). The effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction: A randomized controlled study. Archives of Gynecology and Obstetrics, 309(6), 2459–2474. https://doi.org/10.1007/s00404-023-07115-4
Corrigan, L., Moran, P., McGrath, N., Eustace-Cook, J., & Daly, D. (2022). The characteristics and effectiveness of pregnancy yoga interventions: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 22(1), 250. https://doi.org/10.1186/s12884-022-04474-9
Crowther, S., & Hall, J. (2015). Spirituality and spiritual care in and around childbirth. Women and Birth, 28(2), 173–178. https://doi.org/10.1016/j.wombi.2015.01.001
Delgado, A., Maia, T., Melo, R. S., & Lemos, A. (2019). Birth ball use for women in labor: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 35, 92–101. https://doi.org/10.1016/j.ctcp.2019.01.015
Grenvik, J. M., Rosenthal, E., Wey, S., Saccone, G., De Vivo, V., De Prisco Lcp, A., Delgado García, B. E., & Berghella, V. (2022). Birthing ball for reducing labor pain: A systematic review and meta-analysis of randomized controlled trials. The Journal of Maternal-Fetal & Neonatal Medicine : The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 35(25), 5184–5193. https://doi.org/10.1080/14767058.2021.1875439
Issac, A., Nayak, S. G., Priyadarshini, T., Balakrishnan, D., Halemani, K., Mishra, P., Indumathi, P., Vijay, V. R., Jacob, J., & Stephen, S. (2023). Effectiveness of breathing exercise on the duration of labour: A systematic review and meta-analysis. Journal of Global Health, 13. https://doi.org/10.7189/jogh.13.04023
Jeelani, M. S., & Habeeb, S. (2018). A Study To Assess the Effectiveness of Back Massage on Pain Among Primigravida Mothers During First Stage of Labour. Ijresm.Com, 8(3).
Jha, S., Vyas, H., Nebhinani, M., Singh, P., & T, D. (2023). The Effect of Birthing Ball Exercises on Labor Pain and Labor Outcome Among Primigraviade Parturient Mothers at a Tertiary Care Hospital. Cureus, 15(3), e36088. https://doi.org/10.7759/cureus.36088
Joseph, M. L., Batra, B. S., & Selvan, A. (2024). Comparative Study on Labor Pain Management: Birthing Ball vs. Traditional Methods-A Review. African Journal of Biomedical Research, 27(4), 4372–4386. https://doi.org/10.53555/ajbr.v27i4s.4414
Kamal Abd Elkhalek, N., Ebrahim Ahmed, S., Mohamed Mohamed lotfy, I., & A. Shahin, M. (2021). Natural Methods for Relieving Labor Pain and Anxiety during the First Stage among Primigravida Mothers. Egyptian Journal of Health Care, 12(3), 396–407. https://doi.org/10.21608/ejhc.2021.190768
Katili, D. N. O., Djunaid, U., Melani, N. A. D., Yunus, Y., & Harisa, K. (2023). Pengaruh Teknik Massage Endorphin Dan Teknik Relaksasi Nafas Dalam Terhadap Nyeri Persalinan. Health Information : Jurnal Penelitian, 15(2), 1–7.
Katili, D. N. O., Hiola, F. A. A., Melani, N. A. D., Yunus, Y., & Wulandari, N. (2023). Studi Literatur: Pengaruh Yoga Bersalin terhadap Kemajuan Persalinan Ibu Inpartu Kala I Fase Aktif. Jurnal Kolaboratif Sains, 6(7), 915–922.
Katili, D. N. O., Umar, S., & Gres, A. M. (2019). Pengaruh Telur Ayam Rebus Terhadap Peningkatan Kadar Hb Ibu Hamil Trimester I di Wilayah Kerja Puskesmas Tilango. Madu Jurnal Kesehatan, 8(1), 9–22. https://doi.org/10.31314/mjk.8.1.9-22.2020
Katili, D. N. O., Usman, S., & Potale, K. (2021). Pengaruh Akupresur terhadap Penurunan Nyeri Persalinan Kala I Fase Aktif. Madu Jurnal Kesehatan, 7(1).
Kementerian Kesehatan Republik Indonesia. (2023). Laporan Survei Kesehatan Indonesia (SKI) 2023. In Badan Kebijakan Pembangunan Kesehatan (BKPK) Kemenkes RI. Badan Kebijakan Pembangunan Kesehatan (BKPK) Kemenkes RI.
Kuder, L., Dinevski, D., Dinevski, I. V., Taka?, I., Mujezinovi?, F., & Elvedi Gašparovi?, V. (2025). Benefits of yoga in pregnancy: A randomised controlled clinical trial. Journal of Perinatal Medicine, 53(3), 350–357. https://doi.org/10.1515/jpm-2024-0422
Nahaee, J., Rezaie, M., Abdoli, E., Mirghafourvand, M., Ghanbari-Homaie, S., & Jafarzadeh, M. (2024). Association of childbirth experience with long–term psychological outcomes: A prospective cohort study. Reproductive Health , 21(1), 1–9. https://doi.org/10.1186/s12978-024-01819-9
Ning, S., Ahmad, M., Nontji, W., Yuliana, S., Andi, Nilawati, U., & Arsyad, M. A. (2024). KOMBINASI PRENATAL YOGA DENGAN BIRTH BALL EFEKTIF Combination of Prenatal Yoga with Birth ball is Effective on the Duration of. MEDIA PENELITIAN DAN PENGEMBANGAN KESEHATAN, 34(4).
