Purpose: There are some 650,000 births in the UK each year and more than 90% take place in NHS hospitals. Therefore, providing a safe, comfortable, caring environment should be a priority. This research involves a Post Occupancy Evaluation (POE), which was designed to assess whether maternity facility design met the needs of the users. The POE assessed perceptions of the environment, measuring expectations and satisfaction with facilities using a self-completion questionnaire specifically focussed on design issues.Context: Evidence suggests that hospital design generally can directly influence the health of patients and staff (Baum and Singer 1984; Bell, Greene et al. 2001; Leather, Beale et al. 2003). Research has examined issues relating to primary patient concerns such as privacy, stress noise and security (Diette, Lechtzin et al. 2003; Blomkvist, Eriksen et al. 2005; Walch, Rabin et al. 2005). Perhaps surprisingly, a similar relationship between design and health outcome appears to apply to maternity unit design. Recent reports suggest that childbirth is made more difficult for women by a lack of space and privacy in the typical hospital labour room (Hundley, Ryan et al. 2001; 2005 Commission for Healthcare Audit and Inspection 2005; Boseley 2005). Guidelines advocate that women are 'accommodated in a pleasant room which is comfortable practical and is as homely as possible' (Department of Health 2005). Design Method: This research was conducted in three maternity units in the UK integrated within sizeable hospital complexes. The first was a recently-refurbished unit which was part of a large teaching hospital in a major city in the south of England. The second unit was part of a new purpose-built PFI (Private Finance Initiative) hospital in the north of England. The third maternity unit was also part of a PFI development for a Women and Children's hospital in the east of England. As part of the POE, women delivering at the units were given a self-report satisfaction questionnaire at six days postnatally (n=238). Global measures of satisfaction were asked at the beginning of each section with further multiple items probing satisfaction with different aspects of facility design. The final global question asked participants to rate expectations. Results: Survey results for labour and postnatal experiences revealed a marked difference in reported satisfaction with facilities and service. Participants were asked to rate on a scale of 1 to 10 (with 10 being the optimal score) their satisfaction with the surrounding environment. Participants were significantly less satisfied with their surroundings postnatally than when in the labour suite T = 35.83 p = .000, r = -.61. Participants were also asked to rate the care they received in labour and postnatal stay once more on a scale of 1 to 10 (with 10 being he optimal score). The test showed a significant difference between the two conditions, where participants were less satisfied with the care they received postnatally than in labour T = 40.10, p = .000, r = -.63 To assess the validity of the participants' satisfaction scores a further questions was asked about expectations. Participants were invited to rate their expectations on a scale from much better than expected to much worse than expected. The relationship between satisfaction with the surrounding environment and overall expectations regarding the facilities provided was positively correlated rs = .521, p = 0.01 (1- tailed). Implications: The research aimed to provide a greater understanding of maternity facility design with regard to the needs of the end-users. The findings suggest a difference in perception of the labour and postnatal facility design which impacts on the discernment of care received. The guidelines suggest that postnatal accommodation should consist of a 'small postnatal room with one other mother and baby. It is decorated so as to create a pleasant comfortable environment, including comfortable chairs for nursing. It also has ‘en suite’ toilet and bathing amenities for mothers.' (Department of Health 2005) This was not achieved in the three hospitals surveyed. Participants consistently rated their postnatal stay as less satisfactory than their labour experience. The implications of this study are clear. First, postnatal facilities and care are consistently poorer than labour facilities. This anomaly negatively affects the patient experience. Secondly, it is possible to create a positive image of maternity units, as shown by the affirmative attitude expressed towards the labour suite. Following this through to postnatal care in the ward (which is a crucial time for mother and their newborn) would ensure a consistently positive attitude toward maternity service provision. Thirdly, frequently a maternity unit is the usually the first encounter of hospital women have and enhancing this experience can produce a positive affective evaluation and perception of the hospital.