(B-0510) Maternity Unit

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Australasian

Health Facility Guidelines


Part B - Health Facility Briefing and Planning
510 - MATERNITY UNIT

Revision 5.0
12 April 2012
Australasian Health Facility Guidelines

© 12/04/2012 Australasian Health Infrastructure Alliance


The Australasian Health Facility Guidelines (AusHFG) and the information in them are the copyright of the
Australasian Health Infrastructure Alliance (AHIA). The information in the AusHFG is made freely available.
Australasian Health Facility Guidelines
Address: PO Box 1060, North Sydney NSW 2059
Website: http://www.healthfacilityguidelines.com.au
Email: [email protected]
The AusHFG are an initiative of the Australasian Health Infrastructure Alliance (AHIA). AHIA membership
is comprised of representatives from government health infrastructure planning and delivery entities in all
jurisdictions in Australia and New Zealand.
Disclaimer
AHIA gives no warranty or guarantee that the information in the AusHFG is correct, complete or otherwise
suitable for use. AHIA shall not be liable for any loss howsoever caused whether due to negligence or
otherwise arising from the use of or reliance on this information.
AHIA recommends that those seeking to rely on the information in the AusHFG obtain their own
independent expert advice.

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INDEX
INTRODUCTION 4
Preamble 4
Introduction 5
Policy Framework 5
Description of the Unit 6
PLANNING 12
Operational Models 12
Planning Models 14
Functional Areas 15
Functional Relationships 17
DESIGN 18
Access 18
Parking 18
Disaster Planning 18
Infection Control 19
Environmental Considerations 19
Space Standards and Components 20
Safety and Security 21
Finishes 22
Fittings and Fixtures 23
Building Service Requirements 24
COMPONENTS OF THE UNIT 26
Standard Components 26
Non-Standard Components 26
APPENDICES 29
Schedule of Accommodation 29
Functional Relationships 34
Checklists 35
REFERENCES AND FURTHER READING 36
Further Reading 36
References 37

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INTRODUCTION
Preamble

510.001.000 This Health Planning Unit (HPU) has been developed for use by project staff (architects,
502251 planners, engineers, project managers and other consultants) and for end users, to
facilitate the process of planning and design.
It is intended to assist with the planning and design of a unit that will be fit for purpose in
accordance with its designated service delineation / capability and defined catchment
population.

510.001.005 This HPU an update of the Maternity HPU developed for NSW Health and issued for
502252 Australasian use in 2006. Its development has been informed by an extensive background
research and consultation process.

510.001.010 It should be read in conjunction with the Australasian Health Facility Guidelines (AusHFG)
961080 generic requirements and Standard Components described in:
- Part A - Introduction and Instructions for Use;
- Part B - Section 80 - General Requirements;
- Part B - Section 90 - Standard Components;
- Part C - Design for Access, Mobility, OHS and Security;
- Part D - Infection Prevention and Control; and
- Part E - Building Services and Environmental Design.

510.001.015 EXCLUSIONS
961081
The following services and facilities may be established in major teaching / tertiary
women’s centres but are excluded from this HPU:
- reproductive /infertility units;
- clinical genetics units; and
- birthing centres (as differentiated from a Maternity Unit).

510.001.018 TERMINOLOGY
961083
‘Maternity’ encompasses the disciplines of obstetrics and midwifery and is used to
represent both. ‘Obstetrics’ is generally only used in references.
In the context of this HPU, the term ‘birthing room’ has been used to describe a room
designed to support any woman through labour, birth and the early postnatal period.
‘Birthing Centre’ refers to a discrete unit, usually midwife-managed and led, providing for
more natural 'at-home' style antenatal care, birth and immediate postnatal care for
women accepted into the programme. In the context of this HPU, it is assumed that
Birthing Centres are located on a healthcare campus so that more intensive midwifery and
obstetric care are readily available should an emergency arise. Birthing Centres, however,
are not described in detail in this HPU and no schedule of accommodation is provided.

510.001.020 RELATED PLANNING UNITS


961082
The schedule of accommodation in the original HPU gave details of a Level 2 nursery. This
has been omitted from this revision as details are available in Part B: HPU 390 Intensive
Care - Neonatal Special Care Nursery, Australasian Health Facility Guidelines (AHIA, 2014).

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The original version also gave a schedule of accommodation for an obstetric operating
unit. These details are also omitted. Refer to Part B: HPU520 Operating Unit, Australasian
Health Facility Guidelines (AHIA, 2010).

Introduction

510.002.000 GENERAL
502253
Maternity is the branch of health care which provides services for the management of
pregnancy including pre-conception counselling and care; onset of labour and birth; the
postnatal period and parenting; and immediate care of the newborn. It encompasses the
total needs of the pregnant woman and her family, including the physical, educational and
psycho-social requirements, irrespective of the care setting.

Policy Framework

510.003.000 GENERAL
502254
Policies for the provision of healthcare services are formulated in accordance with the
following principles:
- appropriate service models that ensure a comprehensive service network throughout
state and regional health jurisdictions;
- safe and effective care that minimises both staff and patient risks;
- provision of a safe and efficient environment that minimises risk to all users of the
facility;
- deployment of resources in a fair and cost effective manner to optimise health
outcomes; and
- development and support for enhanced information systems to monitor, plan and
evaluate healthcare services.
Policy frameworks recognise the diversity of the community and that special groups within
communities often require specific consideration to meet their needs and to enhance the
effectiveness of any services provided.

510.003.005 INTEGRATED CLINICAL NETWORKS


961084
A Reform Proposal for Maternity Services in Australia (Boxall, A and Russell, L, 2009) states
the following:
“Each state and territory needs to develop arrangements for fully integrated clinical
networks in public maternity care. These networks should take into consideration state
demographics, the type and distribution of maternity facilities, availability of maternity
beds and workforce. They should outline detailed procedures for responding to changes in
maternal and / or neonatal risk, and outline transport options for women and babies
requiring non-urgent transfer to another facility (e.g. community transport schemes and
neonatal transport services), and urgent transfer (e.g. using land and air ambulance
services).”

510.003.010 MATERNITY POLICIES


961085
Before embarking on a project, planners and project staff are encouraged to familiarise
themselves with individual jurisdiction reports on maternity services (refer to References
and Further Reading) and to the 2009 Commonwealth Report, Improving Maternity
Services in Australia, Report of the Maternity Services Review (Department of Health and
Ageing, 2009).

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510.003.020 Overarching policies include the Disability Discrimination Act 1992, Act No. 135 of 1992 as
961086 amended (Australian Government, 2013).

Description of the Unit

510.004.000 DESCRIPTION OF MATERNITY HEALTH PLANNING UNIT (HPU)


502255
The revised HPU addresses the services and facilities for the care of mothers and
newborns and also addresses the needs of partners, supporters and staff, provided in a
Maternity Unit with a conventional Birthing Unit.
A typical Maternity Unit includes a Birthing Unit, Antenatal Inpatient Area and Postnatal
Inpatient Area, which together provide for the care of mothers with antenatal or postnatal
complications requiring acute inpatient care, as well as healthy mothers having normal
deliveries and healthy newborns (‘unqualified babies’).
Babies requiring ongoing care will be transferred to the appropriate level of neonatal
nursery as may healthy newborns of mothers unable for whatever reason to room-in and
newborns that will be put forward for adoption. (Level 1 General Care Nursery).

510.004.005 PATIENT CHARACTERISTICS


961087
Planning will need to address the needs of all women of childbearing age but some
women have special needs which may be more related to the care provided rather than
any specific facility needs.
Categories with special needs include:
- Aboriginal and Torres Strait Islanders in Australia, and Maori and Pacific Islanders in
New Zealand;
- women who are socially disadvantaged particularly in rural and remote communities;
- women from culturally diverse and non-English speaking backgrounds (NESB);
- women with physical and cognitive disabilities including obese (bariatric) patients;
- women with pre-existing medical conditions;
- women with medical conditions associated with pregnancy (pre-eclampsia, etc.) who
may require ongoing antenatal inpatient care;
- women with drug and alcohol dependencies;
- women with mental health issues;
- women in correctional facilities;
- women who are experiencing fertility problems;
- women who are undergoing terminations for foetal abnormalities (terminations for
medical or psychological reasons are usually performed in the private sector, however
in South Australia, they are also done in the public sector);
- women experiencing stillbirths or deaths in utero needing ongoing maternity care;
- women relinquishing babies for adoption - also needing ongoing maternity care; and
- women with same sex partners.
There are special needs associated with pregnancies resulting from rape, and with
pregnancy in very young women.

510.004.010 ABORIGINAL AND TORRES STRAIT ISLANDERS


961088
For additional details, refer to the literature review undertaken on behalf of the
Department of Health and Ageing (Herceg 2009).

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The importance of the role of the grandmother needs to be recognised. Grandmothers


teach their granddaughters about local Aboriginal traditions.
Models of care for Aboriginal and Torres Strait Islanders would be reflected in the local
Aboriginal and Torres Strait Islanders cultural needs (e.g. birth smoking ceremonies,
values, culture and the spirituality of birth). Additional space may be required in inpatient
bedrooms to allow a grandmother to stay with her granddaughter.
A ground floor location with outdoor access is preferred.

510.004.015 CULTURE / ETHNICITY


961089
Various ethnic groups, particularly migrant and refugee women, have differing customs
associated with pregnancy, birth and the postnatal period. These need to be
acknowledged and accommodated wherever possible although this may be more an
attitude to care rather than any specific facility needs (Cultural Birthing Practices and
Experiences (Boules, N, 2007)).

