Five P's : factors that affect and define the labor and birth process: passenger (fetus and placenta), passageway (birth canal), powers (contractions), position (of the woman), and psychological response

Psychological response

Maternal stress, tension, and anxiety can produce physiological changes that impair the progress of labor.

Scapula

Shoulder bone

Passageway

The birth canal that is composed of the bony pelvis, cervix, pelvic floor, vagina, and introitus (vaginal opening.) The size and shape of the bony bony pelvis must be adequate to allow the fetus to pass through it. The cervix must dilate and effaced in response to contractions and fetal descent.

Positon

The client should engage in frequent position changes during labor to increase comfort, relieve fatique, and promote circulation. Positon during the second stage is determine by maternal preference, provider preference, and the condition of the mother and the fetus. -Gravity can aid in the fetal descent in upright, sitting, kneeling, and squatting positions.

Power

Uterine contractions cause defacement (shortening and thinning of the cervix) during the first stage of labor and dilation of the cervix (enlargement of widening of the cervical opening canal) that occurs once labor has begun and the fetus is descending. Involuntary urge to push and voluntary bearing down in the second stage of labor helps in the expulsion of the fetus.

occiput

back part of the skull

Passenger

consists of the fetus and the placenta. The size of the fetal head, fetal presentation, fetal lie, fetal attitude, and fetal position affect the ability of the fetus to navigate the birth canal. The placenta can be considered a passenger because it also must pass through the canal. *presentation: the part of the fetus that is entering the pelvic inlet first and leads through the birth canal during labor. -it can be back of the head(occiput) -chin (mentum) -shoulder (scapula) -breech (sanctum or feet) *Lie: The relationship of the maternal longitudinal axis (spine) to the fetal longitudinal axis (spine) -transverse: Fetal long axis is horizontal, forms a right angle to maternal axis, and will not accommodate vaginal birth. The shoulder is the presenting part and can require delivery by cesarean birth if the fetus does not rotate spontaneously. -parallel or longitudinal: fetal long axis is parallel to maternal long axis, either a cephalic or breech presentation. Breech presentation can require a cesarean birth. *Attitude: relationship of fetal body parts to one another -Fetal flextion: chin flexed to chest, extremities flexed into torso -Fetal extension: chin extended away from chest, extremities extended. *Fetopelvic or fetal position: the relationship of the presenting part of the fetus (sanctum, mentum, or occiput, in reference to its directional position as it relates to one of the four maternal pelvic quadrants. It is labeled with three letters. -Right (R) or Left (L) : the first letter references either the side of the maternal pelvis. -Occiput (O), sanctum (S), Mentum (M) or scapula (Sc). The second letter reference the presenting part of the fetus. -Anterior (A), Posterior (P), or Transverse (T): The third letter references the part or the maternal pelvis *Station: Measurement of fetal decent in centimeters with station o being at the level of an imaginary line at the ischial spines, and plus stations inferior to the ischial spines.

mentum

fetal chin