Log in or create a free Rosenverse account to watch this video.
Log in Create free account100s 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
This video is featured in the Systems Thinking playlist.
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."
Or choose a question:
More Videos
"An elite athlete doesn’t turn up at the Olympics and do their thing without coaches, physios, nutritionists."
Dr. Karl JeffriesThe Science of Creativity for DesignOps
January 8, 2024
"We often don’t prototype everything ourselves; instead, we role play with client team members to simulate complex organizational aspects."
Milan Guenther Benjamin KumpfThe $212 billion ‘so what?’: unlocking impact in development cooperation
November 20, 2025
"To maintain tagging and freshness, you need content PMs with expertise, supported by robust content management processes."
Ben Davies Matt Duignan Andrew Michael Dr. Emily DiLeoExpert Panel: The Principles of Research Repository Design
March 11, 2022
"We had an engineering culture that confused uniformity with design, and consistency with design."
Phil GilbertA Consistent Culture of Design
May 14, 2015
"Qualitative researchers can help design better human-in-the-loop evaluation guidelines that consider social context."
Prayag Narula Rida QadriHCI 2.0: Humanity Deserves the Attention that UX Research has to Offer
March 28, 2023
"Sometimes research becomes the defacto 'talk to a customer' group, which can distance others from direct customer contact."
Ned Dwyer Emily Stewart James WallisThe Intersection of Design and ResearchOps
September 24, 2024
"Everything is an experiment."
Erin WeigelReal-world lessons to improve your conversion rates
June 26, 2024
"You cannot design for the middle; instead, you must create experiences that are customizable and adaptable."
Samuel ProulxFrom Standards to Innovation: Why Inclusive Design Wins
November 19, 2025
"Pro-social gaming is about designing for positive social interactions that contribute to thriving communities."
Cheryl PlatzEmbrace Your Fun Factor: Game Development Best Practices for Product Design
January 9, 2026
