The effect of stress ball use during the intrapartum period on labor pain and childbirth experience in primiparous women: a randomized controlled trial.

Aim

This study examined the effect of stress ball use during the intrapartum period on labor pain intensity and childbirth experience in primiparous women.

Methods

This two-arm, parallel-group randomized controlled trial was conducted between October and December 2025 in the delivery unit of a public hospital in Türkiye. Sixty-six primiparous women were randomized in a 1:1 ratio to the intervention (n = 33) or control group (n = 33). Outcome analyses included 60 participants with available outcome data (intervention, n = 29; control, n = 31). Women in the intervention group used a stress ball during uterine contractions, whereas the control group received routine intrapartum care. Labor pain intensity was assessed using the Visual Analog Scale (VAS) during the latent, active, and transition phases, and childbirth experience was assessed postpartum using the Childbirth Experience Questionnaire (CEQ).

Results

Pain intensity during the transition phase was significantly lower in the intervention group than in the control group (p = 0.001; Cohen's d =  -0.89), whereas no significant between-group differences were observed during the latent or active phases (p > 0.05). The intervention group had a significantly higher total CEQ score (p < 0.001; Cohen's d = 1.08), with higher scores for birth process (p = 0.001; Cohen's d = 0.93) and agreement in decisions (p < 0.001; Cohen's d = 2.11).

Conclusion

Stress ball use was associated with lower overall labor pain, with a significant between-group difference observed during the transition phase, and with a more positive childbirth experience. TRIAL REGISTRATION www.clinicaltrials.gov identifier NCT07011355.