The effect on the birth experience of women and partners of giving birth in a “birth environment room”: A secondary analysis of a randomised controlled trial

Objective: To evaluate women and partners’ experience of birth in a "birth environment room" compared
to a standard birth room.
Design: A single centre parallel randomised controlled trial. Women and partners were enrolled during
a 3-year period (May 2015 to March 2018).
Setting: The Department of Obstetrics and Gynaecology at Herning Hospital, Denmark.
Participants and intervention: A total of 680 Danish speaking nulliparous women, more than 18 years
old, with a singleton pregnancy in cephalic presentation, and a spontaneous onset of labour, and their
partners were randomly assigned to give birth in a “birth environment room” (n = 340) or in a standard
birth room (n = 340) on arrival at the birth unit.
Measurements and findings: Outcomes were the overall birth experience and overall satisfaction with
care, measured on a Likert scale, obtained in the postpartum questionnaire sent to the women 6 weeks
after birth and to their partners 1/2 weeks after birth. Other outcomes were “staff support for partner”,
“undisturbed contact with new-born”, “feeling of being listened to”, “level of information”, “attention to
psychological needs”, “suggestions for pain-relief”, “participation in decision-making”, “midwife present
when wanted”, “support from midwife”, “birth wishes were met”, “loss of internal control” (only women),
“loss of external control”, “support from partner” (partners: “being supportive for partner”), “importance
of physical environment for birth” and “importance of physical environment for staffs´ ability to involve
the women” (only women). All outcomes were prespecified. We applied Mann Whitney U test for comparing the two groups. Data were collected from 326 women and 236 partners in the intervention group
and from 315 women and 209 partners in the control group. The intention-to-treat analysis revealed no
difference in the overall experience of birth for women or partners (p 0.81 and p 0.17, respectively). Partners in the intervention group reported more overall satisfaction with care compared to partners in the
control group (p 0.048). In the intervention group, fewer women and partners responded they had not
had the opportunity for undisturbed contact with their new-born in the first hours after birth (RR 0.19
(95% CI 0.04-0.87) and OR 0.00 CI (0.00–0.83), respectively). Otherwise, there were no differences between groups. The thematic analysis revealed that many women and partners felt they were not able to
benefit from the features in “the birth environment room” in the most intense hours of birth.
Key conclusion and implications for practice: "The birth environment room" did not improve the overall
experience of birth for women and partners. Partners in the intervention group were overall more satisfied with care. These findings are of importance in the developing of physical birth environments that
support the mental/emotional process of labour.