Study protocol for a randomised trial evaluating the effect of a "birth environment room" versus a standard labour room on birth outcomes and the birth experience

Iben Lorentzen, Charlotte Sander Andersen, Henriette Svenstrup Jensen, Ann Fogsgaard, Maralyn Foureur, Finn Friis Lauszus, Ellen Aagaard Nohr, Iben Lorentzen, Charlotte Sander Andersen, Henriette Svenstrup Jensen, Ann Fogsgaard, Maralyn Foureur, Finn Friis Lauszus, Ellen Aagaard Nohr

Abstract

Introduction: In the last decade, there has been an increased interest in exploring the impact of the physical birth environment on birth outcomes. The birth environment might have an important role in facilitating the production of the hormone oxytocin that causes contractions during labour. Oxytocin is released in a safe, secure and confidence-inducing environment, and environments focused on technology and medical interventions to achieve birth may disrupt the production of oxytocin and slow down the progress of labour. An experimental "birth environment room" was designed, inspired by knowledge from evidence-based healthcare design, which advocates bringing nature into the room to reduce stress. The purpose is to examine whether the 'birth environment room', with its design and decor to minimise stress, has an impact on birth outcomes and the birth experience of the woman and her partner.

Materials and methods: A randomised controlled trial will recruit 680 nulliparous women at term who will be randomly allocated to either the "birth environment room" or a standard room. The study will take place at the Department of Obstetrics and Gynecology at Herning Hospital, with recruitment from May 2015. Randomisation to either the "birth environment room" or standard room takes place just before admission to a birth room during labour. The primary outcome is augmentation of labour, and the study has 80% power to detect a 10% difference between the two groups (two-sided α = 0.05). Secondary outcomes are duration of labour, use of pharmacological pain relief, mode of birth, and rating of the birth experience by women and their partners.

Trial registration: NCT02478385(10/08/2016).

Figures

Fig. 1
Fig. 1
Study flowchart.(Single column fitting image).
Fig. 2
Fig. 2
Standard birth room, showing the adjustable height birth pool and a birthing chair positioned beside the window. In the right side of the picture is a workplace for the midwife.(2-column fitting image).
Fig. 3
Fig. 3
Standard birth room showing the labour bed and chair for the partner. At the opposite side is the resuscitation table for the newborn. (2-column fitting image).
Fig. 4
Fig. 4
The “birth environment room” showing the nature scene projected onto three walls. This is the active zone. (2-column fitting image).
Fig. 5
Fig. 5
The “birth environment room” showing the standard labour equipment in the background and the adjustable height birth pool in the foreground. (2-column fitting image).

