A birthing ball is one of the simplest, most effective tools you can use during pregnancy and labor. Sitting on one with your legs wide apart opens your pelvis, lets gravity help your baby descend, and keeps your hips mobile. In a randomized trial, women who did active pelvic movements on a birthing ball shortened their first stage of labor by nearly three hours and reduced pain by about 2 points on a 10-point scale. You can start using one well before your due date and continue right through delivery.
Choosing the Right Size
Birthing balls come in three standard sizes, and picking the right one matters. When you sit on a properly sized ball, your hips should be level with or slightly higher than your knees, with your feet flat on the floor. Here’s the general sizing guide:
- Medium (48 to 55 cm): Best if you’re 5’3″ or shorter
- Large (58 to 65 cm): Best if you’re 5’4″ to 5’9″
- Extra large (68 to 75 cm): Best if you’re 5’10” or taller
Look for a ball labeled “anti-burst” or “burst-resistant.” These balls deflate slowly if punctured rather than popping. Most quality birthing balls support well over 300 pounds, but check the packaging to confirm. Don’t inflate it to maximum firmness. A slightly softer ball gives you a wider, more stable base to sit on.
Setting Up Safely
Place the ball on a non-slip surface like carpet or a yoga mat. Hard floors, especially tile or wood, can let the ball slide when you shift your weight. Wear socks with grip or go barefoot so your feet don’t slip either. When you’re first getting comfortable, position the ball against a wall or have someone nearby for support. Once you feel stable, you can use it freely.
Exercises During Pregnancy
You can start using a birthing ball from the second trimester onward. Even just sitting on one instead of a chair keeps your pelvis in a more open position and gently engages your core. But the real benefits come from a few specific movements.
Hip Circles
Sit on the ball with your feet slightly wider than hip-width apart. Slowly rotate your hips in a circle, as if you’re stirring a pot with your pelvis. This circular motion helps loosen the ligaments around your pelvis and encourages your baby to settle into an optimal head-down position. Do 10 circles in one direction, then switch. You can repeat this several times a day.
Figure of 8s
Same starting position, but instead of circles, trace a figure-of-eight pattern with your hips. This movement relieves lower back pain and helps guide your baby’s head deeper into the pelvic area. It’s especially useful in the third trimester when back pressure tends to increase.
Gentle Bouncing
Light, rhythmic bouncing on the ball can ease tension in your lower back and pelvic floor. Keep the bounces small and controlled. This isn’t about height; it’s about the gentle, repetitive motion. Many people find this soothing enough to use as a daily desk alternative during the final weeks of pregnancy.
Pelvic Tilts
Sit upright on the ball and rock your pelvis forward and back. When you tilt forward, your lower back arches slightly; when you tilt back, your lower back rounds. This strengthens the muscles that support your spine and can reduce the aching that comes with carrying extra weight in front. Start with 10 to 15 reps and increase as it feels comfortable.
Positions for Active Labor
The birthing ball really earns its place during labor. Staying upright and mobile lets gravity assist your baby’s descent, and the ball gives you a comfortable way to do that when standing feels exhausting.
Sitting and Rocking
Sit on the ball and gently rock your pelvis in circles or forward and back through contractions. This position keeps your pelvis open and uses gravity to bring your baby further down. Many people find the rhythmic motion a natural way to breathe through contractions. Between contractions, you can rest on the ball without needing to get up and lie down.
Leaning Forward Over the Ball
Place the ball on a bed or table and lean your upper body over it while standing or kneeling. This takes pressure off your back during contractions and is particularly helpful if your baby is in a posterior position (facing your belly instead of your spine), which causes intense back labor. Draping over the ball shifts some of your baby’s weight forward and off your spine.
Kneeling With the Ball
Kneel on the floor and hug the ball in front of you, resting your chest and arms on it. This opens the pelvis even wider than sitting and lets you sway side to side. It’s a common position during transition, the most intense phase of labor, because it gives you something to grip and lean into. The ball absorbs your weight so you can stay in this position longer without fatigue.
When You Have an Epidural: The Peanut Ball
A standard round birthing ball requires you to sit upright and balance, which isn’t possible once you’ve had an epidural and can’t feel or control your legs. That’s where the peanut ball comes in. Shaped like a peanut shell with a narrow center, it’s designed to be used while you’re lying on your side in bed.
The peanut ball tucks between your legs to mimic a squatting position while you’re lying down. It holds your pelvis open and can be adjusted to different angles, giving you the benefits of position changes even when you can’t move on your own. Your labor nurse or midwife can help reposition it as labor progresses. If you’re planning to get an epidural, it’s worth asking whether your birth facility has peanut balls available.
How the Ball Helps Your Baby’s Position
One of the biggest advantages of a birthing ball is its effect on fetal positioning. Ideally, your baby enters the pelvis head-down and facing your back (anterior position). When a baby is posterior, labor tends to be longer and more painful, especially in the lower back.
The forward-leaning and circular movements you do on the ball encourage a posterior baby to rotate. When you sit on the ball and lean slightly forward, your belly becomes a kind of hammock that guides your baby’s heaviest part (the back of the head) toward the front of your pelvis. Consistent hip circles and figure-of-eights during the final weeks of pregnancy help create the space and motion your baby needs to settle into the right position before labor begins.
What the Evidence Shows
A randomized trial published in a peer-reviewed physiotherapy journal found that women who performed active pelvic movements on a birthing ball during labor experienced significant benefits across the board. The first stage of labor shortened by an average of 179 minutes, nearly three hours. The second stage (pushing) shortened by about 19 minutes. Pain scores dropped by approximately 2 points on a 0-to-10 scale at 30, 60, and 90 minutes after starting. The same study found reductions in fatigue and anxiety. These aren’t subtle effects. For a drug-free intervention that costs under $30, the results are striking.
Keeping Your Ball Clean
If you’re using your birthing ball at home throughout pregnancy, wipe it down regularly with a mild disinfectant spray or soapy water. For use during labor, hospitals typically clean birthing balls with a surface disinfectant that kills bacteria, viruses, and fungi. A 10% bleach solution handles any heavier contamination. If you bring your own ball to a birth center or hospital, a germicidal cleaner will keep it sanitary. Avoid harsh solvents or abrasive scrubbers that could weaken the ball’s surface over time.
Getting Started
You don’t need a routine or a plan. Start by simply sitting on the ball while watching TV, working at a desk, or reading. Let your hips move naturally. Once that feels second nature, add hip circles and figure-of-eights for a few minutes at a time. By the third trimester, try spending 20 to 30 minutes a day on the ball to keep your pelvis loose and your baby in a good position. The more familiar you are with the ball before labor, the more instinctive it will feel when contractions start.