I am particularly struck by your finding of the absence of the person experiencing PPD in these posters!
I was wondering if you could elaborate on the findings about color choices. What, if any, significance do triadic color choices in the cool or warm hues hold for the analysis of these posters? Proximity also plays a huge role in your research findings – is there a relationship between the color, alignment, and repetition used on a poster compared to the types of proximal associations?
Also, could you talk about how and where you collected the posters for this specific pilot study? I’m curious where the future research might go based on where you started the collection, especially when considering who designed the posters and what kinds of perspectives or ideologies they maintain professionally or systematically.
Methods:
For this study I collected a small, purposefully sampled (Koerber & McMichael 2010) corpus of five PPD awareness posters, designed and distributed by prominent women’s health and advocacy organizations: 2020mom, Postpartum Health Alliance (PHA), Postpartum Support International (PSI) The American College of Obstetricians and Gynecologists (ACOG), and The Blue Dot Project. While widely available online, these posters are intended for distribution and display in sites of medical care (clinics, hospitals), and intended for a primary audience of women (patients) and secondary audience of their adult family members, with the goal of informing and empowering the audience to identify PPD symptoms and to seek treatment. Three of the posters were designed to be customized with local clinic/organization logos and contact information. Each poster was saved for reference on a laptop, and 8×11-sized copies were made on a high-quality color printer.
I would have liked to conduct a study that considers posters on display in the waiting rooms of local women’s health clinics. Unfortunately, the pandemic has restricted some of the methodological possibilities (for example, occupancy limits in waiting rooms make it difficult-even ethically questionable to “take up the space” for observation). In addition, a rise in telehealth appointments might mean that what was once a poster on wall might now be part of a video intro or pre-appointment recording. Since the start of this study, I have altered my thinking to consider that perhaps the next steps require an assessment of the new ‘waiting room” landscape: in the midst of a pandemic, where/how do patients “wait” and (casually) encounter advocacy communication like PPD awareness posters? Is there a “new” medium? I’m not certain (yet) how to go about this, but it could begin with a tour of local clinics to see how they operate (example, telehealth) and communicate with patients while they wait for their appointments.
In addition, I plan to further this research to explore how, document analysis through a feminist lens might also help inform technical communicators who might otherwise be unaware of the subtle (harmful) messages embedded in their designs.
Color
Triadic color schemes promote a sense of balance. They are also “simple,” and could have been used in order to suggest to the reader that the problems and solutions (PPD and treatment) are familiar, easy to see, to understand, recognize, to solve. By contrast (haha) they could also help to normalize PPD, making it seem familiar, a harmonious part of being a woman. Latent suggestions that PPD is “normal” could help to reduce stigmas regarding symptoms and treatment. On the other hand, they could reinforce the idea that suffering and wounds are a natural part of motherhood, balanced by the apparent joy of being a mother, or weighed against the needs of family members (in which case the scales are already tipped against her).
Reds and blues were dominant in 4/5 posters, which may have been chosen for the purposes of contrast, but I found this interesting in that they follow/reinforce the gender binary boy/girl pink/blue stereotypes.
One example of relationships between color, alignment, and repetition are present in poster 2. Here, the Triadic color scheme includes high-contrast reds, blues, and whites (again, reinforcing binary pink/blue, boy/girl gender stereotypes). Here, the mother is present, and repeated in seven identical, pony-tailed figures reminiscent of the “universal” female bathroom symbol, and/or of paper-doll cut-outs (again stereotypical gender binary). Each gazes down at a swaddled infant. Perhaps the repetition is meant to normalize a mother as “any” mother, however, one is irradiated in white against the others, and the proximal text declaring “1 in 7 women will experience depression during pregnancy or after birth” seems to expose more normalize her experience. This poster also lacks clear baselines or stable alignments and lists a smattering of symptoms and statistics in alternating reds and blues. Visually, it demands significant mental and emotional work of the reader, at the potential risk of losing them before they reach help information at the bottom.
jgerdes
1 year ago
Like Kylie, I am very interested in your sampling and poster collection. Your research poster mentions “purposeful sampling,” but I’m not sure I understand your inclusion criteria or how you chose these posters over other media and how you chose your focus on these specific organizations rather than, for instance, looking across media specific to ACOG or doing a comparative analysis of ACOG and a grassroots advocacy program or forum. What does the consistency among materials from these specific organizations mean for how PPD is framed? And in what contexts? How significant is it that these are posters (as opposed to, for instance, social posts or clinical counseling guidelines)? You mention extending the scope of this in future research, and I wonder what methods you would use to examine and understand that spaces and contexts in which posters (as a specific mode of advocacy communication) are encountered.
