Hospital birth units make stress-heads out of mums

The stress a mother experiences during birth can lead to interventions such as caesareans.. Salim Fadhley/flickr

More than 200,000 Australian women give birth in hospital every year, but very few give much thought to the room in which they will do it.

Imagine a woman’s surprise when they walk in to discover that this momentous, life-changing, intimate, exhausting yet exhilarating experience will take place in a bedroom decked out like an operating theatre. For many women this is not a comfortable space. But does it really matter?

New research reveals that indeed it does. Giving birth requires complex chemical processes to unfold in the mother’s brain and body. This process can be interrupted or stopped altogether if the woman becomes frightened or stressed.

The research shows there is a connection between the design of rooms where mothers give birth, their stress levels and the potential effect of such stress on newborns. There may also be a link between the design of birth rooms and the increasing number of emergency surgical births.

So where did the idea that childbirth should take place in stressful surroundings come from?

In historical terms, giving birth in hospitals is very new. Between the two world wars, women in Australia, and in most developed countries, left the comfort of their homes for the strangeness of the hospital on the promise that giving birth in hospital would be pain-free, and might be safer than at home. This continues to be the largest ever uncontrolled experiment.

No-one gave any thought to the hospital room in which the birth would take place. Birthing women were ushered onto beds as if they were patients suffering from an illness, and there they have stayed.

Since birth happens in hospitals, its not surprising that over time, birth itself has come to be regarded as a medical condition that increasingly needs to be treated and managed, rather than something that women do naturally.

The result was that as new hospitals were built, birth rooms accumulated the technology that was considered essential to treat and manage this new disease.

Their design has been largely the result of the need to accommodate a bed on which the woman must lie and room for the equipment. What women might want or need to ensure comfort and to ease their stress has not been considered.

A recent study in the United Kingdom revealed that nine out of 10 women think physical surroundings affect how easy or hard it is to give birth.

Women described the hospital birth spaces as scary and too ‘clean’, too specialised and too dangerous for those (women) not educated in their use.

Women are limited to specific kinds of behaviour in this space. They feel (unconsciously) threatened if they don’t conform; that they have become a spectacle as a result of being constantly watched; passive; and that everyone is fearful (including care providers), watching and waiting for something to go wrong.

Bianca Lepori, an architect who specialises in designing birth rooms tells us that the organisation of the entire setting is a result of the patterns of movement that occur during medical procedures; the space is not built for women at all.

How can we make the birth environment more woman-friendly and comfortable?

Our research aims to discover what kinds of environments birthing women consider as stress reducing. Early research in this area, derived from conversations with birthing women, has recently been used by a group of architects in designing the new award-winning Toowoomba Birth Centre.

The design principles of low stress birth spaces were used as the basis of their design. This included the use of noise reducing building materials so that each room is as sound proofed as possible, flexible lighting with adjustable lighting levels, comfortable domestic furniture, large, low beds and deep, wide, circular baths in each room.

There is no visible technology or equipment in the room, and sharp, square edged and metallic surfaces have been abandoned for natural materials such as wood.

There is ample room to walk around in privacy or to sit, stand, kneel or lie down. There is also a kitchen for preparing food and drink during the many hours of labour, storage for the belongings of the woman and her family or birth supporters, and a domestic feel to the interior décor.

These stress-reducing principles can be easily incorporated into existing birth units. With relatively little cost we should be able to deliver significant benefits to birthing women and their babies.