Director Ahuja Health Services
Winston Churchill did say that ” We shape our building and the building shape us…” Kleeman in his book The challenge of Interior Design states, “ there are those who assert that essentially the design of an interior space and its location not only can communicate with those who enter it but also controls their behaviour”
Traditionally child birth had been taking place in homes only with the help of elderly ladies and mid wifeMen were just onlookers !
To make deliveries safe for mothers and because of advent of antibiotics and blood and trained medical persons ,field of action changed to hospital deliveries in twentieth century.
But in this process “labour became lonely”
Medical historian Judy Leavitt, a professor emeritus at the University of Wisconsin-Madison, traces the history of fathers and childbirth in her book "Make Room for Daddy: The Journey from Waiting Room to Birthing Room- wrote :,"The nurses are busy, going in and out, and the laboring women are laboring on their own. And they don't like it."
In sixties in institutional deliveries father just got a glimpse of babies just through a window as newborns were kept in nurseries. Children and other family members at home felt left out of whole excitement of welcoming new member to the family.” This an extract from a write up in 1988 by Aletha Anderson, a free-lance writer from North Tustin who gave birth to her first child in December1987.
"There was a dehumanizing of the birth process" that isolated fathers and siblings from mother and newborn.
"Outcries to humanize the birth process" led to the popularity of home births and alternative birthing centers within hospitals and to the participation of fathers and families in the birth process and it has become a family experience. In fact, in the 1960s, only nursery room nurses could touch the baby and even new mothers in the hospital were "not to unwrap or touch the baby,given to them in pillow cases"
But drastic changes came in understanding of bonding of mother and child so it became important to have first skin to skin contact of mother and new born immediately after birth of baby.
As this helps the baby adapt to life outside the mother's body. Newborn stress levels are reduced, the heart and respiratory rate stabilizes, glucose levels increase, temperature increases and the newborn starts to move toward the breast to feed. Mothers also have decreased stress and pain levels as they begin to get to know and nurture their newborn.
Instead of nursery care concept of” rooming in” became popular.
Birthing suite/LDR room concept is "not designed to change medical practice"--physicians can give the same care as in a traditional setting,but there is dramatic change in nursing care and in the decision making right with the woman. It is nursing care which is more personal and one to one.
Change of Beds in a normal delivery Process in Labour delivery wards: In a normal hospital setting for conventional non complicated delivery in labour wards , usaul proces is that the woman who enters the hospital in the early stages of labor is put into a semi-private labor room along with her attendant , who is usually the baby's father or in India mother in law./ Or patient is in a general labour ward with no privacy, When birth is imminent, the the woman is wheeled into the delivery room, shortly after the baby is born, the mother is wheeled again, this time to a recovery room, where she is moved onto a new bed ,so another change of bed and the baby is whisked off to the nursery, often with the father in attendance, to be checked over by the nursery staff.After one to two hours in recovery, the mother is transferred once more, this time to her postpartum room, where she'll stay until she's discharged from the hospital. There, in her fourth bed and room, she and the coach can relax with the baby and be joined by the rest of the immediate family.
"To be moved around like that is very disruptive"Getting up and moving when you're in pain is most difficult thing to do."
Birthing suites /LDR rooms are just labour,delivery and recovery rooms with family or birth partner and your Midwife and obstetrician with all facilities for delivery and baby care in the same room.These are woman friendly services.
In the United Kingdom recently reported rates of immersion range from 1.5% of hospital deliveries to 58% of births in a free standing midwifery unit (4,5). Several professional organizations, including the Royal College of Obstetricians and Gynaecologists and the American College of Nurse–Midwives, support healthy women with uncomplicated pregnancies laboring and giving birth in water (6,7). The United Kingdom’s National Institute for Health and Care Excellence states that women should be informed that there is insufficient high-quality evidence to either support or discourage giving birth in water (8).
The LDR and LDRP rooms are the latest step, providing a marriage of the home birthing idea with "all the benefits of the medical world," The concept "is a maturing of physicians and nurses to what the patients really want. It forces people to be a little more sensitive to the needs of the FAMILY."It is woman centred care.
Birthing suites also called LDR and LDRP rooms are designed to have labour , delivery and postpartum care in the same room with the family.Some requirements of these rooms are :
LDR rooms should be designed to meet standards that incorporate best practices to ensure that laboring women are able to relax and be comfortable, their movement is not restricted, and that their privacy is guarded. laboring women are able to relax and be comfortable, their movement is not restricted, and that their privacy is guarded.
Specifically, an LDR room should include:
In India in Public sector the facilities are very indequate and care given to laboring mothers is inadequate in most of the places.
But private sector is giving good facilities and proper LDR rooms and even water birthing facilities are being provided in many centres. One to one care is there in private settings
A 2012 Cochrane review compared traditional hospital births with alternative, home-like settings in or near conventional hospital labor wards. In comparison with traditional hospital wards, home-like settings had a trend towards an increase in spontaneous vaginal birth, continued breastfeeding at six to eight weeks, and a positive view of care.(9) The review also found that having a birth at an alternative birth center decreased the likelihood of medical intervention during labor, without increasing risk to mother or child.(9)