While growing up many of us knew that giving birth was as easy as ABC. In our minds, all that we knew was that as soon as it was time, it was a matter of mom walking into the hospital and have her baby removed from the belly. We didn’t even know how this happened. The situation may not be any different in the thinking of our most citizens today who don’t participate in the process.
However, it is not as easy as any trained health worker will tell you because there are several factors that facilitate a natural delivery to take place. And these factors can be classified into four simple ways; passenger, passageway, powers and psyche, the 4Ps. And these are the focus of our blog this week.

The passenger is the baby. Normally, baby must come and present in a certain angle for it to pass through the passage (pelvis bones). Any deviation in this angle renders it impossible for the baby to pass through. A slight change in flexion of the head increases the angle making the passage so narrow. Yet normally the baby must come in with its head flexed to pass the pelvis bones, with the back of its head first ‘’occiput anterior. ‘’ But sometimes it may come in with the face, chin and shoulders – such presentation results into a big angle hence baby can make it through. Secondly the baby may be too big for the passage, normally babies above 4kg may be too big to pass for most mothers.

The second P, the passage, which is the pelvis should allow the baby to pass if the above conditions are not into place. The pelvis has the inlet the brim, upper part of the pelvis bones, and an out let. But some women are born with narrow bones whereby even if the passenger qualifies to pass, it’s impossible. Women at risk are mostly those with a short stature and those with a family history of narrow pelvis medically termed as contracted pelvis.

Power: This is mainly a maternal factor, literally meaning having ability to push the baby out on time. This means that the contractions should be sufficient to sustain a continuous force to push the baby out.

Finally, the psyche of the mother mind needs to be right. The mother should be strong, fearless and happy. In other words, she needs to be emotionally stable for her to be able to push out her baby. If the mother is emotionally unstable, fearful, tensed and feeling of lack of support may make the delivery difficult.
Remember, no one P is independent of the other. If a natural delivery is to happen, all Ps must be perfect.