In my capstone project, my team and I partnered with the City of Edmonton ( Alberta, Canada) to help address some of the complex needs that the homeless population of the city is having through the means of social and user experience design.

Edmonton typically has 100 pregnant women a year who are experiencing homelessness. Housing is a primary concern for these women, however, they often need various other forms of care. Those who are faced with a homeless pregnancy experience complex issues including substance use, trauma, mental and physical health problems, malnourishment, and an overall difficult time preparing for parenthood.

To address some of these issues we have prototyped a system of care that would supply homeless pregnant women with kits to help them stay on track and healthy in each trimester of their pregnancy and plan for parenthood. The care packages would contain things like bus tickets, vouchers for food, pregnancy vitamins, clean needles for safe injection, and other things to keep the women safe and healthy. The packages would be given by social and healthcare professionals throughout the pregnancy, hopefully resulting in a nurturing relationship with the pregnant individuals.

A care package service that encourages pregnant homeless women to get consistent help from their social care and healthcare providers throughout the pregnancy.

My role

Primary & Secondary Research System Design

My team

Darya Andriyenko
Cole Rennie
Xiya Lu

Tools Used

Illustrator| Rhino | KeyShot

Type and timeline

Service Design
Sept 2019 - December 2020

Understanding the User Group

Primary & Secondary Research

Throughout the year we’ve conducted interviews with the Pregnancy Pathways Housing Program and the Edmonton RECOVER program to gain a better understanding of the pregnant homeless individuals within our community.

We’ve learned that one of the main issues that the women faced was not getting help early enough in their pregnancy. Many of the women would attempt to get housing and social assistance in the last few weeks before giving birth. This would often result in them not being able to decide the future guardianship of their child, a higher chance of complex early birth, and a higher chance of having a malnourished child with potential developmental delays.

Our Research Strategy

On ethical collection of research
Due to ethical reasons, we gathered our information about pregnant homeless individuals by interviewing those professionals who work directly with them (Pregnancy pathways housing centre, and Edmonton’s RECOVER program) and relied on recently published studies (such as the Pregnancy pathways report) to further gain an understanding of their needs.

On following a Harm Reduction Approach
A large amount of pregnant homeless women living in Edmonton are substance users. While ideating on our prototype we had to follow the Harm Reduction Approach. This is an approach to policies, programs and practices that aims to reduce the risks and harm associated with substances while meeting people where they are at. It acknowledges that abstinence is not always a realistic goal for some people.

Pregnancy Pathways

Housing and social services program for pregnant homeless women in Edmonton

To gain a better understanding of the user group with we worked with Pregnancy Pathways Housing Centre for pregnant homeless women. They provide housing, informal social care, as well as advice and assistance with childcare in a judgment-free prochoice environment.

We also used their Pregnancy Pathways for Homeward Trust Edmonton report that summarizes a series of interviews of women who were engaged in the program over 9 months.
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Key Findings:

Seeking out help too late
A majority of the women who obtain a home in the program do not seek out help until their third trimester. This is problematic because there is a higher chance of them not being able to decide the future guardianship of their child, a higher chance of complex early birth, and a higher chance of having a malnourished child with potential developmental delays.
On Substance Use
Several women noted that their use of controlled substances was a form of escapism from the realities of street life. Upon entrance to the program it was not uncommon for women to have been using during their pregnancy. However, through their time at Pregnancy Pathways they were working hard to reduce their use prior to their respective due dates.
On food, clothing, transportation and healthcare
Many of the women are not aware of the available food, clothing and transportation resources that are available to them. The program finds opportunities to obtain free groceries, maternity clothing and transportation options for the women before and after they give birth. they also help the women navigate the healthcare system while preparing them for the upcoming birth.
On building a supportive community
Those working daily with the women talked about how important it was for them to slowly build a trustworthy circle of people. These people would eventually help them in the process of raising the child, getting a job, obtaining housing and getting in touch with their identity ( especially for those who participants who are indigenous). Pregnancy pathways program leaders aim to connect the women to various social and healthcare providers along the way to aid in this process.

Other resources

In addition to our work research Pregnancy pathways we also relied on a few other resources to get us a better understanding of some of the more specific resources and items that a pregnant homeless individual might need.

"Oh Shit, I’m Pregnant" pamphlet
This pamphlet is designed by the city, for those who are living on the streets and are pregnant. It answers some of the commonly asked questions about pregnancy and provides tips on finding shelter and food. It also discusses safe substance use, postpartum, mental and physical health and guardianship.

