BIRTHING BALL EXERCISE REDUCES PAIN AND ANXIETY IN LABORING MOTHERS
Abstrak
Normal childbirth was recommended due to its cost-effectiveness, shorter hospital stays, absence of anesthesia, and lower risks of infection and bleeding. However, most laboring women experienced pain that triggered fear and anxiety, potentially leading to complications. This study aimed to determine the effectiveness of birthing ball exercises in reducing pain intensity and anxiety in laboring mothers at independent midwifery practices in the Kubu Raya District. A quasi-experimental design with two groups was used. A total of 60 participants were selected using consecutive sampling and divided into an intervention group (birthing ball exercise) and a control group (routine breathing exercises). Pain and anxiety levels were measured after the intervention using the Visual Analogue Scale (VAS), Face Pain Rating Scale (FPRS), and Numerical Analogue Scale (NAS), all of which had been validated and shown to be reliable. Data were analyzed using correlation tests, paired t-tests, and the Wilcoxon test. The characteristics of respondents were homogeneous, with most having basic education and being multigravida. Results showed significant differences between the intervention and control groups in reducing pain and anxiety levels (p < 0.05). In conclusion, birthing ball exercises were effective in reducing pain and anxiety during the first stage of normal labor.
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Referensi
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5. Anggraeni kurnia indrayanti purnamasari dan widya. Efektivitas Implementasi Teknik Relaksasi Metode Air Untuk. J Keperawatan. 2019;12(1):35-41.
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13. Grenvik JM, Rosenthal E, Wey S, et al. Birthing ball for reducing labor pain: a systematic review and meta-analysis of randomized controlled trials. J Matern neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2022;35(25):5184-5193. doi:10.1080/14767058.2021.1875439
14. Kjeldsen LL, Læssøe U, Bendix JM, Maimburg RD. Maternal positions in childbirth – A cohort study of labouring women’s movements and body positions the last 24 hours before birth. Sex Reprod Healthc. 2025;43:101059. doi:https://doi.org/10.1016/j.srhc.2024.101059
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16. Ekendiz LS, Ug MUC. Efeeck Of Swiss-Ball core strengg Training On Strength, Endurance, fleksibility and Balanci in Sedatary Women be too¨. Strength Cond. 2010;24(11):3032-3040.
17. Afroz F, Naz MZ, Akhter K, Ahmed T, Siddika A. The Impact of Prenatal Birthing Ball Exercises on First Stage Labor Progression. 2024;6691(12):1840-1846.
18. Karningsih, Mardeyanti, Yulfitria F, Sari DN, Purwanti D. Effectiveness of Pelvic Rocking Exercise with Birth Ball on the Duration of Third Stage of Labor. Int J Sci Soc. 2024;6(1):887-898. doi:10.54783/ijsoc.v6i1.1078
19. James S, Hudek M. Experiences of South African multiparous labouring women using the birthing ball to encourage vaginal births. Heal SA Gesondheid. 2017;22:36-42. doi:10.1016/j.hsag.2016.08.004
20. Yeung MPS, Tsang KWK, Yip BHK, et al. Birth ball for pregnant women in labour research protocol: A multi-centre randomised controlled trial. BMC Pregnancy Childbirth. 2019;19(1):1-6. doi:10.1186/s12884-019-2305-8
21. Sulistianingsih A, Wijayanti Y. Kombinasi Birth Ball Dan Latihan Pernafasan Dengan Penurunan Nyeri Persalinan Kala I. J Ilmu Keperawatan dan Kebidanan. 2022;13(1):66-74. doi:10.26751/jikk.v13i1.1243
22. Sriwenda D. Efektifitas Latihan Birth Ball t erhadap Efikasi Diri Primipara dengan Persalinan Normal Efectivity of Birth Ball Exercise o n Self Efficacy of Primiparous with Normal Labor. J Ners dan Kebidanan Indones. 2014;4(3):141-147. doi:http://dx.doi.org/10.21927/jnki
23. Kurniati I, Graharti R, Tjiptaningrum A, Kurniawati E. Obstruksi saluran napas atas grade III ec kassabach merrit syndrome , bronkopneumonia dan DIC. Medula. 2022;12(3):478-485.
