HASTAC 2023 Conference

Since 2019, the maternal mortality rate in the United States has increased by more than 15%, according to the CDC. While the number of women that die during or after childbirth has fallen globally in recent decades, it has nearly doubled in the U.S. since 1987. In Arkansas, the maternal death rate is one of the highest in the nation. Arkansas also ranks fourth among states where a majority of women live in a maternal healthcare desert, with 37 counties that do not have a single OB/GYN. Furthermore, Arkansas has the highest teen pregnancy rate in the country and, since the Dobbs decision in June 2022, the fourth toughest anti-abortion laws in the country. The lack of access to providers coupled with laws that lead to forced birth have created a complex crisis of reproductive justice in the state.

Understanding the crisis of maternal health in the United States is difficult due to a lack of data, as well as a lack of access to data, because there is no national system for tracking maternal health issues. Funded by a federal legislative proposal, the Arkansas Maternal Mortality Review Committee published findings in 2020 citing a distinct lack of data in the state as a key barrier to improving outcomes. In Arkansas, another significant challenge is the disparate and disconnected nature of birth worker communities. The experiences and perspectives of stakeholders vary widely, and there is a lack of collective understanding of the roots of problems or possible solutions.

In 2022, we teamed up with a group of researchers with backgrounds in nursing, business and design to generate community-led design approaches in addressing the maternal health crisis. Inspired by the 2014 "Make the Breast Pump Not Suck!" Hackathon at the MIT Media Lab, we hosted the Arkansas Maternal Health Community Hackathon. Traditionally, hackathons are multi-day events attended by multidisciplinary professionals, such as programmers, designers, and engineers. While hackathons are rooted in patriarchal tech culture, feminist researchers and designers have recently co-opted them as participatory spaces for social change. With an emphasis on relationship-building and care, feminist hackathons lay the groundwork for a plurality of community-led solutions to complex problems that are equitable, sustainable, and inclusive.

The Arkansas Maternal Health Community Hackathon was a one-day event that brought participants from across the state together to identify the root causes of the maternal health crisis and generate actionable visions for change. Attendees included parents of all genders, birth workers, nurses, doctors, midwives, doulas, public health experts, legal experts, policymakers, journalists, designers and artists. With support through facilitated activities and an on-site makerspace, participants formed teams to address specific problems related to maternal and infant health. This long paper presentation will address the planning, execution, outcomes and impact of the hackathon, as well as implications for future community-led design initiatives. With the feminist hackathon as a guide, we propose a model for participatory design with diverse communities to build coalitions in the uphill battle toward reproductive justice in the South.