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Illuminating water births

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Illuminating water births comic cover

University of Edinburgh, Heriot-Watt University, Loughborough University & NHS Lothian

The aim of this project was to use high quality, interactive and collaborative engagement activities with midwives to inform the design, development and prototyping of an illuminating flexible mirror. Midwives would use the mirror to monitor the progress and assist controlled delivery of the babies’ head in women having a water birth. The final product has the potential to have a major impact on midwifery practice by enabling midwives to view the birth process more easily, improve outcomes for mothers-to-be by offering a more dignified delivery and be safer for babies due to timely observation of the birth process. The
project was funded by Edinburgh and Lothian’s Health Foundation, Tommy’s and Edinburgh Bioquarter.

From the outset, the goal was to embed the views and specifications of midwives (i.e. the end-users) from very early on in the design process and throughout it to ensure that the final product is fit for purpose for the birthing pool environment. The multidisciplinary project and product design team engaged with midwives of a range of experience and seniority who work in both hospital and community settings. The team used a number of interactive vehicles to capture the views of midwives including innovative weekly Comic Book updates, face-to-face interviews, focus groups, online and paper-based surveys and hands-on testing of prototypes in simulated and real (i.e. birthing pool) settings.

At each stage of the prototype development, feedback was sought from midwives. This was used to modify and improve the prototype design. In the initial stages of the project, midwives with varying degrees of expertise in facilitating water births were involved and engaged with. This insight directly influenced key design features including shaft flexibility, location and nature of integrated light source and ergonomic design of the handle. However, as the project progressed, the need to draw on the specific expertise of midwives with current experience of water births became apparent in order to fine-tune the design specification. As a direct result, this more focused approach to garnering feedback resulted in key changes to the prototype design.

The project also engaged with other key stakeholders including infection control and NHS procurement to ensure that the final product fulfilled the stringent specifications required for medical devices. The team also sought feedback from mothers-to-be to make sure that the prototype was aesthetically pleasing and non-intrusive. This multifaceted approach was mutually beneficial for the project team and midwives, empowering both to design and deliver a product that addresses an unmet clinical need.

Product Design teams involved in prototyping projects often have limited access to the target audience and the environment in which the product will be used. Unless this information is clearly identified, articulated and communicated to the members of the Product Design team, there is a risk that the prototypes developed will be neither fit for purpose nor address the needs of the users. The innovative methods of engagement used by this project team ensured that the design process was intelligent, interactive and enabled modification and re-specification of the prototypes in response to feedback by the proposed end-users. 

The relationship with participants and partners has consolidated with time and over the course of this project. The Comic Book proved to be an excellent method of keeping participants interested and involved in the project. There is also a spin-out from the Comic Book; the Obstetric Newsletter which is generated four times a year and provides information to staff about ongoing local obstetric projects.