24. Kurniawati et al. Efektivitas Latihan Birth Ball terhadap Penurunan Nyeri Persalinan Kala I Fase Aktif pada Primigravida Effectiveness of Birth Ball Exercise to Decrease Labor Pain in The Active Phase of The First Stage of Labor on The Primigravida Women. J Kebidanan. 2017;5:2-3.
25. Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res. 2018;11:851-856. doi:10.2147/JPR.S158847
26. Arribas-Pascual M, Hernández-Hernández S, Jiménez-Arranz C, et al. Effects of Physiotherapy on Pain and Mouth Opening in Temporomandibular Disorders: An Umbrella and Mapping Systematic Review with Meta-Meta-Analysis. J Clin Med. 2023;12(3). doi:10.3390/jcm12030788
27. Mirahmadi A, Hosseini-Monfared P, Amiri S, et al. Cross‑cultural adaptation and validation of the Persian version of the new Knee Society Knee Scoring System (KSS). J Orthop Surg Res. 2023;18(1):858. doi:10.1186/s13018-023-04347-7
28. Rusmita E. Pengaruh Senam Hamil Yoga Terhadap Persalinan Di Rsia Limijati Bandung. J Ilmu Keperawatan. 2015;III(2):80-86.
29. Gau ML, Chang CY, Tian SH, Lin KC. Effects of birth ball exercise on pain and self-efficacy during childbirth: A randomised controlled trial in Taiwan. Midwifery. 2011;27(6):e293-e300. doi:10.1016/j.midw.2011.02.004
30. Lövdén M, Fratiglioni L, Glymour MM, Lindenberger U, Tucker-Drob EM. Education and Cognitive Functioning Across the Life Span. Psychol Sci public Interes a J Am Psychol Soc. 2020;21(1):6-41. doi:10.1177/1529100620920576
31. Harahap AP, Utami CA, Aulia R, Fauziyah T, Safitri AH. The Model of Guidance and Counseling Service Strategy and its Effect on Improving Students ’ Learning Memory. 2025;9(1):83-90.
32. Lukman Hakim A, Barokatul Fajri M, Nur Faizah E. Evaluation Of Implementation Of MBKM: Does Academic Stress Affect On Student Learning Outcomes? Int J Educ Res Soc Sci. Published online 2022:1-16.
33. Desi Handayani Lubis,Laurena Ginting NBK. Faktor – Faktor Yang Memengaruhi Persepsi Ibu Hamil Tentang Nyeri Persalinan Di Klinik Pratama Khadijah Medan. Excell Midwifery J. 2024;7(1):29.
34. Farrag RE. Using of Birthing Ball during the first Stage of Labor: Its Effect on the Progress of Labor and Outcome among Nulliparous Women. Int J Nurs Didact. 2018;8(09):01-10. doi:10.15520/ijnd.v8i09.2289
35. Yanti EM, Kurnia Utami D, Dwi Maulina A. Faktor-Faktor Yang Menyebabkan Kecemasan Ibu Hamil Trimester Iii Di Puskesmas Wanasaba. ProHealth J. 2020;17(1).
36. Ratna Sari NLPM, Parwati NWM, Indriana NPRK. The Correlation Between Mother’s Knowledge Level And Husband Support Toward Anxiety Level Of Pregnant Mother In The Third Trimester During Labor. J Ris Kesehat Nas. 2023;7(1):35-44. doi:10.37294/jrkn.v7i1.469
37. Ajeng D, Ramhadani A, Toyibah A, Kusmiwiyati A. Efektivitas Birthing Ball terhadap Nyeri Persalinan. Malang J Midwifery. 2022;4(1):22-31.
