The relationship between birth unit design and safe, satisfying birth: Developing a hypothetical model

Abstract

Recent advances in cross-disciplinary studies linking architecture and neuroscience have revealed that much of the built environment for health-care delivery may actually impair rather than improve health outcomes by disrupting effective communication and increasing patient and staff stress. This is also true for maternity care provision, where it is suggested that the design of the environment can also impact on the experiences and outcomes for birthing women. The aim of this paper is to describe the development of a conceptual model based on literature and understandings of design, communication, stress and model of care. The model explores potential relationships among a set of key variables that need to be considered by researchers wishing to determine the characteristics of optimal birth environments in relation to birth outcomes for women and infants. The conceptual model hypothesises that safe satisfying birth is reliant on the level of stress experienced by a woman and the staff around her, stress influences the quality of communication with women and between staff, and this process is mediated by the design of the birth unit and model of care. The conceptual model is offered as a starting point for researchers who have an appreciation of the complexity of birth and the ability to bring together colleagues from a range of disciplines to explore the pre-requisites for safe and effective maternity care in new ways.

An ethnographic organisational study of alongside midwifery units: a follow-on study from the Birthplace in England programme

“…38 This trend towards designing hospital wards as what are considered to be 'home-like' spaces assumes (problematically) that the home is a therapeutic landscape for all women, while also allowing them to birth within a hospital environment that is specifically away from the home, where those tools that are culturally assumed to improve safety, such as medicines, doctors and monitors, are readily available. This 'hybrid space' 38 is a manifestation of a wider cultural conception of childbirth as both a normal life event 49 and inherently risky and in need of medical assistance (see Hausman 50 for a discussion of the discourse of obstetric risk).…”

Place of Birth and Concepts of Wellbeing

“…Arguably, the 'hybrid space' of the alongside midwifery unit is a manifestation of a wider cultural conception of childbirth as both a normal life event (Foureur et al 2010) and inherently risky and in need of medical assistance (Hausman 2005; Mackenzie Bryars and van Teijlingen 2010).…”

More Than Four Walls: The Meaning of Home in Home Birth Experiences

“…Hospitals and birth have been critiqued in relation to geographical (Abel & Kearns, 1991), spatial (Fannin, 2003;Michie, 1998;Seibold, Licqurish, Rolls, & Hopkins, 2010), and design (Foureur et al, 2010) frameworks as well. The focus for much of the research on homebirth is focused on the importance of issue such as gaining autonomy by birthing outside of the medical system (Dahlen, Barclay, & Homer, 2008;Edwards, 2005;Jackson, Dahlen, & Schmied, 2012;Nolan, 2011).…”

“…While research on the experience, impact, and importance of space when it comes to childbirth is growing, the focus remains primarily on hospital space (Fannin, 2003;Foureur et al, 2010;Hammond, Foureur, Homer, & Davis, 2013;Smyth, Payne, Wilson, & Wynyard, 2013).…”