Becoming a parent this year was emotionally and physically challenging. This experience made me confront issues concerning pregnancy, privacy, dignity and well-being. "In looking back at that first motherhood experience, I now know that it was truly more difficult than most, with my visual impairment an exacerbating factor. I also believe, however, that mothers in general have more in common with one another than we sometimes realize." (Bieber- Schut, 1990).
Existing pregnancy tests feature a tiny +/- indicator. VI women who take the test need someone else to tell them the result. Personal implications for privacy surface, a positive test might not be the result that all women want. "It is a personal experience and each individual will handle the whole experience in a different way, choice and accessibility is key." (Appendix B). To test for pregnancy and get the results in private would give VI women control and dignity in this area of their lives.
Through interviews with VI mothers and literature for disabled parents, I have established that this need exists. A VI Parenting booklet states, "There are currently no home pregnancy tests on the market which can be used independently by visually impaired people." and “I know of no pregnancy tests that can be done without sighted assistance - which really should be addressed." (DPPI, 2005). When the RNIB investigated the experiences of blind and partially sighted people, 95% of participants felt it was important to have health information in a format they can access by themselves. (RNIB, 2009).
The first artefact testing was an online questionnaire about pregnancy testing experiences. Emphatic responses arose when questioned on independent pregnancy testing. "This was a very private moment. I was doing this as a (potential) single-parent-to-be and needed to know for myself, to have my own reaction. As a disabled woman, some of the reactions I got, even from medics, would have robbed me of that ecstatic initial experience." (Appendix A).
DESIGNS FOR INCLUSION
A vital part in the artefact iteration was consulting a product designer to visualise new tests using accessible design principles. Discussions with designer Matthew Cockerill lead to proposals from three approaches.
- Improve the existing paradigm - Enhancing existing tests mean the user is lead through the testing procedure by intuitive layout. Added are perceivable tactile information (a button that clicks up with a positive result), audio component e.g. "Pregnant" or beeps. Colours featured are highly contrastive, with a Light Reflectance Value (LRV) of 30 or more and an enlarged results panel as only 4% of registered blind in the UK have no vision at all, with the majority having partial sight (45%) or very limited vision (51%) (Douglas, Corcoran & Pavey 2007). This redesign is accessible by the widest VI and mainstream audience. However, new medical engineering is a costly and timely investment.
- Offer a service - Existing tests are used in conjunction with a service, e.g. barcode tests and a reply pre-paid envelope, posted for anonymous test reading. Or a smartphone app helps the camera's phone recognise a test, take a photo automatically, calling the user with results. Cost is of vital consideration. Of the UK's 365,000 registered blind (Tiresias Organization, 2010) only 34% of people of working age are employed. The majority felt they were “just about getting by” financially. (Douglas, Corcoran & Pavey 2007). Crucially, these service alternatives are possible to develop immediately, simple to test with user groups, cheap and easy to distribute.
- New paradigm - Creating a completely new design that has accessible design features at its core, plus the potential as a commercially successful product with mainstream appeal. For example, "Toilet Bomb" is a spherical soap-like substance thrown into a toilet after the user has peed. A pronounced colour change if pregnancy is detected, then is flushed away. Usable for many with partial and full vision.
EXPANDING PARADIGMS
One issue was constantly evident in disability research findings; each person with a disability wants to be considered as individual, their impairment having specific demands needing to be met. Artefact iteration was further informed by consultations with VI mothers on their preferred designs or services based on the practical implications of their individual impairments. Progressive designs reflect an understanding of the variety of these individual needs. Additional artefact testing came after consultation with Murtaza Abidi, an RNIB Accessibility Design Moderator who gave feedback on each of the designs, informing and refining the artefact's progression. His plea is for inclusive design principles to be included at inception, not an optional bolt-on. An inclusively designed pregnancy test accessible to all women widens consumer markets.
THE ITERATIVE PROCESS CONTINUES...
This project is ongoing - next year sees testing of a rapid prototype of the smartphone app that automatically takes a photo of a used test, plus the barcoded pre-paid envelope ideas will be floated together with expert user groups at the RNIB. When assessing the project initially, before gathering first-hand accounts of women with disabilities who've tested for pregnancy, I assumed this to be product redesign. Surprisingly, as my perception of disability issues deepen, there is no one easy-fit solution but an open-ended series of processes, amendments to existing designs, new procedures and then distribution of information for disabled parents.
- Bieber-Schut, R., (1990) 13 Visually Impaired Mothers from Essays on the topic of Women and Disability [Internet] Available at:
. [Accessed 25 October, 2010]. Pullin, G., (2009) Design for Disability. Massachusetts: MIT Press, London Royal National Institute for Blind People, (2009). Towards an inclusive health service: a report into the availability of health information for blind and partially sighted people. In: Dr Foster Intelligence, Summary and recommendations. UK, June 2009, London: RNIB. Tiresias Organization. (2009) Visual Impairment Statistics [Internet] Available at: http://www.tiresias.org/accessible_ict/visual.htm [Accessed 13/11/10 (Appendix A) Liz Crow. (2010). MA Design Studies - Pregnancy Test Experiences Questionnaire. Interviewed by Sally Esse. [online survey] 2 November 2010. (Appendix B) Anonymous. (2010). MA Design Studies - Pregnancy Test Experiences Questionnaire. Interviewed by Sally Esse. [online survey] 27 October 2010.