What is snoezelen first of all?
Snoezelen first appeared as a leisure activity for the impaired ones. It has been used in many fields of health care and for big cohorts of patients – psychiatric disorders, dementia and care/nursing homes, physical and mentally impaired, palliative care, and also used for relaxation neonates, critically ill children, and chronic pain. The positive outcomes of the use of a space like this are mentioned in many different articles and studies and seen in practice. The rooms combined with multiple sensory stimulations – vision, touch, sounds, smells, and aromas, provide a plethora of therapeutic and educational effects/outcomes – wellbeing, relaxation, rest, satisfaction, tranquility, joy, serenity, calmness; engaging service user’s within the intervention/process/recovery they’re going through active participation and acknowledging the positive impact of their actions and control of their bodies for more positive outcomes.
The lack of research regarding the impact of multisensory environments in childbirth and laboring women, is noticeable so we would like to share an article about women’s experiences of the use of a snoezelen during birth. This study was completed in Australia, with 16 birthing mothers, who were interview 5-6 weeks after birth after to share their birthing experiences in the snoezelen room. The outcomes and shared experiences in this article will allow you to understand a little bit better this “unconventional” use of different multisensory resources to enhance a more natural and suited birthing experience for different women. Where a client-centred approach, the adaptability of resources, equipment, and the room will provide positive birthing experiences for women through the creation/implementation of an individualised birth space, suited to the women’s needs and wishes.
The analysis of the responses from mothers after the use of a snoezelen room during labour were analysed and 6 themes emerged: distraction, relaxation, comfort, environmental control, choice of complementary therapies, and safety in a non-clinical atmosphere. It is simpler to read and write about it, but we would also like to share with you some of the personal experiences (quotes) from women in this study to try and create awareness about how multisensory environments have positive outcomes during birth:
“I think all of them together because it was such a distraction you’re far more focused on what was going on in the room rather than how you’re feeling” – the power choice in terms of distraction enables women to enjoy the different features of the room, distracting from possible pain and discomfort during the stages of labour.
“The fish tank and there was kind of like coloured lights on the wall as well, they were on, and there was a disco light as well. It was very, very calming.” – Considering one’s sensory preferences Some women attributed a particular feature to enhance their own relaxation, feeling more relaxed during labour.
“The fact that there was moveable furniture there that we could play around with in terms of helping me relax.” … “There was different ways you could sit rather than being stuck over a hospital bed, you could sit all different ways like you’d be at home.” – both aspects show how the flexibility of movement and the different features to change position during labour important factors for more comfortable and relaxed and client-centred care, moving forwards from the industrialised, technologic, and bed-focus maternity care.
“Everything was how I pictured it, using the Snoezelen room, using the spa, walking, being active, very quiet, like I was just in a trance, I was so in control of my own body that it felt really empowering.” … “When the midwives wanted to enter they knocked on the door, there wasn’t anyone just bursting in whenever they wanted to, I couldn’t hear anything else going on outside so we were very much alone.” – Women value this aspect of environmental control, with reason. The privacy and respect showed by professionals by knocking on the door before entering, the windows to the outside, dimmed lights, all help women to focus their energies into that moment and process, empowering them and giving them strength and confidence for what is coming.
“I had my own essentials oils so we put those on in the room, lavender. It was a relaxation CD that they had in there which was quite nice, cause I had my own relaxation CDs with me as well.” – Different features and equipment allow women to try them, allowing them to choose the preferred ones that would induce a calm and relaxed state. Again, each woman will have their own preferences and some might use the music, others the smells and aromas and other just the space in itself for movement, dance, or try the different surfaces for the choice of a comfortable position for birth.
We hope that these experiences will create a much broader awareness and understanding about the use of sensory equipment and resources for a more individualised care and birth outcomes.
Most hospitals have standard birth rooms with not much equipment available for mothers to use during birth. Birth centres here in the UK tend to be more specialised and suited to the individualities of birthing mothers. And even in home births, the home environment is obviously suited to the mother it is familiar to her.
So what can we do to use multisensory resources if they’re not available in the hospital/birthing unit/birth space? – A multisensory toolkit for birth.