38. Nurmaisya E, Mulyati S. Evidence Based Case Report (Ebcr) : Penggunaan Birth Ball Efektif Dalam Mengurangi Nyeri Persalinan Kala I. J Kesehat Siliwangi. 2022;3(1):45-52. doi:10.34011/jks.v3i1.1197
39. Suryaningsih N, Ahmad M, Nontji W, Syam Y, Usman AN, Arsyad MA. Kombinasi Prenatal Yoga Dengan Birth Ball Efektif Terhadap Lama Persalinan Kala I Fase Aktif. Media Penelit dan Pengemb Kesehat. 2024;34(4):981-992.
40. Kurniawati A, Dasuki D, Kartini F. Efektivitas Latihan Birth Ball Terhadap Penurunan Nyeri Persalinan Kala I Fase Aktif pada Primigravida. J Ners dan Kebidanan Indones. 2017;5(1):1. doi:10.21927/jnki.2017.5(1).1-10
41. Taavoni S, Abdolahian S, Haghani H, Neysani L. Effect of Birth Ball Usage on Pain in the Active Phase of Labor : A Randomized Controlled Trial. Published online 2011:137-140. doi:10.1111/j.1542-2011.2010.00013.x
2. Sasmita RE, Syahda S, Handayani F. Asuhan Kebidanan Ibu Bersalin Normal Di Pmb Ketra Delfi Wilayah Kerja Puskesmas Kampar. J Ilm Ilmu Kesehat. 2023;2(1):356-367.
3. Dutta A. Presentation and Mechanism of Labour. In: Chandraharan E, ed. The Continuous Textbook of Women’s Medicine Series – Obstetrics Module Volume 11 LABOR AND DELIVERY. Global Academy of Medical Education and Training; 2021:1-7. doi:10.3843/glowm.414323
4. Musfiroh S, Yulianti RT, Nabilah A, et al. Literature Review: Hubungan Hormon Dan Psikologi Pada Ibu Masa Perinatal. J Matern Kebidanan. 2023;8(2):205-219.
5. Anggraeni kurnia indrayanti purnamasari dan widya. Efektivitas Implementasi Teknik Relaksasi Metode Air Untuk. J Keperawatan. 2019;12(1):35-41.
6. Widiawati1 I. Mengenal Nyeri Persalinan Pada Primipara Dan Multipara. J Bimtas. 2017;2(1):42-48.
7. Sandhi SI, Lestari KD. Hubungan Psikologis Ibu Bersalin Dengan Kelancaran Proses Persalinan Kala Ii Di Rumah Bersalin Bhakti Ibu Semarang. J Surya Muda. 2021;3(1):23-32. doi:10.38102/jsm.v3i1.68
8. Sunarsih S, Sari TP. Nyeri persalinan dan tingkat kecemasan pada ibu inpartu kala I fase aktif. Holistik J Kesehat. 2020;13(4):327-332. doi:10.33024/hjk.v13i4.1365
9. Wati L, Monarisa M, Hamdanesti R. Pengaruh Metode Birth Ball Terhadap Intensitas Nyeri Persalinan Kala I Fase Aktif di Praktek Mandiri Bidan (PMB) Fifi Maryoni. J Ilm Univ Batanghari Jambi. 2022;22(1):89. doi:10.33087/jiubj.v22i1.1666
10. Ningdiah AK, Ningsih AF, Iskandiani L, Lawra C. Literature Review Teknik Mengurangi Nyeri pada Persalinan. Pros Semin Nas dan CFP Kebidanan Univ Ngudi Waluyo. 2022;1(2):892-901.