Second, can you speak to the design choices in your own poster? I was wondering if the use of teal, for instance, was meaningful for your presentation of PPD?
I found category 3 to align with other maternal and child health commonplaces about motherly responsibility, especially as it aligns to your example in Figure 6, and I encourage you to continue exploring this theme and what it means to frame care as a call to seek treatment ala “contact your provider.” In future work, it might be interesting for you to do some comparison of these tropes outside of MCH work. Overall, these three themes were intriguing and provide helpful findings for communication designers working in maternal health settings.
Methods:
There are many motivations behind my research, but at the forefront are the women in my life (close friends and family, as well as “students” in numerous memoir writing workshops over the years who have shared their stories) and their patterns of traumatic (and normalized) experiences in pre-and perinatal “care” and during childbirth. For this study I collected a small, purposefully sampled (Koerber & McMichael 2010) corpus of five PPD awareness posters, designed and distributed by prominent women’s health and advocacy organizations: 2020mom, Postpartum Health Alliance (PHA), Postpartum Support International (PSI) The American College of Obstetricians and Gynecologists (ACOG), and The Blue Dot Project. While widely available online, these posters are intended for distribution and display in sites of medical care (clinics, hospitals), and intended for a primary audience of women (patients) and secondary audience of their adult family members, with the goal of informing and empowering the audience to identify PPD symptoms and to seek treatment. Three of the posters were designed to be customized with local clinic/organization logos and contact information. Each poster was saved for reference on a laptop, and 8×11-sized copies were made on a high-quality color printer. Future Research
I would have liked to conduct a study that considers posters on display in the waiting rooms of local women’s health clinics. Unfortunately, the pandemic has restricted some of the methodological possibilities (for example, occupancy limits in waiting rooms make it difficult-even ethically questionable to “take up the space” for observation). In addition, a rise in telehealth appointments might mean that what was once a poster on wall might now be part of a video intro or pre-appointment recording. Since the start of this study, I have altered my thinking to consider that perhaps the next steps require an assessment of the new ‘waiting room” landscape: in the midst of a pandemic, where/how do patients “wait” and (casually) encounter advocacy communication like PPD awareness posters? Is there a “new” medium? I’m not certain (yet) how to go about this, but it could begin with a tour of local clinics to see how they operate (example, telehealth) and communicate with patients while they wait for their appointments.
In addition, I plan to further this research to explore how, document analysis through a feminist lens might also help inform technical communicators who might otherwise be unaware of the subtle (harmful) messages embedded in their designs.
My own design choices:
Knowing I would be “presenting” this poster asynchronously, I chose a design that allowed space a lot of text! (I created an additional draft that featured the title and key quotes in the center, and moved the majority of the text to the margins; this I would use if I were physically presenting in a room where people were “passing by”). I chose teal suggests clarity and tranquility, and while the latter may not have been at the forefront of my mind I think it suits my research purposes. Consciously, I wanted a color that was both pleasant and striking against the grey background (chosen for its readability). Further, the triadic color schemes of the posters featured pinks and blues (carrying the baggage of problematic gender-stereotypes) so I wanted tertiary color that felt both warm and cool.
ericastone
1 year ago
Hi Dorothy!
Thanks so much for sharing this important pilot study with the SIGDOC community.
Like Kylie, I’d like to hear more about your methods, particularly how you collected the posters, where/when you encountered them, and how you gained access to the research space (presumably a hospital or OB/GYN office). For example, did you encounter the posters during a routine visit to a doctor’s office, or did your interest in the topic originate through personal experience? Note: You are under no obligation to tell/retell a personal story in this public space.
In addition to questions about your research methods, I’m curious to hear how you plan to continue the study. At the end of your poster presentation, you said that these findings “warrant a more-in-depth rhetorical analysis that further considers the
• The intended and unintended audience
• The “spaces” and context in which the posters are encountered
• The role of potential, additional “outside” factors on audience interpretation.”
How do you plan to extend this study and connect it to conversations and/or existing social justice in the field of tech comm and/or information design? What kinds of practical insights might your extended study office social justice researchers and designers who are concerned with mitigating the material harm of disparities in maternal health care?
Thank you for your questions! Methods:
There are many motivations behind my research, but at the forefront are the women in my life (close friends and family, as well as “students” in numerous memoir writing workshops over the years who have shared their stories) and their patterns of traumatic (and normalized) experiences in pre-and perinatal “care” and during childbirth. For this study I collected a small, purposefully sampled (Koerber & McMichael 2010) corpus of five PPD awareness posters, designed and distributed by prominent women’s health and advocacy organizations: 2020mom, Postpartum Health Alliance (PHA), Postpartum Support International (PSI) The American College of Obstetricians and Gynecologists (ACOG), and The Blue Dot Project. While widely available online, these posters are intended for distribution and display in sites of medical care (clinics, hospitals), and intended for a primary audience of women (patients) and secondary audience of their adult family members, with the goal of informing and empowering the audience to identify PPD symptoms and to seek treatment. Three of the posters were designed to be customized with local clinic/organization logos and contact information. Each poster was saved for reference on a laptop, and 8×11-sized copies were made on a high-quality color printer.
