The 5 P’s of Normal Labour and Birth

5 P’s of Normal Labour and Birth

Kiwi Families resident midwife expert, Kathy Fray, breaks down the textbook version of the birthing process. But she adds in a fundamental process that all expecting Mothers need to consider – preparation. Find out more in the 5 P’s of normal labour and birth.

The 3 P’s of normal labour and birth

Traditionally childbirth has been described as consisting of three ‘mechanisms’:

  • Powers – The forceful strength of co-ordinated contractions
  • Passage – The birth canal anatomy, including the size and shape of the woman’s bony pelvis, and resistance of her soft tissue
  • Passenger – The baby, particularly its lie and position of its head

These three ‘P’s are then superimposed as such, over a plotted half-century-old labour standards called the Friedman curve, to ensure ‘Failure to Progress’ does not dictate the need for caesarean-section.

Friedman curve

Source: World Health Organisation

Refreshingly, more recently textbooks are finally beginning to mention the fourth ‘P’, termed Psyche.

That is, the woman’s expectations of the birthing process, and how her anxiety can lengthen labour.

It is the rather belated acknowledgement that empowered, knowledgeable confidence, in her own body’s ability; the positive support of caring birth assistants; a calm holistic labour room environment; and receptive approachable midwifery-obstetric healthcare staff, are collectively and fundamentally influential on reducing a woman’s overwhelming fears. Fears which can negatively interfere in labour progress.

The 5th P of labour and birth

However, there is a fifth ‘P’ which needs mention. And that is, Preparation.

Yes, without doubt it is possible to prepare positively in every way feasible, and still result in a highly interventionalised labour with surgical delivery. Yes, you could ‘do everything right’, and it still ‘go all wrong’ … the difference is, with preparation, it’s simply more likely, it will ‘go all right’.

So if you wish to improve your chances of natural birth, then – without project managing your own pregnancy to the point of stressful obsession – it’s about embracing the holistic mindset from the get-go.

However, if you’re only 10 weeks pregnant and already adamant an Epidural is the only option you’ll consider, then we’d say either do so and do it guilt-free (this is your labour, and you must do what is right for you); or fully investigate the multiple other options to ensure your decisions are genuinely informed.

Popular aspects of the Fifth ‘P’ Preparation can include:

  • Attending childbirth education classes, knowing they are simply an introductory overview – and you need to do more ‘homework’
  • Read great books on labour and birth, with personal favourites including Ina May Gaskin’s Guide to Childbirth, Janet Balaska’s New Active Birth and my own Oh Baby book chapter on Childbirth
  • Block your ears to listening to the copious negative childbirth ‘horror’ stories girlfriends may wish to share – it does nothing to build confidence
  • Attend Preggy Yoga classes
  • Learn the meditative labour practice of Hypnobirthing
  • Receive antenatal care from a maternity Acupuncturist
  • Receive antenatal care from a naturopathic medical herbalist who will prescribe cervical-uterine preparatory remedies such as Nature’s Sunshine “5W” and Evening Primrose Oil

It’s about getting pro-active. It’s about lining up all your ducks-in- a-row to give the best chance possible of experiencing a non-interventionalised normal natural birth – knowing this too, is also actually best for your baby. It’s about knowing you did everything in your power, so later no mother-guilt need ever persist, regardless of the delivery outcome. Or, it’s about standing your ground that your perception of such preparation is bohemian mother earth hippy claptrap, and not for you, and you’re okay with that, full-stop.

The thing you need to avoid – like the plague – is an unintended lack of preparation, resulting in enabling an aching decaying cavity of regret to ever be able to form. It’s about protecting your spirit.

Kathy Fray

Kathy is a wife; mother of three; north Auckland self-employed midwife; weekly Parenting columnist; founding director of BabyOK™ Products (producers of the renowned Babe-Sleeper); and author of NZ’s No.1 guide for new mums “OH BABY…Birth, Babies & Motherhood Uncensored” and the sequel “OH GROW UP…Toddlers to PreTeens Decoded”. You can find out more about Kathy on her website.

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