Considerations for providing continuum of care in children’s hospitals
The design of women’s services within a children’s hospital, from preventive care to birth, wellness and beyond, must offer a fine balance. The spaces should be separate and distinct from pediatric services, welcoming, innovative and comfortable, while prepared for emergent situations.
From dedicated entrances and elevators, attractive and comfortable labor and delivery rooms, flexible ante- and post-partum areas, high-risk responsiveness and C-section suites, hospitals are continuously innovating and elevating their women’s care and childbirth units. The following are considerations that highlight the importance of empathy throughout the planning and design process.
Essential services with a distinct identity
Women’s services within a hospital setting are essential for several reasons. Maternal care includes prenatal care, high-risk obstetrics and labor and delivery services. This ensures mothers with high-risk pregnancies or complications can receive specialized care in a hospital setting equipped to handle both maternal and neonatal needs.
Integrating women’s services promotes family centered care. It allows for coordinated care between mothers and their children, particularly in cases where both require medical attention and support. Many children’s hospitals have specialized neonatal intensive care units for premature babies or infants with complex medical conditions. These units are crucial for providing intensive medical care and monitoring, and are often integrated with women’s services to facilitate immediate care for newborns.
Having women’s services within these hospitals facilitates collaborative research and education, and enhances training opportunities for healthcare providers specializing in maternal and child health. Overall, women’s services in a children’s hospital setting ensure comprehensive care for mothers and children, catering to their unique medical needs and promoting better health outcomes for families.
Women’s services are often co-located on a dedicated floor or area of the hospital, with an internal entry portal marked by distinct branding and architecture, which assists in differentiating the space. The design of the women’s services area should complement the branding, design and material/color palette of the children’s hospital, with an elevated sophistication and style for women. Wayfinding begins with the arrival of patients of various ages and stages who are directed to facility entry/access points and then guided to appropriate areas of the hospital, whether for pediatric or women’s services, from the main public areas.
Advantages of adjacency and connection
Women’s services span prevention and wellness through OB/GYN, prenatal outpatient care (wellness checks during pregnancy of mother and fetus; procedures on fetus in utero), maternal fetal medicine clinic, labor and delivery, post-partum, ante-partum and intensive care services for newborns, infants and children (NICU, PICU, CICU). Health systems should evaluate outpatient services offered for women’s health to determine which are most appropriate to locate on a combined women and children’s hospital campus or within the hospital adjacent to women’s services, such as maternal fetal medicine. Adjacency and co-location of these services greatly increase convenience, expediency and continuity of care.
Coordination of internal circulation is important to assure limited intersection of other services, staff, patients and families with women’s services areas.
Flow and access
When co-locating women’s services, consider the access and flow of varying populations. We’ve discussed patients in need of women’s services who walk into the main lobby. But what of those in distress or in active labor? OB triage and emergency service protocol must be established for women arriving with acute needs during and after regular hours.
Will women arriving by ambulance stop in the emergency center or proceed to labor and delivery? This path should be pre-planned with clear signage and wayfinding. Expectant mothers arriving at the front entry need clear wayfinding, close parking or drop-off and a direct route to labor and delivery triage.
Modernized birth experience
Today’s comfortable and private labor and delivery suites are designed with and for a patient-centric approach, emphasizing comfort, privacy and safety. The aim is a hospitality atmosphere with patient preferences reflected upon arrival. Expectant mothers come in with a customized/personalized plan and expectation, which requires flexibility, choices and attention to detail; the environment should reflect that.
From untethered fetal monitoring systems that allow moms to move around, to birthing beds with adjustable features, technology plays a crucial role in modern LDR suites. Advanced medical equipment should be seamlessly integrated into the room’s design, which enhances clinical capabilities and provides a sense of medical care being available when needed but does not unduly alarm new parents.
Recognizing the importance of familial support during childbirth, modern LDR rooms are larger with space for partners, family members and/or doulas, fostering a supportive environment that promotes early bonding and involvement in the birthing process. There are clear zones within the room for clinicians, patients, families and infants.