Practical Implications:
When constructing the images for a PPD awareness poster, designers could consciously and consistently include an additional adult(s) along with/in close proximity to mothers. These adults can and should be depicted as sources of support for the mother via their posture, expressions, proximity, etc. For example, an adult partner or family member or friend could be depicted sitting next to a mother, holding her hand, or engaged in an activity depicting support (Poster 3 could be re-drawn to depict the mother, perhaps at a dinner table with a smiling toddler, perhaps even holding an infant, and the father could be smiling and cooking dinner). Subtle changes could also be made, for example in Poster 1, the silhouetted mothers could be facing forward, rather than down at her pregnant stomach and then at the infant. She could be looking “forward” or “towards” clinic contact information. In the first image, rather than resting on her stomach, the mother’s arm could be extending outside the frame to suggest someone is holding her hand. Though it may be too formulaic, perhaps what is needed is a set of design principles and rules or ratios specific to PPD awareness (for example: for every mother depicted, there must be one “supporting” adult in proximity). Radical or subtle, (re)designs that emphasize others’ responsibility to care for mothers experiencing PPD (and actively avoid suggestions that it is the mother’s responsibility), could help teach audiences that PPD risks are “normal” in ways that encourage attunement to PPD signs and symptoms and activate meaningful support.
Future Research
I would have liked to conduct a study that considers posters on display in the waiting rooms of local women’s health clinics. Unfortunately, the pandemic has restricted some of the methodological possibilities (for example, occupancy limits in waiting rooms make it difficult-even ethically questionable to “take up the space” for observation). In addition, a rise in telehealth appointments might mean that what was once a poster on wall might now be part of a video intro or pre-appointment recording. Since the start of this study, I have altered my thinking to consider that perhaps the next steps require an assessment of the new ‘waiting room” landscape: in the midst of a pandemic, where/how do patients “wait” and (casually) encounter advocacy communication like PPD awareness posters? Is there a “new” medium? I’m not certain (yet) how to go about this, but it could begin with a tour of local clinics to see how they operate (example, telehealth) and communicate with patients while they wait for their appointments.
In addition, I plan to further this research to explore how, document analysis through a feminist lens might also help inform technical communicators invested in social justice but who might otherwise be unaware of the subtle (harmful) messages embedded in their designs. Along those lines, I would like to pursue a theoretical exploration that could inform (potentially radical) ethical design principles for advocacy communication like PPD awareness posters, via two works: Wilson’s (2015) Gut Feminism, and Cavarero’s (2009) Horrorism: Naming Contemporary Violence.
Cavarero (2009) defines a vulnerable body as one that is simultaneously open to both “wounding and care.” She identifies the way in which mothers are constructed as a constant source of potential harm and the conflicting narratives and practices which deny women and mothers power; yoked to roles of primary caretaker and domestic laborer, simultaneously assigned the incredible power to not only actively wound (in failing to carry out the role of a “good mother,” and or/to deny the role altogether via birth control) but to harm by simply doing nothing.
In Gut Feminism, Wilson (2015) argues for a closer reading of biology and hostility in treating the body specifically for mental illness/disorders, and an openness to “tolerat[ing] the capacity for harm” in feminism. She explores how “primordial psychic powers emerge after normal psychic structures have been violently destroyed by trauma” and encourages feminists to consider “what the body (specifically the gut) can know… hysterical and non-hysterical” to “…understand the character of not just hysterical states but any biological substratum.” Thus, it is critical to acknowledge and present the biological unconscious together with the psyche and the prenatal, pregnant, and perinatal female body as vulnerable (Cavarero 2009; Simpson and Catlin 2016) and the harmful and conflicting roles imposed on women that deny their material (and maternal) struggles, as in traumatic childbirth and postpartum neglect. As important to this work are Walton, Jones, & Moore’s (2019) identification of oppressive practices that place the “burden of proof” on the vulnerable to demonstrate/legitimize their vulnerability.
