What does the research really tell us about Spinning Babies®?
Several years ago, there was little direct research evaluating the Spinning Babies® approach. Today, the picture is different. Published studies have begun examining professional education, Cesarean rates, fetal rotation, and the use of Spinning Babies® in clinical settings. The first randomized controlled trial designed specifically to evaluate the approach is also underway.1–7
That growing evidence is encouraging, but it doesn’t give us a simple yes-or-no answer to the question, “Does Spinning Babies® work?”
Birth is complex. Outcomes may be influenced by parity, fetal position, clinical setting, model of care, provider practices, interventions already in use, and the point in labor when an approach is introduced. A more useful research question asks: For whom? In what context? Compared with what? And measured by which outcome?
That distinction is central to interpreting the growing body of Spinning Babies® research and references accurately.
Why Study Design Matters When We Interpret Birth Research
Different types of research answer different questions.
Observational studies can show us what happens when an approach is used in real-world care. They can identify patterns, associations, and questions worth investigating further. Their limitation is that, even if we try to be as neutral as possible, there may be differences between the groups of people who consent to an intervention and those who do not.
This matters particularly in labor care. A clinician may be more likely to introduce additional positioning or movement when labor has already slowed, fetal position is less favorable, or the clinical situation has become more complex. If those births are later compared with straightforward labors where the intervention was never needed, the groups were different before the intervention began.
Randomized controlled trials try to reduce that problem by assigning participants to intervention or comparison groups randomly. The goal is to create groups that are more alike at baseline, making it easier to examine whether differences observed afterward may be related to the intervention itself.
Both designs can contribute useful evidence, but they allow us to draw different kinds of conclusions.
As Maíra Libertad Soligo Takemoto, midwife, researcher, and Spinning Babies® Approved Trainer, explains, current Spinning Babies® studies can help identify and explore important clinical questions, while study design determines how confidently an effect can be attributed to the approach itself.
What Has Spinning Babies® Research Observed So Far?
Professional Education, Confidence, and Safety Knowledge
A 2024 study evaluated 109 labor and delivery nurses and certified nurse-midwives from three hospitals before and after an eight-hour Spinning Babies® class.1 Participants showed statistically significant improvements in both confidence implementing the techniques and knowledge related to safety in labor positioning.
For clinical leaders, improvements in professional confidence and safety knowledge are relevant outcomes in their own right. The study found measurable gains in both immediately following the training.
What it did not examine was whether those improvements subsequently changed patient-level birth outcomes. The focus was on professional education rather than clinical outcomes.
Cesarean Rates and a Spinning Babies®-Informed Model of Care
Another 2024 study by Bridget Funk, PhD examined what happened at one metropolitan hospital before and after Spinning Babies® education and a new labor-support model were introduced.2
Among 51 nurses with a complete year of data before and after training, the average NTSV Cesarean rate decreased from 27.2% before implementation to 13.96% in the following year. Nurses’ self-efficacy scores also increased significantly.2
Interpreting those numbers requires some context about the study design.
This was a quasi-experimental before-and-after study. The comparison was not between two randomized groups receiving different care at the same time. A year had passed. Nurses had gained experience. Clinical practices, staffing, communication, hospital culture, or other factors may also have changed.
For that reason, the study cannot establish that Spinning Babies® alone caused the reduction in Cesarean births. What researchers observed was a substantial decrease in NTSV Cesarean rates after Spinning Babies® education and a new model of labor support were introduced in this hospital.
That distinction matters when these findings are communicated beyond the study itself.
Fetal Rotation During Labor
A 2025 Italian retrospective study looked specifically at fetal rotation among 244 vaginal births where babies began labor in occiput-posterior or occiput-transverse positions.3
Anterior rotation occurred in 93.3% of births in which the Spinning Babies® approach was documented, compared with 63.6% in the control group. After adjustment for parity and epidural analgesia, use of the approach was associated with a 45% greater likelihood of anterior positioning.3
Because the study was observational, the findings show an association with Spinning Babies®. The finding is promising: among the vaginal births included in this study, use of the Spinning Babies® approach was associated with a greater likelihood of anterior fetal rotation. However, the groups were not identical at baseline, births came from different time periods, and Cesarean births were excluded because fetal position at birth was unavailable for those cases. Additionally, other changes in clinical practice over the years studied could not be fully accounted for.