510.004.020 WOMEN WITH DISABILITIES


961090
Patients may include women with physical, sensory or learning disabilities. Refer to UK
website of ‘Good Practice: Meeting Cultural Needs, Disability, Pregnancy & Parenthood
Journal, Vol 64 (Disability, Pregnancy & Parenthood, 2008).
Refer also to The Reproductive Rights of Women with Disabilities (Thomas, N, 2004).
There is a growing need for at least one room in inpatient units and the birthing unit to be
fully wheelchair accessible and in compliance with Disability Discrimination Act 1992, Act
No. 135 of 1992 as amended (Australian Government, 2013).

510.004.025 WOMEN WITH MENTAL HEALTH ISSUES


961091
Identified mental health issues may be pre-existing conditions or a consequence of the
pregnancy, both antenatal and postnatal. Consider access to single rooms, the need for
specialling, access to NICU or special care nursery if necessary and maintenance of
postnatal care and education. Consider postnatal accommodation in a Mother and Baby
Unit (A National Approach to Perinatal Mental Health in Australia: Exercising Caution in
the Roll-out of a Public Health Initiative, Medical Journal of Australia (Yelland et al, 2009)).
Clinical issues concern adequate antenatal care, use of medications while pregnant and/or
nursing, maternal bonding, and coordinated treatment planning among medical,
addiction, and mental health treatment providers (Antenatal Ambroxol Treatment does
not Prevent the Respiratory Distress Syndrome in Premature Infants, European Journal of
Pediatrics, Vol 156, Issue 5, pp392-392 (Dani C1, Grella PV, Lazzarin L, Rubaltelli FF, 1997)).

510.004.027 WOMEN WITH DRUG AND ALCOHOL DEPENDENCIES


961092
Women with existing and pre-existing drug and alcohol dependencies may require access
to single room accommodation with close supervision during admission.
Clinical concerns would be similar to the identified reference of Women with mental
health issues.
Consideration needs to be given to:
- managing clients who may be experiencing withdrawal from drugs and/or alcohol
who may be violent;
- access and supply of drugs and alcohol from external sources e.g. Visitors; and
- access to support services while an inpatient.

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510.004.030 WOMEN IN CORRECTIONAL FACILITIES OR UNDER HEALTH CARE ORDERS


961093
Consideration needs to be given to:
- managing possible violence of patients and partners - issues of safety and security of
units, internal space and access to units; and
- location of the unit - particularly relevant to services close to women’s correctional
service and maternity services being provided by that public service.

510.004.035 FACTORS AFFECTING PLANNING AND DESIGN


961094
The following are not traditional priorities but are a reflection of changes in society and
may have an increasing impact on design:
- continuing change in the composition of the maternity population with a higher
percentage of older women having first and subsequent pregnancies;
- women with complex pregnancies, particularly multiple births and prematurity;
- early discharge and community care programmes that transfer services from the
hospital to a community setting;
- birthing options and the concept of ‘birth territory’ (Birth Territory: A Theory for
Midwifery Practice, Women and Birth, Vol 19, Issue 2, pp45-50 (Kathleen Fahy, Jenny
Parratt, Maralyn Foureur, Carolyn Hastie, 2006));
- increase in planned induction of labour;
- increase in elective caesarean sections as a birthing option;
- increasing emphasis on mental health and well-being including diagnosis and
treatment of antenatal and postnatal depression;
- managing clients with drug and alcohol toxicity;
- increasing use of alternatives to pain management;
- increasing concerns about infant safety and possible abduction.;
- Aboriginal and Torres Strait Islanders cultural needs (e.g. birth smoking ceremonies,
values, culture and the spirituality of birth); and
- facilities to support the birthing smoking ceremonies as relevant to a jurisdiction.

510.004.040 AMBIENCE
961095
Overall unit / centre design should recognize the pivotal role of the parents and other
family members as part of the whole process of pregnancy, birthing and post-natal care.
Planning and design should:
- create a welcoming environment in all parts of the Maternity Unit;
- provide adequate space and facilities for families;
- allow for privacy and encourage physical infant contact;
- provide quiet facilities for counselling, grieving and care planning;
- provide retreat facilities for patients and staff; and
- facilitate patient to staff and staff to staff communications.

510.004.045 BED CATEGORIES


961096
The range of beds in a Maternity Unit excluding cots may include:
- inpatient beds - antenatal and postnatal;
- beds for women who have had a stillbirth, death in utero or relinquished a baby for
adoption. Ensure that these beds are not located near those of women with healthy
babies;
- day only / ambulatory care beds or chairs for maternal and foetal monitoring;

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- beds / trolleys for assessment of problems of early pregnancy (threatened miscarriage


etc.) and for women in pre-term or premature labour (before 37 weeks gestation)
with attendant possible need to halt or delay labour until the foetal lungs are better
developed. If labour cannot be halted, arrangements may need to be made for
transfer of the premature infant;
- beds for women undergoing planned induction and in very early labour who do not
need to be in a birthing room until labour is established ;
- birthing rooms; and
- beds for women transferred in from other centres accompanying a sick infant, who
may still need some level of ongoing maternity care but do not need an expensive
inpatient bed.

510.004.050 ANTENATAL CARE


961097
One of the main objectives of antenatal care is the early detection of risk factors and
referral to the appropriate level of care. This may require:
- visits to midwife, GP, obstetrician in hospital or community setting;
- day stay monitoring of mother and/or foetus including CTG (cardio tocography),
ultrasound, pathology, blood pressure;
- exercise and parent education classes - in hospital or community;
- relaxation therapies, many of which are conducted in the private sector; and
- hospitalisation. Hospitalisation, sometimes for extended lengths of stay, may be
required for a range of conditions including:
- pre-eclampsia (high blood pressure);
- gestational Diabetes Mellitus;
- placental abnormalities (praevia, placenta accrete);
- hyperemesis (extreme nausea and vomiting); and
- treatment and monitoring of pre-existing medical conditions.

510.004.055 POSTNATAL CARE


961098
Postnatal care may include:
- general recovery in an inpatient unit for caesarean sections, sick mothers and general
mother care;
- mothercraft and parent education (bathing, breast feeding);
- lactation support; and
- community / home-based follow-up.
Postnatal community-based midwifery services are now offered by most units. Services
may be just for routine early discharge follow-up or may be provided to women who
require further supervision after hospitalisation for a range of reasons. It will need to be
ascertained whether the midwives are accommodated in the Maternity Unit or in the
community so that in the former instance appropriate office space and storage can be
provided.
Early discharge is generally defined as discharge from a maternity unit within 48 hours of
giving birth.

510.004.060 BIRTHING ROOMS


961099
Birthing rooms may be used in a flexible way to accommodate different service models
and approaches with some used for the labour, birth and recovery phases with transfer to
a post natal bed. The room may also be used for the labour, birth and recovery phases,

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with the mother occupying the room until discharge.


These rooms need to accommodate multiple births and a peninsula bath.

510.004.065 ASSESSMENT OF BIRTHING ROOM NUMBERS


502256
The anticipated number of births as determined in the Service Plan, average lengths of
stay, number of elective caesarean sections booked directly into the operating suite thus
bypassing the Birthing Unit, policies re early discharge programmes and management of
planned inductions of labour will all affect:
- the number of birthing rooms required; and
- the number of postnatal inpatient beds required.
The following is based on the LDR model and assumes approximately one delivery per
room per 24 hours, although this will vary from unit to unit:
- 1,000 births - 3 birthing rooms plus 1 assessment;
- 1,500 births - 4 birthing rooms plus 1 assessment;
- 2,000 births - 5 birthing rooms plus 1 assessment; and
- 3,000 births - 8 birthing rooms plus 1 or 2 assessment rooms.
South Australian experience suggests that for 3,000 births there is a need for 10 birthing
rooms. Birthing room numbers and assessment room numbers should be decided by
individual jurisdictions at the planning stage.
The schedule of accommodation has been developed for 4 and 8 birthing rooms.

510.004.070 BIRTHING ROOM DESIGN


502257
Birthing rooms should be designed and fitted so that women may use them much as they
would use their own homes. Requirements include:
- privacy: visual from corridor and control over who enters the room (‘please knock’
sign);
- acoustic management in and between rooms;
- control of lighting: dimmable, no fixed operating light but portable available. Natural
light and, where possible, views;
- individual control of room temperature;
- space to walk around in the room;
- varying furniture and fittings: mattress, pillows, bean bag, swiss balls, grab rails or
shelves / benches with curved edges at various levels for leaning / squatting;
- décor: colours, artwork;
- music: CD player, possibly TV / DVD for supporters, if not the mother;
- aromatherapy;
- en suite with double shower;
- optional bath: refer to relevant section in this HPU;
- concealed gases and equipment;
- access to drinks and refreshments for mother and supporters;
- space for family members including children, both inside the birthing room and
outside;
- appropriate bed position;
- bench space for point of care documentation; and
- discreet storage in and between birthing rooms.

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510.004.070 BIRTHING ROOM BED


961100
The bed should NOT be the focal point of the room.
Refer to Re-Conceptualizing the Hospital Labor Room: The PLACE (Pregnant and Laboring
in an Ambient Clinical Environment) Pilot Trial, Birth, Vol 36, Issue 2, pp159-166 (Hodnett,
E. D., Stremler, R., Weston, J. A. and McKeever, P, 2008)) detailing the Canadian concept of
“ambient” birthing room ‘... beds in labor (sic) rooms were more for the convenience of
the medical and nursing staff than the health of the mothers’.

510.004.080 THE IDEAL BIRTHING ROOM


961101
Giving birth and being born are probably the most dramatic experiences of a lifetime.
Appropriate lighting, sound and colour are essential for the mother and particularly the
baby, after his / her nine months of relative peace and darkness.
Healing colours, natural aromas, gentle music and soft lighting will help to keep the
atmosphere calm.
Lights should be turned down as low as possible when birth starts to take place, providing
there are no complications so that the baby can gradually be introduced to light and
sound.

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PLANNING
Operational Models

510.005.000 HOURS OF OPERATION


502258
The Maternity Inpatient Units, Assessment Units and the Birthing Unit will provide service
24 hours per day, seven days per week with admissions occurring around the clock.

