Childbirth supporters' experiences in a built hospital birth environment : exploring inhibiting and facilitating factors in negotiating the supporter role

Objective: To explore inhibiting and facilitating design factors influencing childbirth supporters' experiences. Background: Birthing women benefit from the continuous, cooperative presence of supporters. However, little research has investigated how birth room design facilitates or inhibits supporters' role navigation. Methods: We conducted an exploratory video ethnographic single case study of childbirth supporters' experiences, within an Australian hospital birth environment. Video, field notes, and video-cued reflexive interviews with the woman, her midwives, and supporters were thematically analyzed using ethnographic/symbolic interactionist perspectives to frame supporters' understandings. Results: Findings suggest supporters' experiences are complex, made more complicated by sparse understanding or accommodation of their needs in the built environment. Supporters' presence and roles are not facilitated by the physical space; they experience ''an unbelonging paradox'' of being needed, yet uncertain and ''in the way'' during ''tenuous nest-building'' activities. Conclusions: Suggested design guidelines to facilitate supporters' well-being and their roles in designed hospital birth spaces are provided.