Trigger warning: The following case study discusses domestic violence.
Pregnancy is a time when a mother is physically, emotionally and mentally prone. Thus making this time a high risk period for gendered violence to occur…
How can we encourage the safe and discreet disclosure of gendered violence during pregnancy?
TIME FRAME:
13 weeks
TEAM MEMBERS:
Sarah Sarsam
TOOLS:
Adobe XD, Adobe Illustrator, Adobe Photoshop, Miro, Prott, Trello
MY ROLE:
Exploratory mixed method research
Throughout our research we conducted various modes of contextual research. Personally, I conducted expert interviews, self-report inventories, online ethnographies and literature reviews.
UI/UX design
We collectively designed, developed and iterated through possible design solutions; in particular I created all custom illustrations for the final design and created the final mobile application.
Rapid Prototyping
We collectively prototyped 152 screens when developing the PregnancyPal application, through 4 iterations.
Project Background
Domestic violence refers to any type of abuse between partners or ex-partners. This is not only a devastating crime, but is a violation of a woman’s mental, physical and emotional health. Domestic violence can happen at anytime throughout a woman’s life. However, it often first arises while women are pregnant; with 17% of domestic violence victims being physically or sexually abused for the first time during pregnancy. Therefore pregnancy actually serves as a high-risk life event for women, where physical violence may be initiated or escalated.
Presently, the justice system handles these issues by relying on the victim coming forward to disclose the situation to authorities, however many abused women refrain from talking to others about abuse due to a myriad of reasons. Many victims protect the abuser against authorities as they don’t want to disclose domestic violence out of fear from their abuser, or fear of the Department of Family Services (DoCS) removing their child from an unsafe environment.
This paradigm manifests itself as there is an absence of of screening schemes which are strategically implemented for pregnant women, limiting the discourse which enables disclosure of domestic violence.
Research
Before beginning any research, we recognised that this project had ethical implications that have the potential to be devastating. Therefore, every step of the design process was carefully considered, to not cause additional trauma to those who may be affected by these issues.
To gain a holistic understanding over the problem space, we designed a triangulated research approach and created three streams, with each of us interviewing a different category of stakeholders:
First Responders
- Expert Interviews
- Self-Report Inventory
- Online Ethnography
- Literature Review

Support Services
- Expert Interviews
- Self-Report Inventory
- 5 Why’s
- Literature Review
Demographic women
- Demographic Interviews
- Make and Say
- Online Ethnography
- Literature Review
Understanding how first responder services handle such cases may reveal different motivators for the victim disclosing reports of abuse. Therefore, I was looking to uncover the current processes, protocal, technology and issues from first responders to domestic violence, engaging with the police, paramedics, nurses and midwives. More specifically, I wanted to understand:
- How different services immediately respond to reports of domestic violence
- How first responders feel when handling reports of domestic violence – are there similarities between cases?
- How cases of domestic violence get processed – is there an end?
- How responders feel about the technology they are using
- How different services communicate with each other
I spoke extensively with three police officers, including the Chief Detective of NSW, two nurses, and two paramedics.
Research analysis
After conducting my research, I analysed all of my data firstly using a KJ affinity diagram which grouped the operations of first responders together, and their interactions with the victim. I then created a journey map and series of personas, outlining the discrete steps of the interconnected first response systems.


The group then combined again to share our key insights from our research stream, forming an aggregate of information. This process became extremely complex, as we realised how interconnected each stakeholder’s actions and influence was. This led us to anoher question; how can we best support our stakeholders without sacrificing the integrity of any?
Ideation
Before ideation, we created a custom criteria for success; reframing our problem to better identify clear goals for our design.

We then pooled our stakeholders, technology and pain-points together using forced association techniques, lateral thinking and reverse thinking. In our final round of forced association we also added random words into the pool (i.e. domino, fortune-teller) to make us think outside of the box and prevent of group think.
This lead to over 80 concepts, which we then analysed our ideas by comparing them against our criteria for success, and weighing up how our personas would react to each. This left us with three strong concepts. To select the best concept out of the three, we employed storyboards and Harris Profile Decision Matrices to flesh out their advantages and disadvantages. Personally, I drew all of our storyboards to illustrate the user journey.


Rapid Prototyping
Throughout our design process we wanted users to be involved along every step of the way. Before we even began to prototype we ran card sorting activities with a midwife to categorise the conceptual model of our application, which we then rendered into a diagram.

We then created paper prototypes and sketched for two applications (mobile and desktop) and created task-based activities to establish user logic tests, informing future iterations. To place our paper prototypes in context for our user tests, we decided to upload our sketches into the digital application, Prott.




Moving up in fidelity, we created wire-frame prototypes in Adobe XD, which we continued to test using the same task-based activities to refine the UI with our end users, mothers and health care practitioners. Additionally, we conducted multivariate testing and heuristic evaluation to inform the efficacy of our applications.




For our final prototype, we created fully functional click through mockups of both applications, making minor tweaks to ensure that the UI caters for accessibility issues, and that all text and colours are legible, adhering to WCAG guidelines. In particular, I made the final mobile prototype, as well as the illustration assets to be used across both applications. This was tested with healthcare workers and graduate midwives.




Final Product
While there is no one solution to domestic violence, PregnancyPal aims to facilitate the early detection of domestic violence using a systematic approach. This is achieved by allowing the victims of abuse to be better informed about a greater width of options with the help of their health care practitioner. The application facilitates meaningful discourse with a woman’s healthcare practitioner by allowing them to easily and discreetly convey how they are feeling on a day-to-day basis.
Following the disclosure of abuse to a practitioner, PregnancyPal allows women to safely and effectively access a dynamic support network, enabling her to make informed decisions about escaping the destruction of domestic violence. PregnancyPal provides comprehensive services which not only promote health and safety, but promote them synonymously.
At a surface level, PregnancyPal appears to be a pregnancy support application, providing information about the baby’s development, and helping the healthcare practitioner and mother organise appointments and improve communication streams between them. However on a deeper level, PregnancyPal is a platform that allows healthcare practitioners to gauge how their patients are tracking, and to discretely identify signs of domestic abuse or a traumatic domestic situation; therefore they can provide the necessary assistance to help.

Welcome Onboard
PregnancyPal is easy to use, with a walkthrough tutorial to help you get started with on-boarding. Monitoring your pregnancy and health made simple and intuitive.

Stay informed about your baby’s development
View weekly pregnancy facts, tips and information to ensure you are prepared every step of the way. Toggle through the different weeks to see your baby’s development.

Keep up to date
View weekly pregnancy facts, tips and information to ensure you are prepared every step of the way. Toggle through the different weeks to see your baby’s development.

Monitor your pregnancy
Do daily check-ins to help both you and your midwife track your health. View these trends in your profile section to ensure you are tracking along nicely.

Stay Securely Connected With Your Midwife and Receive Support
View sensitive material and information through a secret section of the app by long pressing in the support tab. When in this mode, the ‘Tap to Hide’ button’ will safely return you back to another screen.

Quickly check all your appointments
See all of your upcoming appointments and the details of each one to prepare you for your day.

Stay informed about your patients health
Stay aware about your patients’ health and wellbeing and see past details about your appointments. See synopsis graphs from your patients’ past Check In trends, or click on each to bring up more details.

Keep in touch with your patients
Send resources to your patient during appointments, and keep track of what your history. You can also automatically and discreetly send domestic violence assistance resources to your patient.

Work side by side and provide the best support network
Create a cohesive treatment system and refer other support professions to assist your patient. E-referrals are also sent to the patient in a streamlined process.