BabyMama's

VITA NOVA - new life-
Design visions for the future of maternal healthcare

By Sana Rabia Saleem & Aleksandra Piechota MT Architecture- CHALMERS 2012

ABSTRACT

Since the 1940’s the facilities for maternal health care are set inside hospitals. Hospitals are spaces designed for the ill, and by planning maternal health care in these facilities, pregnant women, though not ill,are exposed to the acute health care environment. The discoveries of Evidence Based Design have proved the connection between physical environment and clinical effects. This indicates the need for a new strategy. In the reports “A thousand voices for women’s health”, women stated that their hospital visits caused them to feel anxiety, fear and frustration (among other things). Some key factors that needed to be addressed were: reducing moving rates, promoting family to participate in patient recovery, and decreasing the feeling of isolation.

We suggest an alternative, to collect various maternal facilities and to separate them completely from hospitals (building, site and design). Further on, we propose that it is a good idea to combine maternal health care with the services of spa.

Based upon our analysis work, we have created some principles for the layout of functions and zones in a example of a maternity ward. The principles are general and can be applied to different building shapes and scenarios.

In our thesis the focus is put on the client room (patient room) and we research in how this space can change in its function by small messieurs.

We have created a high degree of generality and flexibility in a large and medium scale of planning. In the small scale (client room) we propose a detailed solution that can be transformed depending on the clients individual needs.

BAKGROUND
Health care is a very relevant topic in Sweden and Scandinavia right now are shown by the numerous investments being made in both new and existing health care facilities.

A large number of the existing hospitals in Sweden were planned between 1960- 80’s. In the 90’s there were some investments made for the refurbishment of these buildings. With the exception of a few, there has not been any new hospitals built in Sweden after the 1980’s.

Due to the rapid development of technology and science (which are two important components) health care is one of the fastest changing sectors in our society today.

The demands on health care are different from what they used to be just some decades ago. A key factor is the shift in our attitude:
we now focus on prevention and intervention more, rather than just  treating the illness after the diagnosis is set.

During our third semester in MPARCH- at Chalmers we met Roger Ulrich who is the father of  “Evidence Based Design”. EBD is a method that integrates knowledge from different disciplines in order to establish measurable relationships between physical environment and its effects.

In the initial research done in 1980 Mr Ulrich presented a study done on patients in a surgical ward in Pennsylvania. In his case study, some of the patients had a view towards a green space, others against a bare wall. The researcher was able to show that the time for recovery and consumption of anaesthetics was significantly lower in the “green” group.

In  “Evidence-based design for health care facilities” by Cynthia McCullough and co., the architecture-related factors that have been found to have positive effects on patient health are for example, contact with nature, low noise levels, views, access to natural light.

Since the 1940’s it has been a norm in the western society to plan maternal health care to be spaces inside hospitals. These buildings are designed for the ill and by following this norm, pregnant women are exposed to acute health care environments. This standard leads to an attitude that equates pregnancy with an illness.

In the report “A thousand voices for women’s health”  women stated that their hospital visits caused them to feel anxiety, fear and frustration (among other things). Some key factors that needed to be addressed were: reducing moving rates, promoting family to participate in patients recovery, and decrease the feeling of isolation.

These studies indicates the need for a new strategy for maternal health care.

During the second year of architectural master program, Healh care and Housing, we took part in numerous discussions among professionals and students. We debated about how to define the character of health care in modern society and its role in the future. A few argued that the space for health care could be connected and inspired by the  architecture dedicated to service. A good example of this is the Maasland Hospital in Orbis, Netherlands where the large open space of a atrium is design like a hotel lobby and has the functionality of an airport.

The Dutch architect Henk de Jong has been involved in designing many new hospitals in the Netherlands. At a seminar at Chalmers in 2011 he gave his views on the development in hospital design:

 - In the future hospitals will be built next to shopping centres or airport terminals. Partly it’s about achieving maximum flexibility. But it is also about the fact that there is a shift in situation where the doctor’s power is decreasing and the patient’s power is increasing. The architecture must reflect through open solutions where the patient becomes more like a customer who seeks out health care”

Therefore we suggest an alternative: to collect various maternal facilities and to separate them completely from hospitals (building, site and design). Furthermore, we propose that it is a good idea to combine maternal health care with the services of spa.