Though I do not argue women are “victims” of childbirth, there is room for discussion as to their vulnerability to both care and wounding, and the way the latter has risen and been (mis)handled in the last century (Crowley 2006; Seigal 2014; Owens 2015; Fixmer-Oraiz 2015). And despite good intentions, the language and symbols of maternal care often reinforce and perpetuate oppressive rhetorics, especially when it comes to matters of postpartum depression, where it may be necessary to acknowledge hostility as a legitimate response (past and present) to pregnancy (Owens 2015; Wilson 2015). Further, it sometimes calls for technical communicators to respond in ways that might seem aggressive and/or hostile to an ideology that values women who consider their bodies (and selves) only after/in terms of the needs of their children, spouses, community, nation (Crowley 2006; Fixmer-Oraiz 2015; Owens 2015).
Thank you for the work you did for such an important and necessary study that impacts several women knowingly & unknowingly.
I am interested in an aspect of your study that was not discussed. Is there any correlation in any of these awareness posters that distinguish PPD in women of particular race or ethnicities, or did it appear that the posters are all geared towards women in general disregarding ethnic or cultural backgrounds? I’m curious if this would have any effect on the design elements and how they are reaching audiences/particular demographics. Or if there is a target demographic within the population of women who are affected by PPD. Could you discuss your thoughts on this?
Also. you mention in your implications section we should consider 1) Represent women/mothers in proximity to representations of treatment 2. Represent women/mothers in proximity to (more, various) representations of support, for example, partners and adult family members. Could you discuss 1 or 2 ways you would go about this?
The posters I gathered did not make explicit claims or appeals to specific racial or ethnic communities, apart from the photo representation of what appears to be an Hispanic woman and child. However, the hairstyles depicted in the sillouettes and figures in posters 1 and 2, as well as what might be called an “absence of color” in the father and child in poster 3 suggest a default to “white” as the setting for women/mothers. In addition, though it was not a primary focus of my study, I was concerned by the appropriated # for “momsmatter” in poster 5, which I think does less to elevate mothers and more to diminish the BLM movement. We know racial disparities are already embedded in American health “care,” and a 2019 study found those most at risk of experiencing PPD are minorities and mothers “with low educational attainment” and those on Medicaid. A cumulative, contemporary picture of motherhood is one in which women are instruments designed to reproduce “normal” healthy babies (exemplars of the white race) and to sacrifice everything in the interests of her children and therefore the nation. (Douglass & Moore 2004; Crowley, 2006; Seigal 2014). Fixmer-Oraiz (2015) affirms this ideology is still alive and well, in what she calls “Homeland Maternity,” which regards “[w]hite, wealthy motherhood as optimal, even patriotic,” while non-white, poor mothers (and their children) are property, economic burdens, and problems. Something I would like to consider in future research (if possible) would an exploration of PPD awareness posters (or a related form of advocacy communication regarding PPD) to see if/how racial and ethnic mothers are represented as compared to white (and whether the latter appears as a default setting) mothers. In terms of the latter, I am also interested in narratives of patriotism and whether Fixmer-Oraiz’s (2015) concept of Homeland Maternity is evident in PPD awareness/advocacy communication.
In terms of practical implications, when constructing the images for a PPD awareness poster, designers could consciously and consistently include an additional adult(s) along with/in close proximity to mothers. These adults can and should be depicted as sources of support for the mother via their posture, expressions, proximity, etc. For example, an adult partner or family member or friend could be depicted sitting next to a mother, holding her hand, or engaged in an activity depicting support (Poster 3 could be re-drawn to depict the mother, perhaps at a dinner table with a smiling toddler, perhaps even holding an infant, and the father could be smiling and cooking dinner). Subtle changes could also be made, for example in Poster 1, the silhouetted mothers could be facing forward, rather than down at her pregnant stomach and then at the infant. She could be looking “forward” or “towards” clinic contact information. In the first image, rather than resting on her stomach, the mother’s arm could be extending outside the frame to suggest someone is holding her hand. Though it may be too formulaic, perhaps what is needed is a set of design principles and rules or ratios specific to PPD awareness (for example: for every mother depicted, there must be one “supporting” adult in proximity). Radical or subtle, (re)designs that emphasize others’ responsibility to care for mothers experiencing PPD (and actively avoid suggestions that it is the mother’s responsibility), could help teach audiences that PPD risks are “normal” in ways that encourage attunement to PPD signs and symptoms and activate meaningful support.
Thank you for your thorough response! I enjoyed learning about this topic from a design standpoint.
Joseph Bartolotta
1 year ago
Dorothy, this is a very interesting study on an important topic. You are right to try to explore the potential harm a poster addressing PPD could have on an audience. I am also struck that there is another audience that may impact the dissemination of these posters: health care professionals. Is your study interested in how health care professionals who may hang these posters in the first place evaluate the posters as well? I wonder if the sort of lens you take to evaluating these posters is shared by the sorts of individuals and institutions that can disseminate them.
