J. Marion Sims has been known as the “father of gynecology” for centuries. Now, four San Francisco-based designers are hoping to change that.
About a year ago, Hailey Stewart went for a pelvic examination. A few days later, her co-worker Sahana Kumar had a pelvic examination. And while this routine exam that affects half the population is not openly talked about a whole lot, Stewart had such an uncomfortable experience that she decided to bring it up with Kumar that week.
Everything from the crinkly paper gown she wore to the insertion of a cold, loud, metal vaginal speculum made Stewart uneasy, and Kumar felt the same way about her exam.
Both Stewart and Kumar had just wrapped up client projects at their company, frog design, and they had a few weeks before they both began their next client project. So, Stewart, an industrial designer, and Kumar, an experience designer, teamed up to see if other women felt as strongly as they did that the pelvic exam needed a redesign.
After conducting a mini-research project, in which they interviewed both patients and providers of pelvic exams about their experiences, Stewart and Kumar found that almost everyone felt the same way they did about pelvic exams: anxious. And especially anxious about the vaginal speculum.
Stewart and Kumar shared their findings with co-workers Rachel Hobart, a visual designer, and Fran Wang, a mechanical engineer. Together, Stewart, Kumar, Hobart and Wang named their project yona, which Hobart says is a combination of “yonic” and “vagina,” and the four of them started working on it in their free time.
The more they researched, the more “egregiously shocked and angered at the incredibly dark history behind [the speculum] that none of us knew about,” Wang says. The dark history that Wang is referring to is largely tied to Sims.
Sims is credited for inventing the design of the speculum in the mid-19th century. His practices, however, raised disturbing ethical questions. He’s said to have performed gynecological procedures on enslaved black women without anesthesia or their consent. Despite his concerning legacy, his speculum design has largely been unchanged. “It’s really just abominable that it’s still being used in exam rooms today,” Kumar says.
Wang and the rest of the Yona team came up with a speculum redesign that would be more user and patient friendly. One of the biggest differences is the auditory experience. The speculum that’s used in most exam rooms is two-billed and metal, meaning that when it’s opened for size, it often makes a ratcheting noise. The new speculum is covered in surgical silicone, and instead of a two-billed device, has three leaves that would gently open, with no audible ratcheting.
The Yona team isn’t the first to think of redesigning the speculum. Other companies like FemSuite and Doctors Research Group Inc. have redesigned the speculum, but their designs never went anywhere, reportedly due to unwillingness of doctors to adopt new practices.
Though Kumar knows the medical industry is a hard one to disrupt, she argues that Yona’s redesign is really not asking doctors to adopt new practices, rather to improve existing ones. Yona’s speculum redesign is still in the prototype phase, and hasn’t been implemented in exam rooms yet, but they’ve received encouraging feedback from the reproductive health community.
Lisa Jongewaard, the lead clinician for the San Francisco Planned Parenthood clinic, says that when the Yona team showed her a prototype of the new speculum she was ecstatic. Not only is it more patient-friendly, but Jongewaard says that there are a lot of benefits for the health provider as well. In her daily practice, she says that there is a certain way she has to hold the speculum in order not to pinch the patient’s labia. After experimenting with Yona’s speculum prototype though, Jongewaard thinks it would be almost impossible to pinch a patient’s labia.
“Having that as part of the design going into the pelvic exam — thinking of a woman’s comfort — is pretty novel and wonderful that we’re finally looking at that,” Jongewaard says. “It’s super exciting to see young women who are just passionate about women’s health and reproductive health.”
While Yona remains very much a passion project — Kumar, Stewart, Hobart, and Wang work on it evenings and weekends — they envision a future in which gynecology doesn’t have a “father” anymore. Instead, gynecological tools and practices will be designed by, and for, people that actually have vaginas.