How design can transform the birth experience

OCAD University Professor Emerit Dr. Doreen Balabanoff has spent her career at the intersection of art, design and human experience.

From 1992 to 2002, she taught courses in first-year Design, Environmental Design, Design for Health, Inclusive Design, and the Interdisciplinary Master’s in Art, Media and Design program. She also served in leadership roles, including assistant dean, associate dean, and acting dean in the Faculty of Design.

She holds a Master of Architecture from UCLA and a PhD from University College Dublin. As both artist and designer, her work explores the poetic and embodied nature of how people experience space. She is also a co-founder of the Global Birth Environment Design Network (GBEDN) and the Colour Research Society of Canada (CRSC).

Her practice-based PhD was grounded in the congruence of phenomenology (Maurice Merleau-Ponty) and ecological psychology (James J. Gibson), who both brought forward awareness of the interwovenness of mind-body-environment.

Her doctoral project offered images and concepts that led to recommendations for use of light (the inseparable trio light-colour-darkness) in birth spaces.

Today, she continues to lead international efforts to build a knowledge network to enhance the movement towards better birth spaces worldwide.

This includes the international gathering, Transforming Birthspace: A Global Colloquium, being hosted by OCAD University from Oct. 24 to 27, which she is co-organizing. This colloquium builds on her five-year international partnership research project, Transformational Change for Birth Environment Design.

What is the focus of your research and what inspired you to explore this topic?

My research on birth environment design began in 2011 during a sabbatical leave from teaching and administrative work at OCAD U. I wanted to consider how to make change concerning the places we create for the profound life experiences of birth and death. The PhD thesis needed to have a narrower focus, so I chose birth over death spaces. Architects at the time seemed more interested in designing for death than birth.

In the summer between my first and second years at architecture school, I had a child! I think this was the catalyst ... experiencing birth and critiquing the setting at the same time!

Two years later, my master’s thesis was a community health centre with a freestanding birth centre, set on a hillside overlooking a river ... looking back, I wish I had the web resource I'm working on now to inform my work.

(Doreen’s international partnership research project, Transformational Change for Birth Environment Design has led to the development of an online knowledge resource hub that will be launched on Oct. 24 at the global colloquium. This hub will both inform and inspire changes in birth environment design worldwide.)

What drew you into this field of study in the first place? Was there a turning point or defining moment?

I came to the field of architecture through the medium of stained glass. I spent some years in the United Kingdom studying with eminent artists in the field and travelling to see art and architecture – great cathedrals and monasteries, small chapels or churches, total works of art, including those of Matisse, Chagall, Léger, Manessier and Le Corbusier.

But it was not only the coloured glass – the emotional resonance of great architecture is memorable, and connection to surroundings is such a key aspect of great architectural sites/places/spaces.

I wanted that in my birth experience. But it was nowhere to be found. My first artistic work was in ceramics. But once I began to work with glass, it was light and colour that drew me in to architecture as a spatial practice, and as a connector to the world in which we are immersed.

Light, for me, is the inseparable trio light-colour-darkness. It is not static, and the cycles of light are part of our being and becoming.

What problem or question is your research trying to solve or answer, and why is this important?

The movement of birth into hospitals is a recent occurrence, and the clinical nature of birth in hospitals is an experiential problem – there is a deep loss in this – not only have women lost confidence, but risk assessment and medicalization have set them up as 'patients,’ yet they are not incapacitated or weak or unhealthy.

The situation sets up not only a passivity, but lot of fear and fear leads to a cascade of interventions. All of this is counter-productive to normal, healthy birth processes, and to having a positive experience of this profound moment in one's life.

There are alternatives to this, and models and practices of care are part of it, but I see and feel the need for the architectural profession to take up places of birth as an important agenda of our time.

Across the globe, every child born, all families and societies are affected by the places where birth happens. Of course, maternal and infant health is a complex matter. But as places for birth continue to be built, we need to consider more carefully what we are making, and how design of spaces and places can enhance health and well-being.

There are architects and designers doing important work in this arena and bringing a global awareness of what is possible and desirable is helpful for all.  That’s the work my research is seeking to accomplish.

How do you see the research findings contributing to your field or affecting people’s lives in the real world?

It is amazing to see how many people across the globe are working in this arena, from many different perspectives. Our integrative literature review found over 60 papers/documents specifically on the topic. Researchers are bringing forward many questions and answers.

In Canada, we had an early leader in this work from field of nursing – Ellen Hodnett from the University of Toronto who proposed an ‘ambient’ birthing room. In the United Kingdom, French OB/GYN doctor Dr. Michel Odent brought the hormones of birth to attention, and how the spatial setting impacts them. In Australia, midwifery professor and researcher Maralyn Foureur and colleagues have brought this topic into focus across the globe with their Birth Territory theory.

Bringing knowledge together and making it available is a focus of my research project, Transformational Change for Birth Environment Design, funded by the Social Sciences and Humanities Research Council (SSHRC) Partnership Grant.

With our knowledge mobilization approach to outcomes, we can discuss and present extraordinary and creative solutions, and we can inform and inspire architects and designers to help create the needed change.

When we know the reasons for designing and the issues of import, designers can bring their expertise to supporting real human needs and desires – for dignity and respect, for beauty and safety, for calmness and joy, for care during sorrow, in these memorable life moments.

I imagine a world where birthing persons and their families, and their caregivers, can have safe and calm birth experiences, that support short and long-term health and well-being of all involved.

Are you working with any collaborators, institutions, or funding bodies on this project?

I've been working with academic colleagues/professors from Australia, Italy and the United States, one is a midwife, one an architect, one an interior designer. We are co-founders of a network: the Global Birth Environment Design Network, which aims to find ways of disseminating knowledge and building the project of creating better birth spaces across the globe.

We're very pleased to have had several grants from SSRHC, supporting our work. OCAD U is providing a lot of support for our colloquium, taking place in October 2025 We also have a SSHRC Connections Grant to help with the events including the exhibition. I’m pleased to have OCAD U grads and current students involved in this work.

What do you hope people – both inside and outside of your field – take away from your research?

I hope they come to understand how much art and design and creative endeavours are implicated in and important to human health and well-being, and that making environments that are too focused on ‘clinical’ aspects of care can strip away emotionality and joy and meaning-making.

We need to recognize that we also need sensitive environments that offer place and time for sorrow. The human imagination can do so much to help foster places and spaces that lift us up, and bring us light and life and sustenance.

We need to keep using our imaginative and thoughtful capacities to make places for human flourishing. I hope an awareness – that the environment is part of how we feel and what we are capable of – is made manifest through our work.