How to keep moving with an epidural


This blog posts adds to the video “8 reasons why labor can stall and what to do about it”. In that video, among others, we explain the “roll-over technique from Penny Simkin (see sources below) which allows a woman to keep moving even when she is confined to bed.

There can be many reasons why a woman is confined to bed during labor, like for example, an epidural.

In this blog post, we would like to give you some more information on the roll-over technique and how you can increase the effect.

In order to fully understand this blog post, we recommend watching our video on youtube first. We explain the roll-over technique from minute 11:25 onwards.

How to increase the Effect

There is a simple way to increase the effect of the roll-over technique by using a peanut ball. Please note that by “increasing the effect”, we mean that you make it even easier for your baby to descend in your pelvis. 

A peanut ball can be used for all positions expect from 2 and 6, which are the side-lying positions.

How to use a Peanut Ball for the Roll-over Technique

For both semiprone positions, you would use the peanut ball to rest your upper leg on it: 

Please note that you need the assistance of your midwife in order to do this because she needs to determine the appropriate size of the peanut ball for your particular situation!

For position number 4 (hands & knees) you would simply use a peanut ball instead of a birthing ball. When you do, use the ball lengthways with the narrower end close to your belly!

The shape of the peanut ball is better suitable to support the woman in that position than a birthing ball due to its unique shape.

Because of that, most women prefer a peanut ball over a birthing ball when adopting this position. However, we recommend trying both in order for you to see which ball you find more comfortable!

Finally, it can also make sense to use a peanut ball to support the first position:

Before using a peanut ball for position number 1, please consult your midwife first, if it makes sense to do so, given the current position of your baby in your pelvis! 

Remember: the reason why you adopt these different positions is to support your baby’s descent in your pelvis!

How your Birth Partner can support you during the Roll-over

First of all, it is important to understand that you cannot adopt these positions without assistance! Ideally, your midwife assists you to get in and out of the positions.

However, your midwife might explain your birth partner how to assist you with the position changes so that your birth partner can do it the next time you change your position.

Even more important though, are the many ways your birth partner can assist you WHILE adopting the positions.

Position one is perfect for acupressure, reflexology or a head massage.

Position two and six are great positions for acupressure (just focus on one side of the body only, i.e. the upper part).

Position three and five are great positions for a back massage or a traditional foot massage.

Position four is a great position for hip squeezes, massages of the sacrum as well as acupressure on points which are located along the sacrum.

Let your Midwife guide you!

Please keep in mind that you should always double-check with your midwife, if these positions are right for you given your particular case (as well as the current position of your baby in your pelvis)!

Also, please note that the roll-over technique is only suitable for the first stage of labor, which is the dilation phase. However, it is not suitable for the second stage of labor, which is the pushing phase.


Simkin, Penny; Hanson Lisa and Ancheta, Ruth (2017): The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia. Fourth Edition. John Wiley and Sons.

Medical Disclaimer: The information on this page is not intended to diagnose, prevent, mitigate, treat or cure any disease! It is not personal medical advice. We recommend that you ask a doctor whenver you are looking for medical advice!


Nathalie Kaufmann & Mathias Ritter

Nathalie is a pregnancy and birth Consultant and a TCM Therapist with almost 20 years of experience in Traditional Chinese Medicine (TCM), acupuncture, reflexology, Shonishin baby massage techniques, Western and Eastern massage techniques (including TUINA), as well as herbal medicine and nutrition.

She has worked in hospitals across London and was Head of the Maternity Acupuncture Clinic at the Whittington hospital in London. Today, Nathalie runs her own practice in London and helps pregnant women with pregnancy- and birth-related issues. She also specializes in alternative treatments for babies and children.

Mathias is a Researcher and Science Geek who holds two Master of Science degrees. He has been involved in several health-related businesses over the past 10 years and has held presentations about health-related topics across Europe. He specializes in research regarding pregnancy-, birth and baby-related topics.


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