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Objective: To study the effect of the birthing room design on nulliparous women's childbirth experience up to 1 year after birth. Background: Although it is known that the birth environment can support or hinder birth processes, the impact of the birthing room design on maternal childbirth experience over time is insufficiently studied. Methods: The Room4Birth randomized controlled trial was conducted at a labor ward in Sweden. Nulliparous women in active stage of spontaneous labor were randomized (n = 406) to either a regular birthing room (n = 202) or a new birthing room designed with more person-centered considerations (n = 204). Childbirth experiences were measured 2 hr, 3 months, and 12 months after birth by using a Visual Analogue Scale of Overall Childbirth Experience (VAS-OCE), the Fear of Birth Scale (FOBS), and the Childbirth Experience Questionnaire (CEQ2). Results: Women randomized to the new room had a more positive childbirth experience reported on the VAS-OCE 3 months (p =.002) and 12 months (p =.021) after birth compared to women randomized to a regular room. Women in the new room also scored higher in the total CEQ2 score (p =.039) and within the CEQ2 subdomain own capacity after 3 months (p =.028). The remaining CEQ2 domains and the FOBS scores did not differ between the groups. Conclusions: These findings show that a birthing room offering more possibilities to change features and functions in the room according to personal needs and requirements, positively affects the childbirth experience of nulliparous women 3 and 12 months after they have given birth. [ABSTRACT FROM AUTHOR]