510.005.005 MODELS OF CARE: FACILITIES


961102
The arrangement of units and sub-units will depend on service role and capability. It
should be noted that the number of anticipated births does not necessarily reflect a level
of service. In most tertiary centres the highest proportion of births are women from the
local catchment having normal births and for whom the Unit is their local maternity unit.
Location (metropolitan, rural or remote) and client profiles and culture may affect the
type of unit required.

510.005.010 WOMAN CENTRED CARE


961103
Women are increasingly articulating the need for choice and access to consistent
information with regard to the type of birth they wish to have. They also wish to control
the labour and delivery process and the place of birth (Birth Territory: A Theory for
Midwifery Practice, Women and Birth, Vol 19, Issue 2, pp45-50 (Kathleen Fahy, Jenny
Parratt, Maralyn Foureur, Carolyn Hastie, 2006)). There is also increasing recognition of
the difference between ‘being delivered’ and ‘giving birth’.
Their choices include: the place or environment where they give birth (home, hospital
birthing unit, birthing centre); choice of ‘operator’ (obstetrician or midwife), choice of
support (partner, friend, doula).
Refer to Australian Doula College (website) (Australian Doula College, 2015).

510.005.015 MODELS OF MATERNITY CARE


961104
Maternity services may be delivered in a number of ways that may have greater or lesser
implications for organisation of facilities and provision of offices and workstations.
Continuity of care should underline all models of care, defining the functional relationship
between the identified birthing options.
These models include:
- midwife case load and midwife-managed care;
- group midwives;
- shared care (this may be shared by the midwife and/or medical practitioner and may
include an Aboriginal Health Worker);
- multi-disciplinary team - discipline mix and size;
- obstetrician-led care; and
- continuity of care (defined as the provision of care by the same small team of
caregivers throughout pregnancy) ('It's More than just having a Baby' Women's
Experiences of a Maternity Service for Australian Aboriginal and Torres Strait Islander
Families, Midwifery, Vol 28, Issue 4, pp449-455 (Homer, Caroline S.E. et al, 2012)).
Continuity of care and consistent information is essential to the provision of care that
is culturally sensitive and appropriate.

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Maternity care may be accessed via clinics located at hospitals, community health centres
or GP practices and the model selected may depend on the risk factors inherent in the
pregnancy noting that risk factors may change rapidly.

510.005.020 CENTERING (SIC) PREGNANCY PROGRAM FOR ANTENATAL CARE


961105
This model is based on providing group antenatal care.
Access is required to a room large enough for 8-10 women seated plus space for
examination - may be a floor mat or adjoining exam room. This space may be in the
ambulatory care part of a hospital or in the community. For more details on the Centering
Care Model refer to Centering Care Model Overview, Website (Centering Healthcare
Institute, 2015).

510.005.025 BIRTH CENTRES


961106
The Commonwealth has asked States and Territories to increase the number and use of
birth centres as part of the implementation plan of the Improving Maternity Services in
Australia, Report of the Maternity Services Review (Department of Health and Ageing,
2009). It is essential that the birth centre philosophy is considered as part of this exercise,
including continuity of care which should be able to underline all models of care and
home-from-home environment. Centres are usually located on a hospital campus (either
free-standing or in-hospital) and provided through various jurisdictional programmes or
the private sector. In this way, more intensive medical care is immediately available
should an emergency arise and are only available to pregnancies considered low risk.
Whilst this HPU acknowledges birth centres as a potential component of the model of
care, they are not described in detail. Rather, this HPU addresses conventional Maternity
Units located in-hospital including a detailed schedule of accommodation.

510.005.030 HOME BIRTHS


961107
There has been much discussion and debate regarding home births, the pros and cons of
which are outside the scope of this document. However, where centres do provide a home
birth programme, consideration will need to be given to the following:
- offices / workstations for a programme co-ordinator and midwives;
- access to seminar rooms for lectures and practical skills training such as suturing
- storage for supplies and delivery packs; and
- access to transport 24 hours per day.
Refer to the evaluation of a programme in NSW (Evaluation of the Publicly-funded
Homebirth Program in South East Sydney Illawarra Area Health Service (Homer, Caroline
and Caplice, Shea, 2009)https://www.uts.edu.au/sites/default/files/stgeorge-
homebirth.pdf
Planned home births will need to be registered with the relevant maternity unit and
provision made to accept and accommodate women and neonates in case of maternal or
foetal emergency. Unplanned home births also occur if the woman cannot get into
hospital on time or where no antenatal care has been undertaken. Intra services
arrangements coordinated with maternity services are necessary to support the mother
and child’s safe journey.
It should be noted that the College of Obstetrics and Gynaecology does not support home
births unless very strict criteria are met (Categorisation of Urgency for Caesarean Section
(RANZCOG, 2015)).

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510.005.035 FUTURE DEVELOPMENTS


961108
Future developments include:
- increasing technological support / equipment;
- increasingly sophisticated information systems;
- increasing rate of pre-term delivery (in part at least because of older maternal age);
- increased survival rates of all gestational ages;
- increase in multiple births;
- earlier discharge with community support;
- increased requirement for staff study / in service;
- nurse practitioners; and
- more demand for families to live in.
There is a growing international trend towards birthing as a same-day procedure. In
Australia there is currently a lack of community services to support this. However, it is an
issue in terms of long-term investment in infrastructure.

Planning Models

510.007.000 LOCATION
961109
In order to provide easy access for ambulances, taxis or private vehicles for women in
labour, a ground floor location is preferred for the Birthing Unit (and Birth Centre). Such a
location would additionally facilitate access to hospital grounds and verandas for the
mothers and their supporters. If this cannot be achieved, direct lift access to the Unit is
recommended and access to a secure courtyard is desirable.
Units should be located to avoid:
- disturbing sounds, both on-site and off-site such as ambulance sirens traffic, trains
etc.;
- disturbing views such as cemeteries, mortuaries or their entries; and
- problems associated with prevailing weather conditions. It is preferable for patient
accommodation to have a north-east aspect.
The functional needs of the unit however should take priority over other location needs.
The Birthing Unit and Birth Centre should ideally be located to maximise or provide
quietness, outlook and outdoor access during long periods of labour for both mother and
supporters. Access to outdoor areas is of particular importance for units in rural areas with
high aboriginal populations who are not used to being confined indoors. However, privacy
remains a priority.

510.007.005 Planning should consider the proximity of 24 hour and 8 hour operational zones. Locate
961110 units so that staff are not working in isolation nor have to traverse unoccupied areas at
night. The positioning of units should optimise the capacity for staff to observe and assist
each other. See Part C: Design for Access, Mobility, OHS and Security, Space Standards and
Dimensions, Australasian Health Facility Guidelines (AHIA, 2010)for further information.

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Functional Areas

510.008.000 FUNCTIONAL ZONES


502278
Functional zones may include:
- main entry, reception, waiting;
- assessment / early pregnancy unit;
- outpatient clinics;
- day only unit;
- birthing unit;
- inpatient units / beds; and
- staff offices and amenities not incorporated into individual units;
- teaching and research.

510.008.005 MAIN ENTRY / RECEPTION / WAITING


502279
Size and design will depend on the size of the unit / centre. The area may also include
retail facilities such as a coffee lounge and a baby boutique, although these facilities might
best be located in the main entry for the facility.

510.008.010 ASSESSMENT / EARLY PREGNANCY UNIT


961111
The unit is for the management of pregnant women with threatened miscarriage or
premature labour. Planners will need to determine the preferred location in relation to
the emergency unit.
These are emergency services and the position of the unit would depend on the service
model proposed as part of the planning documents.
Facilities comprise bed bays or single rooms with the necessary clinical and family support
facilities.

510.008.015 OUTPATIENT (AMBULATORY CARE) CLINICS


961112
Maternity outpatient services encompass prenatal, antenatal and postnatal care including
education, counselling and support services for mothers, partners and families to ensure
preparation for, and understanding of pregnancy, birth, parenting and mother care.
Newborn hearing screening may also be undertaken in this service. Increasingly, services
are expanding and diversifying to include follow-up perinatal bereavement counselling.
Related clinics such as fertility services and urogynaecology are also often part of
outpatient services in major centres.
Planners should determine the model of care to be adopted by the facility to determine:
- whether there is sufficient throughput to justify dedicated clinic rooms or shared
rooms with a general outpatients department;
- the range of services to be provided and therefore the number of clinic rooms
required; and
- the location of hospital-based outpatient facilities.
Depending on numbers, a single waiting room may create issues of patient management
as there are different waiting and treatment times for different clinics and this may lead to
agitation in long wait patients. It is suggested that waiting areas are designed into pods
based on common treatment and waiting times - for example maternal foetal medicine,
cultural, midwifery, medical and shared care. Consider the need for separate clusters of
rooms for bereavement counselling and fertility counselling. This area should be child,

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Australasian Health Facility Guidelines

family, disability friendly and safe with adequate circulation space.


Facilities may also include a room for antenatal classes and the Centering Pregnancy
Programme.
Midwives operating a midwife-led, birth centre model will usually see their clients within
the Birth Centre, at home or at an alternative venue.

510.008.020 DAY ONLY MATERNITY AND PERINATAL SERVICES AND FACILITIES


961113
In addition to routine clinic attendances, it may be necessary for some antenatal women
to attend hospital on a day or half-day basis for maternal and foetal assessment and
monitoring (CTG), ultrasound, blood tests etc.
In small hospitals the ambulatory care unit may be utilised. Large regional centres will
have a dedicated unit that may include access to a dedicated obstetric ultrasound unit
depending on the proximity of the main medical imaging unit and operational policy.
Facilities may be collocated with maternity outpatient clinics.

