From IUDs to IVF — Designing for Women’s Health

Women draw themselves on birth control as part of a design research activity
“I’d rather put something in my arm than in my vagina. You could lose your arm and be ok, but if you lose your vagina…”

Everyone had a good laugh, but the logic was solid and it stayed with us. The context was a ‘girl chat’ un-focus group and the topic was birth control, specifically how young women think about IUDs and the implant.

That insight revealed a take on side effects that providers and manufacturers weren’t speaking to. More importantly, it pointed to an opportunity to design more relevant healthcare products, services, and experiences for women.

From period-positive products THINX and Clue, to market-disrupting contraception innovations Lilleta and Nurx.com, digital doulas and doctors by Bloomlife and Maven, and fertility tools courtesy of Celmatix and Ava—women’s health is finally getting the attention it deserves. But successfully designing for it means designing for its unique characteristics.

During my time at IDEO, Smart Design, Celmatix, and other in-house roles, I’ve worked on a range of challenges in women’s health including repositioning IUDs for millennials (hint — don’t call it a LARC), rethinking how infant formula is introduced in hospitals (hint — don’t give it away), and bringing big data to IVF (hint — women can handle numbers).

Whether you’re a designer, product manager, healthcare provider, or for anyone tackling opportunities in women’s health, here are five principles for getting it right.

Design for passive engagement

Healthcare entrepreneurs usually fit the mold of the motivated empowered patient. If they weren’t, many innovations in women’s health would not exist. But it’s a far cry from how most of us engage with our health.

Healthcare is complicated, expensive, and emotional. Taboos and limited access create additional barriers to women’s health which means many engage with it timidly and sporadically, if at all. We need to design for that.

Take fertility. As I’ve written about, there are things women can do to look out for their fertility. However, today a proactive approach to fertility is practically nonexistent — doctors rarely bring it up and most women don’t know if theirs is ok until they start trying.

A super common passive behavior here is the ‘not trying, but not preventing’ approach to getting pregnant.

Because fertility issues are often explored only after someone has been trying to conceive for a specified amount of time, this ambivalent state can make it hard to empower women and their doctors with tools to understand their fertility. Rethinking the standard protocol for initiating fertility testing (which is currently based on how long someone has been actively trying) is one way we can design for passive engagement.

People think like Kim on the left, but when it comes to their health they often act like Kim on the right.

Design for the myths, not just the facts

There are many beliefs and myths out there when it comes to women’s health. It’s tempting to want to dispute or dismiss them, but they often serve an important function like accommodating cultural norms or psychological needs. Negating the myths without providing an alternative that satisfies those norms and needs doesn’t accomplish much.

In order to change behaviors and create impact, we have to design for commonly-held beliefs — accurate or not. One way to do that is by taking them on and diffusing them respectfully and gracefully. Think judo, not karate.

For a communication campaign about IUDs, this meant tackling the notion that IUDs interfere with sex. A little humor (about size), a familiar comparison (to tampons), and approachable tone of voice helped reframe women’s perceptions about their actual physicality, size, and placement.

Tackling myths in a prototype of a communications campaign for birth control.

Design for the conversation women want to have with their doctors

There’s a lot that doesn’t get discussed at the doctor’s office, but should. Appointments are rushed. Doctors can be dismissive of concerns or lacking in bedside manner. Patients are afraid to ask questions or press their needs.

That last one is key. To get the most out of their healthcare experiences, it’s important women feel empowered to have the conversations they want to have with their doctors.

Designing for this might look like creating conversation guides and take-aways for women to bring into their doctors offices. Having a piece of paper in front of them can help women ask for what they need and feel less intimidated. Creating quantified-self tools (i.e. contraction monitors or period trackers) that allow you to share your health data with your doctor are another way to design for these conversations.

A guide to support patients interested in talking to their doctors about fertility testing

Think of it as reclaiming big pharma’s mantra to ‘Ask your doctor about…’ in service of women advocating for themselves and their health.

Design with as few assumptions as possible

If there is one overarching insight about women’s health, it’s that women don’t have enough information about their bodies and how they work.

That’s why period tracking apps have emerged as such a practical and powerful tool. As The New York Time’s Jenna Wortham noted, “They are the rare corner of the trendy quantitative self and health movement that has resonated with me, largely because they provide useful insights…nothing has been as exciting or revealing as tracking my menstrual cycle.”

The most basic insight women want from a period tracker is to know when to expect their period. Many don’t know how long their menstrual cycle is; it can vary in length and sometimes change from one month to the next.

So it was a big user experience fail when a popular period app required I enter the length of my cycle in order to start using it (with no option to select ‘I don’t know’ or skip ahead). The app assumed I had the very insight that I was looking for it to provide, which made it rather useless.

When designing new products and services, it’s easy to forget the range of information women have about their bodies and health. It’s also easier to design without having to account for the knowledge gaps, but it is crucial that we do.

One way to mitigate assumptions is by adopting a beginner’s mind. Another is by talking to extreme users. Both help highlight assumptions about who we are designing for and what their needs are.

Design with side effects in mind

Women deal with a lot of side effects in the name of their health. While to some extent, side effects are a given, their impact on women’s health and decision-making shouldn’t be.

For providers, side effects are par for the course. For many women, they’re a big reason for not attempting or adhering to treatments. As one woman put it, “Birth control makes you a little crazy. I got off of it a couple years ago. My doctor asked if I wanted my refill and I said no. She was like ‘are you aware of what happens?’ Uh yes, I am an adult, thank you.”

Of course, we can’t exactly design our way out of side effects. But we can give them a seat at the table. In doing so, we create the space for honest dialogue and lend credibility to the products, services, and experiences we are designing.

Period tracker Clue does a great job of not only capturing the typical ‘side effects’ associated with menstrual cycles, but sharing and inviting women to talk about other menstrual symptoms. By designing for side effects, it is telling women that it takes them and their health seriously.

The side effect you always suspected is now scientifically validated. Thanks Clue!

What started with a comment about losing your vagina turned into a mission to think differently about how we might design for women’s health.

As Alyson McGregor (doctor and gender in medicine expert) emphasized in her Ted talk, “we have this saying in medicine: children are not just little adults… I know the same thing can be said about women. Women are not just men with boobs and tubes”. Alyson was speaking about differences in physiology, but the same can be said about gender differences in behaviors and attitudes around health. So let’s move beyond shrinking and pinking, and let’s start designing for women’s real needs and behaviors when it comes to their health.