Classroom Activity to Illustrate the Labor Process for Nursing Students : AACN

Classroom Activity to Illustrate the Labor Process for Nursing Students

Overview

This is a classroom activity among nursing students that demonstrates the labor process using balloons and ping pong balls. This activity illustrates the impact of contractions during labor, ultimately causing changes in station, dilation, and effacement. This activity also shows the difference between true labor and false labor, and its impact on the cervix.

How to Use

Preparation:

The instructor should allow between 15–20 minutes to conduct the activity.
Supplies needed are a balloon and a ping-pong ball for each student. The balloon will represent the uterus, while the ping pong ball will represent the baby.
Have students stretch the balloon open and insert the ping pong ball.
Instruct students to blow-up the balloon to 3/4 full.
Direct students to invert the balloon while allowing the ping-pong ball to rest in the opening or neck of the balloon. This now depicts a pregnant uterus with a baby inside, as well as a visible cervix (the opening of the balloon).

Learning points:

True contractions happen in the fundus, which is at the top of the uterus (balloon), and require the entire muscle to contract in coordination. This will cause the baby (ping pong ball) to move down in station and cause cervical dilation and effacement.
False contractions occur on the sides of the uterus and will not cause changes in station, dilation, or effacement. You can squeeze the top and sides of the balloon to illustrate this concept.
In a primigravida, effacement tends to occur before dilation, which can be seen in this activity.
If the uterine muscle has been overworked or contracted for too hard/long, then it has the potential of rupturing, or popping of the balloon.

Integrative Learning Strategies

Students should ideally perform this activity after being introduced to and engaging with content on the labor process, cervical changes, and how to perform a sterile vaginal exam to gain a visual and kinetic representation of these concepts.
This activity will consist of specific stages that provide students with experiences of seeing, doing, and teaching.
The instructor first demonstrates the process to the class using student volunteers, followed by guided student practice as a class.
Each student then performs that activity independently using their class-provided materials. Students then explain the process to their peers.

Assessment Strategies

Instructor demonstration using student volunteers, followed by guided student practice with the entire class.
Students will then be able to demonstrate understanding by performing the activity themselves with their own balloon and ping-pong ball.
Formative assessment and evaluation through open dialogue and observation is used.

Learning Objectives and Exemplars

Learning Objectives:

Differentiate true and false labor contractions through demonstration with the balloon model.
Demonstrate how contractions affect cervical changes using the balloon model.
Describe the physiological cervical changes of station, dilation, and effacement throughout the labor process.

Exemplars:

True contractions happen at the fundus and require the entire muscle to contract in coordination. This will cause the baby (ping pong ball) to move down in station and cause cervical dilation and effacement. False contractions occur on the sides of the uterus and will not cause changes in station, dilation, or effacement. Squeeze the top and sides of the balloon to illustrate this concept.

Possible Courses

Maternal-Newborn Nursing
Perinatal Nursing specialty course

Additional Resources/Publications

Chalmers, L. (2019, May 12). Use a Balloon and Ping Pong Ball to Show How the Cervix Thins (Effacement) and Dilates During Labor. YouTube. https://www.youtube.com/watch?v=4dztPhYtG7k

Sub-competencies for entry-level professional nursing education:

1.1a Identify concepts, derived from theories from nursing and other disciplines, which distinguish the practice of nursing.
1.2a Apply or employ knowledge from nursing science as well as the natural, physical, and social sciences to build an understanding of the human experience and nursing practice.
1.2b Demonstrate intellectual curiosity.

2.2f Demonstrate emotional intelligence in communications.
2.3e Distinguish between normal and abnormal health findings.

10.2b Integrate comprehensive feedback to improve performance.
10.2d Expand personal knowledge to inform clinical judgement.

Posted: July 31, 2025

Submitted by:

Sandy Brooke Freeman, MSN, RN, RNC-OB, Assistant Clinical Professor, Auburn University

If you would like to cite this resource in your own work, please use the following citation:
Freeman, S. (2025). Classroom Activity to Illustrate the Labor Process for Nursing Students. Excerpted from the Essentials Teaching Resource Database. American Association of Colleges of Nursing, Washington, DC. Available at https://www.aacnnursing.org/AACN-Essentials/Implementation-Tool-Kit.