title: Childbirth Supporters' Experiences in a Built Hospital Birth Environment: Exploring Inhibiting and Facilitating Factors in Negotiating the Supporter Role.
abstract: 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.
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia j.davisharte@gmail.com.
authors.forename: J Davis
authors.initials: JD
authors.lastname: Harte
authors.affiliation: School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
authors.forename: Athena
authors.initials: A
authors.lastname: Sheehan
authors.affiliation: School of Design, Faculty of Design, Architecture and Building, University of Technology Sydney, Ultimo, New South Wales, Australia.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Stewart
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
authors.forename: Maralyn
authors.initials: M
authors.lastname: Foureur
mesh_terms: D000328:Adult; D001315:Australia; D016550:Birthing Centers / Q000592:standards*; D059037:Doulas / Q000523:psychology*; D005260:Female; D006749:Hospital Design and Construction / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009721:Nurse Midwives / Q000523:psychology*; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D012944:Social Support
keywords: birth unit design; childbirth supporters; evidence-based design; hospital design; maternity units; video ethnography