11. Nuraini, Karo MBK, Pangaribuan M. Pengaruh Penggunaan Birthing Ball Terhadap Intensitas Nyeri Pada Ibu Bersalin Kala I Fase Aktif. Binawan Student J. 2023;5(3):91-96. doi:10.54771/bsj.v5i3.989
12. Hartati D, Jannah B, Sulasdi NAD, Sinaga SP, Sulistyaningsih, Hafidz F. The effectiveness between of yoga and birth ball in reducing labor pain: a systematic review. BKM Public Heal Community Med. 2024;40(4):e9512. doi:10.22146/bkm.v40i04.9512
13. Grenvik JM, Rosenthal E, Wey S, et al. Birthing ball for reducing labor pain: a systematic review and meta-analysis of randomized controlled trials. J Matern neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2022;35(25):5184-5193. doi:10.1080/14767058.2021.1875439
14. Kjeldsen LL, Læssøe U, Bendix JM, Maimburg RD. Maternal positions in childbirth – A cohort study of labouring women’s movements and body positions the last 24 hours before birth. Sex Reprod Healthc. 2025;43:101059. doi:https://doi.org/10.1016/j.srhc.2024.101059
15. E Silva LM, Da Silva FMB, Alvarenga MB, De Oliveira SMJV. Using the Swiss ball in labor. ACTA Paul Enferm. 2011;24(5):656-662. doi:10.1590/S0103-21002011000500010
16. Ekendiz LS, Ug MUC. Efeeck Of Swiss-Ball core strengg Training On Strength, Endurance, fleksibility and Balanci in Sedatary Women be too¨. Strength Cond. 2010;24(11):3032-3040.
17. Afroz F, Naz MZ, Akhter K, Ahmed T, Siddika A. The Impact of Prenatal Birthing Ball Exercises on First Stage Labor Progression. 2024;6691(12):1840-1846.
18. Karningsih, Mardeyanti, Yulfitria F, Sari DN, Purwanti D. Effectiveness of Pelvic Rocking Exercise with Birth Ball on the Duration of Third Stage of Labor. Int J Sci Soc. 2024;6(1):887-898. doi:10.54783/ijsoc.v6i1.1078
19. James S, Hudek M. Experiences of South African multiparous labouring women using the birthing ball to encourage vaginal births. Heal SA Gesondheid. 2017;22:36-42. doi:10.1016/j.hsag.2016.08.004
20. Yeung MPS, Tsang KWK, Yip BHK, et al. Birth ball for pregnant women in labour research protocol: A multi-centre randomised controlled trial. BMC Pregnancy Childbirth. 2019;19(1):1-6. doi:10.1186/s12884-019-2305-8
21. Sulistianingsih A, Wijayanti Y. Kombinasi Birth Ball Dan Latihan Pernafasan Dengan Penurunan Nyeri Persalinan Kala I. J Ilmu Keperawatan dan Kebidanan. 2022;13(1):66-74. doi:10.26751/jikk.v13i1.1243
22. Sriwenda D. Efektifitas Latihan Birth Ball t erhadap Efikasi Diri Primipara dengan Persalinan Normal Efectivity of Birth Ball Exercise o n Self Efficacy of Primiparous with Normal Labor. J Ners dan Kebidanan Indones. 2014;4(3):141-147. doi:http://dx.doi.org/10.21927/jnki
23. Kurniati I, Graharti R, Tjiptaningrum A, Kurniawati E. Obstruksi saluran napas atas grade III ec kassabach merrit syndrome , bronkopneumonia dan DIC. Medula. 2022;12(3):478-485.
24. Kurniawati et al. Efektivitas Latihan Birth Ball terhadap Penurunan Nyeri Persalinan Kala I Fase Aktif pada Primigravida Effectiveness of Birth Ball Exercise to Decrease Labor Pain in The Active Phase of The First Stage of Labor on The Primigravida Women. J Kebidanan. 2017;5:2-3.
25. Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res. 2018;11:851-856. doi:10.2147/JPR.S158847
26. Arribas-Pascual M, Hernández-Hernández S, Jiménez-Arranz C, et al. Effects of Physiotherapy on Pain and Mouth Opening in Temporomandibular Disorders: An Umbrella and Mapping Systematic Review with Meta-Meta-Analysis. J Clin Med. 2023;12(3). doi:10.3390/jcm12030788
27. Mirahmadi A, Hosseini-Monfared P, Amiri S, et al. Cross‑cultural adaptation and validation of the Persian version of the new Knee Society Knee Scoring System (KSS). J Orthop Surg Res. 2023;18(1):858. doi:10.1186/s13018-023-04347-7
28. Rusmita E. Pengaruh Senam Hamil Yoga Terhadap Persalinan Di Rsia Limijati Bandung. J Ilmu Keperawatan. 2015;III(2):80-86.
