Birth environment interventions and outcomes: A scoping review

Abstract

BackgroundThe physical environments in which women give birth can contribute positively to meeting both physiologic and psychosocial needs during labor. Most studies on the labor and delivery processes have focused on mitigating pain and providing psychological support. Fewer have explored the influence of the physical birth environment. In this study, we performed a scoping review to compile and examine qualitative and quantitative studies related to the characteristics of physical birth environments and their effects on labor outcomes.MethodsWe searched the PubMed, CINHAL, Cochrane, Web of Science, and MEDLINE databases from inception to May 2022. A total of 13 studies met the criteria for inclusion in our review. Two reviewers screened the titles and full‐text articles and extracted data from the included studies. We used summary statistics and narrative summaries to describe the study characteristics, intervention implementation guidelines, intervention selection and tailoring rationale, and intervention effects.ResultsIn previous research, several elements of birth environments have been shown to provide physical and psychological support to birthing people and to improve outcomes related to the experience of care and pain management. We identified five main themes in the included studies: (1) “hominess;” (2) whether spaces are comfortable for activity; (3) demedicalization of the birth environment; (4) accommodations for birth partners; and (5) providing women with a sense of control over their birth environment.ConclusionsBirth environments should be designed to promote positive birthing experiences, both physiologically and psychologically. Facilities and those who manage them can improve the experiences and outcomes of service users by modifying or designing spaces that are “homey,” comfortable for activity, demedicalized, and include natural elements. In addition, policies that allow the birthing person to control her own environment are key to promoting positive outcomes and satisfaction with the birth experience.

The Potential Role of Wearable Inertial Sensors in Laboring Women with Walking Epidural Analgesia

“…Multimodal pain control with preserved motor function and, most importantly, less restricted or non-restricted movements during labor have been studied using traditional outcome measurements such as pain level, opioid consumption, duration of birth phases, maternal satisfaction, neonatal outcomes, and many others [ 21 , 28 , 29 , 30 ]. None of these studies assess the quality and quantity of women’s movements during labor, and the published results, which at time conflict, are not adjusted for movement quantity.…”