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Reducing Length of Labor and Cesarean Surgery Rate Essay (Critical Writing)

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Updated: Mar 23rd, 2021


The paper critiques the research article by Tussey et al. (2015) that is devoted to the use of a peanut ball to reduce the number of cases of prolonged labor. The paper analyzes and evaluates different sections of the research article, giving special consideration to the introduction, the review of literature, the description of the methodology, results, discussion, and conclusion. The article discussed in the paper presents a good example of quantitative research as the process of data collection and analysis is described in an accurate manner.

The work demonstrates scientific novelty because it fills the research gap related to the effectiveness of peanut balls in obstetric patients who use epidural anesthesia. Having analyzed the results of the experiment, the researchers conclude that the use of peanut balls can have a positive impact on the length of labor and reduce C-section rates. Despite that, the researchers acknowledge the presence of study limitations.

Introduction/Literature Review

The study under consideration is the article that was written by Tussey et al. (2015). The research problem introduced by the researchers is a threat of prolonged labor and the necessity of cesarean surgery. The research problem is clearly stated in the introduction section because the researchers reflect on the topic of risks that the use of the C-section involves. The necessity to reduce the average length of labor and minimize C-section rates is extremely important to nursing as it would help to mitigate the risk of infections and complications. The study is justified by the presence of negative health outcomes for women with prolonged labor. The research aims at studying whether the use of a peanut ball for exercises helps to reduce the average length of delivery.

When it comes to the use of theoretical or conceptual frameworks implied in the study, the researchers rely on the findings concerning the safety of labor epidurals, the complications associated with the use of a C-section, and the use of a peanut ball to induce labor. The framework helps the researchers to set expected results based on the previous findings. The research articles and other sources that the authors have used to conduct a literature review are different in terms of the currency of information. In general, the researchers use sources that appeared in different decades, and it could be attributed to the lack of relevant and current studies.

Nevertheless, sources that are not older than five years are also presented. Considering the publication date of the article, there are a lot of current sources used by the researchers. The literature review that the researchers have conducted is very good in terms of its logical organization as the section under consideration is structured around the key themes such as the knowledge concerning prolonged labor, various birth interventions, and a range of risks associated with the latter. As is clear from the literature review, it supports the need for the study because it introduces the audience to the complication related to prolonged labor and the use of epidural analgesia.


As for the study design, the article under consideration reports the results of a quantitative study, measuring the effects of the nurse-driven intervention aimed at reducing the average length of labor. In all likelihood, the design fits the purpose of the study; as is clear from the purpose identified by the researchers, the study is to define the effectiveness of an intervention that includes the use of a peanut ball to facilitate labor. The chosen study design allows the researchers to analyze the average length of labor in groups that use or do not use intervention in order to define the degree to which the use of this tool can be effective.

A little is known about the effectiveness of a peanut ball for parturient women with epidural analgesia, even though this tool is commonly used by nurses. The researchers were using a random sampling method to eliminate the impact of any unobvious factors when dividing the participants into two groups. To analyze the data collected during the research, the authors were using SPSS 17.0. Both sampling method and statistical analysis play an important part in the study design, helping to provide the best possible results.

As for the principles that were used to choose the participants, the researchers were recruiting only those women who were using epidural analgesia and had the fetus in the head-first presentation. As for demographic characteristics, the researchers were ready to include underage obstetric patients (their parents’ consent was required).

The sample used by the researchers included almost two hundred participants who met the mentioned requirements. The sampling procedure is discussed in detail, and the sample is accurately and clearly described in the article. Prior to including participants in the sample, the researchers had conducted a series of short interviews to consider their medical histories, collect demographic data, and exclude the presence of fetus pathology that could impact the results and require special medical supervision. As it follows from the subsequent sections of the article, the researchers acknowledge that the sample size should be larger to provide more reliable results. Nevertheless, the authors suppose that even a sample that includes two hundred people can help to define whether the intervention is effective.

Regarding the study protocol, it is clear and concise, as it follows from the description provided by the researchers. The members of an intervention group were provided with peanut balls to be used during the delivery. All participants were using epidural anesthesia. The members of an intervention group had to place a peanut ball between their legs. The given tool was removed when the cervical dilatation occurred.