Expectant Prototype
We learned about an Edmonton RECOVER prototype called Expectant, aimed to help first-time parents prepare for birth with a custom-tailored kit of goodies. Kits may contain formula, receiving blankets, nipple cream, pre-natal bottles, coupons for house cleaning or meals, and other helpful information for parents.

Pregnancy Timeline

Identifying a point of intervention

It was important for us to establish a rough pregnancy timeline of a pregnant homeless person, to figure out where we could help. From the conducted interviews with Pregnancy Pathways and the City of Edmonton, it was clear that one of the largest hurdles that the women faced was a lack of a proper support system early on in their pregnancy.

How might we foster communication between pregnant homeless individuals and the available supports in the city to encourage a healthier pregnancy?

Final Idea

After ideating on various solutions and getting feedback from the city, we came up with a final idea of a care package service for pregnant homeless people in our community.

We would be providing care packages to pregnant women in each trimester, while slowly preparing them for their birth and getting them closer to a nurse or a social worker in the process.

Prototype Ideation

Awareness Campaign | Care package ideation

After distilling our research and finding an idea, we further ideated various parts of the care package system. This included figuring out the awareness campaign, the ideation of the package itself, and the details of the contents of the care packages.

Awareness Campaign

To grasp the user's attention we thought of an awareness campaign that would encourage some of the pregnant homeless folks to seek help. Based on the City of Edmonton recommendation we chose to make a series of posters to display in various areas of the city.
Focusing on:

Public train and buss terminals
Shelters
Public medical services/ pharmacies

While ideating on the messaging and imagery, the city of Edmonton encouraged us to focus on a general statement of support. This would be more discrete and eliminate unwanted attention. We used the city of Edmonton brand guidelines to visually support the campaign explorations.

Care package ideation

While ideating on the care package appearance, we had to abide by the following criteria, established by our research:

The package should be portable and serve as an ongoing vessel for personal use later on (preferable to act as a bag).
Should not be overly branded or extra bold, to not grab attention on the streets, so that the user is not targeted.

Different needs addressed in different trimesters

Inform

(1st trimester)

Goal
To have the women informed of their choices with regards to pregnancy (birth, abortion, guardianship, etc), and make sure they know there is no judgment. This is the ideal stage to start building initial relationships and to get the women in touch with healthcare and social services.
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Specific Immediate Needs:

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Transportation (bus tickets)
Prenatal Vitamins & Milk
Food (where to get free, nutritious meals?)

Support

(2nd trimester)

Goal
The woman must decide whether or not she will be going through with the pregnancy or abortion. If continuing in her pregnancy journey, she will experience big bodily changes and will require more healthcare and social care guidance in preparation for the birth.
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Specific Immediate Needs:

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Maternal clothing (adjustable waistband clothing, underwear, and bras.)
Substance Support (providing safe injection information and tools if needed)

Prepare

(3rd trimester)

Goal
Nearing the end of pregnancy women will need assistance organizing their birthing plan, future housing, as well as working with CFS (Child Family Services) to ensure guardianship of their child. Baby Safety Plan’s need to be established for CFS and warrants or court orders may need to be addressed. It's crucial to have the Birthing Safety Plan well organized for these women, seeing as some mothers have had their children taken from them at the hospital due to a lack of a post-birthing plan/ strategy.
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Specific Immediate Needs:

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Day planners/ organization folders to organize their Baby Safety Plans.
Newborn items (clothing, diapers, swaddling blankets, formula)
Post-birth items for the mom (liners, nipple cream, breastfeeding pads, tums etc)

Solution

The final Care Package prototype for pregnant homeless women in the city of Edmonton is a system of packages given to the women in every trimester and refilled throughout. It contains items like bus tickets, vouchers for food, pregnancy vitamins, clean needles for safe injection, and other things to keep the women safe and healthy. The packages are customized and provided in set city locations by specific social and healthcare workers.

The mother’s journey has five key stages including, engagement through an awareness campaign, being informed about her options, and being supported and prepared for the birth of the child. Through this process, the social and healthcare workers can slowly help her find appropriate housing, along with nutrition, mental and addiction supports.

Solution at a glance

How might we foster communication between pregnant homeless individuals and the available supports in the city to encourage a healthier pregnancy?

Different needs addressed in different trimesters