Free-Standing Birth Center Environments Influencing Culturally Sensitive Maternal Care Experiences

ObjectiveThis study explores the perspectives of birthing persons (BP) from historically underrepresented communities (HUCs), their support persons (SP), and Free-Standing Birth Centers' (FSBCs) birthing staff (BS) providing maternal care to these communities to understand how FSBC's physical environment influences culturally sensitive maternal care experiences within these settings.BackgroundIn the USA, birthing persons from underrepresented communities have disparate maternal care experiences and outcomes. Studies show that FSBCs, which follow the midwifery model, provide culturally sensitive care for birthing persons from underrepresented communities. However, few studies have explored these community members' perspectives of the physical environment of the FSBC settings they experience.MethodsIn-depth semistructured interviews with 28 BPs, SPs, and BSs from HUCs were thematically analyzed using a deductive-inductive approach to derive the participants' perception (three themes), "care experience" (11 themes), the physical environment at three spatial levels (community, facility, and room level) where these themes were addressed, and their corresponding design elements.ResultsThe physical environment was described positively in most quotations (82%), with "care experience" themes such as autonomy, support, and comfort most frequently discussed across the community, facility, and room level. At the community level, the travel distance and time taken to reach the FSBC were discussed, whereas family and social support spaces and the spatial organization and layout were frequently mentioned at the facility and room level.ConclusionsThe emerging design elements can help inform the physical environment of future maternal care settings to promote a culturally sensitive maternal care experience for people from HUCs.