Real-World Use Can Complicate Outcome Comparisons
A 2026 retrospective study from two Swedish tertiary hospitals offers another useful example of why clinical context matters.4
Researchers reviewed 2,182 term singleton births, with documented Spinning Babies® use in 139. The techniques were most often used during induced, prolonged, or augmented labors. Operative births were more common in the Spinning Babies® group, but the researchers specifically cautioned against interpreting this as an effect of the approach. Spinning Babies® was being offered more often in labors that were already clinically complex.4
This is known as confounding by indication: the reason an intervention is used may itself be related to the outcome being measured.
The study authors therefore treated the findings as descriptive and called for prospective research in more clearly defined populations.4 The Swedish study offers a clear example of the challenge Maíra describes in real-world research: outcomes can reflect when and why an intervention was used, not simply what the intervention did.
What Can the Current Evidence Not Tell Us Yet?
These studies have expanded what we know about Spinning Babies®, while leaving several important clinical questions open.
Current research does not yet allow us to conclude that Spinning Babies® independently causes lower Cesarean rates, that the same findings will occur across different hospitals and populations, or that an association with fetal rotation will necessarily translate into differences in mode of birth or other clinical outcomes.
We also do not yet know which parts of the approach may contribute most to particular outcomes, or how effects may differ according to parity, fetal position, pelvic level, epidural use, model of care, or the point in labor when activities are introduced.
Naming these limitations does not diminish the findings; it helps place them in the appropriate context.
Spinning Babies® is well established in practice, but direct research on the approach itself is comparatively young. Maíra describes the current landscape as an evolving body of evidence: useful research is available, more studies are underway, and the questions being asked are becoming increasingly precise.
In addition to the studies mentioned above, there are a few other real world examples that show positive associations when Spinning Babies® is introduced into a clinical setting. In 2023 Darlene Sears, PhD, CNM completed a quantitative comparative study on how the Spinning Babies® approach was associated with the duration of the first and second stages of labor and delivery outcomes in low-risk nulliparous women. While this study has yet to be published outside of the university, “84% of women who used the Spinning Babies® approach delivered vaginally while 16% delivered by Cesarean section, compared to a vaginal delivery rate of 77% and a rate of 23% for women who did not use the Spinning Babies® approach.”6
And in 2023, Lisa Acosta, RN presented the results of a hospital wide initiative from Florida’s South Miami Hospital aimed at reducing cesarean sections. A major part of the initiative was training nurses and physicians in the Spinning Babies® approach. Over the course of a year and a half post education, the cesarean rate in this hospital was reduced by approximately 15% (from 46% to 31%). 7
Both of these are examples that provide motivation for continued, high quality research to help separate which interventions or influences might be replicated to improve support for physiologic birth.
The Next Step: A Randomized Controlled Trial of Spinning Babies®
One of those next steps is taking place in Brazil.
In May 2026, researchers published the protocol for an open-label, two-arm randomized controlled trial designed specifically to evaluate the Spinning Babies® approach compared with standard intrapartum care.5 The study is being conducted in a large public university maternity hospital in Southern Brazil.
Participants are nulliparous, at term, in spontaneous labor with a singleton fetus in cephalic presentation and the presenting part in the midpelvis. They are randomized 1:1 to either standard care or a standardized Spinning Babies® protocol.
