Ask an Expert: How can design help create safer, more equitable birthing experiences?

Obstetrics design blends medical precision with life's most personal moments. These spaces must support moments of immense vulnerability and joy, while also being ready for the unexpected, from routine deliveries to critical emergencies. As hospitals face increasing pressure from maternal health deserts, rising C-section rates and growing disparities in care access, OB units must do more than function; they must heal, reassure and adapt.

As a leader in OB design and a top 125 Healthcare Architecture Firm according to Building Design + Construction, we take pride in having partnered with a variety of organizations across the nation to create birthing environments that are flexible, family-centered and rooted in both clinical precision and human dignity.

We recently chatted with Tu‑‌A‌nh Bui Johnson, a healthcare planner and principal in our Minnesota office, whose passion for women’s health and deep expertise lie in designing calming, compassionate birthing centers and obstetrics departments. In the conversation below, she shares her perspective on how design can help close care gaps, support evolving patient expectations and create safer, more empowering birthing experiences for all.

1. How do you define a well-designed OB unit? What are the hallmarks of success from both a clinical and human-centered perspective?

In any design project, actively engaging providers and staff at each facility is essential. While code references and general design guidelines provide a foundation, the day-to-day operations and workflows often vary significantly between hospitals. To create effective, responsive spaces, our team prioritizes local needs and insights from those on the ground.

Equally important is considering the patient experience, particularly how patients present at different times of day. Unlike scheduled appointments or procedures, births can occur at any hour, making it critical to ensure a consistent and supportive environment 24/7, informed by both staff feedback and patient behavior patterns.

2. What design elements most effectively support expectant mothers and families during such a high-stakes and emotional journey?

Every mother and pregnancy are different, and facilities that address the spectrum of patient needs while maintaining safety, comfort and happiness will increase the likelihood of a positive experience. Elements like dimmable lighting help create a calm, adaptable environment, while acoustic design and Bluetooth connectivity allow for soothing sounds and reduce stress. Safety features that address mobility and fall risks are essential, as are designated zones for connection, whether with loved ones or care teams.While OB projects must meet strict codes and guidelines, our greatest opportunity to add value often comes in renovations, where creative solutions can transform existing constraints into deeply supportive and healing spaces.

3. How do you accommodate high-acuity situations like emergency C-sections or unplanned transfers without compromising the patient experience?

From both the design and delivery perspective, early planning and consistent communication among providers and staff are essential – not only to ensure a swift response in urgent situations but also to support a smooth and reassuring care journey. It’s not just about how quickly a patient can be transported to the surgical suite in a crisis; what happens afterward matters just as much.

The availability of a nearby, well-equipped recovery space is critical for delivering high-quality, continuous care. For patients and their families, knowing that recovery will happen in a calm, supportive environment close to the surgical area can significantly ease anxiety and enhance the overall experience.

4. What trends are currently shaping OB unit design, and how are shifts in birth practices, like midwifery models or rooming-in, influencing those decisions?

We’ve seen growing interest in incorporating water birth options, prompting us to explore the integration of permanent birthing tubs within labor and delivery suites. This addition introduces a unique set of design and aesthetic considerations, particularly regarding structural integrity, optimal plumbing configurations and the overall visual harmony of the space. These elements must both meet functional requirements and ensure a calming and supportive environment for expectant mothers, whether or not they choose to use the water birth option.

5. How does your approach to OB unit design evolve when working with smaller community hospitals versus large health systems?

In larger health systems, Labor and Delivery units are often separated from Recovery and Postpartum areas, leading to higher patient volumes and more specialized service needs. In contrast, smaller community hospitals typically use an integrated LDRP model, where Labor, Delivery, Recovery and Postpartum care all take place in a single room.

This integrated setup requires careful coordination of patient flow, infection control and safety protocols. Every aspect of the room’s design must be thoughtfully planned to support efficient, safe and seamless care throughout the entire childbirth experience.

Designing for the future of maternal care

In the evolving field of obstetric design, the balance between clinical precision and compassionate care is crucial. As we face growing challenges in maternal health, from healthcare access to disparities in care, thoughtful design can play a transformative role in closing gaps and ensuring every birthing experience is safe, dignified and empowering. Wold is proud to be at the forefront of designing healthcare environments that prioritize both human dignity and clinical excellence. Discover how our design approach can transform your facility today.