2019
LENA: Postpartum Sexual Wellness
LENA: Postpartum Sexual Wellness
Duration
7 Months
My Role
Academic research
UX research
Opportunity analysis
Benchmarking
Design & feasibility
User testing
Thesis paper
Team
Solo project

This thesis gives focus to the very human aspects of a woman’s journey to rediscover and reclaim her new body after giving birth. LENA is intended not only as a physical outcome, but a discursive one as well.

LENA is a set of self-care tools which seeks to guide postpartum women towards healing - both physically and emotionally - in a way that dignifies the body, and acknowledges sexual wellness as an integral part of general wellbeing.

Project Goals & Challenges

  • Develop my own brief and scope so that the project can be completed to a marketable and feasible degree within the given timeframe.

  • Conduct user interviews and testing in a sensitive and compassionate manner, especially given the sexually conservative nature of Asian society.

  • Achieve a design outcome that is both medically and emotionally validated.

  • Communicate the project in an appropriate manner to various stakeholders, as well as my professors and peers.

My Process

4 Months

  • Choose broad area of research
  • Interviews & literature review
  • Opportunity analysis & angle of approach
  • Benchmarking & market positioning
  • Design probes & hypothesis testing
  • Define brief & scope

3 Months

  • Concept ideation & prototyping
  • Form language & semantics
  • Physical ergonomics
  • Detailing/Colour/Materials
  • Technical feasibility & proof of concept
  • User evaluation & feedback
  • Photoshoot & communication

What is sexual wellness?
And what’s the problem?

A holistic approach to sexual wellness

Many sex psychologists and counsellors agree that sexual wellbeing is intricately connected to other areas of wellness such as physical condition. mental health, self-esteem, and social relationships.

By acknowledging this inter-connectedness, we can move away from the idea of sex being something shameful and only discussed in lewd contexts. Instead, we can work towards a deeper understanding of ourselves.

“I want to emphasise that sexual wellness isn’t just intercourse or masturbation. It is related to our  physical, emotional, and relational wellbeing.”

- Erin Chen, sex and relationship counsellor

A medically valid, yet socially taboo issue

66% Of women experience sexual dysfunction during the first year after childbirth. This is a common issue among couples, yet is not openly discussed or taken seriously.

Many cultural traditions acknowledge the emotional and physical vulnerability of postpartum women, but turn a blind eye to sexual recovery due to factors such as social taboo, or lifestyle constraints. Some social norms exacerbate it by deeming her sexually ‘unclean’ or ‘broken’ after birth.

It is crucial to respect a woman’s boundaries and give her adequate time for healing and adjustment, without pressure to resume or prioritise sex. However, this dialogue should never devalue or shame her.

Methods I used to research and collect information

  • Interviewed health professionals (physiotherapists, gynaecologists)
  • Interviewed postpartum women (age range 30 - 60)
  • Surveyed women on general sexual wellness (age range 18 - 60)
  • Observed candid discussions from online support communities

“I find it astounding: the lack of understanding, connection, curiosity to look at your own body. I’ve had many Singaporeans who were literally in tears. They find [their vagina] really ugly.”

- Monica Donaldson, Physiotherapist

Research summary:  Postpartum impact on sexual wellness

Physical
Prolapse & Incontinence

“My physiotherapist told me 40 - 60% of women who have had kids have some form of prolapse! I was pretty upset and self conscious about it.”

Emotional
Body Dissonance & Loss of Confidence

“My body disgusts me. I’ve never been so unhappy about myself in my life. I can’t get naked in front of my S/O. How am I supposed to feel comfortable sleeping with him again?”

Relational
Resentment & Strained Relationship

“It’s the ‘HE DOESN’T KNOW WHAT IT’S LIKE!’ rage. And “YOU DID THIS TO ME! I HATE YOU!” Yeah, all totally normal.”

Dyspareunia (Painful Sex)

“My sex life was a disaster (had no sensation, uncomfortable, could no longer orgasm). Add in some scar tissue just to top things off.”

Penetration Anxiety

“You guys, I am 4 months postpartum and still haven’t had sex. I’m terrified. I keep telling my husband next weekend, but then it comes and goes.”

Pressure to Resume Sex

“We intentionally do it even though sometimes I’m not in the mood. For me, it’s not about whether I want it. It’s, do I want to submit to my husband and satisfy him?”

Bodily Weakness

“I don’t like to feel weak as a woman. I used to work out a lot, to prove that I can do anything a man can. But I feel so tired after having given birth.”

Loss of Personhood

“I feel like I’ve become a human boob. I sleep on the couch so I can nurse every 2 hours while my husband gets to sleep since he has to work.”

Isolation

“It’s 3am, I’m up expressing my milk in the corner, I’m so tired. And I just need somebody there, but I can’t wake my husband because he has work tomorrow. Sometimes I feel very sad.”

“Culturally, we’ve come to accept that once the baby is born, the focus should be on the baby. This paradigm makes any sort of additional maternal care seem like a luxury.”

