SEX, DESIGN & REPRODUCTIVE HEALTH
Graduate Thesis on Communication Design
I partnered with a government-sponsored clinic in San Bernardino, CA to research, experiment, and deliver affordable and easily implemented design solutions to help mothers plan ahead for their next healthy pregnancy.
Process >
How we got to this solution
Thesis Book >
The 10-month project documented into a book
It began when I didn’t have health insurance.
I went to this same clinic years ago as an uninsured patient, where a kind nurse helped me sign up for the free women’s healthcare program. I qualified on the basis of my low income. I went there for a few years and they were amazingly caring.
At the start of my thesis, I thought about how much they had helped me and went back to this clinic to see how I could best help them.
The director of the women’s health clinic said that one of their biggest challenges was reducing unplanned back-to-back pregnancies among patients. Anecdotally, she expressed that it accounts for almost half of all pregnancies the clinic sees.
Back-to-back pregnancies put mothers and babies at risk for serious health issues.
This was not a small problem to take on as a graduate thesis project, but I just couldn’t ignore it. I threw myself into investigation and came up with a plan to immerse myself with who I’m designing for.
In order to speak to patients, I went through the institutional review board (IRB) to be approved to record patient interviews for my research.
I wrote down my experience arriving at the clinic, observations of care spaces, patients in public waiting areas, and gut feelings from interview experiences.
I spent up to 30 minutes per patient prompting each to tell stories about her familial dreams, and who she talks to about sex, birth control, and health as a woman.
I interviewed patients, doctors, and nurses.
The patient population at this women’s health clinic are women from ages 18–44 with most patients 20–30 years old. About 60% are hispanic, 20% white, 5% black, and 5% of other races. The large majority completed high school education, have a low social economic status, and own a smart phone.
As I spent more time with the women I interviewed, I found them to be like me in many ways. Like mine, many of their families never talked about sex at home. Most of us as children dreamed about how many children we would have. And we have never heard of spacing out pregnancies and the dangers of not doing so.
After transcribing the interviews, I broke them up into separate thoughts and tagged each with what I felt was actually happening, including what I believed patients’ underlying values and motivations were.
This is called coding. Coding is an amazing tool ethnographers use to find patterns within field data collection.
Even though there is significant statistics online, it is important that my program was custom for this particular community.
I created several personas based on patients I interviewed. Maya was one of them. Her complete story represented what a back-to-back pregnancy looked like for many mothers in San Bernardino, CA.
Maya became pregnant sooner than she intended. It wasn't because the pill was bad, or that Maya forgot to take a few pills because she was overwhelmed by the needs of her newborn.
It was because Maya's birth control method didn’t fit her life as a new mom.
Using post-its, I transferred patients’ quotes and my codes onto them to relate patterns in a visual cluster. I looked for themes that repeat, as well as anomalies to question why they occur. Many great insights were drawn from this exercise and fed into my experimentation and, ultimately, my final design decisions.
A surprising pattern that made me question my assumption was:
The same women who plan pregnancies can also have their own unplanned pregnancies.
Another pattern that emerged was women trusting other women’s advice — their own mothers, girlfriends, but also other mothers writing about their experiences online.
My research revealed that 90% of the patients owned and actively use their smartphones.
I found it to be a great opportunity for video learning and augmented reality to capture the attention of millennials.
I created an augmented reality experience that can be simply accessed through a smartphone camera and a webpage. Because it required regular monitoring and maintenance, we decided it was not the solution with no upkeep the clinic was looking for.
The text message animation that was inspired by the trust of other mothers also did not make the final cut.
A platform like social media that would host this type of content would also require regular maintenance that the clinic does not have resources for.
A cleverly designed game or quiz on paper turned out to be a great solution. It was affordable, could be used immediately, required no maintenance, and it could be taken home and shared.
Its greatest value is that it can be a tool the doctor or nurse use to explain and make decision together with a patient.
I was able to create What’s Your Choice? video with the help from producer, filmmaker, and copywriter, Marina Valle.
She helped me with filming, questions we asked the women, and gave me several rounds of feedback on my video editing.