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Removing the Bed from the Labor Room

I had heard about this study and was excited to finally see it published. Noted researcher Ellen Hodnett and colleagues did a pilot study looking at the effects of the labor room environment on the amount of time women spend laboring outside a bed and on women’s and caregiver’s perceptions of an alternative set-up for the labor room. In two Toronto hospitals, researchers set-up an “ambient” labor room. The standard hospital bed was removed from the room. Instead a double-sized mattress with a colorful sheet and lots of large pillows were placed in the corner of the room. The room also featured a birth ball and a chair which required an upright or forward-leaning position. Lights were dimmed and DVDs featuring movies of ocean beaches and waterfalls played on one wall. A variety of music that could be played via speakers or earphones was available. Fetal monitoring was accomplished by intermittent auscultation. Purposely, it was difficult to instigate routine medical interventions such as continuous EFM, augmentation, or epidural analgesia. After agreeing to participate in the study, low-risk women in spontaneous labor were randomized to either a standard labor room or to the ambient labor room. The standard hospital bed could be returned to the ambient labor room at any time at the request of the laboring woman or the health care provider. Nearly all the women who were invited to participate in the study agreed to do so. There were 31 women in each group (remember, this was a pilot study.) Far more women in the ambient group (19 versus 4 in the standard group) reported spending less than 50% of the time in a bed. Interestingly, the ambient room group was more likely to report that a nurse spent all or nearly all of labor with them. Only 12 women in the ambient group required augmentation versus 21 women in the standard group. The women overwhelmingly liked the ambient group; caregivers’ attitudes were mixed, sometimes hostile. The researchers concluded that the ambient labor room should be evaluated in an adequately powered RCT. You can read the abstract of this fascinating study at PubMed (ID# 19489810) or you can read the full study in the June 2009 issue of the journal, Birth. Note: Lamaze members can subscribe to the journal, Birth, at a substantial discount. See member benefits on the Lamaze International website.

  1. Debby

    Thank you, Teri, for alerting me to this study in the first place and for inspiring me to learn more about blogging, facebook, and Twitter. One of the best things about being a childbirth educator is the spirit of sharing among educators.

  2. Teri Shilling

    Thanks Debby for highlighting this! I remember being so excited hearing E. Hodnett talk about this innovative study and now to have something in print!
    You spoil us childbirth educators by doing the work to get the PubMed link etc., etc. I haven’t even taken the plastic wrap off the BIRTH journal yet and you have blogged about it.
    Thanks for all you do!


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