COMPONETS OF LABOR(4Ps)

1.Passenger = the size, presentation,and position ATTITUDE- Relationship of fetal parts to each
of the fetus. other
2. Passageway = shape and measurement of
maternal pelvis.
3. Powers = forces of labor, acting in concert, to
expel the fetus and placenta.
4. Placenta = position of placenta

1.) PASSENGER
a. fetal skull

PRESENTATION

LIE- Relationship of fetal spine to maternal spine

Types of Presentation

1. CEPHALIC = the fetal head presents itself to the

passage, occurs in 97% of births
Classified as:
1. Vertex – most common; fetal head is
completely flexed;

2. Military – fetal head is neither flexed

nor extended; top of the head is the presenting
part

3. Brow – fetal head is partially extended;

sinciput is the presenting part

4. Face – fetal head completely extended;

face is the presenting part
2. BREECH (buttocks) or (lower extremities)
a.Frank: thighs flexed, leg extended onanterior
surface, buttocks presenting
b.Full or complete: thighs and legs
flexed,buttocks and feet presenting(squatting)
c. Footling: one or both feet are presenting

LOP - left occiput posterior

3. SHOULDER (Scapula).CS

LOA – left occiput anterior

POSITION - Relationship of landmarks in the

presenting part to the quadrant of the maternal
pelvis

Right Occiput Anterior (ROA)

Right Sacrum Posterior (RSP)

Left Occiput Anterior (LOA)

2.) PASSAGEWAY
= shape and measurement of maternal pelvis and
distensibility of birth canal.
3 phases of labor contraction
1. INCREMENT – building up of the contraction
(longest phase)
2. ACME – peak of the contraction
3. DECREMENT – letting up of the contraction

4. PSYCHE
The woman feels confident in her ability to cope
and find ways to work with the contractions, the
labor process is enhanced.
afterward labor will be viewed as a positive
experience

PREPARED CHILDBIRTH
Engagement: This occurs when the biparietal DICK READ METHOD
diameter is at or below the inlet of the true pelvis. Fear and anticipation of pain
Station: This references the presenting part to the = tension
level of the ischial spines measured in + or - Contraction
centimeters. -Pre-natal courses and training
-reduce fear
STATION
LAMAZE METHOD
Stimulus- response conditioning
Taught to replace responses :
-Anxiety
-Fear
-Loss of control

Hydrotherapy METHOD
-sitting in a warn water during labor.
3.) POWER –uterine contraction
The baby is born underwater.
Dis:
Major forces: Involuntary and voluntary
Contamination of bath water
with maternal feces
Involuntary: includes frequency, regularity,
neonatalAspiration of water
intensity and duration.
Maternal chilling
Voluntary: bearing-down efforts. The contraction
Leboyer method
of levator ani muscles.
Birthing room is darkened, soft music is played,
env’t is kept warm
Uterine contraction Cord cutting is delayed.
Neonatal is placed in warm water bath.
DURATION OF LABOR
PRIMIGRAVIDA
First stage : 12 ½ hours
2nd stage : 1 hour and 20 mins.
Third stage : 20 minutes

MULTIPARA
1ST Stage: 7 hours and 20 mins.
2nd stage: 30 minutes
3rd stage: 10 minutes