Somayeh Makvandi - PhD in Reproductive Health, Department of Midwifery, Faculty of Nursing and Midwifery, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
Khadigeh Mirzaiinajmabadi - Associate Professor, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Najmeh Tehranian - Assistant Professor, Department of Reproductive Health, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
Masoumeh Mirteimouri - Associate Professor, Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran

Background & aim: Recently, the use of birth ball in childbirth has been widely considered. This review study aimed to critically evaluate the evidence regarding the effect of using the birth ball on the mode of delivery and length of labor. Methods: For the purpose of the study, the articles related to the subject of interest and published up to August 5th, 2018 were searched in several scientific databases, including Cochrane library, CENTRAL, and PubMed. This review included all randomized control trials evaluating the use of birth ball for giving birth. Two study outcomes were considered in the present study, namely the type of delivery and length of labor stages. Finally, five studies were entered into the systematic review and meta-analysis. The risk of bias was calculated by means of the Cochrane’s tool. Results: The included studies had a different range of quality, mostly lower than the standard level. The results of the reviewed articles revealed that the group who used birth ball had shorter active labor phase, as compared to the control group (P=0.048). However, the use of birth had no statistically significant effect on the length of the second stage of labor (P=0.128). In addition, using birth ball did not increase the chance of vaginal delivery (P=0.922). Conclusion: Given the findings of the present study, it is essential to perform further high-quality studies with more scientific design to provide clinical evidence on the use of birth ball as a maternity service.

Birth ball, Childbirth, Mode of Delivery, Length of labo