NURS 335 NURSING OF WOMEN
LATEST UPDATED (2025-2026) EXAM
2 STUDY NOTES, VIRGINIA
COMMONWEALTH UNIVERSITY
,The 5 P’s Definition Considerations for labor
Passageway The pelvis- divided into the pelvic inlet, Pelvic shape can influence labor-
midpelvis, and pelvic outlet gynecoid (classic female type)- rounded
android (resembles male)
anthropoid
platypelloid
Passenger the baby, placenta, amniotic membranes, -fetal head: composed of bony parts that
amniotic fluid either hinder or facilitate childbirth
-key influential variables: sutures,
fontanelles (anterior and posterior),
molding, overriding sutures
-fetal lie: relationship of cephalocaudal
axis of fetus to cephalocaudal axis of the
mother
-longitudinal lie- fetal cephalocaudal axis
is parallel to the mother’s cephalocaudal
axis
transverse lie- fetal cephalocaudal axis is
at right angle (90 degrees) to mother’s
cephalocaudal axis (perpendicular)
-fetal attitude: relation of fetal parts to
one another
-expected fetal attitude is flexion
-flexion of head/chin-to-chest, arms
folded across the chest, and legs flexed up
onto the abdomen
-deviations especially related to the head
will present larger diameters of the head
for the pelvis
-fetal presentation: presenting part: what
is it?
-determined by fetal lie, fetal attitude
-station: where that presenting part is in
relation to ischial spine
-engagement
-types of presentations
-cephalic or vertex
-breech: frank(legs not flexed),
complete(bottom is closest to the vaginal
canal), footling (feet is pointed down and
will deliver first)
-shoulder: transverse lie
-fetal position: relationship of fetal
, presenting part to 1 of the 4 quadrants of
the maternal pelvis, (front-anterior, back-
posterior, or sides-right or left)
-most common: occipitoanterior
-notations: right(R) or left(L) side of
maternal pelvis, landmark of fetal
presenting part (occipit), Anterior (A),
posterior (P), or transverse (T), depending
on whether the landmark is in the front,
back, or side of the maternal pelvis
Powers primary: purpose of uterine contractions -phases: increment, acme(baby is most
-effacement: the taking up, drawing up, and impacted), decrement
disappearance of internal os and cervical canal -need rest time between contractions so
into the uterine side walls (muscle tissue baby can recover
shortening and disappearing) -characteristics of contractions are
-dilation-widening of cervical os and cervical frequency, duration, intensity
canal from less than a cm to approx. 10 cm -measure by: palpation, fetal monitor
-dilation (0-10cm)/effacement (0%= long and -early labor contractions are mild, of short
thick; 100%=can’t feel cervix at all)/station duration, and infrequent
(negative is above ischial spine, positive is below -as labor progresses, frequency, duration,
ischial spine) and intensity of contractions increase
secondary: pushing!! contraction of maternal -if cervix is not completely dilated, bearing
abdominal musculature for fetal and placenta down causes cervical swelling or edema,
expulsion lacerations, cervical bruising, and
-only after complete cervical dilation maternal exhaustion
Psychological response how prepared are they knowledge/preparation, past experience,
stress response, support, social factors
(abuse?), cultural factors
Position of the mother Upright position
-gravity assists with fetal descent
-facilitates dilation & effacement
-reduces pressure on major maternal structures
Lateral (side-lying)
-increases cardiac output
-improves perfusion to organs
-removes pressure on major maternal structures
-helps with back pain and facilitates
counterpressure
Semi-recumbent
LATEST UPDATED (2025-2026) EXAM
2 STUDY NOTES, VIRGINIA
COMMONWEALTH UNIVERSITY
,The 5 P’s Definition Considerations for labor
Passageway The pelvis- divided into the pelvic inlet, Pelvic shape can influence labor-
midpelvis, and pelvic outlet gynecoid (classic female type)- rounded
android (resembles male)
anthropoid
platypelloid
Passenger the baby, placenta, amniotic membranes, -fetal head: composed of bony parts that
amniotic fluid either hinder or facilitate childbirth
-key influential variables: sutures,
fontanelles (anterior and posterior),
molding, overriding sutures
-fetal lie: relationship of cephalocaudal
axis of fetus to cephalocaudal axis of the
mother
-longitudinal lie- fetal cephalocaudal axis
is parallel to the mother’s cephalocaudal
axis
transverse lie- fetal cephalocaudal axis is
at right angle (90 degrees) to mother’s
cephalocaudal axis (perpendicular)
-fetal attitude: relation of fetal parts to
one another
-expected fetal attitude is flexion
-flexion of head/chin-to-chest, arms
folded across the chest, and legs flexed up
onto the abdomen
-deviations especially related to the head
will present larger diameters of the head
for the pelvis
-fetal presentation: presenting part: what
is it?
-determined by fetal lie, fetal attitude
-station: where that presenting part is in
relation to ischial spine
-engagement
-types of presentations
-cephalic or vertex
-breech: frank(legs not flexed),
complete(bottom is closest to the vaginal
canal), footling (feet is pointed down and
will deliver first)
-shoulder: transverse lie
-fetal position: relationship of fetal
, presenting part to 1 of the 4 quadrants of
the maternal pelvis, (front-anterior, back-
posterior, or sides-right or left)
-most common: occipitoanterior
-notations: right(R) or left(L) side of
maternal pelvis, landmark of fetal
presenting part (occipit), Anterior (A),
posterior (P), or transverse (T), depending
on whether the landmark is in the front,
back, or side of the maternal pelvis
Powers primary: purpose of uterine contractions -phases: increment, acme(baby is most
-effacement: the taking up, drawing up, and impacted), decrement
disappearance of internal os and cervical canal -need rest time between contractions so
into the uterine side walls (muscle tissue baby can recover
shortening and disappearing) -characteristics of contractions are
-dilation-widening of cervical os and cervical frequency, duration, intensity
canal from less than a cm to approx. 10 cm -measure by: palpation, fetal monitor
-dilation (0-10cm)/effacement (0%= long and -early labor contractions are mild, of short
thick; 100%=can’t feel cervix at all)/station duration, and infrequent
(negative is above ischial spine, positive is below -as labor progresses, frequency, duration,
ischial spine) and intensity of contractions increase
secondary: pushing!! contraction of maternal -if cervix is not completely dilated, bearing
abdominal musculature for fetal and placenta down causes cervical swelling or edema,
expulsion lacerations, cervical bruising, and
-only after complete cervical dilation maternal exhaustion
Psychological response how prepared are they knowledge/preparation, past experience,
stress response, support, social factors
(abuse?), cultural factors
Position of the mother Upright position
-gravity assists with fetal descent
-facilitates dilation & effacement
-reduces pressure on major maternal structures
Lateral (side-lying)
-increases cardiac output
-improves perfusion to organs
-removes pressure on major maternal structures
-helps with back pain and facilitates
counterpressure
Semi-recumbent
