Innovative hospitals incorporate garden design

Innovative hospitals incorporate therapeutic garden design into a holistic care approach.

One such place, Legacy Health, combines its traditional medical expertise with the healing power of a four-season terrace garden at Legacy Emanuel Medical Center (EMC) in Portland, Oregon. The Terrace Garden provides the Family Birth Center and Cardiovascular Intensive Care unit a restorative place that nourishes the community’s psychological, physical and spiritual needs.

The 6,800 square-foot open-air garden extends along a glass-walled public corridor on the second floor of EMC. It overlooks an atrium of towering trees, colorful mosaic motifs, and sensory engaging vegetation that comprise the Children’s Garden. The 24/7 public space is a design solution implementing rooftop and accessible garden design strategies, therapeutic garden characteristics, and design patterns to support expectant mothers and their families.


We recently spoke with Teresia Hazen about the Terrace Garden and the future of therapeutic gardens for expectant mothers and their families. Hazen is a Registered Horticultural Therapist and Coordinator of the Therapeutic Garden Program at Legacy Health. The Terrace Garden was designed to be easily accessible from the Family Birth Center and serves mothers and the entire hospital community. Several characteristics of the Terrace Garden guide future plans for similar spaces.

Therapeutic gardens can support expectant families by:
– Increasing a sense of control
– Encouraging social support
– Facilitating physical movement and exercise
– Experiencing nature benefits

Therapeutic gardens for expectant families incorporate thoughtful design:
– Dappled shade, rather than direct sun
– 24/7 lighting and four-season access, because babies are born every minute!
– Private and social spaces, with perhaps more emphasis on private than is typical
– Well-maintained plant material engage the senses and provide a sense of immersion during a physically and mentally taxing time

The Terrace Garden serves as a model for similar garden spaces in healthcare settings. It provides rocking chairs to claim a sense of space and engage the body during the labor process. A calming fountain, gently sloping walking paths, and guardrails for support all serve the individual needs and differences during the labor process. Based on feedback from the first years of implementation and principles found within Therapeutic Garden Characteristics, Hazen suggests two particularly accurate characteristics in the case of expectant families. “Scheduled and programmed activities” and “Benign and Supportive Conditions”.

Scheduled and Programmed Activities
Special events increase the number of visits and publicizing activities of all kinds familiarize expectant mothers, facility staff, and families of clients. In addition, expectant mothers may prefer independent walks, engaging signage, and comfortable, shaded seating close to the garden entrance. Hazen noticed the well managed vegetation can encourage a mother to keep walking, even if she is uncomfortable during the labor process. Seeing a blue thistle across the garden swaying in the wind calmed and engaged the mothers under Hazen’s care. 

Benign and Supportive Conditions
Mothers tend to want more private, nurturing spaces than the typical garden provides. Although the Terrace Garden does have private and social nooks, future landscape designs could experiment with stronger perimeters and delineated spaces. Expectant mothers want private spaces that only other mothers or their family can enter (rather than families of other mothers, for example). Interior green spaces within a birth center itself could be the next step for therapeutic design.

In addition to the site-specific design and horticultural therapy practice within the Terrace Garden, the garden represents global possibilities in therapeutic garden design, evidence-based therapeutic garden benefits within healthcare settings, and commitment to provide community access to the healing power of nature. The Terrace Garden is supported by the TKF Foundation’s Nature Sacred program.