Single Best Answer (SBA) · Labour Dystocia and Prolonged Labour
A woman in prolonged labour has poor maternal motivation, no companion, and feels unsupported. Using the labour analysis framework, which single 'P' does this represent?
Show answer and explanation
Answer: E. Psyche
Psyche in the 4 Ps
| Factor (the 4 Ps) | Problem |
|---|---|
| Power | Poor/inadequate uterine contractions; maternal or uterine exhaustion |
| Passenger | Malposition, malpresentation or macrosomia (non-cooperative fetus) |
| Passage | Contracted pelvis, cephalopelvic disproportion, past pelvic fracture/abnormality |
| Psyche | Poor maternal motivation/support; lack of empathy, privacy or companionship |
Psyche
- Refers to poor maternal motivation and support.
- Contributors include lack of empathy, vocal abuse, poor privacy and lack of companionship.
Why it matters
- Psychological wellbeing affects the progress and experience of labour.
- Addressing psyche means providing respectful, supportive care: a chosen companion, privacy, empathy and information.
This complements the physical factors (power, passenger, passage) in analysing slow labour.
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