References

    1. Posthumus A.G., Scholmerich V.L., Waelput A.J. Bridging between professionals in perinatal care: towards shared care in The Netherlands. Matern. Child Health J. 2013;17(10):1981–1989.
    1. Kesmodel U.S., Jolving L.R. Measuring and improving quality in obstetrics--the implementation of national indicators in Denmark. Acta Obstet. Gynecol. Scand. 2011;90(4):295–304.
    1. Sandall J., Soltani H., Gates S., Shennan A., Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst. Rev. 2016;4:CD004667.
    1. Hodnett E.D., Gates S., Hofmeyr G.J., Sakala C. Continuous support for women during childbirth. Cochrane Database Syst. Rev. 2013;7:CD003766.
    1. Brown H.C., Paranjothy S., Dowswell T., Thomas J. Package of care for active management in labour for reducing caesarean section rates in low-risk women. Cochrane Database Syst. Rev. 2013;9:CD004907. DOI: (9):CD004907.
    1. Gottvall K., Waldenstrom U., Tingstig C., Grunewald C. In-hospital birth center with the same medical guidelines as standard care: a comparative study of obstetric interventions and outcomes. Birth. 2011;38(2):120–128.
    1. Blix E., Pettersen S.H., Eriksen H., Royset B., Pedersen E.H., Oian P. Use of oxytocin augmentation after spontaneous onset of labor. Tidsskr. Nor. Laegeforen. 2002;122(14):1359–1362. PII: 548516.
    1. Kjaergaard H., Olsen J., Ottesen B., Dykes A.K. Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset. Acta Obstet. Gynecol. Scand. 2009;88(4):402–407.
    1. Tracy S.K., Welsh A., Hall B. Caseload midwifery compared to standard or private obstetric care for first time mothers in a public teaching hospital in Australia: a cross sectional study of cost and birth outcomes. BMC Pregnancy Childbirth. 2014;14 46-2393-14-46.
    1. Beckmann M., Kildea S., Gibbons K. Midwifery group practice and mode of birth. Women Birth. 2012;25(4):187–193.
    1. Berglund S., Grunewald C., Pettersson H., Cnattingius S. Severe asphyxia due to delivery-related malpractice in Sweden 1990-2005. BJOG. 2008 Feb;115(3):316–323.
    1. Berglund S., Grunewald C., Pettersson H., Cnattingius S. Risk factors for asphyxia associated with substandard care during labor. Acta Obstet. Gynecol. Scand. 2010;89(1):39–48.
    1. Oscarsson M.E., Amer-Wahlin I., Rydhstroem H., Kallen K. Outcome in obstetric care related to oxytocin use. A population-based study. Acta Obstet. Gynecol. Scand. 2006;85(9):1094–1098.
    1. Berry L.L., Parker D., Coile R.C., Jr., Hamilton D.K., O'Neill D.D., Sadler B.L. The business case for better buildings. Front. Health Serv. Manag. 2004;21(1):3–24. PMID: 15469120.
    1. Jiang S., Verderber S. On the planning and design of hospital circulation zones: a review of the evidence-based literature. HERD. 2016
    1. Fahy K.M., Parratt J.A. Birth territory: a theory for midwifery practice. Women Birth. 2006;19(2):45–50.
    1. Hodnett E.D., Stremler R., Weston J.A., McKeever P. Re-conceptualizing the hospital labor room: the PLACE (pregnant and laboring in an ambient clinical environment) pilot trial. Birth. 2009;36(2):159–166.
    1. Singh D., Newburn M. Feathering the nest: what women want from the birth environment. RCM Midwives. 2006;9(7):266–269.
    1. Foureur M., Davis D., Fenwick J. The relationship between birth unit design and safe, satisfying birth: developing a hypothetical model. Midwifery. 2010;26(5):520–525.
    1. Hammond A., Foureur M., Homer C.S. The hardware and software implications of hospital birth room design: a midwifery perspective. Midwifery. 2014;30(7):825–830.
    1. Hammond A., Foureur M., Homer C.S., Davis D. Space, place and the midwife: exploring the relationship between the birth environment, neurobiology and midwifery practice. Women Birth. 2013;26(4):277–281.
    1. Uvnas-Moberg K., Petersson M. Oxytocin, a mediator of anti-stress, well-being, social interaction, growth and healing. Z. Psychosom. Med. Psychother. 2005;51(1):57–80. PMID: 15834840.
    1. MacVicar J., Dobbie G., Owen-Johnstone L., Jagger C., Hopkins M., Kennedy J. Simulated home delivery in hospital: a randomised controlled trial. BJOG An Int. J. Obstet. Gynaecol. 1993;100(4):316–323.
    1. Jamshidi Manesh M., Kalati M., Hosseini F. Snoezelen room and childbirth outcome: a randomized clinical trial. Iran. Red Crescent Med. J. 2015;17(5)
    1. MusiCure music as medicine. . Accessed 15 January 2017.
    1. Mertens K. 2018. International Snoezelen Association ISNA - Snoezelen professional e.V. Available at: 10/17, 2014.
    1. Overgaard C., Fenger-Gron M., Sandall J. The impact of birthplace on women's birth experiences and perceptions of care. Soc. Sci. Med. 2012;74(7):973–981.

Source: PubMed

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