Many birthing units in Australia and across the world are being rebuilt or redesigned to promote a more natural process of childbirth and reduce the need for medical intervention.
Changing the way birthing units are designed by turning them into a more home-like environment can help to reduce the need for medical intervention, which often has negative repercussions.
It has recently become accepted as truth that built environments have significant impacts on human health and well-being. This is no different during childbirth, a typically stressful time for most mothers.
In developed countries over the past 50 years, birthing units have been designed in the context of hospital care units equipped with modern technology to ensure safe childbirth. The hospital design and reliance upon medical intervention has led to an increased number of caesarean sections, something that can be decreased with efficient birthing unit design.
Sydney’s University of Technology recently created a design tool called The Birthing Unit Design Guideline to optimise the birthing experience for mothers and hospital staff.
In New South Wales, there was recent critical appraisal of the Department of Health Guidelines for Maternity Services which had been recently updated. A number of new developments based around care and healing architecture appeared to be neglected in the guidelines.
New recommendations geared toward holistic design will optimise healing environments and in turn reduce the mother’s feeling of being a ‘patient’ when simply doing something the body is designed to do.
New birthing units should create a less stressful environment for mothers that encourage normal birth without intervention.
The UK’s National Childbirth Trust (NCT) conducted research that shows women say the surrounding environment is closely linked with the success and ease of the birth.
The most notable findings of the 2003 survey were:
- The ability to move around in the room was highly important
- Physical surroundings affected the ease or difficulty of the birth
- Mothers wanted to control who came in the room, the heating and the light
- Women in comfortable facilities were more likely to give birth naturally
- Privacy was essential – women did not want to be heard or hear other women giving birth
- Important items in the room included a birthing pool, pillows and beanbags
- Women do not want to leave the room to use the toilet – ensuite bathrooms essential
Though the number of home births in Australia is increasing (0.3 per cent of births in 2009), many people are still sceptical because of the lack of medical equipment available if necessary.
By using home births as a guide for hospital birthing unit design, designers can take the comforts of home and replicate them in a hospital setting. Most women would prefer to be in the comfort of their own homes but choose hospitals for their capacity to deal with the unexpected.
Italian architect Biance Lepori believes giving birth in a hospital environment “causes women to accept the technologically expedient pathway laid down by the hospital birthing process.”
Lepori argues for balance between technical and emotional aspects of childbirth and discourages women from disconnecting themselves from active participation in birth.
By understanding what women do naturally during birth in the comfort of their homes, better birthing units in hospitals can be designed to meet the same objectives.
Birthing Unit Design Guidelines
New birthing unit design should include:
- Access to birthing unit from outside – the maternity entrance should be easily identified and welcoming. Entry through the emergency department should be eliminated
- Birthing pools and large baths on the side wall of the birthing unit to avoid placing the mother on display
- Ensuite/bathroom within the birthing unit
- Plenty of natural light and levels of light controllable by the occupant
- Careful colour selection – strong pastel colours are popular
- Medical intervention tools should not be on display, but should be readily available.
- The bed should not be the focus of the room. Most women prefer alternatives to a bed when offered
- Highly soundproof rooms
- Enhancing biophilia – easy access to nature in the form of gardens or courtyards to reduce stress.
The newly constructed Toowoomba birthing centre in Queensland gives women the opportunity to experience childbirth the way they would in their homes. The aim of the project was to take the emphasis off the clinical aspects of birth and create a comfortable centre for safe delivery of babies.
There is no doubt that physical environments contribute to positive or negative birthing experiences and research shows that women want to feel comfortable, not treated as though they are ill.