DownUnder: A Birth Control Decision Aid
The FemTech Collaborative at the University of Pittsburgh
Laura Pedrosa and Will Rutter
Lead UX designer for birth control section and mobile UI. Collaborated on concept development, information architecture, and evaluative research
Figma, Notion, and Lucidchart
Our challenge was to design a mobile application that allows people of any gender, in relationships or single, to learn about, compare, and choose from birth control methods.
Our client, the FemTech Collaborative is bringing together researchers across multiple institutions to create a suite of digital tools to improve approaches to sexual and reproductive health care. The FemTech Collaborative strives to build technologies that proactively identify and address critical gaps in health care, with attention to the needs and preferences of people from socially and economically marginalized populations.
People approach birth control decision making with various levels of knowledge and experience. DownUnder users who are unsure what method is right for them can answer a brief questionnaire about their lifestyle and values to clarify what method might work for them. Alternatively, users who prefer to browse all available methods can browse, filter, and compare methods based on criteria such as efficacy, frequency of use, and potential side effects.
Track Your Journey
Birth control is a long-term, evolving process. DownUnder's Journal section allows users to reflect on their personal experience with birth control methods, which they can easily share with a medical professional should they so choose.
In addition to medical professionals, many people learn about birth control through peers and members of their community. In the Engage section, DownUnder users can read featured articles from other users about their birth control journey. They can also browse and connect with local health clinics and reproductive justice organizations.
Existing birth control selection tools are not mobile-friendly and offer only clinical information that doesn't reflect all the ways people navigate birth control decision-making.
Our research began with an analysis of five existing digital services in the birth control and reproductive health space. These organizations varied widely in scope, audience, interactivity, and medium. They included national organizations like Planned Parenthood, existing FemTech Collaborative services like the MyPath Decision Aid, and local grassroots sex education organizations such as Pleasure Pie.
Existing birth control decision aids are not optimized for mobile use. Most mobile native applications are limited to tracking menstrual cycles.
Although most women will use more than one contraceptive method in their lifetime, existing tools don't account a user's changing needs over time.
Increasingly, birth control decision aids are opting to discuss wider cultural issues related to reproductive justice.
In addition to our top-level insights, we also diagrammed the common sources of information and decision factors that people use when deciding on a birth control method. This diagram was instrumental in determining the information that ultimately made it into our solution.
How might we prompt users to consider and clarify their reproductive health values?
How might we empower users to engage with each other about birth control decision-making and engage with their community around reproductive justice issues?
Seeing a gap among existing birth control digital tools, we identified the need for a mobile experience that allowed users (1) browse clinical information on birth control methods; (2) reflect on their own experiences with birth control methods over time; (3) engage with community members and organizations about reproductive health issues.
This solution is intended to serve as both as tool to help users find an appropriate birth control method, but also serve the FemTech Collaborative's wider mission to address social justice concerns in the reproductive health space.
Given the progressive values of our client, we designed our solution with a left-of-center user in mind.
Although our solution is not overtly political, it promotes reproductive autonomy and promotes reproductive justice organizations. Reproductive justice organizations advocate for adequate prenatal and pregnancy care, access to contraception, and comprehensive sex education among many other issues. We imagine our end users would be supportive of—or at least sympathetic to—these causes.
Our proposed experience is divided into three sections, users can compare and browse birth control methods, track their personal journey, and engage with community members and organizations.
Users can complete a short questionnaire to receive recommended birth control methods, browse and compare all birth control methods, or view worldwide data on contraceptive usage.
Users can create a new journal entry. When they do so, they have the option to choose from a preset selection of prompts or simply write what's on their mind. Users can also browse their past journal entries to see how they've reacted to birth control methods in the past.
Users can view a selection of testimonials from women about their experience with choosing a birth control method. They can also browse local community organizations including health clinics and local reproductive justice organizations.
We tried to understand how potential users would navigate the app by diagramming key tasks they would undertake.
Below is one of the task flows that I was responsible for. It diagrammed how the user would navigate the questionnaire to receive recommended birth control methods.See all of our task flows here
We iterated through low-fidelity sketches and wireframes to find a layout that had high visibility, mapping, and feedback.
In these early wireframes, we focused on a few key app interactions such as the visibility of the three main sections, filtering birth control methods, and comparing selected methods.
We planned and conducted an evaluative research session with two subjects to test the visibility and discoverability of our in-progress design.
One research subject was a woman in her mid-thirties who had experience with several different birth control methods and was not currently exploring new birth control methods. The other interviewee was a woman in her early twenties who had experience with a single birth control method and was actively exploring other options.View our full research plan
The structure of the research was a 45-minute interview conducted remotely. The interview was broken down into several parts, including a walkthrough of our information architecture and wireframes, a series of guided questions, and overall feedback.
A group photo of our evaluative research session
After synthesizing our research using a brief affinity diagramming exercise, we updated three aspects of our concept and prototype related to reliability, clarity, and relevancy.
Providing a forum where users could freely share their experience may encourage misinformation or medically inadvisable practices around birth control methods.
Instead of open forum, provide a curated selection of anecdotal stories that focus on the process of choosing a birth control rather than the method ultimately chosen.
Users felt unclear about whether the Engage section was meant to connect them with local community resources or national political organizations.
Focus the Engage section on local community resources and organizations related to reproductive health.
Including the history and cultural significance of a birth control method in its description was largely unhelpful for users. This information felt irrelevant to their own birth control search.
Remove language about the historical significance of each birth control method from its description.
Our mobile experience aimed to encourage personal conversations around reproductive health that can be uncomfortable. To encourage an inviting and open feeling amongst users, a bright, friendly, and clean palette guided our visual design.
DownUnder: A birth control decision aid that empowers users to choose from contraceptive methods through clinical information, personal reflection, and peer-to-peer connections.
Our final deliverables included annotated wireframes for each section of the app and a representative set of high-fidelity screens.
As technology becomes a larger part of sensitive decision-making areas such as birth control, I'm struck by the responsibility designers have to ensure users understand the source and reliability of information.
The client was thrilled with our approach to the problem and the comprehensiveness of our deliverables. In our presentation, members of the FemTech Collaborative voiced their gratitude that our solution considered and incorporated broader organizational goals, specifically a focus on supporting economically and socially marginalized populations.
Reflecting on this project, I'm left considering questions it raised about how to incorporate community-oriented, peer-to-peer features in healthcare technology. Our team wrestled with how to allow users to share their experiences with birth control without blurring the boundary between anecdotes and verified medical information which could, at best, confuse users and, at worst, risk spreading misinformation.
Ultimately, we decided to include a selection of user-submitted articles about personal experiences with birth control, which would be selected by medical professionals and isolated to the "Featured Stories" section of DownUnder. However, questions remained for our team about how best to distinguish between anecdotal and clinical information. As technology becomes a larger part of sensitive decision-making areas such as birth control, I'm struck by the responsibility designers have to ensure users understand the source and reliability of information.