There are five essential factors that affect the process of labor and delivery.

They are easily remembered as the five Ps (passenger, passage, powers, placenta, and psychology).

a. Passenger (Fetus).

(1) Presentation of the fetus (breech, transverse).

(2) Position of the fetus (ROP, LOP).

(3) Size of the fetus.

b. Passage (Birth Canal).

(1) Parity of the woman, if she has ever delivered before.

(2) Resistance of the soft tissues as the fetus passes through the birth canal.

(3) Fetopelvic diameters.

c. Powers (Contractions).

(1) Force of the uterine contractions.

(2) Frequency of the uterine contractions.

d. Placenta.

(1) Site of implantation.

(2) Whether it covers part of the cervical os.

e. Psychology (Psychological State of the Woman).

(1) Patient extremely anxious.

(2) Emotional factors related to the patient.

(3) Amount of sedation required for the patient.