In the intervention group, trained nurse-midwives apply the Three Balances℠: The Jiggle, Forward-leaning Inversion, and Side-lying Release, followed by asymmetric positions selected according to clinical indication and participant preference. The protocol is repeated every two hours while the presenting part remains in the midpelvis.5
The study’s primary outcome is total labor duration. Secondary outcomes include labor progression, fetal malposition, use of augmentation and analgesia, mode of birth, assisted vaginal birth, and neonatal outcomes.5
A randomized trial will not provide a universal answer, but its design can address some of the methodological limitations seen in earlier observational research. Participants receive care in the same clinical environment and during the same period, while randomization helps distribute baseline differences between groups more evenly.
The trial is designed to tell us more reliably how this standardized Spinning Babies® intervention performs in a clearly defined clinical population. Results have not yet been published.
What Can Clinicians Take From the Evidence Today?
For professionals evaluating Spinning Babies® within a clinical environment, the available evidence offers several findings worth following.
Formal Spinning Babies® education has been associated with increased clinician confidence and safety knowledge.1 One hospital observed significant improvements in nurse self-efficacy and NTSV Cesarean rates after education and a new labor-support model were introduced.2 An observational study of vaginal births found an association between the Spinning Babies® approach and greater anterior fetal rotation.3 Recent real-world data also demonstrate why outcomes need to be interpreted in light of who receives an intervention and why.4
Randomized evidence evaluating clinical outcomes is still developing.5
The current evidence should neither be dismissed because questions remain nor stretched beyond what the study methods can support.
For clinicians, educators, and hospital leaders, careful wording is part of evidence-based practice. Observed after, associated with, and in this population and setting may sound less definitive than proved or caused, but they communicate the research more accurately.
Professionals who want to review the studies themselves can explore the growing collection on the Spinning Babies® Research & References page.
An Evidence Base That Is Growing
The research landscape around Spinning Babies® looks different today than it did several years ago. We now have published research examining professional education, Cesarean rates, fetal rotation, and real-world clinical use, alongside a randomized trial designed to answer more controlled questions about labor progression and birth outcomes.1–5
Important questions remain, but the evidence base is clearly growing.
As that work continues, our responsibility is to remain curious, examine the methods as carefully as the results, and communicate each finding for what it can tell us, not more and not less.
Join the movement, support physiological birth
References
- Spagnoli M, Monroe M, Davies C. The effect of Spinning Babies® education on confidence in implementing techniques and knowledge regarding safety related to labor positioning among birth professionals. J Perinat Educ. 2024;33(4):206-211. doi:10.1891/JPE-2023-0021.
- Funk B. The effects of Spinning Babies® on nulliparous, term, singleton, vertex (NTSV) cesarean rates: a clinical trial. Int J Obstet Gynaecol Nurs. 2024;6(2):101-106. doi:10.33545/26642298.2024.v6.i2b.165.
- Mazzeo Melchionda M, Aloi T, Bruno F, De Lazzari A, Mauri PA, Esposito G. Spinning Babies® approach: a way to promote fetal head rotation during labor?. Eur J Midwifery. 2025;9:40. doi:10.18332/ejm/206972.
- Wohlin Frick S, Partoft R, Mattsson K, Bogren M, Hansson SR, Elden H. Spinning Babies® techniques in two Swedish tertiary birth units: a retrospective cohort study of use and birth outcomes. Sex Reprod Healthc. 2026;49:101254. doi:10.1016/j.srhc.2026.101254.
- Scapin S, Soligo Takemoto ML, Costa R. Effect of Spinning Babies® on labor progression and cesarean delivery rates: protocol for an open-label, two-arm, parallel randomized controlled trial. BMC Pregnancy Childbirth. 2026;26(1):684. doi:10.1186/s12884-026-08948-y.
- Sears, Darlene, “The Impact of the Spinning Babies Method on Labor Duration and Delivery Outcome” (2023). Walden Dissertations and Doctoral Studies. 13765. https://scholarworks.waldenu.edu/dissertations/13765
- Acosta, L. M., RN. (2022). Spinning Babies®: A Professional Development Program for Birth Workers to Reduce C-Section Rates. South Miami Hospital Baptist Health South Florida. (PI/EBP Quality Improvement Project; Magnet-recognized institution.)