The safety and comfort of obstetric patients were the main focus of the intervention, and the researchers were using a range of measures to eliminate the risk of infections. According to the protocol, registered nurses were supposed to provide standard care to both groups of participants. Finally, the researchers and nurses had to take all necessary measurements. For instance, the factors to be taken into account included the presence of cord entanglement, the health of newborn children, their physiological characteristics, etc. The instruments that are described in the article include the use of the Apgar score, helping nurses to evaluate the physical condition of newborn children. Also, the instruments used during the research included the tools helping to measure the weight and height of newborn babies.

All instruments help to measure certain concepts in an effective manner. The researchers do not discuss the reliability of the instruments, but it is confirmed by other studies in the field. The threats to external and internal validity that the study design involves are addressed.

For instance, to mitigate these threats and provide more credible results, the authors provide a standardized research protocol. Also, the researchers mitigate threats to validity, using instruments whose reliability has been proved. The researchers discuss the measures aimed at ensuring the safety of participants, but the data concerning personal information protection is not presented. Potential ethical concerns are not discussed as well. The research process is described in a detailed way, which facilitates the replication of the study.


The characteristics of the sample and the results of statistical analysis are presented with the help of tables. The answer to the research question is presented in a few paragraphs. The data used for the analysis is quantitative; it includes the demographic composition of the sample, the lengths of labor, the presence of complications, and the Apgar score results. Among data analysis procedures helping to answer the research question, there are t-tests, Fisher’s tests of significance, and logistic regression.

These procedures have helped to exclude the impact of additional variables on the results. The combination of these analysis procedures has helped to define whether the use of a peanut ball is a predictor of successful delivery. The text supplements the data in the tables, helping the audience to better understand the results. The findings indicate that the use of a peanut ball helps to shorten the first and the second stages of labor, and this is why this practice is highly recommended.

Discussion/Practical Implications

The relation between the findings and the study’s purpose is clear. There is a research gap concerning the effectiveness of a peanut ball for obstetric patients using epidural anesthesia, but previous studies in the field report the effectiveness of this tool for other categories of patients. Therefore, the findings partially support those from previous studies on the topic. The discussion concerning the conflicts between the findings of different studies is not presented.

Regarding the limitations of the study that may have an impact on the use of intervention and further research, the authors acknowledge that the level of professional experience of nurses could have an impact on the results. Also, some differences between the study groups were not controlled thoroughly. As for new research that the authors are willing to conduct, it includes studying the effectiveness of the intervention with the help of a larger sample. Based on the results, nurses can encourage obstetric patients to use a peanut ball. The latter helps to reduce labor lengths, whereas no complications are associated with its use.

Presentation and Summary

The title describes the study in an appropriate manner. As for the abstract, it provides the most significant facts about the study even though the presence of limitations is not discussed. The report is logically consistent because each stage of the research process is described in detail and explained. Also, each section of the report relates to other sections. The writing style that the researchers utilize is clear, all concepts that the researchers use are explained, and the definitions of key notions are provided to remove the possibilities of misinterpretation.


Tussey, C. M., Botsios, E., Gerkin, R. D., Kelly, L. A., Gamez, J., & Mensik, J. (2015). Reducing length of labor and cesarean surgery rate using a peanut ball for women laboring with an epidural. The Journal of Perinatal Education, 24(1), 16-24.

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"Reducing Length of Labor and Cesarean Surgery Rate." IvyPanda, 23 Mar. 2021, ivypanda.com/essays/reducing-length-of-labor-and-cesarean-surgery-rate/.

1. IvyPanda. "Reducing Length of Labor and Cesarean Surgery Rate." March 23, 2021. https://ivypanda.com/essays/reducing-length-of-labor-and-cesarean-surgery-rate/.


IvyPanda. "Reducing Length of Labor and Cesarean Surgery Rate." March 23, 2021. https://ivypanda.com/essays/reducing-length-of-labor-and-cesarean-surgery-rate/.


IvyPanda. 2021. "Reducing Length of Labor and Cesarean Surgery Rate." March 23, 2021. https://ivypanda.com/essays/reducing-length-of-labor-and-cesarean-surgery-rate/.


IvyPanda. (2021) 'Reducing Length of Labor and Cesarean Surgery Rate'. 23 March.

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