Impact of Birthing Room Design on Maternal Childbirth Experience: Results From the Room4Birth Randomized Trial

Abstract

Objective: To study the effect of the birthing room design on nulliparous women’s childbirth experience up to 1 year after birth. Background: Although it is known that the birth environment can support or hinder birth processes, the impact of the birthing room design on maternal childbirth experience over time is insufficiently studied. Methods: The Room4Birth randomized controlled trial was conducted at a labor ward in Sweden. Nulliparous women in active stage of spontaneous labor were randomized ( n = 406) to either a regular birthing room ( n = 202) or a new birthing room designed with more person-centered considerations ( n = 204). Childbirth experiences were measured 2 hr, 3 months, and 12 months after birth by using a Visual Analogue Scale of Overall Childbirth Experience (VAS-OCE), the Fear of Birth Scale (FOBS), and the Childbirth Experience Questionnaire (CEQ2). Results: Women randomized to the new room had a more positive childbirth experience reported on the VAS-OCE 3 months ( p = .002) and 12 months ( p = .021) after birth compared to women randomized to a regular room. Women in the new room also scored higher in the total CEQ2 score ( p = .039) and within the CEQ2 subdomain own capacity after 3 months ( p = .028). The remaining CEQ2 domains and the FOBS scores did not differ between the groups. Conclusions: These findings show that a birthing room offering more possibilities to change features and functions in the room according to personal needs and requirements, positively affects the childbirth experience of nulliparous women 3 and 12 months after they have given birth.

Implementing a new birthing room design: a qualitative study with a care provider perspective

“…To understand how this complex intervention worked and to provide knowledge about the mechanisms that influenced its implementation [ 22 ], it is crucial to recognise how the users interacted with the birthing room. Labouring women’s use and experiences of the new room have been reported in previous Room4Birth studies [ 17 , 21 , 23 ]. The present study aimed to explore the care providers’ experiences of the implementation of the new birthing room.…”

“…Previous research has highlighted that care providers’ approaches and practices influence the atmosphere of the room, with considerable impacts on childbirth experiences and birth physiology [ 9 , 17 ]. Being supported with emotional presence may have contributed to women randomised to the new room reporting more positive long-term childbirth experiences, as observed in the Room4Birth RCT [ 21 ], compared to women in standard rooms. Additionally, the midwives of the current study regarded the new room as a valuable resource in their endeavour to relieve women’s labour pain through non-pharmacological alternatives, which may partially explain the reduced use of epidural analgesia in the new birthing room [ 8 ].…”

“…Trustworthiness of the study was achieved through repeated discussions involving all authors during the analysis process. It was also a strength that the authors represented different perspectives and that one of the authors (MT) was not involved in the effectiveness studies [ 8 , 21 ]. Another strength was that the purposive sample of participants represented all professions at the labour ward, as well as the organisation of care.…”

“…The hypothesis that the new room would improve the primary composite outcome — spontaneous vaginal birth, no oxytocin augmentation, post-partum blood loss < 1000 ml and a positive childbirth experience in nulliparous women when compared to standard birthing rooms — could not be verified. Results from analyses of secondary outcomes showed that the new room contributed to women’s sense of safety, privacy and control, lowered the use of epidural analgesia, [ 8 ], and had a positive impact on childbirth experiences 3 and 12 months after birth [ 21 ].…”

Impact of hospital architecture on the birthing experience: a phenomenological study with mothers-to-be who are design experts

“…En un reciente estudio sueco 22 se ha comprobado que poder ajustar la sala donde las madres paren en el hospital para adaptarla a sus necesidades (como regular la iluminación natural y artificial, modificar la posición de la cama, parir en vertical aprovechando la gravedad, usar una bañera de partos, escuchar sonidos naturales, o tener una decoración doméstica con dispositivos clínicos ocultos), hace que la experiencia de parto recordada hasta un año después sea más positiva comparada con la experiencia en una sala de partos tradicional. A pesar de que este estudio se basa en datos cuantitativos del mayor nivel de evidencia, obtenidos a partir de un ensayo controlado aleatorizado donde utilizan el cuestionario validado CEQ2 [23][24] , sus con-clusiones recomiendan combinar sus resultados cuantitativos con estudios cualitativos que exploren en profundidad los elementos de diseño que afectan a la experiencia de la madre y perduran en su recuerdo.…”