Ideally, during your birth, nothing is inhibiting your oxytocin production and the fewer stress hormones that are released, the better your labor will be able to progress. The goal is to set up your birth room environment to be a calming, safe environment for you to be in during labor and birth. No matter where you are having your baby you can make adjustments to your surroundings to create the environment that works best for you. This episode dives into the evidence on how your environment impacts your labor and birth, and tips to improve your birth room at home, a birth center, or in a hospital.
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The environment of the room where you give birth is a big deal. No matter where you are having your baby, there is so much you can do to set up your space to be most supportive of the birth experience you want. This episode will dig into the research on the birth environment and have some great hacks to improve your birth environment, whether you are giving birth at your home, in a birth center, or a hospital.
Hormones During Birth
In the wild most animals retreat to a quiet safe place to give birth. If there is any sign of danger it triggers fight or flight hormones and their bodies will literally halt the birth so they can react to the threat and find safety. Humans operate the same way. Oxytocin is the most important hormone during birth and it is what causes your contractions and keeps labor progressing. Your fight or flight hormones, which are known as catecholamines or more commonly adrenaline and noradrenaline, can cause oxytocin levels to decrease and can slow labor down. Ideally, during your birth, nothing is inhibiting your oxytocin production and the fewer stress hormones that are released, the better your labor will be able to progress. The goal is to set up your birth room environment to be a calming, safe environment for you to be in during labor and birth.
Oxytocin serves many purposes and it is not a coincidence that this is also the hormone released when you have an orgasm. Oxytocin is known as the love hormone. It is released when you make your baby, and when you give birth. There is a strong argument that the environment you give birth should be similar to the environment you make love in. I am not saying you have to have your baby at home in a candle filled bedroom. I am saying that you should give some thought to how you envision your birth environment. That is probably going to start with the venue of course but think about the details. What is the lighting like? What do you hear? Who are the people around you? These questions may seem silly but thinking about them beforehand can make a major difference in your birth experience. Your labor will progress best in an environment where you feel safe and relaxed. No matter where you are having your baby you could make some adjustments to your surroundings to create the environment that works best for you.
Home, Hospital, or Birth Center
Picture in your mind what a hospital room looks like. The stereotypical hospital room is brightly lit, it is a sterile environment, the center of the room has a hospital bed, there is probably a lot of medical equipment around the room. A hospital is not known to be the most inviting and calming environment. Thankfully many hospitals are doing more to make the environment in their labor and delivery ward more comfortable and relaxing by doing things like designing cabinets to conceal medical equipment, installing dimmer switches for the lighting, and using paint colors other than white.
In a home birth, you have the most control over your environment. If you are considering a birth center, they tend to be designed to look more like a home than a hospital room. If you are planning to have your baby at a hospital go look at several hospitals. The environments and the feel of them will be different and you may find that you feel much more comfortable at one over another.
Also, think about the environment your baby is in right now. Your uterus is a warm, dark, and quiet place where your baby feels safe. It may be worth thinking about how they will react to their environment when they are born. Going from warm, dark, and quiet to cold, bright, and loud is a pretty big adjustment. Your birth environment doesn’t just affect you but it will also affect your little one when they are born.
The Evidence on Labor Room Environment
There is evidence that the environment in your labor room can impact your labor and birth. In recent years there has been more attention to modifying hospital rooms to be more comfortable spaces. We are also seeing more sensory rooms incorporated into hospitals that focus on elements that make the environment more relaxing and can help a patient with pain management.
One study compared a conventional delivery room and a sensory delivery room. The sensory rooms have programmable calming lights, restful blurred pictures displayed on a wall-sized big screen, and sound effects. The study included 789 participants, 313 gave birth in the sensory delivery room, and 476 in the standard delivery room. The cesarean delivery rate was significantly lower in the group of women giving birth in a sensory delivery room (6.4%) compared with the group giving birth in a standard delivery room (10.7%). There was no statistically significant difference between the two groups regarding the other secondary outcomes of episiotomy, use of vacuum extraction, meconium, Apgar scores, or length of birth.