510.008.022 BIRTHING UNIT


961114
The Birthing Unit consists of LDR (labour, delivery, recovery) rooms, assessment and
induction rooms, staff areas and clinical support areas. The number of LDR and
assessment and induction rooms will depend on the volume of deliveries expected in the
facility.
Staff and clinical support functions in the Birthing Unit can be shared with other Maternity
Unit zones, depending on the functional relationships able to be achieved and size of the
Unit. A factor that will impact on the ability for sharing is that the Birthing Unit needs
physical and acoustic separation from other parts of the Maternity Unit so as not to
impinge on the wellbeing of other occupants, It is also critical that Birthing Unit staff do
not need to travel too far to access supplies, linen, utilities etc, which may interfere with
the birth.

510.008.025 INPATIENT BED MIX


961115
Maternity inpatient units usually comprise a mix of single and two-bed rooms. The mix will
be a decision for individual jurisdictions.
Single bed rooms have infection control benefits and are sought after for privacy and
better accommodate the growing equipment requirements. Two-bed rooms facilitate
socialisation and parentcraft.
Consideration may be given to a four-bed high dependency room but usually only in a
postnatal unit.
Housing of maternity patients in non-maternity units or non-maternity patients in
maternity units raises issues of ongoing maternity care, infection control and infant safety
and should be avoided.

510.008.030 ANTENATAL BEDS


961116
Antenatal beds are used by women with high risk pregnancies. Services operating at Level
4 may have very minimal need for such beds. In Level 5/6 services, antenatal beds may be
a separate unit or a module of beds collocated with postnatal beds. Larger rooms for
bariatric patients will be required.
Lengths of stay will vary but some women may remain for long periods. Many of the
conditions may require considerable rest and quiet and a single bedroom is the preferred
option. However, women may also be ambulant and access to a lounge / dining and
outdoor area for socialisation with other patients and families including young siblings

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should be provided.
Clinical support areas for antenatal beds may be shared with the postnatal zone,
depending on the functional relationships and unit size.

510.008.035 POSTNATAL BEDS


961117
Access to postnatal beds is critical due to the unpredictability of the service and to avoid
exit block from the Birthing Unit when there are surges in birth numbers.
Postnatal maternity services support a wellness model. Provision of space is important for
women to gather, breastfeed and participate in shared groups as part of the promotion of
parenting and education for mothers. Postnatal beds may be clustered for general
maternity care (healthy mother, healthy baby), higher dependency care for closer
observation maternity care (post caesarean section, complex delivery) and a small and
very discreet cluster for women who have lost their baby or have relinquished it for
adoption. It is stressed that this latter category still needs ongoing maternity care,
psychological care, social care and support.
Accommodation in a non-maternity unit is not the best solution.
There is a need for one or two larger postnatal bedrooms to cope with multiple births
(there may be two to three sets at one time) bariatric patients, and people with disabilities
e.g. wheelchair bound.
Clinical support areas for postnatal beds may be shared with the antenatal zone,
depending on the functional relationships and unit size.
Access to space and storage of equipment for undertaking of newborn infant hearing
screening should also be considered as part of planning.

Functional Relationships

510.009.000 The Maternity Unit has functional relationships with the following units / services relevant
961118 to their level of service delivery:
- community maternity services;
- universal newborn health screening service;
- emergency unit;
- Birthing Centre;
- imaging - particularly obstetric ultrasound;
- anaesthetic services;
- operating rooms - for emergency and planned surgery (Levels 1 – 4 in South Australia
with a centre managing 4,000 births needs a designated obstetric theatre);
- special care nursery and neonatal intensive care unit;
- ICU and HDU for sick women;
- ambulance transport bay/s for retrieval services (NSW Newborn and Paediatric
Emergency Transport Service);
- helipad, where provided, for retrieval teams including the Flying Doctor Service;
- gynaecological inpatient beds;
- general hospital support services; and
- pathology and pharmacy services.

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DESIGN
Access

510.010.000 The Assessment Unit, Birthing Unit and Birth Centre require 24 hour access. A direct and
502287 dedicated entry with drop-off parking for cars, taxis and ambulances is preferred. Delivery
by ambulance should not be via the emergency department. The Birth Centre ideally
should have its own entry with internal links to the main Birthing Unit and Operating Unit.
If these Units do not have dedicated entries, specific arrangements will need to be made
for after-hours access.
Access during normal hours should be via the reception area. After-hours access for
expectant mothers and their supporters should be via the birthing area. After-hours policy
may allow restricted access to partners / support persons of mothers in the in-patient area
and parents of neonates in the neonatal special care area.
Planning should minimise the number of night entrances and ensure that staff and the
public can access the unit at entrances adjacent to car parks to limit the time outside of
the facility at night.
Swipe card or key pads at access points should be considered as they provide a more
secure, cost effective access control.

Parking

510.011.000 Parking and drop-off will be required for:


502288
- ambulances, taxis, private vehicles with women in labour;
- on call obstetricians and anaesthetists;
- car parking for partners bringing women to the Birthing Unit; and
- flowers and gift deliveries.
For staff parking, refer to Part C: Section 790, Safety and Security Precautions, Australasian
Health Facility Guidelines (AHIA, 2015).
Parking of vehicles used by midwives providing home services will need to be considered.

Disaster Planning

510.012.000 Each component of the Unit will have operational plans and policies detailing the response
502289 to a range of internal and external emergency situations. During planning and design
phases consider issues such as the placement of emergency alarms, the need for
uninterrupted power supply (UPS) to essential clinical equipment and electronic sensor
taps, services such as emergency lighting, telephones, duress alarm systems and
computers and the emergency evacuation of patients, many of whom will require
assistance.
Refer to Part B: Section 80 General Requirements, Australasian Health Facility Guidelines
(AHIA, 2010) and Part C: Design for Access, Mobility, OHS and Security, Space Standards
and Dimensions, Australasian Health Facility Guidelines (AHIA, 2010) for further
information.

510.012.005 Particular attention is required to the means of evacuation for mothers in advanced
961119 labour, and evacuation of babies to avoid separation from their mothers.

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Infection Control

510.013.000 GENERAL
961120
The following aspects of planning and design contribute to the implementation of
effective infection prevention and control measures and are relevant within the context of
this HPU:
- hand hygiene facilities;
- isolation rooms (if applicable);
- linen handling;
- separation of ‘clean’ and ‘dirty’ work flows;
- storage;
- waste management; and
- surface finishes.
Refer to Part D: Infection Prevention and Control, Australasian Health Facility Guidelines
(AHIA, 2015) and individual jurisdiction policies and guidelines.

510.013.005 ISOLATION ROOMS


961121
It is recommended that there be at least one negative pressure Birthing Room with
Anteroom available in the inpatient units.

Environmental Considerations

510.014.000 ACOUSTICS
502294
Acoustic treatment is essential in the Birthing Rooms to allow the mother to vocalise as
desired during labour without worrying about disturbing others.
Crying babies, especially at night, can be a major source of distress to others, particularly
mothers recovering from surgery or other conditions e.g. pre-eclampsia, for whom noise
may be detrimental to their condition.
One of the prime considerations in the Nursery is the amount of noise created by crying
babies, monitors, suction pumps, ventilators, etc. Methods of sound dampening should be
carefully considered, but should not interfere with observation and ease of access
between the Nursery and staff / support areas.
Refer to Part C: Design for Access, Mobility, OHS and Security, Space Standards and
Dimensions, Australasian Health Facility Guidelines (AHIA, 2010) for further information.

510.014.005 NATURAL LIGHT


502296
Natural light contributes to a sense of wellbeing for all building occupants including
patients, staff and other users. A limited number of research studies suggest a link
between greater levels of natural light with improved clinical outcomes.
Natural light is required to all bedrooms in accordance with Building Code of Australia
(BCA) (ABCB, 2015). Higher levels of natural light may help people better orient
themselves in the building thus enhancing wayfinding. Glare should be minimised.
Greater use of natural light may also reduce energy usage in terms of reducing the need
for artificial lighting.
For these reasons, the use of natural light should be maximised throughout the unit.

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510.014.010 PRIVACY
502297
Ensure that doors to birthing rooms when opened do not expose the labouring woman to
view by others outside the room.

510.014.015 INTERIOR DÉCOR


502298
Interior décor includes furnishings, style, colour, textures, ambience, perception and taste.
This can help prevent an institutional atmosphere. However, cleaning, infection control,
fire safety, patient care and the patients' perceptions of a professional environment
should always be considered.
Some colours, particularly the bold primaries and green should be avoided in areas where
clinical observation occurs such as bedrooms and treatment areas. Such colours may
prevent the accurate assessment of skin tones e.g. yellow / jaundice, blue / cyanosis, red /
flushing.

510.014.020 ARTWORK
961122
Care should be taken in the selection of artwork to ensure no distress to parents who have
very sick newborns or who have experienced neonatal death or abnormality.

510.014.025 SIGNAGE
961123
The orientation of people to and within healthcare facilities, and even safety and security
issues are greatly assisted or hampered by the quality and location of signage which may
be directional, used as a means of identification and/or statutory.
All signage should be easily understood by staff and the general public whether patients or
visitors, and where necessary and appropriate, languages other than English should also
be used.
Any signposting, or other initiatives put in place, should be considered from the
perspective of out-of-hours use. Certain access points may be locked out of office hours or
after visiting hours. Directions indicated through signposting should, therefore, be
evaluated in this context.
Refer to AusHFG Part C: Section 750, Signage and TS2: Wayfinding for Healthcare Facilities,
Issue 5th Ed (NSW Health, 2008).

510.014.030 In particular, signage for access to the Assessment Unit, Birthing Unit and Birth Centre
961124 should be easily identified to avoid confusion.

