Care-in-Retrograde: Designing for Reproductive Health in the Aftermath of Roe.

Paper Title

Care-in-Retrograde: Designing for Reproductive Health in the Aftermath of Roe

Publication Info

• Topic area: Designing technologies for reproductive health in a post-Roe v. Wade context.
• Keywords: Reproductive health, abortion care, intimate care technologies, technofeminism, co-design, privacy, stigma, healthcare infrastructure, sociotechnical relations, feminist HCI.

Background and Problem

• Problem / challenge: The overturning of Roe v. Wade has created a fragmented and inequitable landscape for abortion access in the U.S., with significant legal, financial, and logistical barriers. Existing health technologies are insufficiently designed to address the complexities of this new reality.
• Significance: Abortion care is essential for reproductive justice and bodily autonomy. Designing technologies that address these challenges is critical to improving access, reducing stigma, and supporting vulnerable populations.
• Motivation and related work: Prior HCI research has explored intimate care technologies for pregnancy, menstruation, and fertility but has largely overlooked abortion care. Emerging studies highlight the dual role of technology in facilitating access and enabling surveillance, underscoring the need for privacy-sensitive and context-aware design.

Solution

• Proposed approach: The concept of care-in-retrograde, which reorients health technology design to address the sociotechnical complexities and political disruptions of abortion care in a post-Roe landscape.
• Novelty:
  1. Introduction of care-in-retrograde as a sensitizing concept for designing health technologies amid political and medical reversals.
  2. Use of co-design workshops to capture diverse perspectives from states with contrasting abortion laws (Indiana and New York).
  3. Emphasis on designing for infrastructural relations that extend beyond individual users to include broader networks of care.
  4. Integration of technofeminist theories to critically reflect on the dual role of technology in empowerment and surveillance.
• Procedure and key techniques:
  • Conducted co-design workshops with 16 participants from Indiana (restrictive abortion laws) and New York (accessible abortion laws).
  • Used cultural probes, including "care letters" derived from Reddit posts, to elicit participant reflections on abortion care experiences.
  • Facilitated activities to define non-negotiable design principles and envision future abortion care technologies.
  • Thematic analysis of workshop data informed by technofeminist scholarship.

Results

• Concrete findings:
  • Participants identified stigma, privacy, and access as critical barriers to abortion care.
  • Proposed design solutions included "safe havens" for judgment-free care, privacy-focused technologies, and holistic support systems addressing emotional, legal, and medical needs.
  • Participants emphasized the need for technologies that foster community support and counter stigma.
• Advantage over baselines:
  • Highlights the inadequacy of existing health technologies in addressing the sociopolitical and emotional complexities of abortion care.
  • Proposes a novel framework (care-in-retrograde) for designing technologies that respond to disrupted healthcare infrastructures.
• Experiments / evaluation:
  • Workshops conducted with 16 participants (9 from Indiana, 7 from New York) representing diverse racial and cultural backgrounds.
  • Activities included reading care letters, defining non-negotiable principles, and ideating future technologies.
  • Data analyzed through iterative thematic analysis and informed by technofeminist theories.
• Limitations and future work:
  • Participant pool was self-selective and homogeneous in educational background, limiting generalizability.
  • Focused on women’s experiences, excluding other gender identities.
  • Future work should explore broader socioeconomic contexts, diverse cultural perspectives, and the intersection of reproductive health with other marginalized identities.

Summary

This paper investigates how women in the U.S. conceptualize abortion care technologies in the aftermath of Roe v. Wade. Through co-design workshops in Indiana and New York, the study reveals the sociotechnical complexities of abortion care, including stigma, privacy concerns, and infrastructural breakdowns. The authors propose care-in-retrograde as a framework for designing health technologies that address these challenges, emphasizing holistic, privacy-sensitive, and community-integrated solutions. This work contributes to HCI by expanding the design space of intimate care technologies and offering critical reflections on designing for reproductive health amid political and medical disruptions.