When most of us hear about birth it’s in the singular, “When I was in labor…” or “The baby just didn’t budge.” or “They told me my pelvis was just too small.” or “I felt really strong and proud of giving birth naturally.” All of these things describe just one component of labor and birth. The reality is, that birth is a complex event and all four aspects need to come together to make this birth happen.
These 4 components to the birth process are: the passageway (pelvis), the passenger, the powers and the psyche. All of these must work together in synchronicity to achieve a successful, vaginal birth. Think of them as gears in a machine. If one of the gears is misaligned, then the whole machine malfunctions.
The Passageway (a.k.a The Pelvis):
I want to first talk about the pelvic inlet and the pelvic outlet. The pelvic inlet is the top opening of the pelvis. This is the part the baby’s head enters first. The pelvic outlet is where the baby’s head (and body!) exits mom. These dimensions need to be sized sufficiently to allow baby to maneuver comfortably through the pelvis for birth.
The tailbone (sacrum or coccyx) needs to be sufficiently mobile to be gently pressed back out of the way when baby moves through. Your sacroiliac joint allows this nutation or counter-nutation of the sacrum.
The symphisis pubis is a cartilaginous joint in the front of the pelvis. It also needs to be properly mobile to help the pelvis flex to allow baby to pass through. The relaxin hormone in your body helps both the tailbone and the symphisis pubis become more mobile to facilitate birth
So, all of the physical components of the pelvis need to be working, moving, properly to facilitate birth.
Yep. This would be the baby. Mom carries the baby, hence the term passenger. The baby needs to be positioned properly to make it through the pelvis. The optimal position for birth is Occiput Anterior (OA). However, babies can be born vaginally in a number of positions. To learn more about their positions in the womb (and how you can influence it) check out Spinning Babies.
What’s important to know here is that if baby is mal-positioned, she will have trouble fitting through the passageway, possibly necessitating a c-section.
The other things to note in regards to baby is their desire to be born and their sense of safety outside the womb. Our babies are strongly intuitive beings. They know when mom is fearful, or uncomfortable emotionally. This can have an impact on how baby will choose to be born. (see Psyche below for mom’s mental state)
These are your contractions and your additional efforts for pushing. Your contractions need to be strong enough to dilate the cervix and aid the baby in his decent. They need to be at regular intervals, moving closer together and increasing in strength throughout labor. On the flip side, they can’t be too strong, or too intense or you have a case of fetal distress and / or a mom who can’t cope with her contractions without medical interventions. If the contractions are too weak or not at regular enough intervals, your care provider might suggest using Pitocin (synthetic oxytocin) to amp them up.
The Psyche is another word for you your emotional state during birth. If mom is afraid, tense, stressed out, angry, feels unsafe or unsupported, she will not likely do well during birth. For some, the fear is intense enough to schedule a c-section and to avoid a vaginal birth all together. For others, it may prevent cervical dilation, fetal decent, or prevent mom from pushing effectively. (Think Ina May’s “Sphincter Law”).
A good emotional state helps mom cope with the pain effectively; helps her tune in to her body; helps guide her to her baby’s needs and allows the other 3 P’s to sync up effectively. A mom who’s psyche is healthy, strong and who has good support during labor, will have a good birth. Regardless of the medical interventions she may need, she will ride her labor to a birth experience she will remember with a strong heart and a peaceful mind.
There is no one “P” that can work without the others. All four must be working properly for baby to join the world in the way they are intended. The “P’s” can be influenced by mom’s movements, position, her care provider, her support people, and medical intervention. Birth is a complicated, multifaceted, life-changing event. Get yourself in a good head-space and you will be able to work with issues that may arise with the Passageway, the Passenger and the Powers.