Rosenverse

Log in or create a free Rosenverse account to watch this video.

Log in Create free account

100s of community videos are available to free members. Conference talks are generally available to Gold members.

Systems Thinking and Design Innovation: Working with Leverage Points in Rural Maternal Health Systems

Friday, April 17, 2026 • Rosenfeld Community

This video is featured in the Systems Thinking playlist.

Share the love for this talk
Systems Thinking and Design Innovation: Working with Leverage Points in Rural Maternal Health Systems
Speakers: Meghan Bausone
Link:

Summary

Are some problems too wicked, complex, and systemic for designers to solve? The United States is experiencing a maternal health crisis—with the highest maternal mortality rate among high-income nations globally and an expanding number of counties being deemed "maternity care deserts" or areas without obstetrical services. These failures are disproportionately impacting Black and Indigenous communities, especially in rural areas. In this presentation, Meghan will share research that applies systems thinking to first-hand accounts from maternal health stakeholders to identify leverage points for design innovation. Meghan will break down leverage points using Donella Meadows' framework and discuss the power of her ultimate leverage point — paradigm shifts.

Key Insights

  • The US has the highest maternal mortality among high-income nations, especially impacting Black and Indigenous communities.

  • Maternity care deserts disproportionately affect rural areas, with nearly half of US counties lacking obstetric care.

  • A systemic paradigm shift is needed from technocratic to more holistic maternal health models.

  • Financial barriers like low reimbursement and costly malpractice insurance threaten birth centers’ viability.

  • Rapid labor unit closures create urgent access crises for pregnant people in rural regions.

  • Managerialism and profit-driven goals conflict with maternal safety and compassionate care.

  • Information flow, including transparency of hospital closures and costs, is a crucial leverage point for systemic improvement.

  • Community resilience and self-organization are key structural factors for rebuilding maternal health systems.

  • Pragmatic pluralism exists in maternal health paradigms; multiple belief systems coexist with tension but no clear dominant shift.

  • Design opportunities include supporting grassroots initiatives, improving data communication, and redefining system boundaries beyond hospitals.

Notable Quotes

"The US has the highest maternal mortality rate among high-income nations in the world."

"Birth centers would be replicable if reimbursement structures were adequate, but they can't survive without payment."

"What does a hysterectomy cost? $2,000, $13,000, or $40,000? It depends who you ask and who pays."

"Managerialism justifies one size fits all efficiency techniques that increase burnout and diminish professional authority."

"Paradigm shifts depend on how a problem is described and who controls the narratives and beliefs."

"Where big corporations don't want to bother, little seeds can sprout in maternal health."

"Systems that can self-organize are the strongest form of resilience."

"Maternal health is embedded within a healthcare industry prioritizing cost control, risk management, and standardization, not maternal safety."

"Information flow distortion compounds dysfunction in the system over time."

"The dominant technocratic paradigm under managerialism may be incompatible with rural maternal health needs."

Ask the Rosenbot
Victor M. Gonzalez
Practicing Learners and Learning Practitioners
2021 • Advancing Research 2021
Gold
Sohit Karol
Designing Delightful Listening Experiences: Mixed Methods Research in the Age of Machine Learning
2020 • Advancing Research 2020
Gold
Alana Washington
Theme 1: Introduction and Provocation
2024 • DesignOps Summit 2020
Gold
Sara Conklin
Exit Interview: 20 Years of Tech, One Very Big Bet, and a Lot of Heat Pumps
2026 • Rosenfeld Community
Alana Washington
Theme 3 Intro
2021 • DesignOps Summit 2021
Gold
Brigette Metzler
Research Repositories: A global project by the ResearchOps Community
2020 • Advancing Research Community
Yulya Besplemennova
[Demo] Stress-testing GenAI in user research synthesis
2024 • Designing with AI 2024
Gold
Sarah Coyle
Design and Analytics with Sarah Coyle
2020 • DesignOps Community
Lija Hogan
Contexts of Use: A Framework for Connection
2021 • Civic Design 2021
Gold
Jane Reid
Self-care in User Research
2020 • Advancing Research Community
Jacqui Frey
Panel Discussion: Integrating DesignOps
2018 • DesignOps Summit 2018
Gold
Panel Discussion: Communicating the Value of DesignOps
2018 • DesignOps Summit 2018
Gold
Uday Gajendar
The Wicked Craft of Enterprise UX
2015 • Enterprise UX 2015
Gold
Mark Interrante
AI for Prioritization (3rd of 3 seminars)
2024 • Rosenfeld Community
Carla Casariego
DesignOps in Wonderland
2019 • DesignOps Summit 2019
Gold
Nathan Shedroff
Double Your Mileage: Use Your Research Strategically
2020 • Advancing Research 2020
Gold

More Videos

Jane Reid

"We prepare intensively for the logistics and safety of participants but rarely prepare ourselves for the emotional impacts."

Jane Reid Janice Hannaway

Self-care in User Research

April 2, 2020

Andrea Gallagher

"Data repositories often fail because of the complexity in cataloging and who can access the information."

Andrea Gallagher

The Problem Space

May 16, 2019

Christian Crumlish

"Data can be seductive, but focusing only on clicks risks sacrificing the user perspective."

Christian Crumlish Aditi Ruiz Johanna Kollmann Catt Small

Morning Insights Panel

December 6, 2022

John Devanney

"A well-framed project brief creates opportunities for creativity and better leadership alignment."

John Devanney

The Design Management Office

November 6, 2017

Husani Oakley

"When I walked into the office, my team was ready to quit because they were taking rude user emails personally."

Husani Oakley

Bias Towards Action: Building Teams that Build Work

June 14, 2018

Jen Crim

"Our offices have stand-up desks, nice collaboration areas, and comfy seating with a fresh, on-brand look."

Jen Crim Jess Quittner Saritha Kattekola Alex Karr Gurbani Pahwa

Culture, DIBS & Recruiting

June 11, 2021

Bria Alexander

"Respect and kindness are mandatory; please read our code of conduct to ensure a positive community experience."

Bria Alexander

Opening Remarks

September 9, 2022

Meredith Black

"Design always has a seat at the table at Pinterest because our co-founder is a designer."

Meredith Black

Scaling Design Culture

November 6, 2017

Tricia Wang

"Every culture has things to celebrate and improve upon; we should learn from others instead of imposing our own standards."

Tricia Wang

SCALE: Discussion

June 15, 2018