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Research Projects

NHS Estates £214,035 (Value to University of Dundee: £214,035) 04.2003 – 04.2007

Birth Environment Study
Birth Environment Study
Birth Environment Study

The effects of the interior environmental design on service users and staff in maternity facilities

Main project collaborators

Dr Andrew Symon, University of Dundee (Principal Investigator)
Jeanette Paul, DJCAD, University of Dundee (Co-Investigator)
Dr Valerie Carr, DJCAD, University of Dundee (Research Assistant)
Maggie Butchart, University of Dundee (Research Assistant)

Birth Environment Study Logos DJCAD Team

Jeanette Paul (Co-Investigator)
Dr Valerie Carr (Research Assistant)

Context and background

Birth Environment Study

Environment can have a profound physiological and psychological effect on the users of space and within the stressful situation of healthcare buildings, the quality of environment becomes of critical importance. Research indicates that certain environments can reduce levels of anxiety and stress, influence the healing process and affect recovery rates. Although a number of investigations have been carried out into the effect of environment on the users of healthcare facilities, relatively little research had been carried out into maternity units and that which had been done focussed mainly on staff working methods and clinical results of patients.

Aims and objectives

The Birth Environment Study (BEST) set out to evaluate the perceptions of service users and providers regarding the interior environment of maternity units and to assess whether there were any demonstrable effects of the built environment on the well-being of users. The study evaluated ten maternity units across the UK and sought to elicit information from a wide group of stakeholders.
A combination of both qualitative and quantitative methods were employed to obtain a broad range and depth of information. The quantitative methods provided a large data set which was analysed statistically providing detailed descriptive and correlational information. The qualitative methods provided a useful in-depth understanding of users’ views providing a rich portrayal of the context.


The study identified that birth mothers perceptions of maternity units are strongly associated with quality of care as well as the physical environment. To deliver quality care, staff needs must be attended to. Staff revealed that a number of aspects of their work environment contribute to health problems. The NHS currently is experiencing many difficulties with recruitment, retention and absenteeism of staff in maternity care and consequently, shortage of staff has a direct impact on the quality of care received by the patient. Action influenced by the recommendations of this report will provide staff with a higher quality, supportive work environment which is fit for purpose and will ultimately impact positively on the quality of care received by birth mothers and their partners.


Birth Environment Study The outcome of the research was a report produced for the Department of Health at the culmination of the study. The seven key issues highlighted by the study led to a set of recommendations, the aim being to address issues that had been identified by key stakeholders and which could feasibly be implemented by the NHS. To inform procurers’ and designers’ understanding of the context of every issue, each problem was identified and was laid out in parallel with a recommendation for how this problem should be dealt with. Sixty eight recommendations were made under three categories.

In addition a number of conference papers and journal papers have been published along with press coverage in Hospital, the Official Journal of the European Association of Hospital Managers.

Birth Environment Study - click here to download PDF research description