I am sure all know the 3 P's
Passage
Passenger
Power
well finally seen the 4th one in A text book!
Physche
it claims that the ability to have adequate 2nd stage can be effected by:
-fear
-mothers confidence in her ability
-support she recieves
-response from health care workers
-labor enviroment
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:)