I am particularly struck by your finding of the absence of the person experiencing PPD in these posters!
I was wondering if you could elaborate on the findings about color choices. What, if any, significance do triadic color choices in the cool or warm hues hold for the analysis of these posters? Proximity also plays a huge role in your research findings – is there a relationship between the color, alignment, and repetition used on a poster compared to the types of proximal associations?
Also, could you talk about how and where you collected the posters for this specific pilot study? I’m curious where the future research might go based on where you started the collection, especially when considering who designed the posters and what kinds of perspectives or ideologies they maintain professionally or systematically.
Hello!
Thank you for your questions!
Methods:
For this study I collected a small, purposefully sampled (Koerber & McMichael 2010) corpus of five PPD awareness posters, designed and distributed by prominent women’s health and advocacy organizations: 2020mom, Postpartum Health Alliance (PHA), Postpartum Support International (PSI) The American College of Obstetricians and Gynecologists (ACOG), and The Blue Dot Project. While widely available online, these posters are intended for distribution and display in sites of medical care (clinics, hospitals), and intended for a primary audience of women (patients) and secondary audience of their adult family members, with the goal of informing and empowering the audience to identify PPD symptoms and to seek treatment. Three of the posters were designed to be customized with local clinic/organization logos and contact information. Each poster was saved for reference on a laptop, and 8×11-sized copies were made on a high-quality color printer.
I would have liked to conduct a study that considers posters on display in the waiting rooms of local women’s health clinics. Unfortunately, the pandemic has restricted some of the methodological possibilities (for example, occupancy limits in waiting rooms make it difficult-even ethically questionable to “take up the space” for observation). In addition, a rise in telehealth appointments might mean that what was once a poster on wall might now be part of a video intro or pre-appointment recording. Since the start of this study, I have altered my thinking to consider that perhaps the next steps require an assessment of the new ‘waiting room” landscape: in the midst of a pandemic, where/how do patients “wait” and (casually) encounter advocacy communication like PPD awareness posters? Is there a “new” medium? I’m not certain (yet) how to go about this, but it could begin with a tour of local clinics to see how they operate (example, telehealth) and communicate with patients while they wait for their appointments.
In addition, I plan to further this research to explore how, document analysis through a feminist lens might also help inform technical communicators who might otherwise be unaware of the subtle (harmful) messages embedded in their designs.
Color
Triadic color schemes promote a sense of balance. They are also “simple,” and could have been used in order to suggest to the reader that the problems and solutions (PPD and treatment) are familiar, easy to see, to understand, recognize, to solve. By contrast (haha) they could also help to normalize PPD, making it seem familiar, a harmonious part of being a woman. Latent suggestions that PPD is “normal” could help to reduce stigmas regarding symptoms and treatment. On the other hand, they could reinforce the idea that suffering and wounds are a natural part of motherhood, balanced by the apparent joy of being a mother, or weighed against the needs of family members (in which case the scales are already tipped against her).
Reds and blues were dominant in 4/5 posters, which may have been chosen for the purposes of contrast, but I found this interesting in that they follow/reinforce the gender binary boy/girl pink/blue stereotypes.
One example of relationships between color, alignment, and repetition are present in poster 2. Here, the Triadic color scheme includes high-contrast reds, blues, and whites (again, reinforcing binary pink/blue, boy/girl gender stereotypes). Here, the mother is present, and repeated in seven identical, pony-tailed figures reminiscent of the “universal” female bathroom symbol, and/or of paper-doll cut-outs (again stereotypical gender binary). Each gazes down at a swaddled infant. Perhaps the repetition is meant to normalize a mother as “any” mother, however, one is irradiated in white against the others, and the proximal text declaring “1 in 7 women will experience depression during pregnancy or after birth” seems to expose more normalize her experience. This poster also lacks clear baselines or stable alignments and lists a smattering of symptoms and statistics in alternating reds and blues. Visually, it demands significant mental and emotional work of the reader, at the potential risk of losing them before they reach help information at the bottom.
Like Kylie, I am very interested in your sampling and poster collection. Your research poster mentions “purposeful sampling,” but I’m not sure I understand your inclusion criteria or how you chose these posters over other media and how you chose your focus on these specific organizations rather than, for instance, looking across media specific to ACOG or doing a comparative analysis of ACOG and a grassroots advocacy program or forum. What does the consistency among materials from these specific organizations mean for how PPD is framed? And in what contexts? How significant is it that these are posters (as opposed to, for instance, social posts or clinical counseling guidelines)? You mention extending the scope of this in future research, and I wonder what methods you would use to examine and understand that spaces and contexts in which posters (as a specific mode of advocacy communication) are encountered.
