Immigrants are central to New York City’s story and the history of the United States. These newcomers range from the hopeful to the fearful with the current state of social treatment from governmental organizations, and the misleading stories circulating around the topic of immigration. These stories serve to reaffirm belief systems rather than create an understanding for the issues faced as an undocumented citizen. In this context, the role of the designer is to participate within a networked situation that involves, emotion, economics, technology, politics, cultural optics, and activism.*
I worked directly with people affected by immigration status through collaboration with the Judson Memorial Church and New Sanctuary Coalition, nonprofit organizations in New York City that provides services to those seeking legal status in the United States. The process began with research into immigration stories, those told by museums, those circulating through news media, and those being lived through members at the New Sanctuary Coalition. They provided us access to people with firsthand knowledge of the situations undocumented immigrants manage, who were also part of co-designing and reviewing our work with their expertise.
Unauthorized immigrants’ access to publicly funded health programs has become increasingly limited since the passage of welfare reform in 1996. Unauthorized immigrants are excluded from benefits provided under the Patient Protection and Affordable Care Act (ACA). These barriers to access result in individuals receiving fewer preventive health care services, including prenatal care, and reporting poorer reproductive health outcomes. And even during an emergency, undocumented citizens experience fear with social and medical systems, because they never know if documents will be requested of them or what the consequences are if they don’t have them. Due to the massive influx of pregnant women entering the country seeking asylum, or trying to reactivate forms of citizenship while already pregnant in the United States, prenatal care was the area of focus as it posed a quantifiable need that was overlooked.
* words adapted from Alex Schweder, Undocumented Design
I designed a remote diagnosis kit for undocumented pregnant women in the United States who are in need of prenatal care through the safety of a trusted medical professional. It fits within the framework at New Sanctuary Coalition, where they host weekly clinics for immigrants seeking advice, medical help, or other status information. The kit offers 4 sets of undergarments that are meant to absorb leakage, or designate areas to mark if lumps are felt, either on the breasts or the vagina. Leakage and lumps are the most commonly diagnosable symptoms experienced by women with the potential for serious effects on the pregnancy that can be overlooked.
Women who are connected to New Sanctuary Coalition will receive this kit upon arrival to Judson Memorial Church and will be able to wear the undergarments, observe any leakage in the attached pads, and mark any lumps based on the illustrations shown in the booklet. Then, they will be able to bring the undergarments back to New Sanctuary Coalition in a sealed bag and hand it off to a medical professional or volunteer on staff at the weekly clinics. It is up to the woman if she chooses to have a face-to-face diagnosis of the undergarments, or if she waits for a volunteer to hand back her kit with doctors notes in the back.
Variances in women’s sexual and reproductive health education between Latin America and the United States range from access to culture. This booklet serves as a baseline of how this type of health education is taught in the United States in a simplified way that helps the undocumented women engage in appropriate and informed conversations with a medical professional if they choose to see one.
The knowledge provided in the booklet includes the basic anatomy of the female body, the symptoms of leakage & lumps during pregnancy, and whether you should consult a medical professional based on your observations.
Fitting the Context
Mamá is a low-tech solution that is meant to fit the context of access to women’s health services and working with nonprofits. It is meant to be an instigator of the healthcare process for pregnant women in need of prenatal care, and ultimately a useful transition from alternative healthcare education to United States healthcare education. The prototypes are made of locally-found fabric and repurposed 100% cotton period pads for the nipples and vagina — though it also presents an opportunity to scale vertically to a higher tech solution or horizontally to mitigate other problems of healthcare accessibility that marginalized populations face.