Space Standards and Components

510.015.000 HUMAN ENGINEERING


502300
Human engineering covers those aspects of design that permit effective, appropriate, safe
and dignified use by all people, including those with disabilities. For details refer to Part C:
Section 730, Human Engineering, Australasian Health Facility Guidelines (AHIA, 2010).
As the requirements of occupational health and safety (OHS) and antidiscrimination
legislation will apply, this section should be read in conjunction with Part C: Section 790,
Safety and Security Precautions, Australasian Health Facility Guidelines (AHIA, 2015) in
addition to relevant OHS legislation.

510.015.005 ERGONOMICS
502299
Maternity Units should be designed and built in such a way that patients, staff, visitors and

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Australasian Health Facility Guidelines

maintenance personnel are not exposed to avoidable risks of injury.


Badly designed recurring elements such as height, depth and design of workstations and
counters, shelving and the layout of critical rooms have a great impact on the occupational
health and safety of staff as well as the welfare of patients. Inherent in this is the capacity
to safely treat bariatric patients.
Refer to the section on Access and Mobility in Part C: Section 730, Human Engineering,
Australasian Health Facility Guidelines (AHIA, 2010).

510.015.010 ACCESS AND MOBILITY


502301
Where necessary, design should comply with AS/NZS 1428:2010 Design for Access and
Mobility (Set) (Standards Australia, 2010).
Wheelchair-bound staff including nursing, clerical, support and management should also
be accommodated in accordance with AS/NZS 1428:2010 Design for Access and Mobility
(Set) (Standards Australia, 2010).
Refer to Part C: Section 730, Human Engineering, Australasian Health Facility Guidelines
(AHIA, 2010) for details.

510.015.015 BUILDING ELEMENTS


502302
Building elements include walls, floors, ceilings, doors, windows and corridors and are
addressed in detail in the section on Building Elements in Part C: Section 710, Space
Standards and Dimensions, Australasian Health Facility Guidelines (AHIA, 2010).

510.015.020 DOORS AND DOORWAYS


961125
Ensure that doorways are sufficiently wide and high enough to permit the manoeuvring of
beds, wheelchairs, trolleys and equipment without risk of damage or manual handling
risks.

Safety and Security

510.016.000 RISK / HAZARD MANAGEMENT


961126
Consideration of safety and security risks should begin during the planning and design
phase of a healthcare facility and should continue to be considered during the
construction, use and post occupancy stages.
By adopting a risk management approach, many safety and security related hazards can
be eliminated or minimised at the planning stage before work even begins, reducing the
likelihood of adverse incidents occurring.
Occupational Health and Safety (OHS) or similar legislation requires planners and
designers to identify, assess and control risks and to do this in consultation with
stakeholders, including staff.
Refer to AS/NZS ISO 31000:2009 Risk Management - Principles and Guidelines (Standards
Australia, 2009) and Part C: Section 790, Safety and Security Precautions, Australasian
Health Facility Guidelines (AHIA, 2015).

510.016.005 SAFETY
502303
Facility planners and designers should enhance safety through choices regarding the
design, methods of construction, materials used, and the choice of fittings, fixtures and
equipment.

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510.016.010 SECURITY
502304
Facility planners and designers should enhance security by incorporating the principles of
territorial reinforcement, surveillance, space management and access control into design
decisions.
Minimise entry and exit doors to all areas with newborn babies to minimise the risk of
illegal removal of babies. All access to and egress from the unit should be controlled. CCTV
monitoring of Unit entry and exit doorways and hallways should be considered. The use of
reed switches, electric locking and video intercom on external doors and entries should be
considered. Swipe card readers may be required to both sides of internal doors, to allow
access for authorized staff.
Specific security procedures should be developed and implemented.
The staff station should be located at the main entrance to allow staff to monitor access
and egress. Attention should be paid to reception desk security and a duress alarm
system.
Good visibility from the staff station to nursery is required.
The number of relatives / visitors admitted in the area should be controlled by either
restricting the number of relatives / visitors attending at any one time and/or restricting
visiting hours to set times.
Courtyards, where provided, should be securely screened / fenced and adequately
monitored (from Staff Station, CCTV, etc.).

510.016.015 INFANT SAFETY AND SECURITY


502310
Both mothers and babies require identification bracelets / bands. Keeping mothers and
babies together unless clinically indicated to the contrary enhances the babies’ safety.
CCTV, access control and infant tagging should be considered (Cesario 2003). Consider
implementation of a system that provides baby with an electronic tag around baby’s ankle
and alerts staff / security when the unit boundary is breached via sensor panels located at
the Unit / hospital exits. It should be noted however that infant tagging is costly and has
proved problematic where it has been implemented because neonates lose weight in the
first days of life. The tag bracelets therefore can become too large and may slip off easily.
There is a requirement for a lock down capability of the whole unit when there is a known
security risk e.g. that a baby might be taken.

Finishes

510.017.000 GENERAL
961127
Finishes in this context refers to walls, floors, windows and ceilings.
Refer to Part C: Section 710, Space Standards and Dimensions, Australasian Health Facility
Guidelines (AHIA, 2010) for further details.

510.017.005 WALL FINISHES


502305
Adequate wall protection should be provided to areas that will be regularly subjected to
damage. Particular attention should be given to areas where bed or trolley movement
occurs such as corridors, bed head walls, treatment areas, equipment and linen trolley
bays. Refer to Part C: Section 710, Space Standards and Dimensions, Australasian Health
Facility Guidelines (AHIA, 2010).

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510.017.010 FLOOR FINISHES


502306
The selection of floor finishes should be appropriate to the function of the space and take
into account manual handling issues including the impact of the flooring on push / pull
forces for wheeled equipment.
Consider acoustic performance, slip resistance, consequences of patient falls, infection
control, movement of beds and trolleys, maintenance and cleaning protocols. The flooring
selected should be adequate to avoid the potential for slips, trips and falls to occur,
including as a result of joints between flooring.
Refer to:
- Part D: Infection Prevention and Control, Australasian Health Facility Guidelines (AHIA,
2015);
- TS7 - Floor Coverings in Healthcare Buildings, Issue V1.1 (NSW Health, 2009); and
- Part C: Section 710, Space Standards and Dimensions, Australasian Health Facility
Guidelines (AHIA, 2010).

510.017.015 CEILING FINISHES


502307
Ceiling finishes should be selected with regard to appearance, cleaning, infection control,
acoustics and access to services.
Refer to Part C: Section 710, Space Standards and Dimensions, Australasian Health Facility
Guidelines (AHIA, 2010).

Fittings and Fixtures

510.018.000 DEFINITION
502308
The Room Data and Room Layout Sheets in the Australasian Health Facility Guidelines
define fixtures and fittings as follows.
- Fixtures: Items that require service connection (e.g. electrical, hydraulic, mechanical)
that include, but are not limited to hand basins, light fittings, medical service panels
etc. but exclude fixed items of serviced equipment; and
- Fittings: Items attached to walls, floors or ceilings that do not require service
connections such as curtain and IV tracks, hooks, mirrors, blinds, joinery, pin boards
etc.
Refer to Part C: Section 710, Space Standards and Dimensions, Australasian Health Facility
Guidelines (AHIA, 2010)and to the Standard Components - Room Data Sheets (RDS) and
Room Layout Sheets (RLS), Australasian Health Facility Guidelines (AHIA, 2015) for further
detailed information.
Also refer to Part F: Section 680 Furniture Fittings and Equipment, Australasian Health
Facility Guidelines (AHIA, 2010) regarding fixtures, fittings and equipment.

510.018.005 BIRTHING ROOM BATHS


961128
Baths that are an integral feature of the Birthing Room should be peninsula-style, i.e. not
corner baths.
Corner baths have been identified as an OHS risk. Multi-side access deep baths with
support bars are required even if it affects room size. This is important to aid lifting when
necessary and for observation. This may raise other management issues and the location
and space requirement needs careful planning.
Design of taps and outflows are critical. Warm water is a requirement in all healthcare

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Australasian Health Facility Guidelines

facilities and therefore taps should be large enough to fill the bath quickly before the
water cools to an uncomfortable temperature and outlets should be large enough to
ensure rapid emptying should the need arise.
Spa jets should not be included as spa outlets are unable to be cleaned adequately from
an infection control perspective and ceiling hoists or lifters should be considered.

Building Service Requirements

510.019.000 GENERAL
961129
In addition to topics addressed below, project staff may also refer to:
- Part E: Building Services and Environmental Design, Australasian Health Facility
Guidelines (AHIA, 2010) and
- TS11 - Engineering Services and Sustainable Development Guidelines (NSW Health,
2013).

510.019.005 AIR HANDLING SYSTEMS


961130
All components of the Unit should be fully air-conditioned.
Each Birthing Room should have individual air-conditioning systems. If the thermostats are
located inside the Birthing Room, the controls should be located out of the reach of
children and under the control of staff only. The rooms need to be able to quickly obtain a
temperature range of 25-27°C when the baby is born. The Nursery also requires similar
temperature control.
Refer to Part D: Infection Prevention and Control, Australasian Health Facility Guidelines
(AHIA, 2015) and HB 260:2003 Hospital Acquired Infections - Engineering Down the Risk
(Standards Australia, 2003).

510.019.010 ELECTRICAL SERVICES


961133
It is essential that services such as emergency lighting, telephones, duress alarm systems
(including the central computer) and electronic locks are connected to the emergency
power supply.

510.019.015 INFORMATION TECHNOLOGY AND COMMUNICATIONS


961131
Systems may include:
- wireless technology;
- radiofrequency identification (RFID) for access control, locks etc.;
- duress alarm systems - fixed and personal as required;
- nurse / emergency call systems;
- voice / data (telephone and computers);
- videoconferencing capacity / telemedicine;
- electronic medical records;
- clinical point of care;;
- picture archiving communication system (PACS);
- patient administration systems (PAS);
- radiology information systems (RIS);
- paging and personal telephones replacing some aspects of call systems;
- patient multimedia devices including bedside monitors that function as televisions,
computer screens for internet access, etc.;

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- bar coding for supplies and X-rays / records;


- patient information screen integrated with menu ordering, nurse call and other
modalities;
- server and communications rooms;
- e-learning and simulation;
- e-medication management and e storage systems e.g. automated dispensing systems;
- server rooms; and
- communication rooms / closets.
All communication systems should be compatible with existing or planned overall hospital
systems including staff and emergency call systems.
Annunciator panels should be clearly visible in corridors and be the scrolling type so that
all rooms can be seen. However, the ability to control audibility at night should be a
criterion when selecting systems.

