OBSTETRIC DESIGN
Cristiane N. Silva
Architect Cristiane N. Silva holds a PhD in Architecture from FAU/ UFRJ and Specialist in Health Network Management from ENSP/FIOCRUZ. She is a supporter of hospital ambience for the Ministry of Health and Technical-Scientific Vice-President of ABDEH. Cristiane currently works as a Public Health Technologist at Oswaldo Cruz Foundation – FIOCRUZ – and as a consultant in projects for health buildings.
LDR units (Labour, Delivery, and Postpartum) and Birthing Centres.
of spaces for diverse companions (partners, family members, doulas), and the flexibility for personalising the environment are examples of how design can become more inclusive.
Perinatal grief Perinatal grief, though painful and unfortunately common, is still a taboo subject. Gestational or neonatal loss is a devastating experience that requires specific welcome and support. However, most hospitals do not have adequate spaces for families to experience this moment of pain with dignity and privacy. The absence of environments dedicated to perinatal
grief exacerbates suffering, forcing families to share spaces with those celebrating birth. Design guidelines should include the creation of quiet reception rooms, with soft lighting, comfortable furniture, and access to outdoor areas, if possible. These spaces should be designed to offer a refuge, a place where pain can be expressed and processed without interruption or judgment.
Renata P. Freire
Renata P. Freire is a nurse and a specialist in hospital management and public health. She holds a PhD in Public Health from ENSP/FIOCRUZ, a Master’s degree in Administration, and is a post-doctoral researcher at UFSC. She currently works as a health specialist at the Public Prosecutor’s Office of the State of Rio de Janeiro.
Architecture as political and operational mediation The architecture of healthcare spaces is not neutral – it reflects and reinforces care policies. In the context of obstetric care, design can be a political mediator, promoting or hindering the implementation of humanised practices. Spaces that encourage mobility, the presence of companions, and the choice of birthing positions are
examples of how design can align with a person-centred care policy. Operationally, architecture also plays a crucial
role. The arrangement of environments, the location of equipment, and the circulation of people and materials directly impact the efficiency and safety of services. The integration of LDR units (Labour, Delivery, and Postpartum) and Birthing Centres (CPN) into general hospitals, for example, requires careful architectural planning to ensure process fluidity and resource optimisation.
Challenges and perspectives The implementation of design guidelines for a humanised ambience in SUS obstetric care faces several challenges. The scarcity of financial resources, resistance to cultural changes, and the lack of specific technical knowledge in healthcare design are some of the obstacles. Furthermore, the maintenance and constant updating of these spaces represent an ongoing challenge. However, the perspectives are promising. Growing awareness of the importance of humanising birth, advances in hospital architecture research, and societal demand for more respectful care drive the search for innovative solutions. Collaboration among architects, healthcare professionals, managers, and users is fundamental to overcome these challenges and build a future where birthing spaces in the SUS are truly welcoming, safe, and wellbeing-promoting.
The absence of environments dedicated to perinatal grief exacerbates suffering, forcing families to share spaces with those celebrating birth.
136 Health Estate Journal October 2026
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140 |
Page 141 |
Page 142 |
Page 143 |
Page 144 |
Page 145 |
Page 146 |
Page 147 |
Page 148 |
Page 149 |
Page 150 |
Page 151 |
Page 152 |
Page 153 |
Page 154 |
Page 155 |
Page 156 |
Page 157 |
Page 158 |
Page 159 |
Page 160 |
Page 161 |
Page 162 |
Page 163 |
Page 164 |
Page 165 |
Page 166 |
Page 167 |
Page 168 |
Page 169 |
Page 170 |
Page 171 |
Page 172 |
Page 173 |
Page 174 |
Page 175 |
Page 176 |
Page 177 |
Page 178 |
Page 179 |
Page 180 |
Page 181 |
Page 182 |
Page 183 |
Page 184 |
Page 185 |
Page 186 |
Page 187 |
Page 188
