Open Access Te Herenga Waka-Victoria University of Wellington
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Towards restorative spaces for postnatal recovery in urban tertiary hospitals

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posted on 2021-12-08, 19:05 authored by Lateef Lawal

Modern living and globalisation are increasingly contributing to access to and utilisation of modern healthcare services in both developed and developing countries; from diagnosis, treatments, and even to birth in a specialised healthcare environment. In many resource-rich countries, birth is one of the main reasons for women’s hospitalisation. Research suggests that physical environments of healthcare impact on patient/users’ health outcomes. Yet decisions about healthcare facilities’ design and programming are often made without input from users.  A key challenge for patient-centred care in the maternity field is the assumption that healthcare spaces and facilities created for the general “unwell” hospital population can support the emotional, physiological and psychological needs of healthy women who give birth in hospitals. Previous research into the childbirth environment has focused on physical environments and satisfaction with the labour and birth process. But studies examining the impacts of physical environments on women’s postnatal recovery experience and wellbeing have been limited. The aim of this thesis is to determine the design factors that influence women’s recovery experiences and wellbeing with a view to proposing design guidelines for optimal postnatal environment in large, tertiary hospitals.  A two phase sequential explanatory mixed methods approach was taken to the research which combined a quantitative method (online survey questionnaires) with a qualitative approach (focus group discussions – FGDs). Research was conducted with two user groups, comprising postnatal women and midwives, to examine perceptions of physical environment factors that influence women’s recovery experiences and wellbeing in New Zealand hospitals. The results of the questionnaire surveys were followed up in phase two FGDs to provide explanations and descriptions of architectural factors and design features that impacted on women’s recovery experiences and psychological wellbeing. The results were compared, synthesised and interpreted to inform the outcomes of this thesis.  The research found several physical environment factors and design features which were significant and a number which were non-significant among the two user groups in all four categories investigated: perception of postnatal room features; interior environment; sensory comfort environment and social comfort environment. The research found factors related to maintenance (e.g. cleanliness), environmental design (e.g. noise/quiet in rooms, and daylighting), and interior spatial characteristics (e.g. view to nature, combined home-like and clinical features and privacy) are more important in fostering wellbeing. Strong evidence was found on how building spaces impact on postnatal recovery experience, especially regarding single-bed rooms for emotional support and psychosocial support environments such as communal spaces and outdoor environments.  The original contribution of this thesis is an identification of the environments which have the potential for enhanced recovery experience of women during the postnatal period. This understanding of the architectural design factors and building spaces could help architects, healthcare designers and hospital care providers in applying and promoting restorativeness in large, tertiary hospitals to better help in providing quality postnatal care for women whose hospital stays are crucial to their wellbeing and health prior to going home with their new baby.


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Te Herenga Waka—Victoria University of Wellington

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Te Herenga Waka—Victoria University of Wellington

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Degree Name

Doctor of Philosophy

Victoria University of Wellington Unit

Centre for Women’s Health Research

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Victoria University of Wellington Item Type

Awarded Doctoral Thesis



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Alternative Description

Hospital is the main place of birth for women in many countries. Hospitals, created for an “unwell” population, may not support the needs of mothers who are not unwell including positive experience of hospital stays after the birth. The physical environment for women’s postnatal recovery in hospitals has not been studied. The research examines the design factors that could influence the recovery experiences and wellbeing of women during the postnatal phase in large, tertiary hospitals. As an outcome of the process of a two-phase research, a set of guidelines have been generated which can serve to facilitate a supporting environment for the recovery experiences and wellbeing of new mothers during hospitalisation. The findings and the subsequent design guidelines can be of great value to healthcare designers and hospital care providers in applying and promoting positive recovery experiences in postnatal wards and for optimising existing buildings and in future design of hospital postnatal wards.

Victoria University of Wellington School

Wellington School of Architecture


Vale, Robert; Pedersen Zari, Maibritt