There can’t be many midwives or birth supporters who don’t already know about the advantages of low light for labour and birth. While we are still learning about whether and how darkness and light relate to the release of oxytocin during labour and birth from a scientific perspective, it is a long-held tenet of holistic birth attendants that darkness or low light levels can help create the kind of environment that enables women to feel relaxed and release the hormones that will enable them to labour well. This is relatively easy to achieve at home, where there are generally a range of lights and lamps and few rules about what can and can’t be moved or used. Many birth centres and a few hospitals are also creating environments conducive to the kind of nest-building that facilitates normal birth. But it can be hard for midwives in hospitals to create the right kind of effect on the labour wards where this hasn’t yet become a priority. So, with a big thank you to those who have shared their tips with me both in my workshops and on social media for this article, I have gathered up a few ideas and tips which I hope will help inspire anybody who would like to turn the brightness down a little.
What’s the problem?
The problem with traditional-style labour rooms is, of course, that they have been specifically designed to have really good and bright lighting. Often placed in the centre of the room and dazzling enough to illuminate a night-time football match, the lights are designed to enable practitioners to see well enough to assess women’s and babies’ wellbeing, and carry out procedures requiring excellent illumination, such as perineal suturing. In this respect, they are to be celebrated, but their brightness can feel threatening to women during labour, who tend to need to feel unobserved if they are to progress well. The obvious solutions to this are to turn off the overhead lights, draw the curtains and use alternative sources of lighting to create a more romantic and calmer atmosphere. But what about in skyscraper-level labour rooms where there are no curtains or blinds, because the designers decided that no-one would be able to see in anyway?
Shutting out the daylight
I’ve never worked in a really tall hospital, so I didn’t know the answer to this. But I’m happy to report that some of my city-based colleagues did. A couple of people said they had seen people pinning sheets up on the window, or had used a rebozo to block out the light; but the easiest solution for those who are serious about wanting daytime darkness seems to be disposable blinds, which are sold by DIY stores and can be cut to size and temporarily stuck to the window. That done, we can then go on to create a cosier and more romantic light installation.
Repurposing the lamps
Many labour rooms have an anglepoise lamp, intended as a tool for suturing or procedures which necessitate close visualisation, such as the siting of an intravenous or epidural cannula. One midwife shared that, ‘The light from these can be softened by turning the lamp towards the wall or ceiling, though you may need to experiment with different positions and angles. I’m not very tall so it’s a good thing to ask dads to do.’ Another suggested that a torch can provide gentle illumination in a bathroom; either place it upright on the floor in a corner so that the light shines off the tiles, or reflect the light off a mirror. Other tried-and-tested ideas include turning on the light in an adjacent cupboard or bathroom and leaving the door ajar, but it was in the area of alternative portable mood lighting that people really got creative!
Alternatives to the naked flame
In these days of health, safety and risk assessment, families are unlikely to be allowed to bring in their own plug-in lights or nightlights, which used to be a popular answer to this question. Naked flames are, of course, not an option, because of the risk of fire and the flammable gases that tend to be piped into labour wards. But I and many others have been charmed by the invention of battery-operated fairy lights and candles, which range from tea light size upwards, with some featuring real wax which gives a lovely glowing effect. I’ve met several doulas who pack battery operated fairy lights in their pocket and some midwives and childbirth educators advise couples to load strings of these into their hospital bag.
Friends on social media had even more ingenious suggestions, including battery-operated lava lamps, Himalayan salt lamps, familiar nightlights from home and fairy lights in a large glass jar, lantern or fishbowl, which makes them portable as well as pretty. I now know that, in a pinch or a power cut, one can create a nice soft light by putting a plastic water-filled bottle on top of the flashlight from a mobile phone, while other great suggestions included putting tea or fairy lights into bags made of gold or diaphanous material and toting mini suction cups to stick onto the tiles in the bathroom to hang strings of lights from. I have also learned about the existence of battery-operated floating candles which can be used in birth pools.
Even more ingenious solutions
I have no evidence to support my next statement, and perhaps others will disagree, but I often find that people tend to talk more quietly in a darkened room. However, discussing this phenomenon in workshops often leads to someone lamenting the times where a colleague will enter a labour room and immediately put the main light on, instantly destroying the carefully-crafted atmosphere. Several people suggested putting a notice on the door, and one midwife described her solution to this problem:
‘I made a made-to-exactly-measure box out of thick cardboard and tape and it fits snugly over the light switches in our birth rooms. It’s easily pulled off, but its existence means that someone can’t come in and instantly slap the lights on. Anyone who tries to has to look to see why they can’t, which gives me and the woman’s birth companions the time to ask them not to. I think it works because people who put the lights on sometimes aren’t thinking. It’s an automatic instant reaction to entering a dark room, so you just need to delay them while they take in the situation.’
That kind of solution might not be for everyone, but for me it illustrates the importance of thinking outside the box about why we’re doing what we’re doing, and of being creative in finding ways to help women get what they need, wherever they are.
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This article was originally published as Wickham S (2016). Let there be mood lighting… TPM 19(3):36-37.