Various examples of pessaries from different time periods, ranging in construction material from plastic to metal. A pessary is a prosthetic device that can be inserted into the vagina to support its internal structure

Reproductive Designs and the Stories Behind Them: A Review of Designing Motherhood

Today almost all IUDs (intrauterine devices) look like the letter “T,” with arms that slightly droop and a string that dangles from its trunk. When inserted, the arms press against the walls of the uterus to help prevent pregnancy, and the string dangles down into a woman’s vagina as a way to check that the device is properly positioned. The design seems simple enough, and almost so logical that it’s hard to imagine an IUD that looks otherwise. And yet, the IUD has gone through many manifestations since its invention in the early twentieth century. Some models resembled a wiggly line, like a snake doubling in on itself; others almost look like a horseshoe crab with five tiny legs sticking out of each side; yet another looks like a ram’s horns, each side twirling inward to make a spiral. Someone – or perhaps some people – designed each of these IUDs with a specific intent. Sometimes, however, that design has unintentional consequences, like in the case of the Dalkon Shield IUD – the one that looks like a horseshoe crab – which caused pelvic inflammatory disease, a cause of infertility, in thousands of women because the string that hung down into a woman’s vagina allowed bacteria to enter the uterus.

The Designing Motherhood exhibit, currently on display until December 31 at the Mütter Museum in Philadelphia, aims to tell these stories for the first time. As the curatorial statement of this new exhibit explains, “Designing Motherhood invites you to consider why and how we have developed designs to facilitate reproductive health, and to ponder the political, economic, and social implications of how we medicalize reproduction.” The five stories of this exhibit, each on a different aspect of reproduction, give credit, when possible, to the designer of the object on display and narrate the design’s history.

The exhibit occupies one modest room and may be easy to miss because it’s tucked behind the gift shop of the museum. And while the permanent exhibits of the Mütter Museum seem to use every inch of space to showcase skulls and embryos and various medical devices, the Designing Motherhood exhibit looks sparse in comparison because many reproductive objects are small; a case of a dozen IUDs, for example, is not much bigger than a bread box. However, the curators include a thoughtful booklet, also accessible via smartphone, that provides historical background and information about each design. This narrative behind each object is critical to the mission of this exhibit.

A woman is on an exam table with her legs spread and her feet together to form a "diamond" shape.
Page of a booklet which instructs doctors in various approaches to conducting pelvic exams. (Photo by the author. Courtesy of Designing Motherhood, Maternity Care Coalition, and the Mütter Museum)

My favorite story in the exhibit is titled “Exam,” and it considers the pelvic exam, which historically has been designed from the perspective of the medical practitioner. The exhibit includes a display of speculums from a nineteenth-century reproduction of a speculum used in Pompeii around AD 79 to the infamous speculum designed by the nineteenth-century American physician J. Marion Sims, who constructed his device during his experiments on enslaved women with fistulas. Recently, however, feminist, trans, and disability rights activists have pushed for exam tools and practices that consider the patient. Also included in the exhibit is a product of these efforts: a speculum designed more recently by three women to address some of the discomfort of pelvic exams. (Who hasn’t heard a medical practitioner say during a pelvic exam, just before the speculum has been inserted, “it’s going to feel a bit cold . . .”?) The Yona Speculum prototype is made of silicone and will hopefully make pelvic exams more comfortable and less stressful. Unlike previous designers of the speculum, the women who designed this have experienced pelvic exams themselves from the patient side.

In addition to this display of speculums, “Exam” also features “Table Manners: A Guide to the Pelvic Examination for Disabled Women and Health Care Providers,” a booklet published in 1982 by Planned Parenthood that was written by two physically disabled women, Susan Ferreya and Katrine Hughes, and illustrated by Anne Walzer. The booklet gives medical practitioners advice about how to perform pelvic exams for women with different disabilities by carefully explaining why some positions may work better than others, and it emphasizes giving women with disabilities options to address varying levels of comfort with the exam. It’s also a reminder that a pelvic exam, which most often asks people to lie on their backs with their feet in stirrups – a rather vulnerable position – doesn’t have to be that way. The booklet’s display calls attention to how even things like exams, and the printed materials medical practitioners use to learn about these exams, have a design and a design history.

A metal nipple-shaped cone
19th-century nipple shield. (Wellcome Collection)

The other four stories in the exhibit are titled “Means of Reproduction,” which include the aforementioned IUDs, “Midwives,” “Parturition,” or childbirth, featuring a large collection of pessaries – some of which are horrifying to picture inside anyone – and finally “Milk,” where a collection of nipple shields and breast milk pumps from different eras are displayed. The earliest breast pump exhibited is the Phenix Breast Pump, thought to be from 1879. It’s a hand pump made of glass and rubber, and looking at it now, it’s hard to imagine it being very efficient at extracting milk.

The story on “Milk” exemplifies the exhibit’s groundbreaking approach to showcasing design. The breast pump, in particular, emphasizes the need to bring more attention to how reproductive products and practices are designed. When I went back to work after each of my kids was born, the thing I dreaded most was pumping. While I eventually learned to navigate my pump’s tubes, valves, switches, and bottles, the machine seemed daunting when I first unpackaged it. By displaying a series of breast pumps from several eras, the Designing Motherhood exhibit subtly suggests to museumgoers that perhaps pumping milk doesn’t have to be an overwhelming, annoying, sometimes even humiliating experience. (Have you ever had someone walk in on you while you’re pumping milk? Or knock on the closed door you’re hiding behind, hoping it conceals – but probably doesn’t – the thumping noises of your pump?) Someone designed that pump, and when they designed it, they likely didn’t give much consideration for the woman’s experience while using it.

While we might often discuss design in terms of furniture or cars or kitchenware – all objects regularly displayed in museums – this exhibit points out to us that the products of motherhood have a design that deserves to be recognized as well. Why have the breast pump, the speculum, or a child’s stroller rarely been given space in museums? And while sometimes these designs might be displayed for how much discomfort or annoyance they caused the people using them – like the first enormous metallic breast pumps that look like torture devices – at other times, we should be able to visit museums that celebrate cutting-edge designs like the new Willow Breast Pump, which in 2017 reenvisioned how a pump could work with a woman’s comfort and ease in mind. Designing Motherhood rectifies the omission of these objects from the sanctified space of the museum.

The Designing Motherhood exhibit at the Mütter Museum is part of a collaborative effort that started on Instagram and will be released this fall as a book by Michelle Millar Fisher and Amber Winick with the same name. This September, an expanded exhibit will open at the Philadelphia Center for Architecture and Design. While the exhibit at the Mütter Museum is worth visiting if you’re in Philadelphia already, I recommend waiting until the larger exhibit opens this fall if you’re planning to make a special trip. That’s where the curators are planning to take us on a more comprehensive tour of the designs – and the stories behind those designs – that compose our reproductive lives.

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