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Minerva Ginecologica 2018 December;70(6):687-99

DOI: 10.23736/S0026-4784.18.04327-7


language: English

Optimal settings for childbirth

Nicoletta SETOLA 1 , Laura IANNUZZI 2, Marco SANTINI 3, Grazia G. COCINA 4, Eletta NALDI 5, Lucia BRANCHINI 6, Sandra MORANO 7, Ramon ESCURIET PEIRÓ 8, Soo DOWNE 9

1 TESIS Center, Department of Architecture, University of Florence, Florence, Italy; 2 Physiological Pregnancy Pathway and Margherita Birth Center, Department of Health Care Professions, Careggi University Hospital, Florence, Italy; 3 Department of Health Sciences, University of Florence, Florence, Italy; 4 Department of Architecture and Design, Polytechnic University of Turin, Turin, Italy; 5 Department of Architecture, University of Florence, Florence, Italy; 6 MondoDonna Onlus, Association for Support and Integration of Immigrant Populations and Vulnerable Women, Bologna, Italy; 7 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Infant Sciences (DINOGMI), University of Genoa, Genoa, Italy; 8 Catalan Health Service, Generalitat de Catalunya, Barcelona, Spain; 9 Research in Childbirth and Health Unit (ReaCH), School of Community Health and Midwifery, University of Central Lancashire, Preston, UK

Many studies highlight how health is influenced by the settings in which people live, work, and receive health care. In particular, the setting in which childbirth takes place is highly influential. The physiological processes of women’s labor and birth are enhanced in optimal (“salutogenic,” or health promoting) environments. Settings can also make a difference in the way maternity staff practice. This paper focuses on how positive examples of Italian birth places incorporate principles of healthy settings. The “Margherita” Birth Center in Florence and the Maternity Home “Il Nido” in Bologna were purposively selected as cases where the physical-environmental setting seemed to reflect an embedded model of care that promotes health in the context of childbirth. Narrative accounts of the project design were collected from lead professional and direct inspections performed to elicit the key salutogenic components of the physical layout. Comparisons between cases with a standard hospital labor ward layout were performed. Cross-case similarities emerged. The physical characteristics mostly related to optimal settings were a result of collaborative design decisions with stakeholders and users, and the resulting local intention to maximize safe physiological birth, psychosocial wellbeing, facilitate movement and relaxation, prioritize space for privacy, intimacy, and favor human contact and relationships. The key elements identified in this paper have the potential to inform further investigations for the design or renovation of all birth places (including hospitals) in order to optimize the salutogenic component of any setting in any country.

KEY WORDS: Birthing centers - Health facility environment - Sense of coherence - Midwifery

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