Care of Mother, Child and Adolescent (WellClients)
STUDENT ACTIVITY SHEET
BS NURSING / SECOND YEAR
Session # 12
LESSON TITLE: COMPONENTS OF LABOR
(PASSAGEWAY)
Materials:
Book, pen, SAS and notebook
Reference:
LEARNING TARGETS:
At the end of the lesson, the student nurses can:
1. Enumerate the components of labor.
2. Identify the parts of the pelvis
3. Describe the different pelvic shapes
4. Explain the components of pelvic measurement
Pilliteri, Adele and Silbert-Flagg, JoAnne (2018)
th
Maternal and Child Health Nursing, 8 Edition.
USA: Lippincott Williams and Wilkins
LESSON REVIEW/PREVIEW (5 minutes)
MAIN LESSON (45 minutes)
Please refer to Chapter 15: The Nursing Care of a Family During Labor and Birth-The Components of Labor-The Passage
p. 328
I. COMPONENTS OF LABOR
5 P’s:
1. PELVIS (the PASSAGE)
2. FETUS (the PASSENGER)
3. Uterine factors (POWERS of labor)
4. a woman’s PSYCHE
5. POSITION
 If the 5 Components:
 (1) the woman’s PELVIS (the passage) is of adequate size & contour
 (2) the FETUS (the passenger) is of appropriate size & in an advantageous position & presentation
 (3) the uterine factors (powers of labor) are adequate
 (4) her (Position) is comfortable and facilitates the labor process
 (5) the woman’s PSYCHE is preserved so that afterward, labor can be viewed as a positive experience
A. PASSAGEWAY or PASSAGE (PELVIS)
2 Divisions of the Pelvis:
 Refers to the route a fetus must travel from the
 FALSE PELVIS- upper half which supports
uterus through the cervix & vagina to the external
the uterus during the late months of pregnancy
perineum
& aids in directing the fetus into the true pelvis
 It is the mother’s bony pelvis and soft tissues of
for birth
the cervix, pelvic floor, vagina and introitus
Functions
 Support & protect the reproductive & other
pelvic organs
 Accommodation of the growing fetus
 Anchorage of the pelvic support structures
 TRUE PELVIS- lower half of the pelvis;
long, bony, curved canal divided into 3
parts:
o inlet,
o pelvic cavity
o outlet
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Education (Department of Nursing)
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
Composition
 Anterior & lateral portion made up of 2
innominate hip bones divided into 3 parts
(ilium, ischium and pubis
LINEA TERMINALIS or BRIM- imaginary line
from the sacral promontory to the superior border
of the SP which divides the pelvis into true & false
pelves
 Posterior portion: sacrum, coccyx
1. Types of Female Pelvic Shapes
c. Anthropoid- “APE-LIKE”
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a. Gynecoid Pelvis “FEMALE”
 Has an inlet that is well-rounded and has a wide
pubic arch
 Ideal for childbirth
b. Android- “MALE”
 The pubic arch forms an acute angle, making the
lower dimensions of the pelvis extremely narrow
 A fetus may have difficulty exiting from this type
of pelvis


It’s transverse diameter is narrow; the
anteroposterior diameter of the inlet is larger than
usual.
Even though the inlet is large, the shape of the
pelvis does not accommodate a fetal head as well
as the gynecoid pelvis
d. Platypelloid – “Flattened” (oval)
 It has a smoothly-curved oval inlet, but the
anteroposterior diameter is shallow.
 A fetal head might not be able to rotate to match
the curves of the pelvic cavity
2. ESTIMATING PELVIC SIZE (PELVIMETRY)
 2 important pelvic measurements to determine the adequacy of the pelvic size:
• the DIAGONAL CONJUGATE (anterior-posterior diameter of the inlet)
• the TUBERO-ISCHIAL or BI-ISCHIAL DIAMETER (transverse diameter of the outlet)
 DC (Diagonal conjugate) is the narrowest diameter of the inlet & the (TD) Tubero-ischial Diameter is the
narrowest diameter of the outlet (11.5 cm)
 TD of pelvic cavity/inter-spinous diameter= 10 cm
 TD of outlet/bi-ischial diameter= 11.5
Anteroposterior Measurements of the Inlet
a. DIAGONAL CONJUGATE= 10.5 - 11 cm.
o It is the measurement between the
anterior surface of the sacral prominence
(sacral promontory) and the posterior
surface (inferior margin) of the symphysis
pubis
o measured by internal examination; AP
diameter
b. OBSTETRIC CONJUGATE= > 10 cm.
