The calm-inducing, restorative power of nature is well researched and has been used in psychological treatments such as nature-based talking therapies or horticulture groups. Studies show that exposure to nature can offer a panoply of tangible physical benefits: reduction and stabilisation of heart rates, decreased blood pressure, lower levels of stress hormone cortisol and both an increase in parasympathetic nervous system activity and a decrease of sympathetic nervous system activity. Research also shows that the healing benefits of nature extend beyond those activities taking place in nature and can be felt by simply viewing nature images that project a calming perspective such as a path through a forest, waves crashing onto a beach or the expansive rolling hills of countryside.
A study of hospital patients with a view of nature or a flowering plant in their room revealed that the patients experienced less pain and anxiety, and reported increased levels of positive emotions. This evidence offers an exciting opportunity to potentially transform the birthing space. From our conversations with mothers who birthed in hospital one theme that emerged was that the room felt sparse and clinical, and was unwelcoming and intimidating. Comments included the following: “It was a depressing place, with nothing to look at”, “All the white walls were disorientating”, “there were no windows and it felt oppressive”, “it felt like a tower block, and was not a nice place to be”. One mother we talked to said that during her caesarian she felt “scared and out of control staring at the ceiling unable to move”, and that she wished she had something calming to focus on instead of the metallic surgical equipment around her and the white ceiling tiles.
Speaking with midwives we suggested the idea of nature imagery – either large printed images on the walls, or even moving, projected images, and the response was one of excitement and encouragement. One midwife said that nature imagery would “take you somewhere else” and help the woman to deal with pain, and also to bring a welcome sense of calm and peace to both mother and midwife and improve the whole atmosphere. Research about birth spaces suggest that a calming, supportive birth environment is key to influencing a successful physiological birth, with fewer interventions and less medication. If nature imagery provides just such a calm environment the potential to transform the space is huge: It offers a way to challenge the pain and anxiety felt by many birthing women, and to replace them with a sense of calmness and the encouragement of a natural, physiological birth.
Some women voiced feelings of claustrophobia in the room, the corridors or on the ward, with one mother describing it “like you are in a baby factory”. It is certainly a challenge to support the natural, primal instincts of a birthing woman in a hospital environment which is stark, sterile and clinical. Research involving midwives in Australia describe this challenge, with some referring to a hospital birth as “a procedure”, and the birthing space as a “cold, alien space” where the room “is dominated by a bed”. The midwives describe how difficult it is for them to facilitate a normal physiological birth in spaces such as this, and how the birthing women need more pain relief and labour longer.
Products are available on the market which deliver nature scenes via LED ‘moving ceilings‘ or ‘sky tiles‘, allowing the effect of viewing nature in environments such as hospital rooms or operating theatres, and these lend themselves particularly well to the birthing space where birthing people (and partners, midwives and other medical staff) can receive the physiological benefits of access to nature. Consideration should be given to those that are differently-abled, and as such it needs recognising that these products would not be suitable for birthing people who have visual impairments. Nature sound audio (such as birdsong or ocean sounds) may offer similar benefits, or essential oils of nature-based smells such as lavender, eucalyptus or cedar may offer a suitable alternative.
Birth is an emotional and psychological process, as much as a physical one, and architects and spatial designers should be mindful of this in their design of birth spaces. Research using environmental psychology, neuroscience and human brain dynamics to explain the interaction between person and place make a compelling case for a careful, innovative approach to the design of birth spaces. Interestingly, one theme emerging from research on nature-influenced design is that the primal fight or flight response is increased when individuals are exposed to elements that are seen as artifical or unnatural, such as hard-edged architecture or design (such as the rectilinear properties of hospital rooms or corridors, the sharp corners of furniture and equipment, and even the hard lines of abstract art). Conversely, the fight or flight response decreased when exposed to design elements that were perceived as more natural, and that had softer contours (such as rooms edges and room divisions that are curved and furniture with softer, rounder edges), furthermore, curvilinear spaces were perceived as more private and safe (a crucial element to birth). For those birthing people that are differently-abled, all furniture should be adaptable and accessible.
In short, the typical hospital birthing room does not meet the needs of birthing people and their families, nor the midwives, and evidence suggests this may negatively impact birth experience/outcomes. Nature-inspired design elements are effective at mitigating the negative aspects of traditional birth spaces, and bring many emotional, psychological and physiological benefits. Cost-effective, impactful and evidence-driven, nature imagery has much to recommend it in the design of birth spaces.
By Zoe Markham. August 2020.
What does this information mean for the design of birth spaces?
- How can nature be brought into the birth space in terms of the visual/audio/olfactory design elements? What resources or technology can be used?
- How can you utilise the benefits of curvilinear design? For example, an examination curtain on a curved track, rather than a straight dividing line.
- How do the benefits of nature-based design extend beyond those of the labouring and birthing woman/person? For example, can the benefits can also positively impact the ‘golden hour’ after birth when the baby bonds with its new parent/s?