- Yuka Polovina, health education specialist

Mapping existing care solutions

Many healing practices currently used do not dignify the body, and instead imply it to be a broken machine. Current postpartum products and tools are often have a utilitarian or makeshift nature. They solve physical problems, but are clinical, alienating, and/or baby-centric.

Analysis of findings: Insights & Opportunities

Opportunities
Insights

Many women feel alienated from their new postpartum bodies.

Women will overcome bodily shame or shyness in a medical context.

Some believe their bodies should only be accessed by their husbands.

How can we reduce shame barriers and give women more ownership over their bodies?

How can self care tools facilitate the relationship between women and their bodies? How can we treat the body with dignity?

Postpartum women have so little time for themselves; can physical recovery be a window for mindfulness and self-care?

Postpartum women describe themselves as ‘cows’ or ‘machines’.

Women resort to DIY solutions, eg. putting diapers on the breast.

Even those with supportive partners may struggle with self-esteem.

Postpartum life is extremely hectic and demanding.

Many women accept bodily dysfunction as normal.

Postpartum women seek comfort in small windows of me-time.

What is a dignified, elegant way to reapproach the new body?

Refining scope and angle of brief

Recovery as rediscovery:

We often talk about ‘bouncing back’, but the reality is that the body will not be the same again, even after a proper recovery.

What if the recovery process wasn’t about ‘bouncing back’, but instead a new journey? Many women, especially in Asia, do not have a close relationship with their bodies. Can the recovery process let them develop a deeper understanding that they didn’t have before? What is an elegant way to reapproach the new body?

Final brief:

To re-design the experience of medically validated remedies, introducing both physical and emotional ergonomics that were lacking.

Ideation

Postpartum women are extremely busy and cannot afford to waste much time on impractical things. At the same time, many have said that self-care is important for their sanity.

I mapped out various ailments and their treatments, then brainstormed ways to redefine the experience of them by including elements of self-care and empathetic design. To make sure the project was accessible and safe,  I focused mainly on ailments that were common, and could be treated at home.

Chosen Concepts

To evaluate my ideas, I conducted more surveys and interviews to seek the opinions of postpartum women and medical professionals.

Three final concepts were chosen:

  • Perineal scar tissue massager

  • Heated breast massager

  • Angled vulva mirror

The trio made a good set because they addressed the body in three different zones, and has the potential for a mix of physiotherapeutical, emotional, and eventually sexual uses.

Tool #1: Perineal scar tissue massager

What is perineal scar tissue?

The perineum is the area between the vulva and anus. Very commonly, this area is torn or surgically cut (episiotomy) during birthing, and requires stitches afterwards. Post-episiotomy scar tissue can be stiff or painful, impairing pelvic function and intercourse.

How is it usually treated?

It can be softened over time by massaging the perineum every night. Usually, the woman must insert either her thumb or a pelvic wand into her vagina, and slowly stretch the stiff tissue by pressing down against the lower wall.

There are two common techniques for this:

Clock stretches
Moon strokes

Emotional & physical ergonomics

Current methods for massaging the scar tissue are not ideal:

Using the thumb can cause a lot of physical strain on the tendons in the hand and wrist. And for women with limited mobility, it may be altogether physically impossible.

Pelvic wands can be difficult to manoeuvre carefully. And inserting a cold, hard crowbar into a sensitive area is frightening to many women, especially given the existing pain in the area.

Prototyping

Instead of closing the hand into a fist, I decided to preserve the idea of using the thumb as the point of contact. This connects the hand with the body in a much more natural way. The spoon shape functions as a kind of ‘extended thumb’ that is angled to make the exercise more physically comfortable.

A lot of attention was paid to small details - not only in physical usability, but also in emotional approachability and intuitiveness.

Chosen form

The final design features a friendly shape that is not strongly phallic. Various women gave feedback that the object was ‘cute’, and ‘like a spoon’. It felt reassuring in the palm, and was easy to maneuver with fine control.

The massager not only helps to heal the episiotomy scar, but gently reintroduces penetration on the woman’s own terms.

The final product is envisioned to be silicone-coated, as it is safe, hygienic, and body-friendly.

Tool #2: Heated breast massager

What are blocked milk ducts?

During breastfeeding or milk expression, the breastmilk may not fully drain. The leftover milk solids then form blockages in the breast ducts. These blockages can be extremely painful and distressing.

How is it usually treated?

Traditionally, either heat or massage is used to relieve the pain and unblock the duct. Using both at the same time is more effective, but inconvenient. This would involve massaging the breast while standing under a hot shower.

Products such as heating pads require time to heat up, then cool down to the right temperature.

Additionally, the breast cannot be massaged while being heated.

DIY remedies for this issue are very common. They include:

  • Using the vibration from an electric toothbrush
  • Using the vibration from a sexual toy
  • Heating a damp towel
  • Putting a cold cabbage leaf in one’s bra

Emotional & physical ergonomics

The need to relieve pain and feed the baby can be an urgent and intense experience. But the only accessible way to use both heat and massage at the same time is to take a hot shower. It isn’t practical to do so when there’s a hungry baby waiting and crying.

