Editing Maternal and Newborn Nursing (section)

=== Onset and the five P's ===

Premonitory signs include lightening, increased Braxton Hicks contractions, cervical ripening, bloody show, a small weight loss, a burst of energy (nesting), and rupture of membranes. '''True labor''' produces regular contractions that increase in frequency, duration, and intensity, are usually felt in the back radiating to the abdomen, are not relieved by walking or rest, and '''produce cervical dilation and effacement'''. '''False labor''' is irregular, felt mostly in the abdomen, often relieved by walking, position change, or hydration, and does not change the cervix. Cervical change is the deciding criterion.

The '''five P's''' are '''passenger''' (fetal size, lie, presentation, attitude, position), '''passageway''' (pelvis and soft tissues), '''powers''' (contractions and maternal pushing), '''position''' (maternal position), and '''psyche''' (emotional state and support). Fetal '''station''' is the relationship of the presenting part to the ischial spines: 0 is engaged, negative numbers are above the spines, positive numbers are below.