Designing out fear

Modern birth spaces are built to facilitate surveillance of the labouring and birthing woman. The high bed on which she is usually located ensures her body is available for the gaze of her care providers and is immediately accessible should the need arise to intervene. There is an array of medical/technical equipment including an imposing infant resuscitaire, with oxygen and heater, located close by the bed and there is an operating theatre light positioned overhead. The bed is covered with white sheets and a white pillow and possibly a plastic mattress cover and padded blue mat, implying its use for soaking up body fluids. The flooring is shiny; the surfaces of cupboards and metal trolleys are shiny, cold and crisp. There are no curtains to soften the light coming through the wide windows. There is a pervasive smell of cleaning products and disinfectant. …and the noise! The woman in the next room is giving birth with loud grunts as she pushes in tune with a crowd of supporters and professionals urging her on. Footsteps rushing, buzzers calling for help.

 

On entering this space many women find their excitement at the day of the baby’s birth having finally arrived – disappears in an instant – to be replaced by a feeling of disquiet and for some women even intense emotions of threat and fear.

 

This presentation focuses on the impact of the birth environment on women during labour and birth from a neurophysiological perspective. It explores theoretical but inherently practical ideas about the design principles we need to keep in mind when preparing the room to welcome the woman and her supporters into a space they will perceive as a safe, sanctuary.

 

Reference: Stenglin M, Foureur M. (2013). Designing out the Fear Cascade to increase the likelihood of normal birth. Midwifery 29(2013) 819-825