Second, can you speak to the design choices in your own poster? I was wondering if the use of teal, for instance, was meaningful for your presentation of PPD?
I found category 3 to align with other maternal and child health commonplaces about motherly responsibility, especially as it aligns to your example in Figure 6, and I encourage you to continue exploring this theme and what it means to frame care as a call to seek treatment ala “contact your provider.” In future work, it might be interesting for you to do some comparison of these tropes outside of MCH work. Overall, these three themes were intriguing and provide helpful findings for communication designers working in maternal health settings.
Thank you for your questions!
Methods:
There are many motivations behind my research, but at the forefront are the women in my life (close friends and family, as well as “students” in numerous memoir writing workshops over the years who have shared their stories) and their patterns of traumatic (and normalized) experiences in pre-and perinatal “care” and during childbirth. For this study I collected a small, purposefully sampled (Koerber & McMichael 2010) corpus of five PPD awareness posters, designed and distributed by prominent women’s health and advocacy organizations: 2020mom, Postpartum Health Alliance (PHA), Postpartum Support International (PSI) The American College of Obstetricians and Gynecologists (ACOG), and The Blue Dot Project. While widely available online, these posters are intended for distribution and display in sites of medical care (clinics, hospitals), and intended for a primary audience of women (patients) and secondary audience of their adult family members, with the goal of informing and empowering the audience to identify PPD symptoms and to seek treatment. Three of the posters were designed to be customized with local clinic/organization logos and contact information. Each poster was saved for reference on a laptop, and 8×11-sized copies were made on a high-quality color printer.
Future Research
I would have liked to conduct a study that considers posters on display in the waiting rooms of local women’s health clinics. Unfortunately, the pandemic has restricted some of the methodological possibilities (for example, occupancy limits in waiting rooms make it difficult-even ethically questionable to “take up the space” for observation). In addition, a rise in telehealth appointments might mean that what was once a poster on wall might now be part of a video intro or pre-appointment recording. Since the start of this study, I have altered my thinking to consider that perhaps the next steps require an assessment of the new ‘waiting room” landscape: in the midst of a pandemic, where/how do patients “wait” and (casually) encounter advocacy communication like PPD awareness posters? Is there a “new” medium? I’m not certain (yet) how to go about this, but it could begin with a tour of local clinics to see how they operate (example, telehealth) and communicate with patients while they wait for their appointments.
In addition, I plan to further this research to explore how, document analysis through a feminist lens might also help inform technical communicators who might otherwise be unaware of the subtle (harmful) messages embedded in their designs.
My own design choices:
Knowing I would be “presenting” this poster asynchronously, I chose a design that allowed space a lot of text! (I created an additional draft that featured the title and key quotes in the center, and moved the majority of the text to the margins; this I would use if I were physically presenting in a room where people were “passing by”). I chose teal suggests clarity and tranquility, and while the latter may not have been at the forefront of my mind I think it suits my research purposes. Consciously, I wanted a color that was both pleasant and striking against the grey background (chosen for its readability). Further, the triadic color schemes of the posters featured pinks and blues (carrying the baggage of problematic gender-stereotypes) so I wanted tertiary color that felt both warm and cool.
Hi Dorothy!
Thanks so much for sharing this important pilot study with the SIGDOC community.
Like Kylie, I’d like to hear more about your methods, particularly how you collected the posters, where/when you encountered them, and how you gained access to the research space (presumably a hospital or OB/GYN office). For example, did you encounter the posters during a routine visit to a doctor’s office, or did your interest in the topic originate through personal experience? Note: You are under no obligation to tell/retell a personal story in this public space.
In addition to questions about your research methods, I’m curious to hear how you plan to continue the study. At the end of your poster presentation, you said that these findings “warrant a more-in-depth rhetorical analysis that further considers the
• The intended and unintended audience
• The “spaces” and context in which the posters are encountered
• The role of potential, additional “outside” factors on audience interpretation.”
How do you plan to extend this study and connect it to conversations and/or existing social justice in the field of tech comm and/or information design? What kinds of practical insights might your extended study office social justice researchers and designers who are concerned with mitigating the material harm of disparities in maternal health care?
Thank you for your questions!
Methods:
There are many motivations behind my research, but at the forefront are the women in my life (close friends and family, as well as “students” in numerous memoir writing workshops over the years who have shared their stories) and their patterns of traumatic (and normalized) experiences in pre-and perinatal “care” and during childbirth. For this study I collected a small, purposefully sampled (Koerber & McMichael 2010) corpus of five PPD awareness posters, designed and distributed by prominent women’s health and advocacy organizations: 2020mom, Postpartum Health Alliance (PHA), Postpartum Support International (PSI) The American College of Obstetricians and Gynecologists (ACOG), and The Blue Dot Project. While widely available online, these posters are intended for distribution and display in sites of medical care (clinics, hospitals), and intended for a primary audience of women (patients) and secondary audience of their adult family members, with the goal of informing and empowering the audience to identify PPD symptoms and to seek treatment. Three of the posters were designed to be customized with local clinic/organization logos and contact information. Each poster was saved for reference on a laptop, and 8×11-sized copies were made on a high-quality color printer.
