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Room 4 Birth - The effect of an adaptable birthing room on labour andbirth outcomes for nulliparous women at term with spontaneous labour start: study protocol for a randomised controlled superiority trial in Sweden
Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University.
Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0002-3195-5702
Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University.
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2019 (English)In: TrialsArticle in journal (Refereed) Published
Abstract [en]

Background

An important prerequisite for optimal healthcare is a secure, safe and comfortable environment. There is little research on how the physical design of birthing rooms affects labour, birth, childbirth experiences and birthing costs. This protocol outlines the design of a randomised controlled superiority trial (RCT) measuring and comparing effects and experiences of two types of birthing rooms, conducted in one labour ward in Sweden.

Methods/design

Following ethics approval, a study design was developed and tested for feasibility in a pilot study, which led to some important improvements for conducting the study. The main RCT started January 2019 and includes nulliparous women presenting to the labour ward in active, spontaneous labour and who understand either Swedish, Arabic, Somali or English. Those who consent are randomised on a 1:1 ratio to receive care either in a regular room (control group) or in a newly built birthing room designed with a person-centred approach and physical aspects (such as light, silencer, media installation offering programmed nature scenes with sound, bathtub, birth support tools) that are changeable according to a woman’s wishes (intervention group). The primary efficacy endpoint is a composite score of four outcomes: no use of oxytocin for augmentation of labour; spontaneous vaginal births (i.e. no vaginal instrumental birth or caesarean section); normal postpartum blood loss (i.e. bleeding < 1000 ml); and a positive overall childbirth experience (7–10 on a scale of 1–10). To detect a difference in the composite score of 8% between the groups we need 1274 study participants (power of 80% with significance level 0.05). Secondary outcomes include: the four variables in the primary outcome; other physical outcomes of labour and birth; women’s self-reported experiences (the birthing room, childbirth, fear of childbirth, health-related quality of life); and measurement of costs in relation to the hospital stay for mother and neonate. Additionally, an ethnographic study with participant observations will be conducted in both types of birthing rooms.

Discussion

The findings aim to guide the design of birthing rooms that contribute to optimal quality of hospital-based maternity care.

Place, publisher, year, edition, pages
2019.
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-22321DOI: 10.1186/s13063-019-3765-xISI: 000504430900001PubMedID: 31744523Scopus ID: 2-s2.0-85075285529OAI: oai:DiVA.org:hb-22321DiVA, id: diva2:1381441
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2020-01-10Bibliographically approved

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