Physiological Birth: a Concept Analysis

Tuesday, 14 July 2009

Adriana Arcia, BSN, RN
School of Nursing and Health Studies, University of Miami, Coral Gables, FL

Learning Objective 1: recognize the defining attributes of physiological birth

Learning Objective 2: describe the relationship between physiological birth and the related concepts of natural birth and normal birth


The aims of this presentation are to clarify the concept of physiological birth and to compare it to the related concepts of natural birth and normal birth.


Concept analysis was conducted using the Walker & Avant (2005) method.

Twelve defining attributes of physiological birth are identified.  They are: (a) the onset of labor is spontaneous (b) labor is not augmented but proceeds spontaneously (c) no intravenous fluids are administered (d) the labor and delivery are unmedicated (no epidural) (e) no routine interventions are used (f) there is no artificial rupture of membranes (g) the laboring woman has freedom of movement (h) she uses advantageous (non-supine) pushing positions (i) episiotomy is not performed (j) the birth occurs vaginally (k) the placenta is delivered without the use of oxytocics (l) and the result of the delivery is a live newborn.  A model case, alternative cases, antecedents, consequences, and empirical referents of physiological birth are all described.

Neither ‘natural birth’ nor ‘normal birth’ are ideal terms for use in research or in practice.  ‘Natural birth is a value-laden term with imprecise boundaries.  ‘Normal birth’ is conceptually unstable because its meaning is unclear and context-specific.  ‘Physiological birth’ is the appropriate term to fill a critical void in the lexicon of birth care.


In research and in practice, productive discourse about birth requires commonly accepted conceptual referents.  Both ‘natural birth’ and ‘normal birth’ are inadequate in this regard.  By contrast, ‘physiological birth’ is conceptually clear, stable, and value-neutral.  Because its defining attributes are derived from the physiological processes of birth, and not by care practices, ‘physiological birth’ can be used and understood within and across cultural contexts.


Walker, L. O. & Avant, K. C. (2005). Strategies for theory construction in nursing (4th ed.). Upper Saddle River, New Jersey: Pearson/Prentice Hall.