Some hospitals offer birthing units within the hospital, separate from the traditional labor and delivery unit. If you want the setting of a birth center, but the medical and technological capabilities of a hospital this may be a good option for you. A review of ten trials involving 11,795 women compared bedroom‐like settings with conventional labor wards. Women who were randomized to receive care in an alternative birth setting were less likely to use pain medication or have oxytocin augmentation, and more likely to have a spontaneous vaginal birth. The researchers concluded that hospital birth centers are associated with lower rates of medical intervention and higher levels of satisfaction, without increasing risks to mothers or babies.
This study examined Snoezelen rooms for birth. Snoezelen is a Dutch term that describes a controlled multi-sensory environment. These rooms featured an overhead projector emitting green light and different images and there was an aquarium with live fish. The rooms had oil-burning candles with the option to add a drop of lavender essential oil. Rooms also had light music playing. The Snoezelen rooms were associated with a lower mean score of pain intensity than the control group. The mean pain score of participants in the Snoezelen rooms was 5.26, compared to 9.56 for those in the control group. You may not have access to a Snoezelen room, but you can alter the light, smell, and sounds of any environment.
There is more research in the works to investigate what effects birth room environments have on labor and birth. This randomized controlled trial will compare a conventional hospital room to a birth environment room. These rooms are designed to bring nature into the room. Researchers are investigating to see if these rooms decrease the use of synthetic oxytocin during birth. Another randomized controlled trial aims to compare traditional labor rooms with rooms designed to foster more upright positions and mobility during birth. The goal is to see if these newly designed rooms have a positive impact on births and reduce the cesarean rate. With the evidence available now and more studies in the pipeline, we will likely see changes to hospital labor and delivery units in the future.
Changing Your Birth Environment
Until hospital birth rooms are designed to be more comfortable and more like a home environment, there is a lot you can do to easily change the look and feel of your room.
Making the Space Yours
The room you are in for your labor and birth is your space and you should feel comfortable about adjusting it. Make the space yours and do not worry about putting things in particular places or tiptoeing around to be considerate for doctors and hospital staff. Your birth is about you and the more comfortable you are, the better experience you will have. Don’t feel like you can’t use things in the room, move things around, and put your stuff where you want to. Make the space yours.
Bright light is perfect for a beach day but may not be perfect for birth. Even in a hospital filled with fluorescent lighting, you can adjust the brightness in your room. Ideally, if there are dimmer switches installed you can dim the lights. If not just turn off some of the lights. If your care provider or a nurse needs brighter lights for a specific procedure you can ask them to dim or turn off some of the lights when they are not needed. Candlelight is relaxing and although candles may not be permitted at a birth center or hospital due to fire risk, an alternative would be to use battery-powered candles. Some birth centers may have these available and if not you can always bring them with you. If you have windows in the room natural light can be a nice change from artificial lights and you can control the amount pouring in by partially closing the blinds or curtains.
Sound can be a game-changer for your environment. This could include music, meditations, or even white noise or ocean sounds to drown out other noises that can be a distraction. If you want specific music create a playlist ahead of time and make sure that you have a way to listen to it whether you will be using your phone or bring a small speaker with you. If you will be doing meditations or listening to MP3s it could be helpful to have headphones so you can really focus and not hear any other noises going on around you. Turn off your phone notifications, and ask your partner to do the same to limit those distractions.
A busy hospital can be a noisy place, and even having some music or background noises like the sound of the ocean can help to mute other noises, and maybe even be helpful for you or your partner to sleep. If you are being continuously monitored with an electronic fetal monitor you can request to turn the volume down or off on monitors or other machines that beep or make noises. Even the volume of voices can affect your environment. If you prefer to keep your labor room as quiet as possible do not hesitate to ask anyone present to speak at a low volume if that is important to you. When your baby is born they will be able to recognize your voice and your partner’s voice and the quieter the room is the better they will be able to hear you and know mama is right there.
