The 4 P’s, a.k.a the driving force behind your labour


Us doulas in Edmonton and those of us who teach childbirth classes in Edmonton very frequently consider four factors when trouble shooting or anticipating any stalls in our clients labours. These bad boys are what we like to call the 4 P’s of childbirth! (and how convenient that they all happen to begin with the letter P, right?). So here’s the deal with the 4 P’s and why they matter: essentially, these four factors are going to determine how, when and even if your baby will be delivered vaginally! They are all very complex and have many different possible scenarios, and today I’d like to dive in to each individual “P” and what it might mean for your birth.

Powers – oxytocin, the uterus and the strength of birth

Powers is the first of the 4 P’s and refers to the strength of the birthing person’s contractions. As most of you will know, oxytocin is the beautiful hormone that causes much of the power behind labour. Oxytocin is released when your baby is ready to meet you, and sends a signal to your brain to start producing it in super high amounts (getting higher and higher through out your labour as well). The oxytocin pulsing through your blood is what will cause your uterus to contract, and the contractions are the “powers” that bring baby out – therefore the amount of oxytocin will obviously determine the strength of your contractions. Many women experience what is referred to as “prodromal labour”, when your body starts to produce oxytocin but maybe in an amount that’s not high enough to progress the labour forward. This can cause days and sometimes weeks of labour and can cause women to get so frustrated that they decide that it’s a good time to get pitocin (the oxytocin drip) at the hospital. One thing to always remember about pitocin (or syntocinon, what us Edmonton doulas know it as) is that it is a synthetic form of oxytocin – it’s not the real stuff. Sure it will give you power that you might need to get baby out, but it may be more than your body can handle. You run the risk of over-stimulating your uterus, aka too much power, to the point in which it can tire out and stop functioning properly on its own. So how can you add some of this natural power that’s signaled by your own brain? Well, oxytocin is in fact the love hormone, so having intimate time with your partner, using nipple stimulation or even having an orgasm can start to bring up that oxytocin naturally so your uterus can work its magic!

Passage – your pelvis!

The pelvis can sometimes be a complicated factor in childbirth. Many do not know that the pelvis is so much more than just a bone structure; it’s meant to move into a more open state during pregnancy and birth to make room for baby. It does this by its structure also containing ligaments and joints, which soften with the presence of relaxin (which I’m sure you can all guess the function of this hormone!). With all of this in mind, there’s more than just simply opening involved with the pelvis. Unfortunately in today’s society things like driving, working in an office, accidents, etc. have the potential of causing our pelvis to be unbalanced and make it hard for it to function properly. Another thing to note is that there are 4 types of pelvic shapes, and not all are ideal for a vaginal birth (but not impossible!). There are lots of healing modalities that can help to better balance the pelvis to allow for optimal opening – things like chiropractic work, massage and cranio-sacral therapy can all help it become ready for the birth of your baby.

Passenger – your little human

Believe it or not, your little one plays a part in how they are born too! Things like their position or presenting part might be a bit tough for them to control, but there are a few ways in which you baby will control the outcome of your delivery. First of all, unless in the presence of a medical reason to induce, you baby actually determines when you will go into labour. Studies have suggested that babies lungs secrete a certain protein when they are near the end of development that signals the mother’s body to begin preparing for labour. It’s your baby that signals your brain to start producing large amounts of oxytocin (necessary for labour), and this ensures that baby is fully developed and ready for life outside the womb. Finally, babies instinctively move in the right directions to make their way through your pelvis. This involves their head rotating, chin tucking and others called the seven cardinal movements of labour (check out more information on this here). So as you can see, babies don’t just rely on their birthing parent to get them to come out!

Psyche – controlling your experience with your mind

The last of the P’s and probably the most under-estimated of all is your psyche. Our minds are hard-wired to shut down labour for a reason, and that has to do with our most primal instincts for survival. In our earlier years as cave men when we had predators who were going to attack, our brains would trigger an adrenaline release which actually halts oxytocin production. This is so that we aren’t giving birth when we fear an attack, instead we are able to find a safe space to birth. However, in today’s society with all the wacky stories and misinformation about birth out there, our fear is cultivated through reasons that aren’t really rational – but nonetheless, it’s still fear and still inhibiting our oxytocin regulation. So in other words, if we are afraid, our labour will not start or continue! Our mind is so powerful in regulating all of our systems, its no wonder that it has so much impact on birth. Keeping a calm mind, exercising regularly to reduce stress and being educated to eliminate irrational fears will all help labour start at the exact perfect time for you and baby, and will help to avoid any stalls along the journey.

So you can imagine that we can’t completely control the 4 P’s of our labour, but how can we positively impact them to have the smoothest experience possible? A big answer to your question is to hire a birth doula, as we have various tips and tricks to keeping your mind and body on the right path. Check out my post here to find out a bit more about doulas, and I’ve also got some helpful posts about our relationships with midwives, nurses and birth partners.

Have you ever experienced a slow or stalled labour? Post about your experience in the comments section!

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