An ethnography of the influence and meaning of the hospital birthing room for labouring nulliparous women

• Background: Since giving birth is a profound life experience, it is important to understand the impact of the physical and psychosocial environment on women´s birth processes. As part of the Room4Birth research project, a birthing room at a labour ward in Sweden was redesigned to increase its potential to be adapted to personal needs, reduce stress, enable the endogenous oxytocin release and thereby facilitate a healthy labour and birth process. Aim: To explore the influence and meaning of the birthing room for nulliparous women. Methods: Ethnographic fieldwork was conducted, including five months of participant observations of nulliparous women (n = 16) labouring in either a regular birthing room (n = 8) or the redesigned birthing room (n = 8). Reflective memos and informal interviews with women, companions, and care providers were transcribed and in-depth interviews with eight of the women were conducted two to seven months after birth. An ethnographic iterative process was used to analyse the data. Results: We identified the birthing room as consisting of the physical space, the human interaction, and cultural practices within it. The Birth Manual was an identified analytic concept for managing birth according to the organisational authority that was incorporated into the birthplace. The conforming of this manual affected the atmosphere, birth practices, and role disposition in the room. The results describe how authoritative guidance of birth processes can disposition women as passive participants, but also how midwives can enable a birth environment where women experience safety and a sense of agency. Conclusions: Regardless of the design of the room, a power imbalance between birthing women’s needs and organisational demands was identified. This emphasises the need to modify the physical design of birth units, but more importantly, to incorporate a care philosophy that promotes childbirth physiology and agency of birthing women.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)

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