The depth structure of a good birth: Reconfiguring the environment in a high-risk labour ward birth and creating sanctuary behind a screen

Jane Clossick^*

• London Metropolitan University, London, United Kingdom

This article explores how the spatial, relational, and sensory conditions within an obstetric-led hospital birth room was subtly reconfigured to support a safe, satisfying birth even though the birth in question was considered high risk. Drawing on autoethnographic reflections and interviews with caregivers from the author's own birth at the NHS Royal London Hospital the paper examines the transformation of a standard labour ward room through a low-tech intervention: the erection of a cloth screen brought from home. This simple act created a distinct spatial zone in which institutional norms were less prevalent, fostering privacy, autonomy, and integrative care practices that protected physiological labour and enhanced maternal agency. The article situates this personal narrative within broader theoretical frameworks of birth territory, sociospatial theory, environmental psychology, and institutional power, arguing that space and care interact in complex ways to shape birth experiences. It contributes to calls for more humanised, woman-centred approaches to birth architecture and practice, particularly in highly techno-rational and medicalised settings, and proposes that even small acts of spatial resistance have the potential to generate meaningful shifts in care culture. Section 4 is a narrative birth story, based on the birth notes obtained from the hospital, along with my own recollections, those of my husband Colin, our doula Becky and the obstetrician Philippa. Section 5 is a series of reflections on the three key spaces which feature in the birth story: the bed, the bathroom and the screened birthspace and how these spaces interacted with caregiving practices and institutional norms at the Royal London in ways which resulted in my experiencing a safe, satisfying birth. Finally in the conclusion (section 6), some implications are suggested for future design and research.