Re-Conceptualizing the Hospital Labor Room: The PLACE (Pregnant and Laboring in an Ambient Clinical Environment) Pilot Trial

Authors

  • Ellen D. Hodnett RN, PhD, FCAHS,

    Corresponding author
    1. Ellen Hodnett is Professor and Heather M. Reisman Chair in Perinatal Nursing Research, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto;
      Ellen D. Hodnett, RN, PhD, FCAHS, Professor & Heather M. Reisman Chair in Perinatal Nursing Research, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St., Suite 130, Toronto, Ontario M5T 1P8, Canada.
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  • Robyn Stremler RN, PhD,

    1. Robyn Stremler is Assistant Professor in the Lawrence S. Bloomberg Faculty of Nursing, and Adjunct Scientist in the Hospital for Sick Children (SickKids), Toronto;
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  • Julie A. Weston RN, MSc,

    1. Julie Weston is Senior Trial Coordinator in the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto;
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  • Patricia McKeever RN, PhD

    1. Patricia McKeever is Professor in the Lawrence S. Bloomberg Faculty of Nursing and Bloorview Kids Foundation Chair in Childhood Disability Studies in Bloorview Research Institute, Toronto, Ontario, Canada.
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  • Financial support for the PLACE Pilot Trial was provided by Dr. Hodnett's Heather M. Reisman Chair funds, Toronto, Ontario, Canada.

Ellen D. Hodnett, RN, PhD, FCAHS, Professor & Heather M. Reisman Chair in Perinatal Nursing Research, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St., Suite 130, Toronto, Ontario M5T 1P8, Canada.

ABSTRACT:

Background:Nearly all hospitalized laboring women spend most of the time in bed. We made simple but radical modifications to a hospital labor room, which included the removal of the standard hospital bed and the addition of equipment to promote relaxation, mobility, and calm. We designed a pilot study, the objectives of which were to test the feasibility of a randomized trial and the acceptability of the modified labor room to women and their care providers.Methods:Women were assessed and invited to participate just before their admission to the labor and delivery suite. Sixty-two women at two Toronto teaching hospitals were randomly allocated to either the standard labor room or the “ambient room.” Data about labor and birth events were abstracted from the medical records. Participants and their nurses and physicians completed questionnaires to elicit their views of their experiences with the labor rooms.Results:Women's and practitioners’ evaluations of the ambient room were generally very positive. Nineteen women (65.5%) in the ambient group, compared with 4 (13.3%) in the standard group, reported spending 50 percent or less of their hospital labor in the standard labor bed. Twelve women allocated to the ambient room had artificial oxytocin infusions, compared with 21 allocated to the standard room (X 2 = 4.73, p = 0.03).Conclusion:We conclude that the ambient labor room should be evaluated in an adequately powered randomized controlled trial. (BIRTH 36:2 June 2009)

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