510.019.020 HYDRAULIC SERVICES


961132
Warm water systems will be required.

510.019.025 LIGHTING
961134
Colour-corrected dimmable lighting is essential in all patient areas where high dependency
care is provided, i.e. birthing / assessment rooms and birthing room en suites and
bathrooms, all nurseries and baby bathing / examination / resuscitation areas.

510.019.035 MEDICAL GASES


961135
Each bed will require oxygen, suction and medical air. Service panels, mother and
newborn, in Birthing Rooms should be enclosed.
For anaesthesia requirements in birthing rooms refer to Recommendations of Minimum
Facilities for Safe Administration of Anaesthesia in Operating Suites and Other
Anaesthetising Locations - Interim Review 2008 (Australian and New Zealand College of
Anaesthetists, 2009).

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COMPONENTS OF THE UNIT


Standard Components

510.020.000 Standard Components (SC) refer to rooms / spaces for which Standard Components -
502312 Room Data Sheets (RDS) and Room Layout Sheets (RLS), Australasian Health Facility
Guidelines (AHIA, 2015) have been developed and are available on the AusHFG website.
Their availability is indicated by “Y” in the SC column of the Schedule of Accommodation.
Standard components are provided to assist with the development of a project. Their use
is not mandatory and if used they can be edited to be project specific.
Refer to AusHFG Part B: Section 90, Standard Components for the text and to separately
itemised Standard Components - Room Data Sheets (RDS) and Room Layout Sheets (RLS),
Australasian Health Facility Guidelines (AHIA, 2015).

Non-Standard Components

510.021.000 Non-standard components are unit-specific and provided in accordance with specific
502313 operational policies and service demand. The following non-standard components are
described below:
- Assessment Room and Assessment / Induction Room;
- Bay – Neonatal Resuscitation;
- Bay – New Weighing / Assessment;
- Newborn Bathing Room / Examination / Treatment Room;
- General Nursery; and
- Breastfeeding Room.

510.021.005 ASSESSMENT ROOM AND ASSESSMENT / INDUCTION ROOM


502314
Description and Function
An Assessment Room is located in the Assessment / Early Pregnancy Unit. It is used to
conduct patient examinations and monitor foetal activity, heart beat etc.
An Assessment / Induction Room is located in the Birthing Unit and is used to conduct
patient examinations and monitor foetal heart beat etc. at the very early stages of labour.
It can also be used for the application of drugs to induce labour.
Location and Relationships
These rooms should be located in close proximity to the Staff Station to allow ongoing
supervision. The Assessment / Induction room should be in close proximity to Birthing
Rooms for ease of transfer when labour is established.
Considerations
Assessment Rooms in the Assessment / Early Pregnancy Unit may be enclosed rooms or
bays, however in the Birthing Unit, these rooms should be enclosed.

510.021.010 BAY – NEONATAL RESUSCITATION


502315
Description and Function
This area is an emergency treatment bay in the Birthing Unit for babies who are
compromised and need emergency intervention / support e.g. oxygen, resuscitation,
stabilisation prior to transfer to Neonatal Intensive Care Unit (NICU).

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Location and Relationships


This area should be located centrally within the Birthing Unit, but should have privacy
from other women and support persons in the Unit. Plan an appropriate route for transfer
/ evacuation of the newborn to NICU should it be required.
Considerations
Medical gases, resuscitation and emergency equipment are required. Bench space for
write up is also needed.

510.021.015 BAY – NEWBORN WEIGHING / ASSESSMENT


961136
Description and Function
A small bench area in the Birthing Unit for weighing new born babies and completing
associated paperwork. This area is optional as scales could be located within each birthing
room as an alternative.
Location and Relationships
This area should be located centrally in the Birthing Unit, able to be accessed from all
Birthing Rooms.
Considerations
It is preferable for baby to be removed from the Birthing Room only in the company of a
parent / support person.

510.021.020 NEWBORN BATHING / EXAMINATION / TREATMENT ROOM


502316
Description and Function
A room for infant examination, administration of vaccines and hearing screening, and
demonstration of baby bathing techniques as part of parentcraft education. Size will
depend on operational policy regarding demonstration and whether bathing occurs in
mothers’ bedrooms. It is recommended that purpose-built baby baths and sinks are used
for OHS reasons rather than portable baths or bassinets.
Location and Relationships
The room may be a separate room in the Postnatal zone adjacent to an optional General
Nursery, or the two spaces can be combined to include the General Nursery function.
Considerations
Storage for baby scales.
Attention to height of benches and mounting of baby baths.

510.021.025 GENERAL NURSERY


961137
Description and Function
A room where babies can be cared for by maternity unit staff for a short period. This room
is optional. In some jurisdictions the practice of caring for babies in a nursery is not
supported; rooming in is encouraged.
Location and Relationships
This room should be located in the Postnatal zone and be oversighted by the staff station.
It is preferable for it to be adjacent to or incorporated in the Bathing / Examination /
Treatment room.

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510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

Considerations
Inclusion of a General Nursery requires consideration to be given to staffing requirements
to ensure appropriate supervision of babies in the Nursery at all times. Infection control
issues also need to be considered.

510.021.030 BREASTFEEDING ROOM


961138
Description and Function
A room for demonstrations, breastfeeding or using breast pumps for expressing milk. In
small units, the room may also be used to prepare and store formula / breast milk
substitutes in line with the Baby Friendly Health Initiative.
This room is optional if other space is available for demonstrations (group or individual)
e.g. meeting room and a fridge / freezer is available in the formula room for storage of
breast milk.
Location and Relationships
The Breastfeeding Room should be located with convenient access to the Nursery or to
the Inpatient Unit.
Considerations
The Breastfeeding Room will require the following:
- bench with an inset sink;
- hand basin (Type B) for mothers and staff;
- comfortable chairs suitable for breastfeeding;
- lockable refrigerator / freezer (if required);
- storage for pump and attachments;
- general power outlets for use of a breast pump;
- access to educational material either within the room or conveniently located nearby;
and
- visual and acoustic privacy.

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APPENDICES
Schedule of Accommodation

510.022.000 A schedule of accommodation is shown below and lists generic spaces for this HPU. Please
961139 note that in the schedules:
- SC refers to standard component (drawings and data sheets);
- (o) indicates the component is optional; and
- "Y" refers to whether available in these guidelines.

510.022.005 ENTRY / RECEPTION


961140

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Entry / Reception Yes 1 x 10 1 x 12

Waiting Yes 1x9 1 x 12

Interview Room Yes 1x9 1x9

Bay - Vending Yes 1x2 1x2

Bay - Water Cooler Yes 1x1 1x1

Toilet - Public Yes 2x3 2x3

Toilet - Accessible Yes 1x5 1x5

Discounted Circulation 32% 32%

510.022.010 ASSESSMENT / EARLY PREGNANCY UNIT


961141

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Assessment Room 4 x 12 8 x 12 Rooms or bed bays.

Ensuite - Standard Yes 4x5 8x5 Reduce if only bed bays planned.

Interview Room Yes 1x9 2x9

Lounge - Patient/Visitor/Beverage Yes 1 x 12 1 x 20

Staff Station Yes 1 x 10 1 x 12

Clean Utility Room Yes 1 x 10 1 x 12 Includes medication storage.

Dirty Utility Room Yes 1 x 10 1 x 12 Initial Cleaning of vaginal probes – to be


cleaned in scope cleaners.

Store - Equipment Yes 1x4 1x6 Space for CTG, Ultra sound machines.

Discounted Circulation 32% 32%

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510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

510.022.015 BIRTHING UNIT


961142

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Bay – Handwashing Type B Yes 1x1 1x1 At Unit Entry with PPE.

Assessment / Induction Room 2 x 15 4 x 15

Birthing Room Yes 4 x 30 7 x 30 Number determined by number of


births. Capacity for multiple births,
peninsular bath.

Birthing Room - Isolation Yes 1 x 30 Negative pressure.

Anteroom Yes 1x6 For isolation (negative pressure) room.

Ensuite – Birthing Room Yes 4 x 10 8 x 10 Include double shower.

Store – General Yes 2x8 4x8 Shared space between birthing rooms
for CTG, cribs with discreet access from
birthing and entry corridor.

Bathroom Yes 1 x 15 1 x 15 Configured specifically for birthing.


Optional - Birthing Pool. Replaces
ensuite.

Bay - Neonatal Resuscitation 2 x 12 2 x 12 Neonates - All medical gases to be


provided.

Bay – Newborn Weighing / Assessment 1 x 1 (o) 1 x 1 (o) May be performed in Birthing Room.

Staff Station Yes 1 x 12 1 x 14

Office - Clinical / Handover Yes 1 x 15 1 x 20 Provide hot desks for visiting staff e.g.
community midwives, medical staff,
allied health.

Office - Single - 9m2 Yes 1x9 1x9 Unit Manager.

Store - Files Yes 1x8 1 x 10

Clean Utility Yes 1 x 12 1 x 14 Includes pharmacy products.

Dirty Utility Yes 1 x 10 1 x 12 Include locked fridge / freezer for


placenta storage and initial cleaning of
scopes etc.

Disposal Room Yes 1x8 1 x 10 May be shared with Ante/ Postnatal.