Private LDR bathrooms are generously spaced, and some showers offer water massage jets, benches for seating and ambient audio features. Water births may be offered.
Complex pregnancies
Mothers who experience complicated deliveries and/or caesarian sections deserve patient spaces designed with equal amenities. High-risk pregnancies require specialized care and facilities equipped to handle complex medical conditions that may be pre-existing or emergent in both mother and infant. Integrating maternal fetal medicine with women’s services in a hospital enables coordinated care for mother and baby. Additionally, it ensures a smooth transition to post-birth care.
Units within the hospital designated for high-risk obstetrics ensure specialized care, while minimizing potential complications and risks associated with mainstream maternity wards. Ultramodern monitoring systems integrated into high-risk facilities allow for continuous surveillance of maternal and fetal health parameters, enabling early detection of complications and timely intervention. Open spaces help communication and teamwork among multidisciplinary healthcare providers, supporting coordinated care delivery and best outcomes.
Cesarean section surgeries require dedicated operating rooms designed to accommodate the unique needs of surgical childbirth. Innovations in C-section suites focus on efficiency, infection control and patient safety. This area should be separate from the children’s surgical suite with potential shared use of services such as central sterile.
Rooming in and specialty spaces
Ante- and post-partum areas focus on promoting healing, recovery and maternal-infant bonding. As soon as the infant can be stabilized, the focus is on infants staying with their mothers and families in rooming-in programs. Nurseries are used more for exams or transitional care.
Post-partum room design supports this focus with space and furnishings for partners and family members for overnight stays; a clear, open area for the placement of multifunctional infant bassinets for sleeping, changing, exams and bathing; and room for personal storage. High-risk post-partum rooms may consider added amenities on the unit to accommodate longer lengths of stay, including more personal storage/space for snacks/mini fridge; a family lounge, workspace and community space.
The advantages of couplet care, where a sick or pre-term newborn remains within easy reach of mother, are now well proven. This requires decisions about location (NICU or post-partum), who will be accommodated within this space and specialty furnishings and equipment such as bassinets with sides that lower for mothers to have access to their newborn without standing or getting out of bed.
Families in all situations
Spaces should be available that honor diverse types of families, making each individual feel as welcome and comfortable as any other. For example, overnight stay spaces should be provided for surrogates and adoptive families, to create the same level of hospitality.
Bereavement areas or “butterfly rooms” should also be available for families to spend their infant’s last moments in a soothing environment and to have transition time before leaving.
Domestic and family disputes can bleed over into birthing areas. Controlled access to labor and delivery areas enhances patient safety and privacy, and security measures such as surveillance cameras and restricted entry points protect patients and staff.
Holistic care continuum
Ante- and post-partum areas focus on promoting healing, recovery and maternal-infant bonding and require flexibility of design, augmented by modular layouts and flexible furniture arrangements, allowing spaces to adapt to varying patient needs. Incorporating lactation rooms, relaxation areas and education spaces enhances the overall experience for expectant and new mothers, supporting their physical and emotional well-being. Options for mothers to control room temperature, music, lighting and other environmental factors enhance comfort and relaxation during labor. New mothers may be overwhelmed and need the support and reassurance of knowledgeable staff.
Biophilic design principles introduce natural elements such as sunlight, greenery and nature-inspired motifs, promoting stress reduction, faster recovery and a connection to the outdoors. Incorporating elements like natural light, soothing colors and nature-inspired decor creates a healing environment conducive to childbirth and recovery.
The importance of empathy in the planning and design of women’s services spaces cannot be overstated. To provide emotional or physical support to individuals and families coping with significant life transitions by lowering stress and enhancing their comfort, health and safety is no small feat. But a calm, aesthetically pleasing and thoughtfully designed space for women’s services will not only benefit patients, families and staff — but the next generation.
