SUPER GREEN - the International Academy of Design and Health

Design & Health Scientific Reviewroom. An alcove at the entry can providea place to wash hands and a cupboardfor supplies before entry to the unit. Thewoman can see who is entering and hascontrol over her space. The room shouldhave an atmosphere of cleanliness and orderand contain feminine symbols of beauty,wholeness and harmony.Home comfortsMany women complain that rooms aredesigned around clinical procedures andthe simple things, which make the spacefamiliar and accessible, are missed 14 . Thereshould, therefore, be a cupboard to provideadequate space for the woman’s belongings.This should be designed for easy access, andfor quick unpacking and repacking as womenare not there for long.Birthing pools and large bathsIn the NCT study 14 , the second mostimportant feature of the labour roomidentifi ed by the women as helping tofacilitate their birth was access to a poolor large bath. Of those who felt this wasan important element, two-fi fths had nothad access to a pool during their last labour.Midwives who use birthing pools say womenprefer the bath not to be in the centre of aspace but drawn over to one side of theroom. The ability to lie in the water, hold onto a supporter, kneel, move about or sit up,all assist during labour and birth.There should therefore be a tub bath inone corner of the room, preferably designedso that only one side of the bath faces theroom and is not able to be approached fromall sides – thereby not placing the occupanton display. The approach side of the bathshould allow a support person or midwifeto sit and assist or to remain for some timewithout discomfort. There also needs to bea wide edge on the wall side of the bath sothe women can sit out of the bath or thepartner can lean in (as shown above).The bath must be deep enough for awoman to be on her hands and knees withher bottom submerged. Most commercialbaths are not deep enough and mean thata woman must recline (lie on her back) tolabour or give birth. A supine position hasbeen shown to be counterproductive to thephysiology of giving birth.The bath must have a showerhead witha pulsing feature and the fi xed rail for theThe birthing pool should be suffi ciently deep and provide comfortable access for birthing partners and midwivesshower head must be nogged into the wallif plasterboard, so the woman by pulling upcan use it for support. Keeping the bathwater hot is an issue and considerationmust be given to allowing higher levels oftemperature or faster fl ow rates than thenormal to quickly add hot water to the bath.Spa baths are not recommended due tocleaning and infection control issues.Convenient ensuite/bathroomIn addition to the bath, which becomesmore of a feature of the birth room, thereshould be a bathroom with toilet, hand basinand shower for normal ablution functions.The studies supported by the NCT surveyindicate that ready access to an ensuite toiletenables women to remain relaxed and canopen up their bodies without fear of soilingfl oor mats or the bed.Material support for birthingWomen will use other features in the roomat different times during labour and birth.Such items include a mantle piece for thewoman to lean on. Women often feel morecomfortable leaning on something whilestanding. The mantle piece should preferablybe of wood so that the texture and theappearance are domestic and have a naturalfeeling. Where possible, there should betiered soft-covered benches along a wall sothat the woman can lie or sit on them. Thesespaces are also important for the midwife orpartner to rest on as well.The woman can sit on the fl oor and leanagainst the benches, or use them to stabiliseherself while squatting. They need to becovered in soft material that can be easilycleaned. Material such as fl oor mattresses,bean bags, balls, pulling ropes and othersupports for labour and birth should beavailable but kept out of the room andbrought in as required.Lighting sets the moodLighting is critically important. In the fi rstinstance, natural light should be available andused. Natural light supports the biorhythmsof the body and knowing whether it is day ornight is an important orientation. Light affectsmood and stimulates people physiologicallyas well as psychologically.Colour builds the spiritCareful selection of colours is importantto support mood, by either stimulatingwith brighter colours or providing restfulpsychological responses with warm tonesthat are more subdued in colour. Smallamounts of strong colour will providestimulating vignettes but generally roomsmust have less white and cream in exchangefor stronger pastel colours.52 October 2008 | WORLD HEALTH DESIGN