o
o
Measurement of the Transverse Diameter of the Outlet
a. TUBERO-ISCHIAL or BI-ISCHIAL Diameter of
the Outlet
 It is the distance between the ischial tuberosities,
or the transverse diameter of the outlet (the
narrowest diameter at that level, ot the one most
apt to cause a misfit)
 It is made at the medial and lowermost aspect of
the ischial tuberosities, at the level of the anus
 Diameter of 11 cm is considered adequate
because it will allow the widest diameter of the
fetal head, or 9 cm, to pass freely through the
outlet
It is the distance between the midpoint of
the sacral promontory & the midline of
the symphysis pubis which is ascertained
by subtracting 1 to 1.5 cm from the
diagonal conjugate
OC= DC – 1 to 1.5
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Education (Department of Nursing)
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c. TRUE CONJUGATE/CONJUGATA VERA= > 11 cm.
o It is the distance between the midpoint of
the sacral promontory and the upper
or superior margin of the symphysis
pubis
CHECK FOR UNDERSTANDING (25 minutes)
You will answer and rationalize this by pair. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
Multiple Choice
1. Which of the following factors affecting labor is associated with passageway?
A. Size of the fetal head and its ability to mold to the maternal pelvis
B. The presentation of the fetus in relation to the maternal pelvis
C. The structure of the maternal pelvis
D. The frequency, duration and strength of the contraction
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________ _______________________
2. Which of the following pelvis is round in shape, the most common type of pelvis among females and allows
fetus to pass with ease?
A. Anthropoid
B. Gynecoid
C. Platypelloid
D. Android
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________ _______________________
3. Which of the following diameters will pose a problem for vaginal delivery?
A. True conjugate 11.5 cm or greater
B. Transverse diameter of inlet less than 12 cm.
C. Oblique diameter of the inlet is 12.7 cm or greater
D. Anteroposterior diameter of the outlet is 11.7 or greater
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
______________________________________________________________________________________
4. It is the measurement between the anterior surface of the sacral prominence (sacral promontory) and the
posterior surface (inferior margin) of the symphysis pubis
A. Diagonal conjugate
B. Obstetric conjugate
C. True conjugate
D. Bi-ischial conjugate
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________ _______________________
5. It refers to the route a fetus must travel from the uterus through the cervix & vagina to the external perineum
A. Passageway
B. Passenger
C. Powers
D. Psyche
ANSWER: ________
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Education (Department of Nursing)
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RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________ _______________________
6. It is the upper half of the pelvis which supports the uterus during the late months of pregnancy & aids in
directing the fetus into the true pelvis for birth
A. Inlet
B. Outlet
C. False pelvis
D. True pelvis
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________ _______________________
7. It is a landmark of the midpelvis and is important for determining engagement
A. symphysis pubis
B. iliac crest
C. Ischial tuberosities
D. Ischial spines
ANSWER: ________
RATIO:___________________________ _______________________________________________________________
_________________________________________________________________________________________________
______________________________________________________________________________________
8. These are functions of the pelvis except:
A. Support & protect the reproductive & other pelvic organs
B. Accommodation of the growing fetus
C. Anchorage of the pelvic support structures
D. Nourishment of the growing fetus
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________ _______________________
9. It is a the most reliable measurement of the outlet
A. Bi-ischial diameter
B. Diagonal conjugate
C. Obstetric conjugate
D. True conjugate
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________ _______________________
10. It is the condition where the fetal head cannot fit into the diameters of the maternal pelvis; thus, necessitating
a C-section
A. Dystocia
B. Cephalopelvic disproportion (CPD)
C. False labor
D. second stage arrest
ANSWER: ________
RATIO:__________________________________________________________________________________________
_________________________________________________________________________________________________
______________________________________________________________________________________
This document and the information thereon is the property of PHINMA
Education (Department of Nursing)
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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
2. ANSWER: ________
RATIO:_______________________________________________________________________________________
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3. ANSWER: ________
RATIO:_______________________________________________________________________________________
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4. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
5. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
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6. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
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7. ANSWER: ________
RATIO:_______________________________________________________________________________________
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8. ANSWER: ________
RATIO:_______________________________________________________________________________________
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9. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________ ________________
10. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
LESSON WRAP-UP (5 minutes)
You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.
You are done with the session! Let’s track your progress.
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Period 2
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AL STRATEGY: CAT 3-2-1
This closure activity is to evaluate what you had learned after the discussion and the activity .
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Education (Department of Nursing)
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3-2-1
Three things you learned:
1. __________________________________________________
2. __________________________________________________
3. __________________________________________________
Two things that you’d like to learn more about:
1. __________________________________________________
2. __________________________________________________
One question you still have:
1. ___________________________________________
For next session: Kindly read Please refer to Chapter 15: The Nursing Care of a Family During Labor and Birth-The
Components of Labor-The Passenger p. 329
This document and the information thereon is the property of PHINMA
Education (Department of Nursing)
7 of 7