29. Gau ML, Chang CY, Tian SH, Lin KC. Effects of birth ball exercise on pain and self-efficacy during childbirth: A randomised controlled trial in Taiwan. Midwifery. 2011;27(6):e293-e300. doi:10.1016/j.midw.2011.02.004
30. Lövdén M, Fratiglioni L, Glymour MM, Lindenberger U, Tucker-Drob EM. Education and Cognitive Functioning Across the Life Span. Psychol Sci public Interes a J Am Psychol Soc. 2020;21(1):6-41. doi:10.1177/1529100620920576
31. Harahap AP, Utami CA, Aulia R, Fauziyah T, Safitri AH. The Model of Guidance and Counseling Service Strategy and its Effect on Improving Students ’ Learning Memory. 2025;9(1):83-90.
32. Lukman Hakim A, Barokatul Fajri M, Nur Faizah E. Evaluation Of Implementation Of MBKM: Does Academic Stress Affect On Student Learning Outcomes? Int J Educ Res Soc Sci. Published online 2022:1-16.
33. Desi Handayani Lubis,Laurena Ginting NBK. Faktor – Faktor Yang Memengaruhi Persepsi Ibu Hamil Tentang Nyeri Persalinan Di Klinik Pratama Khadijah Medan. Excell Midwifery J. 2024;7(1):29.
34. Farrag RE. Using of Birthing Ball during the first Stage of Labor: Its Effect on the Progress of Labor and Outcome among Nulliparous Women. Int J Nurs Didact. 2018;8(09):01-10. doi:10.15520/ijnd.v8i09.2289
35. Yanti EM, Kurnia Utami D, Dwi Maulina A. Faktor-Faktor Yang Menyebabkan Kecemasan Ibu Hamil Trimester Iii Di Puskesmas Wanasaba. ProHealth J. 2020;17(1).
36. Ratna Sari NLPM, Parwati NWM, Indriana NPRK. The Correlation Between Mother’s Knowledge Level And Husband Support Toward Anxiety Level Of Pregnant Mother In The Third Trimester During Labor. J Ris Kesehat Nas. 2023;7(1):35-44. doi:10.37294/jrkn.v7i1.469
37. Ajeng D, Ramhadani A, Toyibah A, Kusmiwiyati A. Efektivitas Birthing Ball terhadap Nyeri Persalinan. Malang J Midwifery. 2022;4(1):22-31.
38. Nurmaisya E, Mulyati S. Evidence Based Case Report (Ebcr) : Penggunaan Birth Ball Efektif Dalam Mengurangi Nyeri Persalinan Kala I. J Kesehat Siliwangi. 2022;3(1):45-52. doi:10.34011/jks.v3i1.1197
39. Suryaningsih N, Ahmad M, Nontji W, Syam Y, Usman AN, Arsyad MA. Kombinasi Prenatal Yoga Dengan Birth Ball Efektif Terhadap Lama Persalinan Kala I Fase Aktif. Media Penelit dan Pengemb Kesehat. 2024;34(4):981-992.
40. Kurniawati A, Dasuki D, Kartini F. Efektivitas Latihan Birth Ball Terhadap Penurunan Nyeri Persalinan Kala I Fase Aktif pada Primigravida. J Ners dan Kebidanan Indones. 2017;5(1):1. doi:10.21927/jnki.2017.5(1).1-10
41. Taavoni S, Abdolahian S, Haghani H, Neysani L. Effect of Birth Ball Usage on Pain in the Active Phase of Labor : A Randomized Controlled Trial. Published online 2011:137-140. doi:10.1111/j.1542-2011.2010.00013.x
Penulis
Sudarto, S., Rahayu, H., Hardika, R., Amandus, H., Rangkuti, W. F. S., & Virdiyanti, R. (2025). BIRTHING BALL EXERCISE REDUCES PAIN AND ANXIETY IN LABORING MOTHERS. JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, Online ISSN 2579-8103, 17(2), 752–763. https://doi.org/10.34011/juriskesbdg.v17i2.2913
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