Your sense of smell can have an impact on your mood and your environment. At home, you can control the smells in your environment but at a birth center or hospital, you may be smelling cleaning products and chemicals used throughout the facility that doesn’t help you feel comfortable and relaxed. Bringing something from home like a blanket that smells like home or a scented candle could be helpful. Keep in mind that you may not be able to light a candle if it is against the policy of the hospital or birth center, but it still may help fill the room with a nice scent. Essential oils are becoming increasingly popular for use in labor. If you are interested in incorporating essential oils in your labor and birth it may be helpful to put oils on cotton balls and store them in a Ziploc bag. Diffusing oils may be against the policy of a hospital or birth center and it would be helpful to know what their policy is before bringing a diffuser with you. Also, in the event a particular scent is no longer helpful for you, it is much easier to seal up a bag and open a new one than to clear the air and get a smell out of an entire room. Not all essential oils are recommended for expecting moms and if you have any concerns about using particular oils consult your care provider and do your research.
Visitors and Privacy
During your labor and birth, you should be surrounded by supportive, and trusted people you have invited to be in your space. If someone is there it should be because you asked them to be there. Do not let anyone pressure you into including them or bringing them into your environment if you do not want them present. Remember, this is your day and you are running the show. Due to COVID-19 hospitals have been more restrictive about their policies for visitors. Make sure you know the policy where you plan to give birth so you can plan accordingly.
Privacy is a big deal for your birth environment. How would you react if someone came to visit you at your home and walked right in without any warning? Some women make it a point to request that anyone who wishes to come into their labor room knock first. This is a reasonable request and gives you a heads up that a stranger is coming into your room. Ina May Gaskin has written extensively about the presence of a male stranger actually reversing dilation of the cervix during labor, called pasmo. There is also a past podcast episode on the concept of pasmo. I am not saying that men should be banished from your birth. There are many fantastic doctors who are men and I am a huge proponent of your partner being present for your birth, regardless of what their gender is. Even a female doctor or nurse who you have never met walking in your room can be an invasion of your privacy and catch you off guard. Part of feeling you have privacy is also being able to do whatever it is that will help you during labor without worrying about who will walk in, who can hear you, and who can see you. You can keep doors closed and curtains drawn if that makes your room feel more private.
Even in a private environment, you may be considering inviting in a birth photographer, or a close friend to take pictures, to document your day and the birth. There are so many incredibly beautiful photographs from births. In some ways it made me wish that we had done a better job documenting it. If this is something you are considering, talk to the photographer beforehand about your labor room environment so they can plan ahead to work with the lighting and surroundings you prefer. If you want photos of the birth it is a good idea to coordinate with your care provider to find out what their guidelines are for photography. If your partner or someone else will be taking photos you may want to request they do not use a flash so it isn’t a distraction for you and of course, they will not be using a flash for pictures of your new baby. If there is anything off-limits for pictures mention it, the most important thing is that you are comfortable. If the thought of someone snapping photos like paparazzi sounds terrible to you then you can certainly skip it. If you do want professional photos you could also wait until after your baby arrives and have someone come in to take some pictures after the birth.
What you are wearing can have a big impact on how comfortable you are. Hospitals tend to encourage patients to wear a hospital gown when you are admitted. These gowns are not designed for maximum comfort. Wear clothing you are comfortable in or no clothing at all. You can buy your own gown to bring with you, or even pack a lightweight bathrobe. Any clothing you wear during labor does the potential to get stained from all of the fluids that come along with birth. If you do not want to wear a hospital gown please speak up and advocate for yourself.
Anything you can add to your environment to make you feel more comfortable the better. Make sure you visit a hospital or birth center before you go into labor so you know what the labor and delivery rooms look like, and brainstorm some ways you can make it feel more like home. One easy way to make your surroundings more familiar is to include pictures of your family, a drawing from a big brother or sister to be, or an affirmation that you want to be reminded of during your labor. You want to set up the room to be your room. If there is anything that would make a difference to you pack it in your hospital or birth center bag. If something about the environment is not working for you, ask if you can adjust it, remove it, or turn it off. The more comfortable you are in your surroundings the more relaxed and at ease, you will be to focus on meeting your baby.
Including Your Birth Environment in Your Birth Plan
Planning ahead for your birth environment is part of the process of creating your birth plan. If you will be writing a birth plan and are having some trouble with where to start I would be happy to send you a copy of mine as an example. Your preferences will be different from mine, but at least you can see an example of how a birth plan could be worded and structured. The Your Birth Plan book is a step-by-step guide to writing your birth plan with samples and a template you can customize.
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