Birth Unit Design

The BUD project

Maralyn Foureur visiting birth unit in Denmark.

Maralyn Foureur visiting birth units in Denmark. 

The Birth Unit Design (BUD) Project is an ongoing program of work examining the design of maternity units. Many maternity units in Australia are currently undergoing or planning rebuilding projects to modernise existing birthing facilities. New insights emerging from an increased understanding of how the birth environment impacts maternal anxiety and physiology and subsequent childbirth outcomes can be incorporated into a set of design principles that need to be considered for optimising the healthy aspects of birth settings.

Using the BUDSET as an audit tool for evaluating existing birth units allowed the research team to select two metropolitan hospital birth sites to study the communication patterns and behaviours of women, their midwives and childbirth supporters during labour. Video ethnography and video-reflexive interviews served to gather data from multiple perspectives in this qualitative, interpretive and descriptive study. The analysis process is currently underway.

This project will help provide evidence for use in the design of birthing units that may subsequently reduce anxiety in mothers and their supporters, improve staff wellbeing and potentially lead to safer, satisfying birth experiences.

This study is supported by a UTS Challenge grant and ARC Discovery Grant DP110104108.

Ethical approval for the study was provided by Northern Sydney Central Coast AHS Human Research Ethics Committee (HREC/10/HAWKE/135) and the University of Technology Sydney Human Research Ethics Committee (UTS HREC REF NO.2011-063R).

Translation into practice

Royal North Shore Hospital, St Leonards, Sydney, NSW

Invited to provide input into the design of the Maternity Unit/Birth Suite of the new Women’s and Children’s Hospital – to be completed in 2015. This consultative work is ongoing and will continue until the design is signed off and commissioned by NSW Ministry of Health.

Mater Mothers Hospital in Brisbane

An invitation was received from the Mater Mothers Hospital in Brisbane concerning the redevelopment of their Birth Unit. As a consequence a new research project has been designed around the redevelopment, using the design principles of the BUDSET.

Birthing units, Denmark

Maralyn Foureur and Deborah Davis visit and tour Denmark birth units to gain an international perspective, 31 May – 8 July 2013.

BUDSET (Birth Unit Design Spatial Evaluation Tool)

In pursuit of developing a database for further research about the BUDSET, if you have used the BUDSET as an audit tool in any of your work please email Maralyn.Foureur@uts.edu.au to communicate the details of your particular audit. We are looking for information about the setting where you used it, the findings and any other relevant information you may have on how the BUDSET worked for you.

BIRTHING UNIT DESIGN SPATIAL EVALUATION TOOL (BUDSET) (PDF, 230KB)

 

BUD publications and presentations

Associated publication titles

Presentations

2013
  • ‘An interdisciplinary approach to exploring the influence of design on the care of women during labour and birth’, Health Environments Design Conference, Brisbane, 14 July
    Fenwick, J. & Foureur, M.
  • ‘Neuroscience and Birth Environment’, Reimagining Birth, International Research Symposium, Humanities Institute, University College Dublin, UK, 2nd July
    Foureur, M.
  • ‘Normalising Birth: Culture and Environment’, Normal Birth conference at the Royal Society of Medicine, London, 3 June
    Leap, N. & Foureur, M.
  • ‘Exploring the influence of Birth Unit Design on communication in maternity care’, UTS: Midwifery as Primary Healthcare, Graduate Diploma class, Course Number 92631, Guest presenter, Sydney, 23 May
    Harte, J.D. & Foureur, M.
  • ‘Evidence based research for effective modernisation of birthing units’, Australian Healthcare Week 2013 Future proofing healthcare delivery, Sydney, 25 – 27 February
    Foureur, M.
2012
  • ‘Understanding the Birthing Unit Design Spatial Evaluation Tool (BUDSET)’, Forbes, I.
    15th Annual Health Facilities Planning & Design Summit, Sydney, 5 December
  • ‘Does current Birth Unit Design meet the needs of women during labour and birth?’, Foureur, M.
    Mater Mothers Hospital, Research Seminar, Brisbane, 28 November
  • ‘Birth Unit Design in the Australian Health System’, Harte, J.D., & Foureur, M.
    Chinese Delegates Training Program on Hospital Management, Australia-China Relationship Association, UTS, Sydney, 19 September
  • 'Exploring the influence of design on communication in maternity care’, Harte, J.D., & Foureur, M.
    Australian College of Midwives, NSW branch, Labour and birth one day seminar, ‘Something old/something new’, Sydney, 6 July
  • ‘Exploring the influence of design on communication in maternity care’, Leap, N., & Foureur, M.
    International Association People-Environment Studies: IAPS2012 Conference, Glasgow, 24-29 June
2011
  • ‘Evidenced based health facility design: Research to inform the design of birth settings’, Fenwick, J.
    Gold Coast Health & Medical Research Conference 2011, Griffith Health Institute. Gold Coast, Sea World Resort, 1– 2 December.
  • ‘Creating optimal birth space: How physical and psychological environments impact on the health of mothers and babies’, Foureur, M.
    Home Birth Aotearoa National Conference, 2011: Today’s choices tomorrow’s parents; Bridging hearts, homes and humanity, New Plymouth, New Zealand, 28-30 October
  • ‘Design briefs for birthing units are not all black and white’, in K. Fahy (ed), Pandolfo, B. & Verghese, G.
    Women and Birth, Journal of the Australian College of Midwives, proceedings of the Australian College of Midwives 17th National Conference, 2011: A Midwifery Odyssey, Sydney, pp. S33-S34.