It’s simple. From our OT perspective and knowledge gained through this placement opportunity, the continuity of birth care and preparation for birth should (ideally), include a “getting to know” the birthing mother – gathering information about her preferences, likes and dislikes, wishes and expectations (what we mean by this is put it into words/visuals etc, the type of birth they want to have if they don’t mind getting touched, privacy aspects, partners presence, use of music, massage or other equipment/resources that they find useful for a more relaxed state). We are aware that the birth plan would include some of these important aspects, however as OT’s, we strongly believe that the preparation for the birthing environment, building trust and respectful relationships with women, involving partners or other family members should be the standard practice and key interventions during birth.
For the preparation of the environment, we meant the trial of the different features, equipment, and sensory stimulation; the use of different relaxing strategies (like massage, breathing exercises, water immersion, partners role within the environment; that will benefit the women (and partners! Yes they do need to be more relaxed too, and so do the midwives and health professionals!) during birth, achieving a more tranquil and relaxed state that will enhance oxytocin release and the onset of birth.
For this, health professionals, in preparation for birth, could deliver preparation sessions for women to experience and try the potential birth room/space, equipment, and features. Having on display all the features of a typical snoezelen or multisensory room would enable the birthing mother and partner to chose their own sensory preferences to induce relaxation and a stress-free birthing event (e.g. fibre optic lights, lava lamps, dimmed lights, music or relaxation cd’s, aromas, cushions/gym balls/birthing stools, massage, or even the birthing pool (if available! We all know the analgesic power of water in childbirth – the inclusion of a birthing pool in every birth space would be an ideal and powerful transformation in my point of view, as well as hanging bars or straps for an upright optimum birth position – check more about this optimum birth position here – spinning babies and here for waterbirths). This preparation, through experimentation and choice of the appropriate and individualised resources to use, the connection that this experience provides to the couple, and the “getting to know” and familiarise with the environment, will help the physiological process of hormonal release (feeling good hormones, the power of oxytocin and endorphins during birth) enhancing labour and habituation of that emotional and life-changing process.
Furthermore, mothers could then, at their own time, find or request assistance in acquiring some of these features/resources so they can prepare themselves at home to achieve this crucial relaxed, and calm state for the birthing event. The choice of music, the smells they like, the presence of partner massaging her back, the ability to move around and stay upright or use a gym ball, all this shows how individualised and client-centred the midwifery practice could potentially be, resulting in better and more positive outcomes for birth (if you include OT’s within the amazing multidisciplinary teams in midwifery even better, there’s a lot of scope for OT’s to work within antenatal, birth and postnatal care, where the focus on environment-mother-birth are explained in our blog regarding the OT model, PEOP (the interactions between person-environment-occupation-performance) – if you are an Occupational therapy interested in this area check here about the potential role of OT’s in maternity care!
Below, you can find a range of pictures of the different features and resources that could be used to enhance a more relaxed and stress-free birth space and experience. A multisensory toolkit for birth could be a potential resource for a more suitable and individualised intervention, reducing the costs of the necessity to build snoezelen rooms in every hospital/maternity unit/birth centre, where birthing mothers and partners familiarise themselves with the equipment and features during the preparation for birth, for a more positive birthing outcome and experience.
Check this link for more information about complementary therapies during labour.
Also, check these 2 articles about the design of alternative delivery rooms inspired by the principles of healing architecture and Snoezelen for client-centred care and more positive birth outcomes and an evidence-based guide to birth environment design.
By Raquel Caninas de Freitas, August 2020
Time to reflect… considerations for the future.
For health care professionals:
Health care professionals in maternity care, how can they be able to provide this client-centred environment for birthing mothers, considering constraints regarding time management, resources, and costs for NHS?
Is it time to rearrange the multidisciplinary team in maternity care, by including this emerging occupational therapy role, to support mothers and partners to prepare not only for birth but for the environment itself (birth space), the new occupational role as a mother/father, always considering their individualities, strengths, needs, choices, and rights, in this so well-known client-centred approach by Occupational Therapists?
What types of resources/equipment options are there to help birthing mothers to give birth in an upstanding position, discontinuing the focus of the bed as the “main” place to give birth? Straps hanging from the ceiling to support birthing mothers? Hoists or something similar? How can we improve this upstanding birthing position and how can we help women during pregnancy to adapt to this new holistic turn of maternity care?
For birthing mothers:
What is the best complementary therapy/ resource that would help me relax and feel less stressed for the birth of my child?
What are my sensory preferences? Visuals? Sounds and music? Smells and aromas? or Tactile, like a massage? What would make me feel super comfortable and achieve this optimal relaxing state? Water immersion?
How can I prepare myself for this new birth environment?
