Op-Ed: Elevating architecture for birth: a global initiative
Transforming Birthspace: A Global Colloquium, held at OCAD University in late October, brought together architects, designers, artists, midwives, doctors, doulas and health-care researchers from across the globe. Their presentations and discussions aimed to gather and mobilize knowledge about how architectural design could transform the experience and outcomes of birth.
Design of birth environments might seem to be a minor and highly specialized architectural focus, of little interest to most architects; however, the colloquium sought to challenge that perception.
The organizers and presenters posit that transforming birth space and place is a significant architectural project of our time. The transdisciplinary gathering of invited speakers brought together diverse research-informed content – discussing what is needed, what is influential, and why.
The colloquium underscored the message that designing better places is not related to creating a sense of luxury. It is about challenging clinical and impersonal models of birth care, and supporting the neurophysiology of birth processes. It is about embracing and enhancing the emotional and spiritual nature of birth. It is about creating an architecture for birth that has an atmosphere of safety, belonging, familiarity, and connection to nature and culture.
Sensitive design for birth is situated within a philosophy of architecture that values the built environment as a provider of existential meaning and human connection to place and context. Personal dignity and agency, cultural safety, and positive birth experiences are at stake; escalating rates of medical interventionism, operative birth, and birth trauma are implicated.
Reinvention of care spaces for mothers, infants and families, in both higher and lower economic status locales, can include, but also move beyond, hospital layouts and birth rooms.
Designers working with midwives and communities of care are developing new projects around the world, using ecological and local materials. The need is great, and exciting work is underway, as the Transforming Birthspace events made evident.
Culmination of a five-year research program
The four-day colloquium, related exhibition and web resource launch represented the culmination of a five-year initiative, funded by several grants from the Social Science and Humanities Research Council of Canada, and led by OCAD U Professor Emerita Dr. Doreen Balabanoff. A longstanding faculty member in Environmental Design program, she has been involved with OCAD U’s graduate programs in Design for Health, Inclusive Design and Interdisciplinary Art, Media and Design. Her practice-based doctoral study, Light and Embodied Experience in the Reimagined Birth Environment, was grounded in her work as an artist and designer.
The research initiative was developed as a collaboration between institutional partners: OCAD U (Design), the University of Florence (Architecture), Flinders University in Australia (Midwifery) and Boston Architectural College (Design for Human Health). The principal investigators – Dr. Balabanoff, Setola, Newnham, and Harte – are founding members of the Global Birth Environment Design Network.
The case for design intervention
“Birth spaces occupy a unique position within health-care architecture. While most medical facilities focus on patients who are ill or injured, birth spaces are mostly occupied by healthy persons. Birth is not an illness, it’s a lived experience,” says Dr. Balabanoff. “Whether discussing individual labour and delivery rooms, or operating rooms where caesarean births take place, there is a need for more empathic and experientially oriented design.
She notes: “To create spaces that provide the possibility of undisturbed birth, designers need knowledge about the physiological processes of birth – and a wealth of knowledge exists. To enhance psychological and spiritual wellbeing around birth, many aspects of comfort and control need to be designed into the setting.”
Dr. Balabanoff says that “architects need to be aware of the lack of respectful care and personal safety that many women have experienced, and continue to experience, in medical birth settings. Historical legacies of oppression and denigration of women, of racism and colonisation, are still present in birth culture today – here in Canada, and across the globe. The accommodation of personal, emotional, and culturally sensitive aspects of birth is often missing. The environment is implicated. Families experiencing trauma or grief, and ‘high risk’ mothers are also not adequately considered…their needs for sensitive environments are not being met. We can do so much better.”
Knowledge Hub: web resource for architects and designers
A key goal and outcome arising from the research partnership was the development of a Web Resource for architects and designers. This knowledge hub presents detailed ‘positive exemplar’ case studies, birth centres or maternity units visited by the research team. Interviews were recorded with architects, founders, midwives, doctors, and mothers and partners. The website provides a rich body of information and inspiration, utilizing a framework connecting visual images of built spaces, the design issues the architects addressed, and the architectural concepts they developed.
Transdisciplinary perspectives
Invited colloquium guest speakers came from Austria, Australia, Canada, Denmark, Germany, Ireland, Israel, Italy, Mexico, Nigeria, Spain, Switzerland, and the United States, and represented diverse fields including architecture, midwifery, medicine, neuroscience, biomedical science, public health, Indigenous healthcare, consciousness studies, art, social sciences, and patient advocacy.
Canadian midwife/educator/researcher Dr. Vedam delivered the opening keynote on respectful care and equity in birth. Her research at the BirthPlace Lab has focused on issues of respect and dignity in maternal healthcare care, particularly for marginalized communities who experience disproportionate rates of disrespect, coercion, and significantly poorer outcomes in conventional hospital birth settings.
Australian midwife/educator/researcher Dr. Foureur’s keynote focused on the neurohormones of birth, and the role of neuroarchitecture and neuroaesthetics in the development of better birth spaces. Her Emotional Design Brief is a major and recent addition to the Australian health-care architecture field.
Spanish architect Marta Parra gave the third keynote, presenting multiple built projects within diverse settings, offering rich insight into aspects of design that can be implemented to make birth spaces comfortable, private, and amenable to physiological birth, while responding to and expressing sense of place.
Additional presentations covered topics that ranged from built architectural projects to studies of consciousness, biology, neuroscience, postpartum spaces, Indigenous traditions, art, humanism and post humanism, space syntax, trauma-informed design, light and atmosphere.
An open access YouTube channel is available for viewing the colloquium presentations and discussions.
Exhibition: design prototypes
Complementing the colloquium was the exhibition, Transforming Birth Through Architecture and Design, held at OCAD U’s Open Space Gallery from October 24 to November 10. The exhibition presented architectural proposals and prototypes that challenged conventional birth room typologies, offering tangible examples of how research translates into design practice.
The exhibited designs ranged from interventions within existing hospital infrastructure to comprehensive designs for freestanding birth centers. Projects addressed various scales of intervention—from immersive art installations capturing birth and hydrotherapeutic experiences, to room-scale environments that prioritize comfort and choice, to facility-wide planning that integrates different models of care within a single campus.
Policy development and professional impact
The colloquium concluded with two collaborative workshop sessions to consider further work towards transformational change: ideas for systemic change, and continuation of the discourse and collective knowledge mobilization. A policy document is being developed, as part of the colloquium knowledge mobilization work. Those interested can follow the progress and developments by joining the Global Birth Environment Design Network through the website at gbedn.org.
A global movement
The Transforming Birthspace initiative connects to a growing international network of researchers and practitioners focused on birth environment design. The Global Birth Environment Network aims to facilitate collaboration among architects, designers, midwives, and researchers worldwide.
The network is informal, but future developments are in progress, so that this work, spanning across disciplines, research findings, design innovations, implementation strategies, and different healthcare contexts, can continue and grow. Successful birth space design requires balancing evidence-based and research-informed practice with cultural knowledge, empathic understandings, and community engagement.
We welcome Canadian architects and designers: your thoughts and questions, and your interest in joining this movement for architecture and design for birth that responds to the deep human need for improving the birth experience. Please reach out to the Global Birth Environment Network.
Dr. Doreen Balabanoff is an OCAD U Professor Emerita.
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