Bay - Mobile Equipment Yes 1x4 2x4

Bay - Linen Yes 1x2 2x2

Bay - Blanket Warmer Yes 1x1 2x1

Bay - Resuscitation Trolley Yes 1 x 1.5 1 x 1.5 For adults.

Store – Drugs Yes 1 x 5(o) 1 x 5(o) May be included in sterile stock store
with appropriate security or part of
clean utility.

Store - Sterile Stock Yes 1 x 12 1 x 16

Store - Equipment Yes 1 x 14 1 x 20

Store – General Yes 1x9 1x9

Bay – Wheelchair Park Yes 1x4 1x4

Bay – Beverage, Enclosed Yes 1x5 1x5

Cleaner's Room Yes 1x5 1x5 May be shared with Ante/ Postnatal.

Lounge / Beverage - Visitors Yes 1 x 12 1 x 16

Part B - Health Facility Briefing and Planning Page 30


510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Meeting – Medium / Large Yes 1 x 15 1 x 20 Meetings and education.

Staff Room Yes 1 x 12 1 x 16 May be shared with Ante / Postnatal.

Change - Staff Yes 2 x 10 2 x 10 Shower, toilet, lockers. May be shared


with Ante / Postnatal.

Discounted Circulation 35% 35%

510.022.020 INPATIENT UNIT - ANTENATAL


961143
Notes:
- Bed numbers are indicative only and will need to be modified on a project-by-project
basis.
- Level 3/4 beds may be included in the Postnatal Ward.

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Bay – Handwashing Type B Yes 1x1 1x1 At Unit Entry with PPE.

1 Bed Room - Standard Yes varies x 15 8 x 15 Level 3/4 beds may be included in the
Postnatal Ward.

1 Bed Room - Special Yes varies x 18 2 x 18 Level 3/4 beds may be included in the
Postnatal Ward.

2 Bed Room Yes varies x 28(o) varies x 28(o) Optional.

Ensuite - Standard Yes varies x 5 8x5 Depends on number of 1 bed rooms


(standard).

Ensuite - Super Yes varies x 6 2x6 Depends on number of 1 bed rooms


(special).

Lounge - Patient / Visitor / Dining Yes 1 x 12 1 x 15

Discounted Circulation 35% 35%

510.022.025 INPATIENT UNIT - POSTNATAL


961144
Bed numbers are indicative only and will need to be modified on a project-by-project
basis.

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Bay – Handwashing Type B Yes 1x1 1x1 At Unit Entry with PPE.

1 Bed Room - Standard Yes varies x 15 17 x 15 May be used as Class S/Type 4 Isolation
Room. Level 3/4 beds may be shared
with the Antenatal Ward.

1 Bed Room - Isolation Yes varies x 15 1 x 15 Negative pressure.

Anteroom Yes varies x 6 1x6 For isolation bed room.

1 Bed Room - Special Yes varies x 18 2 x 18 Bariatric, double bed, multiple births,
wheelchair may be accommodated in
these rooms.

2 Bed Room Yes varies x 28(o) varies x 28(o)

Ensuite - Standard Yes varies x 5 17 x 5 Depends on number of 1 bed rooms

Part B - Health Facility Briefing and Planning Page 31


510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)
(standard).

Ensuite - Super Yes varies x 6 3x6 Depends on number of 1 bed rooms


(special).

Newborn Bathing / Examination / 1 x 12 1 x 16 Bathing/examination; phototherapy.


Treatment Room Include neonatal resuscitation trolley.
Adjacent to General Nursery.

General Nursery 1 x 12(o) 1 x 16(o) Directly adjacent to, or incorporated


into, the Newborn Bathing /
Examination / Treatment Room -
optional.

Bay - Blanket Warmer Yes 1 x 1(o) 1 x 1(o) Optional.

Breastfeeding Room 1x9 1 x 12 Adjacent to nursery.

Meeting Room – Large Yes 1 x 20 1 x 30 Patient education classes. Need spacing


to accommodate cots. May share with
Antenatal.

Formula Room Yes 1x8 1x8 Unless located in NICU or Paediatric


Unit. Additional 1 m2 for freezer would
be included.

Office - Single 9m2 Yes 1x9 1x9 For lactation Consultant.

Patient / Visitor Lounge Yes 1 x 12 1 x 15

Discounted Circulation 35% 35%

510.022.030 CLINICAL SUPPORT – ANTENATAL AND POSTNATAL INPATIENT UNITS


961145
These facilities may be shared between Antenatal and Postnatal Units, decentralised to
each Inpatient Area, or a combination of both, depending on Unit bed numbers and
functional relationships. Some rooms may also be shared with the Birthing Unit,
depending on Unit size and functional relationships.

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Staff Station Yes 1 x 12 1 x 12 May include space for 2 bassinets -


increase by 3m2. May also have
additional decentralised staff stations.

Office – Clinical Handover Yes 1 x 15(o) 1 x 15(o) Optional.

Bay – Handwashing Yes 1x1 2x1 Handbasins included in every bedroom.

Bay - Flowers Yes 1 x 2(o) 1 x 2(o) Optional – included in dirty utility.

Store - Equipment Yes 1 x 10 1 x 12 Spare bassinets, transport humidicrib.

Store – General (Rental baby capsules) 1 x 6(o) 1 x 9(o) Optional - due to jurisdictional
protocols and guidelines.

Store – General Yes 1x8 1x9 Bulky items etc.

Pantry Yes 1x8 1x8

Dirty Utility Yes 1 x 10 1 x 12

Clean Utility Yes 1 x 12 1 x 14

Bay – Linen Yes 1x2 2x2

Bay - Resuscitation Trolley Yes 1 x 1.5 1 x 1.5 For adults.

Cleaner’s Room Yes 1x5 1x5 May be shared with Birthing Unit.

Part B - Health Facility Briefing and Planning Page 32


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Australasian Health Facility Guidelines

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Disposal Room Yes 1x8 1 x 10 May be shared with Birthing Unit.

Discounted Circulation 32% 32%

510.022.035 STAFF AREAS AND AMENITIES – ANTENATAL AND POSTNATAL INPATIENT UNITS
961146
These facilities may be shared between Antenatal and Postnatal Units, decentralised to
each Inpatient Unit, or a combination of both, depending on Unit bed numbers and
functional relationships. Some rooms may also be shared with the Birthing Unit,
depending on Unit size and functional relationships. Reference should be made to the
relevant jurisdiction’s office accommodation policies.

Room/Space Standard Qty x m2 Qty x m2 Remarks


Component (Level 3/4) (Level 5/6)

Meeting Room - Medium Yes 1 x 15 1 x 20 Adjust size to suit establishment.


Consider location between postnatal
and antenatal.

Office - Single 9m2 Yes 1x9 1x9 For Unit Manager.

Office - Shared 12m 2


Yes 1 x 12 1 x 12 Clinical Nurse Consultant, nurse
educator etc.

Office - Single 9m2 Yes 1x9 For Reproductive Loss Co-ordinator.

Workstations Yes varies x 4.4 varies x 4.4 for midwives. As per staff
or 5.5 or 5.5 establishment.

Toilet - Staff Yes 1 x 3(o) 2 x 3(o) Optional – may be part of staff change
rooms.

Staff Room Yes 1 x 12 1 x 16 May be shared with Birthing Unit.

Change - Staff Yes 2 x 10 2 x 10 Shower, toilet, lockers. May be shared


with Birthing Unit.

Store – Photocopy / Stationery Yes 1x8 1x8 May be shared with Birthing Unit.

Discounted Circulation 32% 32%

Part B - Health Facility Briefing and Planning Page 33


510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

Functional Relationships

510.023.000 FUNCTIONAL RELATIONSHIP DIAGRAM: CENTRALISED CLINICAL SUPPORT


502249

Part B - Health Facility Briefing and Planning Page 34


510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

510.023.010 FUNCTIONAL RELATIONSHIP DIAGRAM: DE-CENTRALISED CLINICAL SUPPORT


961147

Checklists

510.024.000 For planning checklists, refer to Parts A, B, C and D of the Guidelines.


502343

Part B - Health Facility Briefing and Planning Page 35


510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

REFERENCES AND FURTHER READING


Further Reading

510.025.000 General Policies


502344
Policies that occur in most HPUs are presented in a separate document. The resources
listed below are specific to maternity and related services.
Maternity Services / Jurisdiction Reports
- Boxall, A-M and Russell, LM 2009, A reform proposal for maternity services in
Australia. January 2009, Menzies Centre for Health Policy, The Australian National
University and The University of Sydney;
- Department of Health and Ageing 2009, Improving Maternity Services in Australia:
The Report of the Maternity Services Review, Commonwealth of Australia;
- DHS Victoria 2004, Future directions for Victoria's maternity services, DHS Victoria;
- Hirst, C 2005, Rebirthing: Report of the review of maternity services in Queensland,
QLD Health;
- NSW Health 2000, The NSW framework for maternity services, NSW Health;
- QLD Health 2006, Government response to: Re-Birthing: Report of the review of
maternity services in Queensland, QLD Health;
- SA Health 2009, Standards for maternal and neonatal services in South Australia 2009,
SA Health;
- Tasmania. Refer to www.bubhub.com.au/serviceshospitalstas.php.
- WA Health 2007a, Models of Maternity Care - A Review of the Evidence, WA Health;
and
- WA Health 2007b, Improving maternity services: Working together across Western
Australia: A policy framework, Health Policy and Clinical Reform, WA Health.
College Statements
- Australian and New Zealand College of Anaesthetists 2008, T1 - Recommendations of
Minimum Facilities for Safe Administration of Anaesthesia in Operating Suites and
Other Anaesthetising Locations - Interim Review 2008, ANZCA;
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists 2007,
College Statement C-Obs 14: Decision to delivery interval for Caesarean Section,
RANZCOG;
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists 2009a,
College Statement C-Obs 2: Home Birth, RANZCOG;
- Royal Australian and New Zealand College of Obstetrics and Gynaecology 2009b,
College Statement C-0bs14: Categorisation of urgency for Caesarean section,
RANCOG; and
- Royal Australian and New Zealand College of Obstetrics and Gynaecology 2009c,
College Statement C-0bs24: Warm water immersion during labour and birth,
RANCOG.

