The Environmental Load of Childbirth Settings: Development and Testing of a Measurement Tool

Abstract

Numerous studies in environmental psychology have examined the physiological and/or psychological effects of various environments. Examples of such research have included investigations of the neurohormonal effects of selected social and therapeutic environments (Dimascio, Boyd, Greenblatt, & Solomon, 1956; Kiritz & Moos, 1974; Ostfeld & Shekelle, 1967). One characteristic of environments that has received special attention is the "load" of the environment. Mehrabian (1976) has defined "environmental load" as the degree of novelty, complexity and stimulus intensity of an environment. He has described environments as either high-load or low-load settings: high-load settings are novel, complex, high-stimulus settings, while low-load settings are familiar, simple, low-stimulus settings (Mehrabian, 1976, pp. 12-13), and the load of the settings has had demonstrable effects on physiological, cognitive and behavioural functioning (Mehrabian, 1978). Recently, attention has been paid to the effects of the environment in which women labour and give birth. Alterations in methods of care for women during childbirth, including the increasingly routine use of sophisticated medical interventions (such as electronic fetal monitoring, continuous epidural anaesthesia and intravenous oxytocin), have led to speculation that current North American birth environments can have a negative impact on childbirth outcomes (Norr, Block & Charles, 1977; Richards, 1982). In response to consumer pressure, many hospital labour wards have endeavoured to provide more home-like birthing environments. The redecorated labour rooms are often called "birthing rooms" and are set aside for women who are deemed to be low in obstetrical risk and who desire unmedicated, spontaneous vaginal births.