Experience ≠ Outcome: Rethinking Birth through Space, Systems, and Research

In this deeply personal and thought-provoking conversation, Adrienne Erdman shares her journey from biomedical engineering and human factors into architecture and healthcare design. As Director of Design Research at Ewing Cole and Vice President of Research & Development for the Trauma-Informed Design Society, Adrienne brings a systems-thinking, human-centered lens to the built environment.

The heart of this episode explores birth as a design challenge, not just clinically, but emotionally and operationally. Adrienne vulnerably shares her own birth experiences, highlighting how small operational breakdowns, sensory overload, and communication gaps can compound into trauma, even when clinical outcomes are positive.

We explore her recent national birth experience survey and the powerful "She Said" exhibit, which centers the voices of mothers through immersive storytelling. Together, we examine how healthcare designers can balance safety, personalization, emotional support, and operational efficiency to create spaces that truly honor families at one of life's most pivotal moments.

Key Takeaways

40% of surveyed mothers described their birth experience as traumatic even when outcomes were medically "successful." Experience does not equal outcome. Positive clinical results do not guarantee positive emotional impact. Human factors design examines biomechanics, cognition, psychology, sociology, and systems, and applies them to both products and spaces. Designing with people, not for them, builds trust, buy-in, and better outcomes. Maternity spaces often prioritize worst-case medical readiness over physiological normalcy and emotional comfort. Environmental stressors, lighting, noise, temperature, and interruptions significantly shape perception of care. Partner accommodations are frequently overlooked but critical to family-centered care. Access to maternity care remains fragile, especially in rural communities. Prenatal experiences are often inefficient and disruptive, presenting an opportunity for redesign. The future of healthcare must be holistic, integrating lifestyle, environment, nutrition, and lived experience.

Why This Matters

Birth is one of the only reasons a healthy person enters a hospital. It is a clinical event but also a life milestone, a family origin story, and a deeply vulnerable experience.

When design fails to account for emotional context, sensory experience, and operational nuance, trauma can occur even when clinical metrics look