I was reading a blog called Academic OBGYN and found a fascinating article about handling slow labor. After the article, I always read the comments....sometimes just a handful of opinions since a lot of these blogs will boast hundreds of comments. Near the top I found a comment by Amy Romano, who is a pretty well known and respected midwife who writes a blog for Lamaze International called Science and Sensibility. In her comment she took a moment to talk about what she calls "The Four Preventative P's":
I give a talk on optimizing labor progress and talk about “Four Preventive P’s” rather than the 3 P’s and other variations, all of which I think address how to treat rather than prevent dystocia.
Briefly, the four P’s are:
Permission – freedom of movement, autonomy in decision making, freedom to vocalize, throw up, ask for help, or whatever it is the woman needs to do to get her baby out.
Physical environment – there are some intriguing pilot studies showing beneficial effect of simple alterations like removing the labor bed and/or giving women freedom to rearrange furniture and props in her own room.
People – continuous support from a doula or other trained labor companion has many documented benefits and should be the standard of care.
Practices – avoid routine use of interventions that slow labor down. Avoid arbitrary time limits, etc.
Of course, you don’t get the Four Preventive P’s in most hospital environments.
I give a talk on optimizing labor progress and talk about “Four Preventive P’s” rather than the 3 P’s and other variations, all of which I think address how to treat rather than prevent dystocia.
Briefly, the four P’s are:
Permission – freedom of movement, autonomy in decision making, freedom to vocalize, throw up, ask for help, or whatever it is the woman needs to do to get her baby out.
Physical environment – there are some intriguing pilot studies showing beneficial effect of simple alterations like removing the labor bed and/or giving women freedom to rearrange furniture and props in her own room.
People – continuous support from a doula or other trained labor companion has many documented benefits and should be the standard of care.
Practices – avoid routine use of interventions that slow labor down. Avoid arbitrary time limits, etc.
Of course, you don’t get the Four Preventive P’s in most hospital environments.
I had a thought after reading this that this could be a birth plan for any mother planning a natural childbirth. Its short, easy to read and gets right to the point. If her doctor or midwife has problems with any of these four things, it would be a good indication that she isn't going to get the birth she wants and should look for a new provider. Also, I like how it simplifies the requuests to four items. Sure, there are a lot more than four things asked for here, but since it basically bullet-points four things, it doesn't look like such a long laundry list of requests.
What do you think? Would this work as a birth plan?
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