Part B - Health Facility Briefing and Planning Page 36


510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

References

510.026.000 - ABCB, 2015, Building Code of Australia (BCA) (ABCB, 2015), Building Code of Australia
961148 (BCA), Australian Building Codes Board, Canberra ACT.
- AHIA, 2010, Part C: Design for Access, Mobility, OHS and Security, Space Standards
and Dimensions, Australasian Health Facility Guidelines (AHIA, 2010), Australasian
Health Facility Guidelines, Australasian Health Infrastructure Alliance (AHIA), Sydney,
NSW.
- AHIA, 2010, Part E: Building Services and Environmental Design, Australasian Health
Facility Guidelines (AHIA, 2010), Australasian Health Facility Guidelines, Australasian
Health Infrastructure Alliance (AHIA), Sydney, NSW.
- AHIA, 2010, AusHFG Part B: Section 90, Standard Components, Australasian Health
Facility Guidelines, Australasian Health Infrastructure Alliance (AHIA), Sydney, NSW.
- AHIA, 2010, Part B: Section 80 General Requirements, Australasian Health Facility
Guidelines (AHIA, 2010), Australasian Health Facility Guidelines, Australasian Health
Infrastructure Alliance (AHIA), Sydney NSW.
- AHIA, 2015, Part D: Infection Prevention and Control, Australasian Health Facility
Guidelines (AHIA, 2015), Australasian Health Facility Guidelines, Australasian Health
Infrastructure Alliance (AHIA), Sydney, NSW.
- AHIA, 2010, Part C: Section 730, Human Engineering, Australasian Health Facility
Guidelines (AHIA, 2010), Australasian Health Facility Guidelines, Australasian Health
Infrastructure Alliance (AHIA), Sydney, NSW.
- AHIA, 2010, Part C: Section 710, Space Standards and Dimensions, Australasian Health
Facility Guidelines (AHIA, 2010), Australasian Health Facility Guidelines, Australasian
Health Infrastructure Alliance (AHIA), Sydney, NSW.
- AHIA, 2015, Part C: Section 790, Safety and Security Precautions, Australasian Health
Facility Guidelines (AHIA, 2015), Australasian Health Facility Guidelines, AHIA, Sydney,
NSW.
- AHIA, 2010, AusHFG Part C: Section 750, Signage, Australasian Health Facility
Guidelines, Australasian Health Infrastructure Alliance (AHIA), Sydney, NSW.
- AHIA, 2010, Part F: Section 680 Furniture Fittings and Equipment, Australasian Health
Facility Guidelines (AHIA, 2010), Australasian Health Facility Guidelines, Australasian
Health Infrastructure Alliance (AHIA), Sydney, NSW.
- AHIA, 2014, Part B: HPU 390 Intensive Care - Neonatal Special Care Nursery,
Australasian Health Facility Guidelines (AHIA, 2014), Australasian Health Facility
Guidelines, Australasian Health Infrastructure Alliance (AHIA), Sydney, NSW.
- AHIA, 2015, Standard Components - Room Data Sheets (RDS) and Room Layout Sheets
(RLS), Australasian Health Facility Guidelines (AHIA, 2015), Australasian Health Facility
Guidelines, AHIA, North Sydney, NSW.
- AHIA, 2010, Part B: HPU520 Operating Unit, Australasian Health Facility Guidelines
(AHIA, 2010), Australasian Health Facility Guidelines, AHIA, Sydney, NSW.
- Australian and New Zealand College of Anaesthetists, 2009, Recommendations of
Minimum Facilities for Safe Administration of Anaesthesia in Operating Suites and
Other Anaesthetising Locations - Interim Review 2008 (Australian and New Zealand
College of Anaesthetists, 2009), Australian and New Zealand College of Anaesthetists,
Sydney, NSW.
- Australian Doula College, 2015, Australian Doula College (website) (Australian Doula
College, 2015), Australian Doula College, Kensington, NSW.
- Australian Government, 2013, Disability Discrimination Act 1992, Act No. 135 of 1992
as amended (Australian Government, 2013), Disability Discrimination Act 1992,
Commonwealth Government of Australia, Canberra, ACT.

Part B - Health Facility Briefing and Planning Page 37


510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

- Boules, N, 2007, Cultural Birthing Practices and Experiences (Boules, N, 2007),


Baulkham Hills Holroyd Parramatta, Migrant Resource Centre, Sydney, NSW.
- Boxall, A and Russell, L, 2009, A Reform Proposal for Maternity Services in Australia
(Boxall, A and Russell, L, 2009), Menzies Centre for Health Policy, The Australian
National University and The University of Sydney, Sydney, NSW.
- Centering Healthcare Institute, 2015, Centering Care Model Overview, Website
(Centering Healthcare Institute, 2015), Website, Centering Healthcare Institute,
Boston, MA.
- Dani C1, Grella PV, Lazzarin L, Rubaltelli FF, 1997, Antenatal Ambroxol Treatment does
not Prevent the Respiratory Distress Syndrome in Premature Infants, European
Journal of Pediatrics, Vol 156, Issue 5, pp392-392 (Dani C1, Grella PV, Lazzarin L,
Rubaltelli FF, 1997), European Journal of Pediatrics, vol. 156, no. 5, pp. 392 - 392,
Belgian Pediatric Association, Brussels.
- Department of Health and Ageing, 2009, Improving Maternity Services in Australia,
Report of the Maternity Services Review (Department of Health and Ageing, 2009),
Commonwealth of Australia, Barton ACT.
- Disability, Pregnancy & Parenthood, 2008, Good Practice: Meeting Cultural Needs,
Disability, Pregnancy & Parenthood Journal, Vol 64 (Disability, Pregnancy &
Parenthood, 2008), Disability, Pregnancy & Parenthood Journal, vol. 64, Disability,
Pregnancy & Parenthood, London.
- Hodnett, E. D., Stremler, R., Weston, J. A. and McKeever, P, 2008, Re-Conceptualizing
the Hospital Labor Room: The PLACE (Pregnant and Laboring in an Ambient Clinical
Environment) Pilot Trial, Birth, Vol 36, Issue 2, pp159-166 (Hodnett, E. D., Stremler, R.,
Weston, J. A. and McKeever, P, 2008), Birth, vol. 36, no. 2, pp. 159 - 166, Wiley,
Toronto, Ontario.
- Homer, Caroline and Caplice, Shea, 2009, Evaluation of the Publicly-funded Homebirth
Program in South East Sydney Illawarra Area Health Service (Homer, Caroline and
Caplice, Shea, 2009), St George Hospital, Homebirth Steering Committee, Sydney,
NSW.
- Homer, Caroline S.E. et al, 2012, 'It's More than just having a Baby' Women's
Experiences of a Maternity Service for Australian Aboriginal and Torres Strait Islander
Families, Midwifery, Vol 28, Issue 4, pp449-455 (Homer, Caroline S.E. et al, 2012),
Midwifery, vol. 28, no. 4, pp. 449 - 455, Elsevier Ltd, Melbourne , VIC.
- Kathleen Fahy, Jenny Parratt, Maralyn Foureur, Carolyn Hastie, 2006, Birth Territory: A
Theory for Midwifery Practice, Women and Birth, Vol 19, Issue 2, pp45-50 (Kathleen
Fahy, Jenny Parratt, Maralyn Foureur, Carolyn Hastie, 2006), Women and Birth, vol.
19, no. 2, pp. 45 - 50, Australian College of Midwives, Canberra, ACT.
- NSW Health, 2013, TS11 - Engineering Services and Sustainable Development
Guidelines (NSW Health, 2013), Technical Series TS11 - Engineering Services and
Sustainable Development Guidelines, NSW Government, North Sydney, NSW.
- NSW Health, 2009, TS7 - Floor Coverings in Healthcare Buildings, Issue V1.1 (NSW
Health, 2009), no. V1.1, NSW Government, North Sydney, NSW.
- NSW Health, 2008, TS2: Wayfinding for Healthcare Facilities, Issue 5th Ed (NSW
Health, 2008), no. 5th Ed, NSW Government, Sydney, NSW.
- RANZCOG, 2015, Categorisation of Urgency for Caesarean Section (RANZCOG, 2015),
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists,
Melbourne, Vic.
- Standards Australia, 2009, AS/NZS ISO 31000:2009 Risk Management - Principles and
Guidelines (Standards Australia, 2009), Standards Australia, Sydney, NSW.
- Standards Australia, 2003, HB 260:2003 Hospital Acquired Infections - Engineering
Down the Risk (Standards Australia, 2003), Standards Australia, Sydney, Australia.
- Standards Australia, 2010, AS/NZS 1428:2010 Design for Access and Mobility (Set)

Part B - Health Facility Briefing and Planning Page 38


510 - Maternity Unit, Revision 5.0, 12 April 2012
Australasian Health Facility Guidelines

(Standards Australia, 2010), AS/NZS 1428:2010 Design for Access and Mobility (Set),
Standards Australia, Sydney, Australia.
- Thomas, N, 2004, The Reproductive Rights of Women with Disabilities (Thomas, N,
2004), Women with Disabilities Australia (WWDA), Lenah Valley, TAS.
- Yelland et al, 2009, A National Approach to Perinatal Mental Health in Australia:
Exercising Caution in the Roll-out of a Public Health Initiative, Medical Journal of
Australia (Yelland et al, 2009), Medical Journal of Australia, Medical Journal of
Australia, Sydney, NSW.

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510 - Maternity Unit, Revision 5.0, 12 April 2012

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