Messages from space: An exploration of the relationship between hospital birth environments and midwifery practice (original) (raw)
Objective: To explore the relationship between the birth environment and midwifery practice using the theoretical approach of critical realism. Background: Midwifery practice has significant influence on the experiences and health outcomes of childbearing women. In the developed world most midwifery practice takes place in hospitals. The design and aesthetics of the hospital birth environment impact on midwives and inevitably play a role in shaping their practice. Despite this, we understand little about how midwives’ own thoughts and feelings about hospital birth environments may influence their behaviours and activities when caring for childbearing women. Methods: An exploratory descriptive methodology was used and 16 face-to-face photo-elicitation interviews were conducted with practising midwives. Interviews were audio recorded and transcribed verbatim. Thematic analysis informed by the theoretical framework of critical realism was undertaken. Results: Midwives clearly identified cognitive and emotional responses to varied birth environments and were able to describe the way in which these responses influenced their practice. The overarching theme ‘messages from space’ was developed along with the three sub-themes of ‘messages’, ‘feelings’ and ‘behaviours’. Midwives’ responses aligned with the three domains of a critical realist world-view and indicated that a relationship existed between the birth environment and midwifery practice. Conclusions: The design of hospital birth rooms may shape midwifery practice by generating unseen cognitive and emotional responses, which influence the activities and behaviours of individual midwives.
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