Practical Implications:
When constructing the images for a PPD awareness poster, designers could consciously and consistently include an additional adult(s) along with/in close proximity to mothers. These adults can and should be depicted as sources of support for the mother via their posture, expressions, proximity, etc. For example, an adult partner or family member or friend could be depicted sitting next to a mother, holding her hand, or engaged in an activity depicting support (Poster 3 could be re-drawn to depict the mother, perhaps at a dinner table with a smiling toddler, perhaps even holding an infant, and the father could be smiling and cooking dinner). Subtle changes could also be made, for example in Poster 1, the silhouetted mothers could be facing forward, rather than down at her pregnant stomach and then at the infant. She could be looking “forward” or “towards” clinic contact information. In the first image, rather than resting on her stomach, the mother’s arm could be extending outside the frame to suggest someone is holding her hand. Though it may be too formulaic, perhaps what is needed is a set of design principles and rules or ratios specific to PPD awareness (for example: for every mother depicted, there must be one “supporting” adult in proximity). Radical or subtle, (re)designs that emphasize others’ responsibility to care for mothers experiencing PPD (and actively avoid suggestions that it is the mother’s responsibility), could help teach audiences that PPD risks are “normal” in ways that encourage attunement to PPD signs and symptoms and activate meaningful support.
Future Research
I would have liked to conduct a study that considers posters on display in the waiting rooms of local women’s health clinics. Unfortunately, the pandemic has restricted some of the methodological possibilities (for example, occupancy limits in waiting rooms make it difficult-even ethically questionable to “take up the space” for observation). In addition, a rise in telehealth appointments might mean that what was once a poster on wall might now be part of a video intro or pre-appointment recording. Since the start of this study, I have altered my thinking to consider that perhaps the next steps require an assessment of the new ‘waiting room” landscape: in the midst of a pandemic, where/how do patients “wait” and (casually) encounter advocacy communication like PPD awareness posters? Is there a “new” medium? I’m not certain (yet) how to go about this, but it could begin with a tour of local clinics to see how they operate (example, telehealth) and communicate with patients while they wait for their appointments.
In addition, I plan to further this research to explore how, document analysis through a feminist lens might also help inform technical communicators invested in social justice but who might otherwise be unaware of the subtle (harmful) messages embedded in their designs. Along those lines, I would like to pursue a theoretical exploration that could inform (potentially radical) ethical design principles for advocacy communication like PPD awareness posters, via two works: Wilson’s (2015) Gut Feminism, and Cavarero’s (2009) Horrorism: Naming Contemporary Violence.
Cavarero (2009) defines a vulnerable body as one that is simultaneously open to both “wounding and care.” She identifies the way in which mothers are constructed as a constant source of potential harm and the conflicting narratives and practices which deny women and mothers power; yoked to roles of primary caretaker and domestic laborer, simultaneously assigned the incredible power to not only actively wound (in failing to carry out the role of a “good mother,” and or/to deny the role altogether via birth control) but to harm by simply doing nothing.
In Gut Feminism, Wilson (2015) argues for a closer reading of biology and hostility in treating the body specifically for mental illness/disorders, and an openness to “tolerat[ing] the capacity for harm” in feminism. She explores how “primordial psychic powers emerge after normal psychic structures have been violently destroyed by trauma” and encourages feminists to consider “what the body (specifically the gut) can know… hysterical and non-hysterical” to “…understand the character of not just hysterical states but any biological substratum.” Thus, it is critical to acknowledge and present the biological unconscious together with the psyche and the prenatal, pregnant, and perinatal female body as vulnerable (Cavarero 2009; Simpson and Catlin 2016) and the harmful and conflicting roles imposed on women that deny their material (and maternal) struggles, as in traumatic childbirth and postpartum neglect. As important to this work are Walton, Jones, & Moore’s (2019) identification of oppressive practices that place the “burden of proof” on the vulnerable to demonstrate/legitimize their vulnerability.
