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.

The research study aims at identifying the optimal birth layout according to users’ needs and staff organization, in supporting the design of a new Midwifery-Led Unit in Italy. Midwifery-Led Units are connected to reduced childbirth medical interventions and better health outcomes. This model of care needs a proper architectural response that lacks knowledge around physiological birth space design. The Research Group (architects, environmental psychologists and midwives) entrusted with reshaping an existing Midwifery-Led Unit project, analysed how to better respond to the specific spatial and organizational needs. The process, initially based on literature review, case studies and interdisciplinary meetings lead to the analysis of critical aspects of the preliminary project. To better investigate some relevant architectural topics and set new requirements, supplementary research was conducted to understand stakeholders’ needs. Spatial layout analysis was compared to users' perception, experience, thoughts and expertise collected through questionnaires and focus groups. The research identified new requirements and design suggestions able to address the future design process and project, and created a new layout for a Midwifery-Led Unit. The results, as translation of spatial and environmental users’ needs, increased the knowledge about birth spaces and represents an innovative model for Hospital Management and Technical Office. The findings represented the base field to create a built environment able to improve health outcomes, achieve healthy behaviors and foster staff practice, also inside a traditional and rigid hospital layout.