Setting up a Birth Room
Setting up a birth room in a midwifery business isn’t just about where the bed should go and birth tub. Each setting has its own unique challenges. We want the space to be pretty and functional at the same time.
The size of the room, door ways, windows, layout is just one piece of the puzzle. There are times when you have no control of layout like in a home birth. You are coming into a woman’s space and need to be more flexible. I like to do 36wk gestation home visit to help me understand her home layout. Basements are harder to do water births with emptying the tub outside (need pump available versus self draining). Main level births are my preference if there is an emergency, EMS can access mother and baby easier. Are there dogs, parking restriction, Amish with no electricity? There are many things going through a midwife’s mind to make a safe birth environment.
Hospital regulations and infection control sometimes dictate what type of furniture, accessibility to tub, bed, and bathroom is present. City regulations may require additional building support under tub. I had a city require drains placed in floor near tub if over flow was a potential. I didn’t argue, because I knew it was a challenge to get birth center going in this area. You pick which inspection or regulation requirements to battle.
Is there a hospital bed or standard bed? Do you get a queen or king sized bed? Protective mattress cover that can easily be cleaned between patients. What birth supplies should be present behind pictures and in shelves? What can be kept in room, locked up, and refrigerated?
Home birth midwives needs to pack bags that have everything they need. This settings needs to be extra prepared, because there isn’t a pharmacy to get back up medications, another birth room to grab supplies from, or additional staff if emergency is occurring. Having a reliable birth assistant on call is very important versus an extra nurse on hospital unit coming into room for delivery time to assist with newborn care.
Supplies needs to be sterilized, kept for long term durable packaging, and easily available if rushing into home for precipitous delivery. I kept basic supplies in one section if birth was happening fast and I was only by myself (assistant hasn’t arrived yet). Making sure inventory is checked out after every birth and once a month see how close medications are to expiring and use closest expiration first. Being resourceful of inventory when it is your own midwife business purchasing supplies. Hospital midwives tend to not realize back drop costs of equipment and supplies when their salary comes each week whether one pad is used or twenty.
Privacy protection is so important. Is bathroom or tub separate from birth room? Even the simple thought of which way door opens to birth room is needed to be discussed. Floor plans from an architect are helpful. I loved playing around with free online programs like https://floorplancreator.net/ . Being able to see how much space their “really is” for me, family, and furniture in the birth rooms.
In my birth center, made sure there was a sink and shelf to set supplies (customized dresser) next to bed and birth tub for easy clean up and grabbing things. Handicapped accessibility of all birth rooms for visitors and patients we serve. Hand rails for getting in and out of birth tub were really nice when a women had her baby’s head out and a shoulder dystocia was present in the tub.
Having access on both sides of bed and at least two sides of birth tub is really helpful. In a home setting, there is less flexibility to birth room layout and that needs to be taken into account when transport and safety protocols are being made for emergency situations.
Good lighting (I placed dimming switches in my birth rooms) is very important for assessing vaginal bleeding during labor and postpartum, newborn assessment, charting paperwork, and cleaning up messes. I had handheld lights near my charting and birth supplies if the room was dark. I have separate lighting system directly over the birth tubs and the main room with bed.
Everyone’s favorite part is picking color scheme and the decorations that are calming to mother and family, but that is just a small part of overall midwife business planning. Having safety and home like environments are vital to a successful practice.