As part of a new health care building project and the research project Room4Birth (R4B) as well, a birthing room at a hospital in the West of Sweden was built and furnished with physical features designed to be more adaptable to women´s personal wishes and needs during labour and birth. The physical environment can have an impact on both staff and birthing women’s experiences. A number of issues, related to the design and integration in overall hospital design, has been raised. This paper presents the design of this new birthing room, decision making concerning the room when planned and constructed and how the nine prominent features in the room has been assessed in relevance by women being cared for in the room. The purpose is to share experiences and knowledge to contribute to the development of birthing rooms and labour wards.