Room4Birth
Short description
A safe and comfortable environment is an important prerequisite for optimal healthcare. The overall purpose of the Room4Birth Research is to extend the evidence-based knowledge on the design of the maternal healthcare environment and how it influence health and outcome of care. Focus is on the birthing room and how it influence labour and birth outcomes including the experience of the birthing woman.
The Room4Birth research project – a multi-disciplinary programme
The Room4Birth research project is an interdisciplinary activity conducted by the Institute of Health and Care Sciences at the Sahlgrenska Academy, University of Gothenburg.
The Principle Investigaor is Professor Marie Berg.
Most studies are conducted in Sweden, and a few in the Democratic Republic of Congo. The Room4Birth programme also includes several development studies, pedagogical projects and master theses.
Collaborating partners:
- Centre for Healthcare Architecture, Chalmers University of Technology. Gothenburg Sweden School of Nursing & Midwifery, Trinity College Dublin, Ireland
- Evangelical University in Africa, D.R. Congo
- University of Borås Sweden
- Sahlgrenska University Hospital Gothenburg Sweden
- Panzi general referral hospital, Bukavu, D.R Congo, and Birth Rights Sweden.
Motif and theoretical basis
To give birth is a central life event that is remembered and affects the woman throughout her life. It is an innate, biological, instinctive process that has always been, and still is, linked to certain risks. Therefore, mammalian mothers, including human beings, have instinctively always chosen to give birth in an environment perceived as safe, secure, and private. When a woman in labour arrives at the hospital, fear and defense functions may be activated (by such factors as loud noise, light, a strange, unfriendly environment), and the activity of some parts of the brain cortex and amygdala that signal danger can increase. Consequently, the activity of the body's stress and defence system also increases (the HPA axis). Under such circumstances, oxytocin release may be inhibited, and/or the sympathetic nervous system activity may increase. Consequently, labour contractions can become too strong and painful, or even cease, leading to medical intervention, and to a remaining fear of giving birth again.
The opposite also applies; if the cortex and amygdala perceive the environment as safe, harmless, friendly, and inviting, this leads to physical and mental relaxation, and to decreased fear and stress responses. Oxytocin release increases together with the activity of the parasympathetic nervous system. This leads to more effective labour contractions and to a good blood circulation in the uterus, which positively affects the progress of childbirth, increases oxygenation of the fetus, and prevents postpartum hemorrhage. In addition, it is more beneficial to give birth at night16. The hormone melatonin, more often released during darkness, promotes labour and birth by decreasing the effect of the sympathetic nervous system and increasing the effect of the parasympathetic nervous system, which facilitates oxytocin-induced uterine contractions. Touch, warmth and closeness also promote the release of oxytocin, increase the function of the parasympathetic nervous system and decrease stress levels.
Giving birth can be a strengthening force for women who experience safety and who are able to give way to the labour flow. It can also leave negative impressions such as feelings of helplessness, loss of control, insecurity, fear, and objectification. Historically, women have generally been attended and supported by other women (lay or professionals) during labour. In later years, fathers to be/partners have often taken over this role.
In Sweden women give birth mainly at hospitals. The goal is that the majority of the women have a spontaneous vaginal birth without instrumental interventions. However, statistics show that caesarean sections and extractions with vacuum suction have increased in recent decades. This trend towards less spontaneous vaginal, non- instrumental births is unfortunately similar in low-income countries such as in D.R. Congo.
Experience of non-empathetic treatment by healthcare professionals that work in threatening or over-medicalised environments can further influence negative impressions. A negative experience of childbirth can cause ill-health in women such as posttraumatic stress disorder, depression, and persistent intense fear of childbirth, and may be related to a delayed subsequent pregnancy and to demands for future operative birth.
The healthcare environment affects the patient's recovery and health, however the healthcare environment in relation to birth is sparingly studied.
Researchers
University of Gothenburg
Marie Berg
Lisa Goldkuhl
Hanna Gyllensten
Helle Wijk
Urban Berg
Others:
Cecily Begley
Göran Lindahl
Christina Nilsson
Kerstin Uvnäs Moberg
Anna-Karin Ringqvist
Anna Andrén
Denis Mukwege Mukengere