Some women also report having sore and cramped hands after massaging their breast for a long time, especially if they have underlying conditions such as carpal tunnel syndrome.

Furthermore, the undignified nature of common DIY treatments only emphasizes the notion that the baby comes first, and the mother’s own needs are an afterthought.

We must also consider the context of the activity. Whether it’s feeding directly or pumping via machine, many women find it to be an isolating and even depressing experience, especially at night. This feeling is compounded with the dehumanising nature of breast pump devices.

Prototyping

The idea was to design a rechargable heated breast massager that could be temperature controlled.

Commonly recommended massage techniques include both broad rolling motions, as well as point-targeted pressure. I wanted to design a tool that could offer this range of different usage styles, while easing hand strain.

The form should be comforting to hold, and feel like a natural bridge between the hand and body.

Chosen form

The final design is a sympathetic object - a companion that provides warmth, relief, and comfort. Women gave feedback that it was pleasing to touch and hold, and appreciated the vagueness of the form. Different women found different ways to hold it, depending on how they thought they would use it.

The final product is envisioned to be encased in silicone, with temperature controls and a charging indicator. For a seamless and hassle-free experience, the massager would be wirelessly charged via an induction charging pad.

Tool #3: Angled vulva mirror

Why is it important to look?

The vulva undergoes traumatic injury during birthgiving, so it is important to monitor healing progress and watch for complications such as pelvic organ prolapse.

It is helpful for a woman to be familiar with her own vulva and listen to her body, so that she can accurately and comfortably communicate any concerns to her doctor. This empowers her to make informed decisions.

After the scars have healed, it is common for women to restore their pelvic strength using Kegel exercises. For beginners, it can be very helpful to use a mirror for visual feedback on whether the exercise is done correctly.

How is it usually done?

Physiotherapists recommend two body positions for examining the vulva: either reclining against a pillow, or standing with one leg up. Physiotherapist Danielle Barratt recommends the standing position for her clients because it is more empowering, and can avoid triggering any trauma responses.

Emotional & physical ergonomics

Many women have an uncomfortable relationship with their sexual anatomy. When asked to examine themselves, they feel like they are doing something shameful. Dedicating a product that is specially designed for the task would help to communicate social permission, and normalize having a close relationship with your body.

Depending on the type of mirror available, examining the vulva can be difficult. The wrist may struggle to hold the mirror in a good position, and the mirror may be too far away to see properly.

Prototyping

In order to be physically comfortable, the mirror would need to have an extended, slightly angled handle.

Part of the challenge was how to unite the whole set of tools and establish visual harmony. i studied the relationships between various shapes, including whether or not the wireless charger should be part of the mirror itself.

Chosen form

The final mirror design has an elegant shape reminiscent of a petal, or an embracing dish. It allows the hand to not only feel comfortable, but look elegant while holding it. The viewing surface is a magnification mirror, allowing details to be shown clearly and examined.

LENA: A celebration of the new postpartum body

Final outcomes

LENA is a postpartum healing kit that bridges the emotional relationship between women and their bodies by encouraging active, mindful gestures of self care.

Each tool is designed facilitate a dialogue between the hand and the body, with attention to the emotional effect of using the tool.

The beautiful, sculptural quality of the set makes it suitable as a bedside piece, and something that a woman could be proud to display, rather than shamefully hide in a drawer. In this way, it is a statement piece that celebrates the new body and new life.

Feedback

Grace, 54 years old, 23 years postpartum

“The breast massager is quite a good idea. Oh actually, the husband can use this to massage your back too right? I like it, it’s so smooth.”

“I never heard of massaging the scar. But maybe I would have used it. Eventually you will get back to sex and you don’t want your husband’s penis to be the first thing in there.”

“II was amazed at how ugly the vulva is. I used to think that the urethra and the vagina were the same opening. But that’s just me.”

“I think visually it is very soothing. It makes you want to pick it up and wonder what it does.
For all you know, it could be a piece of art.”

Mrs. J, 34 years old, 2 months postpartum

“Of all the 3, I would be most interested to use the breast massager. The contours allows you to fit to specific parts of your breast to allow better massage. The heat setting is a good idea because sometimes when I massage my breast with a warm cloth, the heat dissipates as soon as I use it.”

“Overall, the product is aesthetically pleasing, the colours are quite feminine. Because of the curves, it gives me a feeling that this product is gentle (reminds me of the “dove” logo).”

Danielle Barratt, Women’s Physiotherapist

“Your designs and tools are truly fabulous and a huge credit to you. They are user friendly, ergonomic, and tastefully designed. If it progresses to a real prototype - and I hope it does - I’d love to see more! All the best for your presentation.”

Conclusion

LENA is named after the moon, representing feminine energy. But more importantly, it means to bring light into a dark place.

Female sexuality has long been a subject of disgust and taboo; in balancing the visual languages of sensual and maternal, I hope to express that there is a place for sexual wellness even in the most challenging of times.