Birth environments for women with complex pregnancies: A mixed-methods systematic review

Sands, Gina; Evans, Kerry; Spiby, Helen; Eldridge, Jeanette; Pallotti, Phoebe; Evans, Catrin

Abstract

Background: Birth environments can help support women through labour and birth. Home-like rooms which encourage active birthing are embraced in midwifery-led settings. However, this is often not reflected in obstetric settings for women with more complex pregnancies. Aim: To investigate the impact of the birth environment for women with complex pregnancies. Methods: This was a mixed-methods systematic review, incorporating qualitative and quantitative research. A literature search was implemented across three databases (Medline, CINAHL, Embase) from the year 2000 to June 2021. Studies were eligible if they were based in an Organisation for Economic Cooperation and Development country and reported on birth environments for women with complex pregnancies. Papers were screened and quality appraised by two researchers independently. Findings: 30,345 records were returned, with 15 articles meeting inclusion criteria. Studies were based in Australia, the UK, and the USA. Participants included women and health professionals. Five main themes arose: Quality of care and experience; Supportive spaces for women; Supportive spaces for midwives; Control of the space; Design issues. Discussion: Women and midwives found the birth environment important in supporting, or failing to support, a positive birth experience. Obstetric environments are complex spaces requiring balance between space for women to mobilise and access birthing aids, with the need for medical teams to have easy access to the woman and equipment in emergencies. Conclusion: Further research is needed investigating different users’ needs from the environment and how safety features can be balanced with comfort to provide high-quality care and positive experiences for women.

Citation

Sands, G., Evans, K., Spiby, H., Eldridge, J., Pallotti, P., & Evans, C. (2023). Birth environments for women with complex pregnancies: A mixed-methods systematic review. Women and Birth, 36(1), 39-46. https://doi.org/10.1016/j.wombi.2022.04.008

• Journal Article Type: Article
• Acceptance Date: Apr 8, 2022
• Online Publication Date: Apr 14, 2022
• Publication Date: 2023-02
• Deposit Date: Apr 13, 2022
• Publicly Available Date: Apr 15, 2023
• Journal: Women and Birth
• Print ISSN: 1871-5192
• Electronic ISSN: 1878-1799
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 36
• Issue: 1
• Pages: 39-46
• DOI: https://doi.org/10.1016/j.wombi.2022.04.008
• Keywords: Maternity and Midwifery; Obstetrics and Gynecology
• Public URL: https://nottingham-repository.worktribe.com/output/7758767
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1871519222000737