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Paperless Pregnancies: Access to prenatal healthcare for undocumented migrants

Paperless Pregnancies is a project about improving access to prenatal healthcare for women without a residence permit – undocumented migrants. In the Netherlands, this marginalised group is highly at risk of adverse perinatal outcomes, like preterm birth and perinatal death. Even though these women are excluded from all citizen rights like having health insurance, by law they have the right to receive prenatal care. In reality, undocumented migrants start prenatal care late – an essential factor in higher pregnancy risks.  Paperless Pregnancies provides information to migrant women to give them timely access to prenatal care. The tool helps them navigate the Dutch prenatal care system and educates them about their healthcare rights.

“Immersing myself between the undocumented mothers led to far richer insights than any conventional user research could have provided.”
Demi Jansen

To understand the women’s situation and needs, Demi worked as a volunteer for four months at the Worldhouse, an aid organisation for undocumented people in Amsterdam. She volunteered at the support group for undocumented mothers and children, which allowed her to build trust and learn about their personal stories and struggles. Based on this experience, combined with insights from aid and medical professionals, she developed Paperless Pregnancies.

Undocumented people are often unable to access healthcare directly but rely on finding aid or medical practitioners to act as a mediator. Paperless Pregnancies provides a digital platform that guides women to the best practitioner for their situation. Moreover, it provides information kits about the prenatal care system and healthcare rights tailored to different situations like NGOs, shelters or public spaces.

“Although this design cannot change a larger power structure, it can give women the tools to better navigate a system that was not made for them.”
Demi Jansen

The treatment and rights of migrants remains a much-disputed topic, one that has been reignited with the reception of Ukrainian refugees and the recent overflows seen at the registration centre for asylum seekers. Where the current Dutch political agenda is shaped to discourage asylum seekers, Paperless Pregnancies favours the wellbeing and health of women over their status. Although this design can not change the system or policies that undocumented migrants are subject to, it can support undocumented women in making the most of the aid and rights they are entitled to.

“To design for ecosystems, I needed a solution that fits and utilises the already existing network in order for it to become durable.”
Demi Jansen
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