Part 1 General

Part 2 Outpatient Facility Types

ANSI/ASHRAE/ASHE Standard 170-2017 Ventilation of Health Care Facilities

Heads up: There are no amended sections in this chapter.
Appendix material, shown in shaded boxes at the bottom of the page, is advisory only.
A birth center is exclusively dedicated to serving the childbirth-related needs of women and their newborns.
This chapter shall apply to any health care facility, place, or institution that is not a hospital or in a hospital where birth is planned to occur away from the mother's residence following a low-risk, uncomplicated pregnancy.
The birth center shall meet the standards described in this chapter and the standards in Part 1 of these Guidelines as amended in this section.
Requirements set forth in Chapter 2.1, Common Elements for Outpatient Facilities, shall apply to birth centers as cross-referenced in this chapter.
A2.4-1.2 Functional program. For additional information on generally accepted guidelines and standards for birth centers, contact the primary accrediting entity, the Commission for the Accreditation of Birth Centers (www.birthcenters.org), and refer to the following publications:
  1. American Association of Birth Centers, Standards for Birth Centers
  2. American College of Obstetricians and Gynecologists and American Academy of Pediatrics, Guidelines for Perinatal Care
Department sizes and clear floor areas depend on program requirements and organization of services in the facility. As required by community needs, combination or sharing of some functions shall be permitted, provided the layout does not compromise safety standards and medical nursing practices.
Transfer and service affiliations with hospitals with obstetrical services shall be part of planning for a birth center.
Mode of transport and travel times to affiliated hospitals shall be considered in facility location and design.
  1. Timeliness of maternal-fetal transport for commencement of cesarean delivery shall be the prime consideration.
  2. Other considerations shall include neonatal and maternal transport to surgical or specialty care.
The location of a birth center shall be accessible from public transportation, if available.
In the absence of a formal parking study, one space shall be provided for each birthing room plus one space for each employee normally present on any single weekday shift.
A2.4-1.3.2.1 Additional parking may be required to accommodate other services.
Designated space shall be provided for emergency transfer vehicles.
A2.4-2 Newborn care area. Although a separate newborn care area is not required in a birth center, if the governing body determines during project planning that some provision for emergency care of the newborn is desired, a separate newborn care area may be provided.
Where an examination room(s) is provided, it shall meet requirements in Section 2.1-3.2.1 (Examination Room).
The number of birthing rooms shall be as determined by the owner to accommodate the projected number of patients served at one time.
The maximum number of beds per room shall be one.
  1. Birthing rooms shall be located to address privacy during occupancy for labor, birth, and postpartum care.
  2. Birthing rooms shall be located out of the path of unrelated traffic and under direct supervision of the facility staff.
A birthing room shall have a minimum clear floor area of 200 square feet (18.58 square meters), including the newborn care area.
A birthing room shall have a minimum clear dimension of 12 feet (3.66 square meters).
Each birthing room shall have an outside window.
Windows or doors within a normal sightline that would permit observation into the room shall be designed for mother and newborn privacy.
Each birthing room shall be equipped with a hand-washing station in accordance with Section 2.1-3.8.7 (Hand-Washing Station).
Each birthing room shall have direct access to a private bathroom with the following:
Where support areas are required for the services offered in the birth center, identifiable spaces shall be provided for each.
The size and location of each support area shall depend on the numbers and types of modalities served.
Staff work area(s) with counters and space for storage shall be provided.
For birth centers that provide health education and a library, dedicated education/library facilities shall be provided.
A2.4-2.8.5 A multipurpose room employed for health education should be equipped for use of audiovisual aids.
Hand-washing stations shall be located in, next to, or directly accessible to staff work area(s).
See Section 2.1-3.8.8 (Medication Safety Zones) for requirements.
Where a nourishment area is provided, it shall meet the requirements in Section 2.1-3.8.9 (Nourishment Area or Room).
Each birth center shall have equipment to provide ice for treatments and nourishment.
