Product and User Research
Designing the birthing experience for low resource settings
This project is a design outcome of my Master of Arts thesis titled ‘Designing the birthing experience for low resource settings - A Human Centered Design Approach’, which aimed to provide, simple, practical and low cost alternative for emergency or ad-hoc birth and home-birth in developing countries such as India.
The thesis work has been done in three phases over a period of one and half years. The first part (Jan -July 2016) was done as part of Lab.our Ward project which was a cross-disciplinary innovation project to design novel
maternity ward services, products and spaces that are based on women’s and care providers’ needs in the context of low-resource settings at M4ID Oy. The project was supported by Bill & Melinda Gates foundation. The second and third phase were done individually with support from Aalto Arts (grants).
The first phase included desk research, field visits, co-design sessions, making prototypes and exhibition at Women Deliver in Copenhagen. The second phase was about feedback analysis and improvements of one of the promising ideas (Delivery Stool). The last phase included field evaluation in India along with co-authoring a full conference paper along with my thesis advisor (Dr.Mariana Salgado and Charlotta Liukas) and thesis documentation.
Since completion, the project has been published on Yanko design website and showcased at Global grad show at Dubai in Nov 2017. You can see the master's thesis here
Client / Sponsor /
Aalto University / M4ID Oy / (BMGF)
My Role /
User Research / Concept/ Prototype / Field validation / Documentation
Project /
Master's thesis project at Aalto University, School of Arts, Design and Architecture
Project Grade /
Grade 5/5
Project Guide /
Advisor / Dr.Mariana Salgado
Supervisor / Prof. Eero Miettinen
Year /
2016 / 17
Portable Delivery Stool
Project Background
As per WHO (2015), it was estimated that in 2015, roughly 303 000 women died during and following pregnancy and childbirth. Most could have been prevented. Many are attributable to a lack of access to skilled routine and emergency care. Overcrowding, uncleanliness and lack of means to support emergency or accidental deliveries suggest that for many women, the experience of birth is neither safe nor comfortable. With number of births continuously rising around the world, the health facilities must be adequately prepared to deal with both normal pregnancies and complications that requires prompt, lifesaving interventions. Hence innovative and life-saving product such as the one I have designed, the Portable Delivery Stool could help to deliver high quality care to women and newborns everywhere.
Concept - Portable Delivery Stool
This portable delivery stool could save lives by supporting emergency deliveries. It offers an alternative birthing positions and is a solution for home birth and accidental delivery across /outside the facility.
The stool concept combines a traditional squatting birth position with low cost furniture. It is lightweight, made of plastic and low cost. Inside the stool is a set of basic delivery kit. It could be stored in the facility entrance or can also be used by trained professionals in rural areas. It is wrapped in a mat that unfolds and offers a clean delivery surface. The inspiration came from Finnish Delivery Stool.
The advantages of using birthing stool (for squatting posture) are - It flexes the legs and expands the size of pelvis, helps use gravity to promote the downward movement of the baby and reduces risk of having an episiotomy. Other than squatting posture, the stool could be used for other positions as well.
Project Timeline
Field Research
The research part consisted firstly of going through the project (report) findings from previous field based project - Better outcomes in Labour Delivery (BOLD) related to Maternal, Newborn Child Health (MNCH). Secondly it describes the insights gathered from field visit conducted between March-April 2016.
The initial visit was made at Kätilöopisto Maternity Hospital located in Helsinki, Finland and later in India, in the states of Bihar and West Bengal. The overall aim of the field visits were to build a basic understanding of the current practices, protocols followed, tools and equipment’s (products in specific) used during the women’s maternal journey inside the facilities and most importantly identifying gaps and opportunities for design intervention.
Problems / Challenges
Design & development process
Co-design & Ideation
In short co-design indicates collective creativity as it is applied across the whole span of a design process. The objective of this session was to bring together industrial designers and one health expert in order to collectively reflect on some of the problems that has been identified from the field research. In addition the goal was to come up with some thought-provoking ideas. At the same time the health expert could instantly help designers to answer their questions and even get first hand feedback about their ideas.
Role-Play
The main objective role-play was to get deeper understanding of the user (pregnant women) and midwife during different stages of labour and delivery. In order to gain deeper empathy towards the user’s need a mixed method approach was taken. It consisted of enacting specific labour and delivery moments through role play. Some common objects such as table, chair, cardboard box, cushion, yoga mat, rope, etc., were used as probes to create a reasonable enactment of labour and delivery situations.
Quick -Prototyping
Physical prototyping has been used in participatory design to support non-designers abilities for expressing personal experiences in various projects. In this project, the process of prototyping was approached from the perspective of healthcare experts to share their knowledge in order to define important aspects which might not been considered earlier.
Expert feedback & Idea evaluation
The early stage idea (in the form of prototype) was shown and exhibited at Women Deliver exhibition.
The objective was to get feedback and development comments that could help to design a new version of the product and also validate the idea itself. Some of the suggestions received for improvements :
• To fix the seating height and angle.
• To have more rounded corner in the front part of the seat.
• To have a more sturdy carrying handle.
• To rethink stool placement in relation to health practitioner working posture while attending the pregnant woman.
• To evaluate how easy is to clean the stool and integrate with a sterilization or delivery bowl.
Design improvements (based on feedback)
The second prototype of the stool was made to to incorporate some of the feedback (bowl integration, round corners) received during the Women Deliver exhibition. Apart from improvements, other critical aspects were matching the stool dimensions as per Indian Anthropometric dimensions and integrating with a wheel trolley which would make the stool easier to carry for longer distances.
<Improved Prototype>
Field Evaluation & User testing (India)
India was the country chosen to test and evaluate the improved prototype, because of ease of traveling, logistics,
knowledge of local language, and personal contacts. The places visited in India, were the state of Uttar Pradesh and Bihar, two of India’s most populous and poor states.
The main objectives of the field evaluation were:
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Validation of concept in terms of acceptance and motivational factors for usage,
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Evaluation of the aesthetics and functional details of the product,
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Evaluation with different user groups and Maternal and Newborn Child Healthcare (MNCH) experts (midwives, health care providers , pregnant mothers as well those who have given birth in normal delivery bed (in lying down position).
Findings & Conclusion
Overall the feedback from midwives, doctors and pregnant women were positive. most of the interviewees thought that having some kind of backrest support as an option would be needed in order to help the pregnant women relax during the labour stages. Placing the delivery stool against a wall was not seen as a comfortable since they pointed that the back support would make them feel more secure.
Most of the discussions ended with the feedback that it needs to be tested further to confirm as the concept is so new and the care providers were giving feedback based on their own experience with other products while not having tried the stool out.
The concept of Delivery Stool is a new product in maternal and newborn child health. It implies alternative birthing positions (such as squatting) which is a relatively a new concept at least in rural India, therefore in order to use it, first it should be taught how to use.
My recommendations, based on my fieldwork, is that the stool cannot just be placed in the facilities and used, but it needs to be integrated within a program that would train midwives and nurses to use it and understand the benefits of the different birth positions. The Delivery Stool could be further envisage as a part of training toolkit that could help nurses and healthcare workers (ASHAs in India) to promote the benefits of alternative delivery positions and presence of companion during delivery. At the same time the existence of the stool (inside the facility or in a village community center) could aid pregnant women during emergency situations, similar like having a first-aid kit to handle unexpected moments. At present, I am trying to get permission from maternity centers to perform actual delivery to improve further.
