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I taught English As A Foreign Language for 16 years, before qualifying as a midwife at the age of 40. I promised myself 10 years' front line midwifery, so I slept with a mobile phone for 8 of them as an on-call caseload midwife. I gained an MSc .in Advanced Clinical Practice whilst working on call and undertook empirical research for the dissertation component with a phenomenological exploration of Midwives' Perceptions of Barriers to Meaningful Antenatal Education. My move to research was kick started by a 12 month teaching secondment to the University of Southampton. I was lucky enough to be accepted for the Clinical Doctorate through Bournemouth University and the Isle of Wight NHS Trust, thus committing to an unusual commute.

I believe in the power of midwifery-led research to challenge out-dated perceptions of the neurophysiology of labour and birth and drive further improvements in maternity care and outcomes. I was overwhelmed to receive financial support from the Iolanthe Midwifery Trust in 2017, which funded the purchase of 28 birth balls for the BALL trial. I am also very grateful to the Federation of the Isle of Wight Women's Institutes who funded a further 2 birth balls and the Birthease company who arranged an extra ball and free shipping to the Trust.

This is a superb opportunity to conduct an RCT with the additional support of the NIHR - any researcher's dream. I am determined to put Isle of Wight research on the map and owe grateful thanks to my midwifery colleagues for putting up with me and the families who are participating in the trial.

Research

Using a birth ball to reduce pain perception in the latent phase of labour: a randomised controlled trial.

Hospital admission in latent (early) labour increases obstetric intervention, including caesarean section. Women are advised to remain at home until active labour establishes. However, they find current early labour advice unsatisfactory and ineffective, reporting pain and anxiety as their principle motives for seeking hospital admission. Although a meta-analysis of birth ball use in active labour suggests that they are effective in reducing pain perception (Makvandi et al.2015), no trials have examined using a birth ball at home in early labour to improve birth outcomes.

A randomised, controlled, single centre trial for 332 low risk pregnant women. Control participants receive usual care. Intervention participants view an animated infomercial, ‘Having A Ball in Early Labour’ and receive a birth ball. On admission in labour, all participants provide a Visual Analogue Scale (VAS) score. A postnatal questionnaire assesses satisfaction and acceptability. Birth outcomes are being collated. The primary outcome is a 1.0 reduction on the VAS.

The BALL trial challenges outdated concepts of pain perception in maternity care. Using a birth ball to assume upright positions facilitates fetal descent and cervical effacement to engage the neurophysiological intrinsic pain modulation pathway. The trial offers a sustainable, cost-effective and evidence-based strategy for families to use at home in the latent phase of labour.

Recruitment commenced 1st February 2018 and continues until 31st October 2018.

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