BUD research team

Faculty of Health

Maralyn Foureur
Chief Investigator, Visiting Professor of Midwifery

Professor Maralyn Foureur leads the project and will have overall project responsibility and coordination, supervision of research staff and support of a research assistant. Her interest in birth unit design has arisen from her many years observing women in her role as midwife. “I’ve observed what goes on in spaces. I used to think that women would have a better experience if they got to know their midwives so they had companions … that would allow them to do all sorts of things (during labour). But then I watched, even when women had their own midwives and they had somebody they knew, but even then if they weren't able to … move around in the space and do everything that they wanted to do, (it was) because the facilities just don't support it.”

Caroline Homer
Former Director of the Centre for Midwifery, Child and Family Health

Caroline has an extensive background in maternity service provision and has led research into effective models of maternity care as well as safety and quality, culture, severe maternal morbidity and workforce stress and turnover. She has strong links with policy makers and clinicians and is well known across the country in a multidisciplinary context.

Nicky Leap
Adjunct Professor of Midwifery (former staff member)

Nicky brings methodological expertise to the project as she has used video ethnography in research with colleagues at Kings College, London. She will also be responsible for supporting the researchers collecting video at the sites.

Deborah Davis
Adjunct Professor and University of Canberra and Clinical Chair in Midwifery ACT Government Health Directorate

Associate Professor Deborah Davis has expertise in researching notions of space and maternity care. Her PhD thesis on caseload midwifery with a focus on the obstetric hospital setting shaping midwifery practice and birth will be drawn on in this research project as will her recent project in New Zealand using the internet site "Second Life" to study the impact of design upon learning.

Faculty of Design, Architecture and Building

Ian Forbes

Adjunct Professor, School of Design


Ian brings a background as a practising architect and principal health planner to this project. His expert understanding of the relationships between architecture and its impact on human behaviour, particularly in the area of stress and its physiological consequences is an essential component of this project. He will be responsible for leading the design analysis of this project.

Berto Pandolfo
Director Industrial Design, School of Design

Berto has more than 20 years’ experience in industrial design after gaining his Bachelor of Arts in Industrial Design in 1988 from the University of Canberra and his Master of Arts in Industrial Design in 1992 from the Domus Academy, in Milan, Italy. Since attaining these qualifications, Berto has worked in the design industry and higher education. His experience in industrial design will assist in exploring new and emerging technologies that can be introduced to the environment and benefit the end user in a nonexclusive manner. Berto will play a key role in video analysis in terms of environmental design.

Interdisciplinary members

Roslyn Sorensen
Professor and Head of the School of Public Health, Griffith University

Roslyn has research expertise in health service organisation and safety and quality.

Jennifer Fenwick
Professor of Midwifery, Griffith University and Clinical Chair Gold Coast Hospital

Jennifer is an experienced clinician and academic with a national research profile in the area of women's childbirth expectations and experiences. Her work has involved the implementation and development of women centred models of maternity care in both the public and private sector in Australia. She has expertise in qualitative research design and analysis and her early work, on a large NHMRC project grant exploring the communication patterns and relationships between parents and nurses within neonatal nursery spaces is well cited.

George Verghese
Dean of the Faculty of Design, Kwantlen Polytechnic University, Canada

George has extensive international experience in education and practice in interior design and interior architecture, including work in North America with the internationally renowned firm of Yabu Pushelburg and NORR Partnership. He was associate professor and Chair of the School of Interior Design/Interior Architecture Educators Association, and also holds memberships in numerous professional interior design associations. George will contribute his expertise to the analysis phase of the project through his understanding of nonverbal communication in interior design.

Associated researchers

Annabelle Sheehy
Research assistant
Maree Stenglin
Associate Research Fellow

Maree is an Associate Research Fellow in Midwifery, Child and Family Health at the University of Technology Sydney and an Honorary Researcher at the University of Sydney.  Her research interests include social semiotics, with a strong focus on 3D spaces, both built and natural. Her doctoral thesis, Packaging Curiosities: Towards a Grammar of three-dimensional space, developed a social semiotic theory of space. This theory proposes tools for both the analysis and design of spatial meaning. In the past 10 years, she has applied this theory to the analysis of indoor and outdoor museum exhibitions as well as homes, restaurants, a winery and virtual spaces. She is currently collaborating with Professor Maralyn Foureur to extend this theory of 3D space to the analysis of hospital birth spaces for women.

Students

BUD students

J. Davis Harte, Project Coordinator and PhD Candidate
Faculty of Health, UTS
Supervisor: Maralyn Foureur
Thesis: The childbirth supporter study: Video-ethnographic examination of the physical birth unit environment.
Completed: 2016

Calida Bowden, Bachelor of Midwifery Honours
Faculty of Health, UTS
Supervisor: Maralyn Foureur
Thesis: Birth room images: What they tell us about childbirth.
Completed: 2015

Athena Hammond, PhD candidate
Faculty of Health, UTS
Supervisors: Maralyn Foureur and Caroline Homer
Thesis: Oxytocin and adrenaline spaces: midwives’ perceptions and beliefs about the design of hospital birth rooms. 
Completed: 2017

Associated BUD students

Tamzin Mondy, Master’s candidate
Griffith University
Supervisor: Professor Jennifer Fenwick

Sara Menke, Bachelor of Midwifery honours candidate
Australian Catholic University, Brisbane
Supervisor: Supervisors Dr Helen Stapleton and Professor Sue Kildea

 

Acknowledgement of Country

UTS acknowledges the Gadigal people of the Eora Nation, the Boorooberongal people of the Dharug Nation, the Bidiagal people and the Gamaygal people, upon whose ancestral lands our university stands. We would also like to pay respect to the Elders both past and present, acknowledging them as the traditional custodians of knowledge for these lands.