Optimal settings for childbirth

Abstract

Many studies highlight how health is influenced by the settings in which people live, work, and receive health care. in particular, the setting in which childbirth takes place is highly influential. The physiological processes of women's labor and birth are enhanced in optimal ("salutogenic," or health promoting) environments. Settings can also make a difference in the way maternity staff practice. This paper focuses on how positive examples of italian birth places incorporate principles of healthy settings. The "Margherita" Birth centre in Florence and the Maternity Home "il Nido" in Bologna were purposively selected as cases where the physical-environmental setting seemed to reflect an embedded model of care that promotes health in the context of childbirth. Narrative accounts of the project design were collected from lead professional and direct inspections performed to elicit the key salutogenic components of the physical layout. comparisons between cases with a standard hospital labor ward layout were performed. cross-case similarities emerged. The physical characteristics mostly related to optimal settings were a result of collaborative design decisions with stakeholders and users, and the resulting local intention to maximize safe physiological birth, psychosocial wellbeing, facilitate movement and relaxation, prioritize space for privacy, intimacy, and favor human contact and relationships. The key elements identified in this paper have the potential to inform further investigations for the design or renovation of all birth places (including hospitals) in order to optimize the salutogenic component of any setting in any country.

What Information is Available to Women Regarding Coronavirus and Childbirth in Italy? A Mixed-methods Exploration of the Web During the COVID-19 Lockdown

“…The keywords adopted to identify the sources were 'associazioni ostetriche e Lombardia' [midwifery associations and Lombardy], 'case maternità e Lombardia' [maternity homes and Lombardy]. To note, maternity homes are not equivalent to birth centres in Italy; birth centres are managed by public health services while maternity homes are exclusively run by independent midwives and offer both social and maternity services (13).…”

Women's Experiences of Vaginal Examination During Normal Childbirth and Affecting Factors: A Qualitative Study

“…Especially in the VEs performed in the maternity ward, the differences in the environmental conditions such as the shape of lithotomy table, color of environment, goods and materials in the delivery room cause the women feel more stress (31,32). Taking into account all the study results provided above, the fundamental quantities given importance are as follows: the doors, windows and lighting system of the childbirth and VE rooms should be designed to ensure privacy (31), the rooms should be soundproof, single-room and furnished with furniture to give comfort in the home environment (32)(33)(34), the materials used in VE should be sterilized and aceptic (19,35), medical and emergency equipment in the VE environment should be hidden by visual art (36), lithotomy table of VE must be at proper height (32,34), relaxation music should be provided in the environment during the VE process (37). In the present study, in accordance with the literature, the women emphasized the need for the VE environment ensuring the physical and social privacy, the hygiene, private room, ergonomic lithotomy table and relaxing music.…”

Hospital responses to COVID-19: evidence from case studies to support future healthcare design research

“…This research led to a series of indications for hospital design based on the best scientific evidence obtained to support designers with guidelines, definitions of specific requirements and technical recommendations to create optimal healthy spaces (Ulrich et al , 2010; Nickl-Weller and Nickl, 2013; Del Nord, 2006; Setola and Borgianni, 2016). These contributions span different intervention scales, from systems through to buildings, units and individual rooms and different types of sources, from scientific papers to hospital construction manuals and recommendations on specific areas, for example, operating rooms, birth spaces, intensive care and hospital rooms (Wagenaar et al , 2018; Meuser and Labryga, 2019; Joseph et al , 2017; Denham et al , 2018; Rashid, 2015; Foureur et al , 2011; Setola et al , 2018).…”