Study protocol for a randomised trial evaluating the effect of a “birth environment room” versus a standard labour room on birth outcomes and the birth experience

Abstract

Introduction In the last decade, there has been an increased interest in exploring the impact of the physical birth environment on birth outcomes. The birth environment might have an important role in facilitating the production of the hormone oxytocin that causes contractions during labour. Oxytocin is released in a safe, secure and confidence-inducing environment, and environments focused on technology and medical interventions to achieve birth may disrupt the production of oxytocin and slow down the progress of labour. An experimental “birth environment room” was designed, inspired by knowledge from evidence-based healthcare design, which advocates bringing nature into the room to reduce stress. The purpose is to examine whether the ‘birth environment room’, with its design and decor to minimise stress, has an impact on birth outcomes and the birth experience of the woman and her partner. Materials and methods A randomised controlled trial will recruit 680 nulliparous women at term who will be randomly allocated to either the “birth environment room” or a standard room. The study will take place at the Department of Obstetrics and Gynecology at Herning Hospital, with recruitment from May 2015. Randomisation to either the “birth environment room” or standard room takes place just before admission to a birth room during labour. The primary outcome is augmentation of labour, and the study has 80% power to detect a 10% difference between the two groups (two-sided α = 0.05). Secondary outcomes are duration of labour, use of pharmacological pain relief, mode of birth, and rating of the birth experience by women and their partners. Trial registration NCT02478385(10/08/2016).

Healing architecture and Snoezelen in delivery room design: a qualitative study of women’s birth experiences and patient-centeredness of care

“…The study setting was an obstetric unit at a regional hospital in Denmark caring for approximately 2500 births yearly. The alternative delivery room was opened in January 2015 [25]. As seen in Table 2, it differed from traditional birth environments on several parameters.…”

“…Further information on the background of the alternative delivery room and the RCT can be found in the Study protocol for the RCT. Visualization of both the alternative delivery room and a standard delivery room in Denmark are also to be found here [25].…”

Sensory Design in the Birth Environment: Learning from Existing Case Studies

“…The possibility of personalization of the birth space enhances feelings of comfort, hominess, and privacy [80]. Interactive audio-visual systems-controlled by users with a touch panel and allowing them to design their own birth sensory setting and match it with the different stages of labour, according to hard work or relaxation, including turning everything off-promote feelings of relaxation and avoid stressful situations [15,96].…”

“…Women and birthing companions could match the scenarios to the stages of labour, shifting between hard work or relaxation, including turning them off. The nature scenarios were developed on the Snoezelen principle [96]. The four scenarios integrated soothing music for relaxation from "MusiCure" (two scenarios) and sounds from nature (two other scenarios).…”

‘What Makes It Nice Is Also What Makes It Difficult’

“…The empirical material that this article builds on is part of a larger study of new patient rooms, technologies and atmospheres in a maternity ward in a | 37 Danish Regional Hospital (Folmann 2020;Lorentzen et al 2019). The study served as a pilot project for exploring new standards for hospital rooms for the construction of a new hospital in the region and was for that purpose monitored by researchers.…”