Designing for the stigma of unintended pregnancies — a UX case study
Introduction
In early June, I published an article titled Designing for stigmatized communities: a framework, which served as an exploration in design thinking to help us — designers — create increasingly inclusive products. A few weeks ago, I decided to take the idea further by applying the framework to a large people problem — unintended pregnancies. Below is a case study on the work, and snapshot of the current state of the product, in an effort to open-source the work and allow anyone to collaborate on pushing it forward.
Before I move on, I do want to address the elephant in the room. It is not lost on me that I am a male prescribing a potential solution for a problem that directly effects women. I think it is worth noting, throughout my entire design process I have been in constant contact with fantastic female researchers, designers, engineers, etc. to receive feedback and make sure a woman’s understanding and intuition are taken into account during the design of potential solutions. Hopefully collaboration will happen in the future, although thus far, time constraints have worked against us and unfortunately, limited our collaborations to feedback conversations. I believe, collective female understanding and intuition, coupled with my experience as a digital health entrepreneur, place me in a good position to thoughtfully create a product that may serve as a solution — and I hope it is received as such.
People Problem
Today, the only way a woman can receive counsel for an unintended pregnancy is through a clinic — planned parenthood or otherwise. This offline experience presents many barriers, challenges, and pain points.
- It is challenging to find time to go to a clinic.
- Going to a clinic subjects women to a social experience that excites stigma — which deters the behavior.
- Going to a clinic subjects women to physical/emotional harm from protesters and women’s health opposers.
This problem is important because a lack of abortion referral access leads to an influx of unintended pregnancies, which leads to population increases, increased costs — both privately/publicly funded — to support individuals/families with unintended pregnancies, increased costs on the entire healthcare system to provide services delivering and caring for unintended pregnancies. There are costs attached to all of the aforementioned problems. Intangibly, there is a significant problem with the fact that there is not sufficient infrastructure to help a woman effectively manage her reproductive health.
Considerations
- Low income women disproportionately affected.
- Potentially sharing phones
- Dog whistle verbiage common, and may be effective in app experience, marketing, and otherwise. Ex. ‘I want my period to return’, etc.
- Possession of app on phone can be uncomfortable and an adverse signal
Secondary Research
- Induced Abortion in the United States
- U.S. Abortion Patients — May 9, 2016 Infographic
- Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008
- Counseling and Waiting Periods for Abortion
Hypotheses
According to the research mentioned above, 36 million US women will have an abortion before their 45th birthday. For this reason, the target audience for this product is US base women between the ages of 18–39. If we provide a telehealth app, then we expect more patient-clinician conversations to happen, which can be measured as realized video calls and text conversations. Additionally, if we provide a social network for women, then we expect the network to decrease aggregate misinformation and stigma, which can be measured as conversations within the community and connections made between community nodes. More broadly, after collecting some primary research, I learned security and anonymity are very important to the
Metrics For Success
- Realized Clinic Video Calls
- Clinic Text Conversations
- Community Conversations
Designs
Below are some early — unfinished — designs that I created to begin testing the hypotheses mentioned above.
Home Flow
The Home screen and flow allows people using the app to quickly connect with clinical teams via asynchronous chat and video. Access to unbiased research and educational content is also provided from the Home screen.
Video Call Booking Flow
In the event someone wants to speak to a clinician, they would click on the Call button from the Clinics screen, and be entered into the call booking flow. The call booking flow allows the person using the app to book a virtual appointment via HIPAA Compliant videoconferencing tech. The flow is optimized for speed in an effort to capitalize on the will of the person booking, and serve as a streamlined experience to connect clinician and patient as quickly and effortlessly as possible.
Community Flow
The Community section aims to facilitate connection between the people using the app. I hope to create an experience in which people can support and help each other. Understanding the nature of the topic the app is designed to address, security measures have been taken into account, and a no tolerance approach to bullying will be in place.
The community connects around categories and topics. Anyone using the app can suggest a category or topic for the team to approve and add to the product. Categories are high level themes and topics are sub categories that fit within a given category. Activity within each category is represented in the categories feed for followers to comment, like, etc.
Direct Messages
People using the product can manage all of their conversations within their Inbox.
You can check out all of the designs along with interactions for the entire flow by checking out the link below.
Next Steps
The next phase of the project requires a lot of experimenting. The designs are in a good place to begin testing. We need to learn the following in the presented order:
- Will women use a telehealth app to connect with doctors for reproductive health issues?
- How much does privacy drive engagement/bookings with clinics?
- Does access to women who have gone through similar experiences decrease stigma, increase knowledge sharing, and increase clinic engagement/bookings?
- Does access to relevant content increase knowledge sharing and/or clinic engagement/bookings?
Some methodologies that may help facilitate the next phase of learning process include the think-aloud protocol, a co-design workshop, potentially creating perceptual maps. Additionally, there are plenty of other considerations — regulatory, operational, technological, etc. — to take into account before actualizing a product like this. For example, the product needs to make sure patients can only see clinicians certified in their state. There are many other, constantly changing, regulations like this to be aware of as well. Luckily, I have thought through, and addressed many of these issues with the last company I co-founded, Level Therapy. Since this is a UX case study, I decided not to highlight constraints outside of the UX, but for anyone interested, I am more than happy to talk through them with you.
I hope you like this project and if you have any suggestions or comments, please feel free to reach out. You can contact me at hi [at] danmmiller.com. Thanks!
