I am sure all know the 3 P's
well finally seen the 4th one in A text book!
it claims that the ability to have adequate 2nd stage can be effected by:
-mothers confidence in her ability
-support she recieves
-response from health care workers
it also states that for women who feel overwhelmed, the psycological stress added to the physical stress interferes with labor progress
there were a few others but i can not recall them at the moment.
I always thought the physche had a great effect on labor and birth. finally someone agrees with me
Mar 29, '03
I was witness to the 4th "p" last night with a primip who had pushed for two hours, and flat-out gave up, saying "no puedo" ( I can't do it in Spanish). She had given up and decided a csection was the only way she was gonna go. Boy, I sure hate when it comes to this and sometimes you have to get creative to get them past this mindset.
Fortunately for me, There were several generations of female relatives in the room with her. In Spanish, I asked them to come to her and convince her that her body is a marvelous creation; and to trust it to do what it was made to. These ladies did an amazing job! They encouraged her, held her, comforted her and got her thru it. With their encouragement, eventually, her confidence returned and she gave it "one more try". Having a mirror there to enable her to see the progress she was making helped a lot, also. I like when they consent to this.
Well, With this last push of effort, I watched the baby's head turn, around the pubic bone it came, and down he came!!!! I actually had to SLOW her pushing efforts to let her perineum stretch and avoid a tear from rapid decent! It was a marvelous thing to witness. She delivered with only a skid mark on her peri. After 6 years in L and D, I love watching the machinations of the fetal head as it decends! It is indeed an awesome thing to me.
Yes, I have to agree; The power of the psyche is at LEAST as important as any other aspect of labor/delivery success. I have seen it time and again. But it is not just about the PATIENT's psyche. I contend a strong belief in the very amazing and capable female body is a MUST for EVERY obstetric attendant (nurses, doctor, labor support people, and most importantly, the MOTHER HERSELF). Our minds can do amazing things along with our bodies! Good points, Mark!!!!
Last edit by SmilingBluEyes on Mar 29, '03
Apr 3, '03
The 5 P's (Powers, Passage, Passenger, Pain and Psyche) are INTRINSIC things that affect labor, according to the Labor Progress Handbook By Penny Simkin and Ruth Ancheta. But did you KNOW: there are also EXTRINSIC factors that they discuss that may be of interest to you all??? As familiar as we are with these factors, they are only part of the story. The extrinsic factors according to the authors are:
Environment (feelings of physical/emotional safety generated by the setting/people around the laboring mom)
Ethno-cultural Factors (the degree of sensitivity/respect for the woman's culture-based needs and preferences)
Hospital or Caregiver Policies (how flexible, woman/family-centered, evidence-based)
Psycho-emotional care (the priority given to NON-clinical aspects of the childbirth experience).
This Labor Progress Handbook, to me, is a must for every labor nurse or doula to read. It is compact and very portable, inexpensive and indispensible to me. It is extremely helpful in teaching us as caregivers to REALLY know what LABOR SUPPORT IS and be facilitators in a successful and joyful birth for the birthing family.
Last edit by SmilingBluEyes on Apr 3, '03