Though I do not argue women are “victims” of childbirth, there is room for discussion as to their vulnerability to both care and wounding, and the way the latter has risen and been (mis)handled in the last century (Crowley 2006; Seigal 2014; Owens 2015; Fixmer-Oraiz 2015). And despite good intentions, the language and symbols of maternal care often reinforce and perpetuate oppressive rhetorics, especially when it comes to matters of postpartum depression, where it may be necessary to acknowledge hostility as a legitimate response (past and present) to pregnancy (Owens 2015; Wilson 2015). Further, it sometimes calls for technical communicators to respond in ways that might seem aggressive and/or hostile to an ideology that values women who consider their bodies (and selves) only after/in terms of the needs of their children, spouses, community, nation (Crowley 2006; Fixmer-Oraiz 2015; Owens 2015).
Awesome! Thanks, Dorothy!
Thank you for the work you did for such an important and necessary study that impacts several women knowingly & unknowingly.
I am interested in an aspect of your study that was not discussed. Is there any correlation in any of these awareness posters that distinguish PPD in women of particular race or ethnicities, or did it appear that the posters are all geared towards women in general disregarding ethnic or cultural backgrounds? I’m curious if this would have any effect on the design elements and how they are reaching audiences/particular demographics. Or if there is a target demographic within the population of women who are affected by PPD. Could you discuss your thoughts on this?
Also. you mention in your implications section we should consider 1) Represent women/mothers in proximity to representations of treatment 2. Represent women/mothers in proximity to (more, various) representations of support, for example, partners and adult family members. Could you discuss 1 or 2 ways you would go about this?
Thank you for your questions!
The posters I gathered did not make explicit claims or appeals to specific racial or ethnic communities, apart from the photo representation of what appears to be an Hispanic woman and child. However, the hairstyles depicted in the sillouettes and figures in posters 1 and 2, as well as what might be called an “absence of color” in the father and child in poster 3 suggest a default to “white” as the setting for women/mothers. In addition, though it was not a primary focus of my study, I was concerned by the appropriated # for “momsmatter” in poster 5, which I think does less to elevate mothers and more to diminish the BLM movement. We know racial disparities are already embedded in American health “care,” and a 2019 study found those most at risk of experiencing PPD are minorities and mothers “with low educational attainment” and those on Medicaid. A cumulative, contemporary picture of motherhood is one in which women are instruments designed to reproduce “normal” healthy babies (exemplars of the white race) and to sacrifice everything in the interests of her children and therefore the nation. (Douglass & Moore 2004; Crowley, 2006; Seigal 2014). Fixmer-Oraiz (2015) affirms this ideology is still alive and well, in what she calls “Homeland Maternity,” which regards “[w]hite, wealthy motherhood as optimal, even patriotic,” while non-white, poor mothers (and their children) are property, economic burdens, and problems. Something I would like to consider in future research (if possible) would an exploration of PPD awareness posters (or a related form of advocacy communication regarding PPD) to see if/how racial and ethnic mothers are represented as compared to white (and whether the latter appears as a default setting) mothers. In terms of the latter, I am also interested in narratives of patriotism and whether Fixmer-Oraiz’s (2015) concept of Homeland Maternity is evident in PPD awareness/advocacy communication.
In terms of practical implications, when constructing the images for a PPD awareness poster, designers could consciously and consistently include an additional adult(s) along with/in close proximity to mothers. These adults can and should be depicted as sources of support for the mother via their posture, expressions, proximity, etc. For example, an adult partner or family member or friend could be depicted sitting next to a mother, holding her hand, or engaged in an activity depicting support (Poster 3 could be re-drawn to depict the mother, perhaps at a dinner table with a smiling toddler, perhaps even holding an infant, and the father could be smiling and cooking dinner). Subtle changes could also be made, for example in Poster 1, the silhouetted mothers could be facing forward, rather than down at her pregnant stomach and then at the infant. She could be looking “forward” or “towards” clinic contact information. In the first image, rather than resting on her stomach, the mother’s arm could be extending outside the frame to suggest someone is holding her hand. Though it may be too formulaic, perhaps what is needed is a set of design principles and rules or ratios specific to PPD awareness (for example: for every mother depicted, there must be one “supporting” adult in proximity). Radical or subtle, (re)designs that emphasize others’ responsibility to care for mothers experiencing PPD (and actively avoid suggestions that it is the mother’s responsibility), could help teach audiences that PPD risks are “normal” in ways that encourage attunement to PPD signs and symptoms and activate meaningful support.
Thank you for your thorough response! I enjoyed learning about this topic from a design standpoint.
Dorothy, this is a very interesting study on an important topic. You are right to try to explore the potential harm a poster addressing PPD could have on an audience. I am also struck that there is another audience that may impact the dissemination of these posters: health care professionals. Is your study interested in how health care professionals who may hang these posters in the first place evaluate the posters as well? I wonder if the sort of lens you take to evaluating these posters is shared by the sorts of individuals and institutions that can disseminate them.