Aims: To capture the organisational and communication dimension of birthing in order to analyse if the birthing space has any impact upon these dimensions. The study will explore the benefits of using video ethnography to observe, record, and analyse the effect of physical context/environment on communication, behaviour and interactions between women and their care providers within the labour and birth room in two Sydney maternity units in Australia.Background: Prior research about birthplace and communication has been undertaken through narrative accounts of experiences provided by women and midwives and via observation. These studies have revealed that women, midwives and other health care providers regard the hospital labour and birth environment as a highly stressful location that is often characterised by poor verbal communication that may lead to unsafe care. In other studies women have reported less than adequate or limited options for use of the physical spaces within the birth room that they regard as contributing to difficult and unsatisfying birth experiences.Experts in the area assert that most communication occurs at a non verbal level, therefore filming interactions between women and staff within particular labour and birth environments is important to fully understand the relationship between environment and non verbal as well as verbal communication.The premise of this study is that optimally designed birth units could reduce staff and women's stress, positively influence the quality of communication and quality of care, facilitate physiological birth, and increase woman/baby safety thereby reducing the likelihood of adverse events and litigation.The influence of design on communication has been established in other video ethnographic work in health that we have recently completed. Video filming is internationally recognised as an innovative research method in the areas of intensive care, emergency, spinal care and trauma units as well as ambulance services, handover and open disclosure studies.Participants: Volunteer staff and a total of 10 birthing women and their supporters will be recruited to provide video recordings for analysis.Video: Using an unobtrusive, hand held video camera, recordings will be made of samples of communication interactions between staff (at the desk and during handover), and between staff, women and supporters (during admission plus one hour_ handover plus one hour).In depth interviews will be conducted with each woman and with staff, during which the video will be reviewed for reflexive interpretation and for any edits or deletions of footage.Analysis: Video and interview data will be subjected to qualitative ethnographic analysis.