Optimal settings for childbirth

Abstract

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 Centre 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 toinform 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.
(Cite this article as: Setola N, Iannuzzi L, Santini M, Cocina GG, Naldi E, Branchini L, et al. Optimal settings for childbirth.
Minerva Ginecol 2018;70:000-000. DOI : 10.23736/S0026-4784.18.04327-7)