What are the 4 p’s in birth process?

The process of giving birth is complex, and women have to be ready for various physiologic adaptations during labor. Anderson and Avery (2019) introduce the 4 P’s (components) during labor and birth: the power, the passenger, the passage, and the psyche. Powers or contractions may be involuntary or voluntary to expel the passenger (fetus and placenta) from the uterus. The passenger, including the size of the fetal head, defines the quality and the length of the birth process. The passageway or the birth canal consists of the pelvis, soft tissues of the cervix, vagina, introitus, and pelvic floor (Anderson & Avery, 2019). It is recommended to define the pelvis’ size and shape before labor. The psyche or the emotional state of a woman during birth determines the quality of labor. Positive psychological responses promote the possibility to cope with pain and choose the most effective tune, and negative emotions result in fear and tense.