Overview
This lecture covers the five "Ps" of labor—Passageway, Passenger, Position, Powers, and Psych—detailing their roles in the labor and delivery process.
The Five Ps of Labor
- The five Ps are Passageway, Passenger, Position, Powers, and Psych, each influencing labor and delivery outcomes.
Passageway
- Passageway refers to the birth canal, including the bony pelvis, cervix, pelvic floor, vagina, and vaginal opening.
- Four pelvic types: gynecoid (most favorable, pumpkin-shaped), anthropoid (human-shaped, also favorable), android (robot/alien-shaped, poor prognosis), platypelloid (flat, poor prognosis).
- Android and platypelloid pelvises often require C-sections.
Passenger
- Passenger includes the fetus and placenta.
- Fetal presentation: part of the fetus entering the pelvic inlet first.
- Fetal lie: relationship between the mother's and fetus' spinal axes (can be parallel or transverse).
- Fetal attitude: degree of flexion or extension of the fetal head and limbs.
- Fetal position: location of the fetal presenting part in relation to the maternal pelvis.
- Fetal station: level of fetal presenting part relative to maternal ischial spines.
Powers
- Powers refer to uterine contractions that thin and dilate the cervix and push the fetus downward.
- Contraction duration: length of a single contraction from start to finish.
- Contraction frequency: time between the start of one contraction and the start of the next.
- Intensity: strength of the contraction.
Position
- Position addresses the maternal position during labor, such as standing, sitting, upright, or using a birthing ball.
- Frequent position changes help relieve pain and facilitate labor.
Psych
- Psych refers to maternal emotional state, including stress, anxiety, and self-esteem during labor.
- Nurses can promote comfort with calming music, massage, aromatherapy, clear information, ice chips, and breathing techniques.
Key Terms & Definitions
- Passageway — The route through which the baby travels during birth, including pelvis and soft tissues.
- Passenger — The fetus and placenta moving through the birth canal.
- Fetal Presentation — Which fetal part enters the pelvis first.
- Fetal Lie — Orientation of the fetus' spine to the mother's spine.
- Fetal Attitude — Flexion or extension of fetal limbs and head.
- Fetal Position — Reference of the fetal presenting part to the maternal pelvis.
- Fetal Station — Position of fetal presenting part relative to maternal ischial spines.
- Powers — The uterine contractions during labor.
- Duration — Length of each contraction.
- Frequency — How often contractions occur.
- Intensity — Strength of contractions.
- Psych — Maternal psychological and emotional state during labor.
Action Items / Next Steps
- Review pelvic types and their impact on labor.
- Practice identifying fetal positions and stations.
- Study maternal comfort techniques for labor support.