Nisha, A., Shamim, A., Rizvi, A., Mahmood, T., Goswami, B., Ahsan, F., Sharique, M., & Parveen, S. (2025). A Comprehensive Review of Experimental Models of Stress: Pragmatic Insight Into Psychoneuroimmunology. Health Care Science, 4(1), 4–13. https://doi.org/10.1002/hcs2.70002
Nori, W., Kassim, M. A. K., Helmi, Z. R., Pantazi, A. C., Brezeanu, D., Brezeanu, A. M., Penciu, R. C., & Serbanescu, L. (2023). Non-Pharmacological Pain Management in Labor: A Systematic Review. Journal of Clinical Medicine, 12(23). https://doi.org/10.3390/jcm12237203
Phalswal, U., Jha, S., Dixit, P., & Yadav, R. (2024). Effectiveness of Birthing Ball Exercises Therapy in Improving Labor Pain and Labor Outcomes: A Systematic Review. Journal of Family and Reproductive Health, 18(4), 208–216. https://doi.org/10.18502/jfrh.v18i4.17409
Rantala, A., Hakala, M., & Pölkki, T. (2022). Women’s perceptions of the pain assessment and non-pharmacological pain relief methods used during labor: A cross-sectional survey. European Journal of Midwifery, 6(April), 1–10. https://doi.org/10.18332/ejm/146136
Sahara, R., Dahlan, F. M., & Suralaga, C. (2022). Science Midwifery The Effect Of The Use Of Birth Ball On Intensity Of Labor Pain I Active Phase In Primigravidal Mothers In Pmb Bekasi City In 2022. Science Midwifery, 10(3), 2721–9453.
Stephens, I. (2017). Medical yoga therapy. Children, 4(2), 1–20. https://doi.org/10.3390/children4020012
Tabuk, S., & Banjar, K. (2023). Penerapan Birthing Ball pada Ibu Bersalin. Pengabdian Kepada Masyarakat, 2(02), 349–365.
Terres, M. T., de Carvalho Souza, M. V., Costa, L. M. O., Novaes, L., de Avila, M. F., Barros, S. G., Provinciatto, H., & Piovezan, A. P. (2025). Efficacy of birthing ball exercises to reduce labor pain and cesarean rates: An updated meta-analysis of randomized controlled trials. Archives of Gynecology and Obstetrics, 311(5), 1331–1341. https://doi.org/10.1007/s00404-024-07930-3
Villar-Alises, O., Martinez-Miranda, P., & Martinez-Calderon, J. (2023). Prenatal Yoga-Based Interventions May Improve Mental Health during Pregnancy: An Overview of Systematic Reviews with Meta-Analysis. International Journal of Environmental Research and Public Health, 20(2). https://doi.org/10.3390/ijerph20021556
Wadhwa, Y., Alghadir, A. H., & Iqbal, Z. A. (2020). Effect of Antenatal Exercises, Including Yoga, on the Course of Labor, Delivery and Pregnancy: A Retrospective Study. International Journal of Environmental Research and Public Health, 17(15). https://doi.org/10.3390/ijerph17155274
Walter, M. H., Abele, H., & Plappert, C. F. (2021). The Role of Oxytocin and the Effect of Stress During Childbirth: Neurobiological Basics and Implications for Mother and Child. Frontiers in Endocrinology, 12(October), 1–10. https://doi.org/10.3389/fendo.2021.742236
Watson, K., White, C., Hall, H., & Hewitt, A. (2021). Women’s experiences of birth trauma: A scoping review. Women and Birth, 34(5), 417–424. https://doi.org/10.1016/j.wombi.2020.09.016
Williams, Heidi J, Broomé, Rodger E, & Markette, Nicholas. (2023). Fathers’ Lived-Experience of Childbirth: A Descriptive Phenomenological Psychological Inquiry. Journal of Humanistic Psychology, 00221678231194096. https://doi.org/10.1177/00221678231194096
Yekefallah, L., Namdar, P., Dehghankar, L., Golestaneh, F., Taheri, S., & Mohammadkhaniha, F. (2021). The effect of yoga on the delivery and neonatal outcomes in nulliparous pregnant women in Iran: A clinical trial study. BMC Pregnancy and Childbirth, 21(1), 351. https://doi.org/10.1186/s12884-021-03794-6
Yeun, Y.-R., & Kim, S.-D. (2021). Effects of yoga on immune function: A systematic review of randomized controlled trials. Complementary Therapies in Clinical Practice, 44, 101446. https://doi.org/10.1016/j.ctcp.2021.101446
Zuarez-Easton, S., Erez, O., Zafran, N., Carmeli, J., Garmi, G., & Salim, R. (2023). Pharmacologic and nonpharmacologic options for pain relief during labor: An expert review. American Journal of Obstetrics and Gynecology, 228(5S), S1246–S1259. https://doi.org/10.1016/j.ajog.2023.03.003
DOI: https://doi.org/10.14421/biomedich.2026.151.421-431
Refbacks
- There are currently no refbacks.
Copyright (c) 2026 Dwi Nur Octaviani Katili, Nour Arriza Dwi Melani, Alya Agustina Utiarahman
Biology, Medicine, & Natural Product Chemistry |
|