Location of the ice-making equipment shall be permitted in the clean workroom or in the nourishment area.
Ice accessible to the public shall be served from self-dispensing ice-makers.
A clean work area or clean workroom shall be provided.
Clean work areas or workrooms shall be separate from and have no direct connection with soiled workrooms or soiled holding rooms.
Where the clean work area or workroom is used for preparing care items for mothers and newborns, it shall meet the requirements in Section 2.1-3.8.11.2 (Clean workroom).
A soiled workroom or soiled holding room shall be provided in accordance with Section 2.1-3.8.12 (Soiled Workroom or Soiled Holding Room).
Where only a soiled holding room is provided, facilities for cleaning bedpans shall be provided in the mothers' toilet rooms.
See Section 2.1-4.4 (Linen Services) for storage requirements.
See Section 2.1-3.8.13.4 (Emergency equipment storage) for requirements.
An environmental services room that meets the requirements in Section 2.1-5.3.1.2 (Environmental services room for facility-based environmental services) shall be provided for the exclusive use of the birth center.
A2.4-2.8.14 Environmental services rooms should be planned to accommodate carts if carts are used in the housekeeping process.
A lounge for staff shall be provided.
Multi-use areas shall be permitted to serve as the staff lounge.
A readily accessible toilet room for the use of staff shall be provided.
Securable lockers, closets, and/or cabinet compartments shall be provided for the personal articles of staff.
Where a changing room for staff is provided, a readily available staff shower shall be provided.
See Section 2.1-4.4 (Linen Services) for requirements.
Any food service facilities and equipment provided shall conform to requirements in these Guidelines and to the standards of NSF International and other applicable codes.
Where on-site food service is provided, the following requirements shall apply as suitable to the food service provided.
  1. Provision shall be made to protect food delivered to ensure freshness, retain hot and cold temperatures, and avoid contamination. Where delivery is from outside sources, protection against weather shall be provided.
  2. Provision shall be made for thorough cleaning and sanitizing of equipment to avoid mixing soiled and clean equipment.
Where vending devices are used, a separate room shall be provided.
A2.4-4.5.2.2 Vending room. In addition to vending machines, a vending room may contain a seating area, microwaves, and trash-holding containers.
See Section 2.1-5.1 (Materials Management) for requirements.
See Section 2.1-5.2 (Waste Management) for requirements.
Space for mechanical and electrical equipment and for maintenance of the equipment shall be provided.
A reception area shall be provided and located to control and monitor access to the birth center.
A waiting area or room shall be provided in accordance with Section 2.1-6.2.3 (Waiting Area or Room).
A2.4-6.2.3 Waiting area or room. Seating capacity may need to be increased from that specified in appendix table A2.1-a (Waiting Area Seating Capacity) based on projected family size, visitor numbers, and travel distance to the facility.
Office space shall be provided to support the needs of the birth center.
See Section 2.1-6.3.5 (Medical Records) for requirements.
The birth center shall be permitted to fall under the business occupancy provisions of applicable life safety and building codes.
In the absence of local codes or ordinances, the required minimum corridor width shall be 44 inches (1.12 meters).
Finishes shall be selected to facilitate cleaning and to resist strong detergents.
Finishes in food service areas shall be selected to ensure cleanability and the maintenance of sanitary conditions.
HVAC, electrical, plumbing, and related building systems shall meet state and local building codes.
The birthing room shall provide lighting capable of providing at least 70 foot-candles in the delivery and newborn care area(s).
A2.4-8.3.1 The 70-foot-candle requirement may be met with a combination of fixed and portable lighting.
See Table 2.1-1 (Electrical Receptacles for Patient Care Areas in Outpatient Facilities) for requirements.
Birthing rooms shall have available oxygen and vacuum per the requirements of Table 2.1-2 (Station Outlets for Oxygen, Vacuum, Medical Air, and Instrument Air Systems in Outpatient Facilities).
Use of portable equipment shall be permitted.
Medical gas storage shall be provided in accordance with NFPA 99: Health Care Facilities Code.
A security risk assessment shall inform decisions about the need for active and passive security systems. See Section 1.2-4.7 (Security Risk Assessment).
Where elevators are provided, elevator cars shall have minimum inside dimensions of 5 feet 8 inches (1.73 meters) wide by 7 feet 6 inches (2.29 meters) deep.
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