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Birth in Nature

The physical environment is one of the factors that affect women's experience of labor. The basics of the childbirth process have not changed since the beginning of human existence; however, the environment in which women today give birth has changed significantly (Butani & Hodnett, 1980). One study found that 94% of women thought that the physical environment affected how easy or difficult giving birth was. However, the literature on the impact of interior/architectural design on women's birth experience is limited (Newburn& Singh, 2003). Incorporating design elements and strategies that calm and reduce negative emotions may create positive experiences for women in labor. The purpose of this study was to examine the impact of one such strategy, namely the presentation of images of nature, on the labor and delivery experience. The sample consisted of 50 women in labor. The participants were recruited during prenatal classes offered at a birth center in a medium- sized city in Texas, and from Health Point clinic in the same city. The sample were divided randomly into two groups, A and B. Group A was the control group with no exposure to images of nature. Group B had the opportunity to view images of nature displayed on the labor and delivery room TV. After delivery, all participants were given two questionnaires. The first questionnaire was a demographic one, and the second was a sub-scale adapted from the questionnaire of Quality from Patients' Perspective (QPP). In addition, vital signs (including blood pressure and heart rate), use of epidural and pain relief medications, and Apgar score were examined from the subjects' medical records. The study findings showed that the experimental condition has a higher score on the QPP sub-scale, Group A m= 4.46, Group B m=4.63. In addition, there was a positive correlation between hours of viewing Nature video and QPP mean scores. The analysis showed an increase of the QPP scores associated with the increase of Nature TV watching time, QPP mean of watching time (less than an hour) Group m=4.5, QPP mean of watching time (more than 3 hours) m=4.8. Pearson's correlation showed a significant negative relationship between QPP means scores and pain medications r= -.341, p=. 039. The mean score for the heart rate was lower in the experimental condition m= 84.60, than in the control condition m= 90.49. For Apgar, the mean score was higher for the experimental Group A m= 8.65, Group B m=8.92. These findings support the study hypothesis which states that the nature images would influence the labor experience positively. In addition, the findings emphasize the importance of incorporating non-pharmacological techniques in LDR units to sooth the pain. Adding Nature imagery to the LDR environment can be one of these techniques.