Maternity is a interesting topic, especially because it is such a existential question and a subject that we can relate to being young women. But what really made this subject appeal to us is the fact that the two of us have different cultural backgrounds (Islamic and Christian) and now we are settled Sweden (which is highly secularized country) so therefore our views are very eclectic.
Our discussions and designs are affected by this very fact and we made a conscious decision early on to investigate space that is equally appealing to all women no matter what their differences are.

DESIGN VISION
VITA NOVA -New life
Design visions for the future of maternal health care

The title stands for a metaphor marking a new stage in one’s life. A birth is not just having a child: it effects the parent/ parents/ family in every aspect of their life. The title has been chosen to point out that the action goes beyond just the act of giving birth and having a baby.  It also marks out that the architecture dedicated to this moment must extend beyond generalizing the topic as purely medical and technical. New life will be given to the architecture as well, in order to foster an optimal environment for birth.
 
Why?
According to EBD the physical environments that surround us have tremendous effects on our mental and physical health. In the case of pregnant women, stress/ stressful environments can lead to premature births. Studies have shown that prematurely born babies stand a higher risk for allergies, weaken immune system and some emotional disorders. In the case of the mother, it can lead to trauma, depression and emotional detachment from the child.  

In the report  “A thousand voices for  women’s health” done in Canada, researchers investigated in what women want from future hospitals. The studies marked the following common desires:

• Sense of belonging  
• To be provided with options and the freedom of choice
• Prevention rather then treatment.
• Focus on wellness, not illness
• To be seen as a person, not just another patient
• Feel special

We wish to create a design vision for the physical environment of maternal health spaces so the number of positive outcomes
(in health, social aspects and finance) can be increased.

We believe that our proposed hybrid solution can be a alternative approach to meet the demands of futures clients. Hopefully by this action, a more healthy attitude towards pregnancy/ maternity can be promoted.

What?
We are proposing a design vision for future maternal health care as an alternative to current standards.

Our vision is specially created for Sweden with a 20 year perspective and the report consists of analysis and design.

A part of our concept is to introduce a hybrid: the combination of maternity health care with the services of a SPA. In our proposed alternative, we collect various maternal facilities and separate them from hospitals.

Maternity is not an illness. In this thesis the care receivers of maternal health care are referred to as “Clients”

After taking part of some studies/ literature, the idea of pairing the services of a SPA with space for maternity seemed natural to us. SPA offers space for recreation, where one can turn to when seeking harmony in body, mind and soul.

Early on, we decided to start a blog about our master thesis. There we  document data from study visits, diary, internship reports, workshop reports etc.

In an interview for “Läkartidningen” Peter Fröst, professor in Architecture- Health care and Housing at Chalmers, stated that the most important findings of Evidence Based Design are those linked to the single patient rooms.

We agree with Peter Fröst and see the patient room as a first and arguably the most important step in finding better alternatives for maternal health care. Therefore we have focused our research on a single patient (client) room design. It has great potential for positive change in regards to technology, adaptability, functions, social, cultural and individual aspects.  

How?
To maximize the number of positive effects, we have applied the following principles of Evidence Based Design in our work: close connection to nature, natural light,  usage of natural elements/ materials, promoting clients integrity, freedom of choice, family centred care and reduction the number of transfers between different rooms. Our ambition is to create a proposal that allows flexibility in three different scales of planning.

Large scale
We are working with a rational modular system and this structural approach creates the possibility to investigate different configurations of units on a larger scale. This flexible attitude creates the possibility to try out different versions of (geometric) volumes, landscapes, and urban placement.

Medium scale
By analysing the different function, connection, flows and zones of various maternal wards we create a vision for the layout in a future ward. This layout is general and can be applied to different configurations of wards in maternal departments.

Small scale
The room design is created by applying different demands of for example Normal delivery, Postpartum, checkup, spiritual room (prayer and farewell), minor NeoNatal, documentation, information and consultation room in one space.

Aims
We wish to propose a valuable design vision for the future of maternal health care.  The design is created with the ambition to increase the number of positive effects of the client’s health.
Our goal is not only to provide a collected hub for maternal health care, but also a relaxed and inviting place for women to turn to during all stages of pregnancy.  

We hope that our thesis will help start a discussion about maternal health care among different social groups. The blog is created with the ambition to reach a larger group of people.