Making Space for Midwifery in a Hospital: Exploring the Built Birth Environment of Canada’s First Alongside Midwifery Unit

Abstract

Background: Canada’s first alongside midwifery unit (AMU) was intentionally informed by evidence-based birth environment design principals, building on the growing evidence that the built environment can shape experiences, satisfaction, and birth outcomes. Objectives: To assess the impact of the built environment of the AMU for both service users and midwives. This study aimed to explore the meanings that individuals attribute to the built environment and how the built environment impacted people’s experiences. Methods: We conducted a mixed-methods study using a grounded theory methodology for data collection and analysis. Our research question and data collection tools were underpinned by a sociospatial conceptual approach. All midwives and all those who received midwifery care at the unit were eligible to participate. Data were collected through a structured online survey, interviews, and focus group. Results: Fifty-nine participants completed the survey, and interviews or focus group were completed with 28 service users and 14 midwives. Our findings demonstrate high levels of satisfaction with the birth environment. We developed a theoretical model, where “making space” for midwifery in the hospital contributed to positive birth experiences and overall satisfaction with the built environment. The core elements of this model include creating domestic space in an institutional setting, shifting the technological approach, and shared ownership of the unit. Conclusions: Our model for creating, shifting, and sharing as a way to make space for midwifery can serve as a template for how intentional design can be used to promote favorable outcomes and user satisfaction.

Challenges of Management and Care in Normal Birth Centers: Qualitative Study With Obstetric Nurses

“…National and international literature highlights the role played by health professionals such as nurses in care activities during labor, delivery, and the postpartum period, satisfactorily evaluated by parturients, their companions, and families, with actions permeated by attention, understanding, and resolution 1,[3][4] .…”

“…These spaces are considered propitious instruments for changes in maternal and child health, with the use of more humanized and participatory practices through the work of obstetric nurses who promote the role of women and their families during labor and birth 1,3 . In the global context, these health institutions are consolidated in many places, such as Canada and Japan, with promising health results [4][5] .…”

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“…Estes espaços são considerados instrumentos propícios para as mudanças na saúde materno-infantil, com a empregabilidade de práticas mais humanizadas e participativas por meio da atuação de enfermeiros obstetras que promovem o protagonismo da mulher e da família durante o parto e nascimento 1, 3 . No contexto mundial, estas instituições de saúde são consolidadas em inúmeras localidades como Canadá e Japão, com resultados promissores em saúde [4][5] .…”

Retos Del Manejo Y Atención en Los Centros De Parto Normal: Estudio Cualitativo Con Enfermeros Obstétricos

“…Estos espacios son considerados instrumentos propicios para cambios en la salud materno-infantil, con la empleabilidad de prácticas más humanizadas y participativas a través del trabajo de enfermeros obstétricos que promueven el protagonismo de la mujer y la familia durante el trabajo de parto y el parto 1,3 . En el contexto global, estas instituciones de salud están consolidadas en numerosas localidades como Canadá y Japón, con resultados prometedores en salud [4][5] .…”