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

Area of Science:

• Environmental Psychology
• Healthcare Design
• Perinatal Outcomes

Background:

• Improving birthing room design may positively affect perinatal outcomes.
• Understanding the mechanisms and contextual elements of such interventions is crucial.
• This study explores care providers' experiences with a new hospital birthing room designed to support birth physiology.

Purpose of the Study:

• To explore care providers' experiences implementing a new hospital birthing room.
• To understand how the new design influences the interplay between birth physiology and the environment.
• To identify factors affecting the integration of the new birthing room into daily practice.

Main Methods:

• Qualitative study reporting on the implementation of a new birthing room evaluated in the Room4Birth randomised controlled trial.
• Individual interviews conducted with 21 care providers (assistant nurses, midwives, obstetricians, managers).
• Content analysis of interview data using the Normalisation Process Theory coding manual (implementation context, mechanism, and outcome).

Main Results:

• The new room challenged the prevailing biomedical paradigm, increasing awareness of the environment's impact on birth physiology.
• Care providers became more emotionally present, shifting focus from monitoring practices.
• The unfamiliar design created insecurity, acting as a barrier to integrating the room into everyday care.

Conclusions:

• A disparity exists between care providers' perceived value for women's childbirth experience and their environmental needs.
• Hospital birthing rooms should support women's emotions and birth physiology.
• Standardized birthing rooms are needed to meet care providers' requirements for a functional work environment.