Cesarean birth and other outcomes were similar.<h4>Conclusions</h4>The peanut ball shortened active labor but did not reduce maternal pain, anxiety, or oxytocin use within our setting.<h4>Clinical trial registration</h4>The study is registered on the official website of ClinicalTrials.gov.<h4>Identifier</h4>NCT06811584. The gene discussed is OXT; the disease is Anxiety.