The space where babies are born – whether at hospital, birth centre or at home – is an important and critical space. The needs of the birthing woman and people, child and medical or healthcare professionals work in a complex dynamic towards a central aim: the safe delivery of a child.

Labour goes beyond the physicality of birth – it is an intensely emotional and psychological process – yet this has historically been the focus of birth space design. Birth spaces that are emotionally and psychologically welcoming are sacrificed for the medical model of a hospital birth in which the room is clinical and dominated by medical equipment, typically with the birthing woman and people labouring and giving birth on a bed, attended to by doctors.

The evidence is clear – outcomes for birthing women and people and infants improve when they are supported to give birth in spaces that encourage relaxation, where they feel emotionally and psychologically supported and where they are free to move about. Despite this, the spaces in which people give birth do not routinely facilitate this. This leads to increased anxiety for the birthing women and people, a higher risk of medical interventions (and the consequent increase of adverse outcomes), and a more stressful working environment for midwives.

The authors of this website are three Msc Occupational Therapy students from the University of Brighton. We have been invited to consult with the midwifery department to explore the design of an innovative birth space. Our aim has been to identify any shortcomings of current hospital delivery suites, to explore the medical, social and environmental issues surrounding hospital births and to make suggestions for improvements based on available evidence. Occupational therapists working in the maternity pathway have unique skills to offer and have varied roles, but to be involved in the design of a birth space is a new focus of our skills. Occupational therapy is a holistic practice which empowers people to realise their full potential, taking into account their abilities, their environment and any barriers they may face. To apply this in terms of a birthing space we have considered the unique process of childbirth not only as a physiological process, but also in how it affects the person emotionally, psychologically and spiritually. To view childbirth as an ‘occupation’ we have come to understand that there is a shifting of identity and power, and that birthing women and people need the right support and encouragement in order to step into this new role. In particular, we have identified that childbirth extends beyond the delivery room, and that the events that occur therein can have a profound and lasting impact. As such our OT recommendations have been to put the birthing woman and people at the centre of all our recommendations, and to use robust evidence to support the design of a birth space that responds to the needs of those giving birth and that removes barriers to providing the birth that people hope for. We have been fortunate to speak with a number of people about their hospital birth experiences which have been invaluable in understanding what people find most important about the experience. These discussions are quoted throughout the website as they offer valuable perspectives on the current hospital maternity provisions. We have also spoken with experienced midwives about what they know and understand about the labour and birth process, and how important they feel the physical birth environment is and about the opportunities for innovation.

This project provides ideas for a birthing space that is fit for purpose – not just the safe delivery of a child, but also where the emotional and psychological needs of everyone involved are respected and catered for. To design a space that follows the evidence supporting a healthy and safe natural birthing process, to put the birthing person at the centre of the birthing process and to facilitate a birth experience that birthing women and people can own and be proud of, however it happens.

By Zoe Markham. August 2020.

We would like to extend our thanks to our project leader Jo Gould, Senior Lecturer in Midwifery at the University of Brighton, for her expert advice and leadership. Jo led us through the main themes of midwifery, and gave excellent direction and feedback as we embarked on this journey into the unknown!  We have enjoyed the sharing of ideas, and have found learning about a new discipline a rewarding endeavour.

We would also like to show our gratitude to our placement supervisors Audrey Yong and Paul Boyle, Senior Lecturers in Occupational Therapy at the University of Brighton. Your steady and encouraging supervision helped keep us on track, made sure we kept an occupational focus, and helped make a success of this novel placement concept.

Thanks also goes to the women we interviewed about their birth stories – this added useful insight and we very much appreciate them sharing their stories with us. And to the midwives we interview from Kingston Hospital maternity unit – their knowledge and experience was invaluable, and being able to test theories about birth space design with them was hugely useful.