A Broad Study to Develop Maternity Units Design Knowledge Combining Spatial Analysis and Mothers’ and Midwives’ Perception of the Birth Environment

Abstract

Objectives: This article investigates how the physical birth environment is perceived by the users (women and midwives) in different settings, a midwife-led unit and an obstetric-led unit, placed in Italy. Background: In the field of birth architecture research, there is a gap in the description of the spatial and physical characteristics of birth environments that impact users’ health, specifically for what concerns the perception by women. Methods: The study focuses on multi-centered mixed methods design, employing both quantitative and qualitative research methods (questionnaire, spatial analysis) and covering different disciplines (architecture, environmental psychology, and midwifery). Results: The results revealed significant differences between the two settings and some associations between perceived and spatial data concerning: calm atmosphere, greater intimacy, spacious birth room, clarity of service points, clarity in finding midwives, sufficient space for labor, noise, privacy, and the birth room adaptability. Conclusions: The findings confirm the importance of the spatial layout and indicate documented knowledge as an input to consider when designing birth spaces in order to promote user well-being.

Sensory Design in the Birth Environment: Learning from Existing Case Studies

“…For example, an intimate space can promote a calm environment and support the relationship with the partner and the ability to work together; the room's adaptability can facilitate women's sense of control and improve their comfort, changing the environment and the sensory stimulations depending on their specific needs and sensory preferences and regulation. Many design aspects can contribute to the creation of a calm atmosphere: the configuration of the birth unit, the quality of natural and artificial light, the access to views and greenery, the quality of furniture, the opportunity to hide medical supplies, and the use of art and colours in the room or on the walls, as well as reproducing music and providing aromatherapy to make the spaces warm, hospital, and domestic [11].…”

“…Mothers' perceptions of spaciousness were strongly associated with overall satisfaction with surroundings and facilities, as well as with care received [51]. The built environment can improve women's free movements and encourage them to walk around by offering free, accessible, and quality spaces [11] to guarantee the maximum emotional and physical freedom.…”

“…The perception of intimacy and privacy upon entering the birth room influences the users' emotional sphere [11]. A quiet dimly lit warm space where they feel much more enveloped can help women go inside themselves to proceed with the hard part of labour [75].…”

“…Emotions and feelings play a central role in behaviour regulation and decision making [10]. Specifically, in the birthing environment, spatial, psychological, and sensory features of the birth spaces can influence health outcomes and affect physiological birth by limiting interventions [11][12][13]. A calm atmosphere can reduce stress and enable relaxation, which can support normal birth and increase physiological benefits [7,11,14].…”

“…Specifically, in the birthing environment, spatial, psychological, and sensory features of the birth spaces can influence health outcomes and affect physiological birth by limiting interventions [11][12][13]. A calm atmosphere can reduce stress and enable relaxation, which can support normal birth and increase physiological benefits [7,11,14]. Environmental comfort and wellbeing could affect women's (and partners') behaviours and has an important role in their individual and collective experiences [6,7,[15][16][17][18].…”