Health care spaces to support maternity care

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Labor, delivery and postpartum maternity care differs from other types of health care for several reasons. Childbirth is the only instance when health care staff are responsible for two patients at the same time, and one of the rare instances when generally healthy people require significant care.

However, even healthy patients can suddenly become high-risk, and childbirth morbidity and mortality remain high even among industrialized nations. Improvements require a multifaceted approach, much of which can be supported by design.

The Center for Health Design’s Knowledge Repository includes salient studies on design for labor, delivery and maternity care. Three recent articles are highlighted here.

A study by Sherman and colleagues out of the Stanford “d.school” used design thinking to examine design for maternal and neonatal care. Through observations, photographs, tours and interviews with clinicians and design professionals, the researchers found areas where the physical environment can support better outcomes. These included provisions to support blood availability for hemorrhage management, appropriate space for neonatal resuscitation and access to equipment and supplies.

One of the main challenges in designing for the birthing experience is meeting individual patient needs for such a personal and significant event, while also addressing safe patient outcomes for a wide variety of circumstances and potential complications.

A recent study in Sweden by Skogström and colleagues looked at what women find important in a birthing room. Women in labor were assigned to either a traditional birthing room or a room designed with several options such as dimmable lights, music, a bathtub and a window with an option of a screen with programmable nature scene projections. Medical devices were hidden behind wooden panels unless needed. Women shared that they felt “welcomed and strengthened” by the room and they appreciated the variety of options, especially the bathtub.

The aim of a recent review of the literature by Blair and colleagues was to provide an update on the current state of the evidence around design for maternity care for women with physical disabilities. Even though this review focused on studies in high-income countries, the results highlighted disappointing and even unsafe birthing experiences for many women with disabilities.

Findings revealed the frustrating and demeaning experience of giving birth at a facility without accessible parking, ramps, automatic doors and accessible bathrooms. There also appeared to be a lack of adjustable equipment (e.g., exam tables and baby cots) in many facilities, making it impossible for women to comfortably receive care and to care for their new babies.

Childbirth is one of the most personal and significant experiences in life and, while women and infant needs vary widely, the environment must be designed to support all abilities, safety and better outcomes. To learn more about how design can impact the experience of labor, delivery and postpartum care, as well as several other topics related to health care design, visit The Center for Health Design’s Knowledge Repository.

Research used for this column

The following research citations from The Center for Health Design’s Knowledge Repository of health care design resources were used by the author when writing this column:

• J. P. Sherman, et al., “Understanding the Heterogeneity of Labor and Delivery Units: Using Design Thinking Methodology to Assess Environmental Factors That Contribute to Safety in Childbirth,” American Journal of Perinatology 37, no. 6 (2020).
• L. B. Skogström, et al., “Women’s Experiences of Physical Features in a Specially Designed Birthing Room: A Mixed-Methods Study in Sweden,” HERD: Health Environments Research & Design Journal, 2022, in press.
• A. Blair, et al., “Access to, and Experiences of, Maternity Care for Women with Physical Disabilities: A Scoping Review,” Midwifery 107, no. 103273 (2022).

About this column

“Design Discoveries” highlights research from The Center for Health Design’s Knowledge Repository, a user-friendly library of health care design resources. This research effort is supported by the American Society for Health Care Engineering, the American Institute of Architects, the Academy of Architecture for Health Foundation and the Facility Guidelines Institute.