Delivering Kindness Through Kindred: Here’s how Victoria Ayo plans to connect doulas to mothers and mothers-to-be.

“I wanted to touch systemic change as well as solutions that empower women individually to seek support. Because, ultimately, the pregnancies that are highly supported are usually more successful.”

Victoria Ayo is the founder of Kindred, a first of its kind pregnancy care app that brings a virtual doula to any pregnant woman for a low monthly cost. A Product Designer at Spotify by day and designer-in-health by night, Ayo discusses her work with design and health, black women’s maternal health outcomes, and her personal experiences navigating healthcare in the US vs. Sweden.

Sri Narasimhan: Could you tell me more about yourself and how you got started in design in health?

Victoria Ayo: My intro into design was also an introduction to design in healthcare. I attended undergrad at Georgia Tech in Atlanta and majored in computer science before deciding that it just wasn’t for me. I enjoyed working with people and creating things that were really solving problems for them, and I realized I could make a career out of that when I took my first Human-Computer Interaction class. We designed solutions for users with specific needs, like users with certain impairments. That was super interesting to me — it’s something that I had never really done before, at least in the formal sense.

Growing up in New York, I was quite crafty. I was also the oldest of my siblings with two working parents, tinkering with things all the time and trying to solve my own problems in any way that I could. Getting to unlock that side of me in my HCI class pushed me to change my focus to interaction design.

After that, I started working with a postdoc designer on ways design can help create healthy eating patterns and habits for at risk youth, especially minority youth in the Atlanta area. She was developing a platform that would encourage youth to question their eating decisions and the advertisements they saw from fast food companies. That was when I really saw design in action, and how technology could be used as a force for good in healthcare.

I then graduated from Georgia tech and worked in UX design, before going on to graduate school and making maternal mortality and maternal health the focal point of my thesis.

SN: Could you tell me more about your graduate thesis and your subsequent work with maternal health? How did you get started with that?

VA: That project was initially going to be about my personal challenges with the healthcare system. I’d always been someone who didn’t like going to the doctor’s office. I had what they call “white coat hypertension”, where your blood pressure goes up if you go to the doctor. What I really wanted to know was, “Am I alone in this?” So my thesis was about black women in the healthcare system and if my experiences were shared with them.

I ran a participatory design session with black women, thinking about how their relationships with their bodies were shaped by the medical system at large. One issue that kept coming up was the fear of having children in this country, and what that would mean for your livelihood, or your life. That changed the entire course of my project, essentially. I was living in New York City at the time, a place with pretty large health disparities in general. But when thinking about black women and their maternal health, the numbers were not uplifting.

The great thing about being in New York was that I got a bird’s eye view of the medical system, grassroots organizations, and the midwives and doulas in action, all acting in the system. This helped inform my design propositions — I wanted to touch systemic change as well as solutions that empower women individually to seek support. Because, ultimately, the pregnancies that are highly supported are usually more successful.

SN: So that’s what led you to found Kindred and focus on the whole doula aspect of the system?

VA: Right. I really wanted to figure out how we can address barriers to equitable health care in ways that were scalable and attainable for all women. You do need a support system, but not every woman is able to afford a doula in a traditional sense. Also, not everyone is interested in a traditional doula. And also, just the fact that not everyone is aware of their resources.

I wanted to make something portable — something you can carry around (because it’s on your mobile phone) that would always be with you. Something reassuring that allows you access to someone who cares about you, even if you’re going through a pregnancy without a traditional support system. As long as you have just one person in your corner, you have an army of people ready to fight for you and support you throughout your pregnancy. So the biggest thing was making this truly accessible to all mothers and mothers-to-be.

SN: What do you think is the biggest challenge when working in this part of the system? When thinking about doulas, where do you anticipate black mothers facing the most friction in other parts of the process?

VA: There are a few places. The first is the lack of awareness of options in your pregnancy journey. The data shows that black women seek care a lot later than their counterparts. And a lot of times that could be because they’re working, or scared, they don’t have a support system, or they don’t want people to know what’s going on with them.

Another problem I saw in my research is that women often don’t feel like they have an advocate in the doctor’s office. They mostly assume the doctor knows best, but they also know their bodies best because they’re living in it. This is more of a wicked problem to tackle because it’s systemic. We all have unconscious biases, and we don’t always know it. But it’s about informing the medical system of these unconscious biases before black women seek care. And this kind of has to do with my final point: that there just aren’t enough medical personnel or workers that look like black women. The numbers are increasing, but data has shown that when people of color have healthcare providers who are of the same ethnic background, they’re more likely to seek care and have better long-term health outcomes. So those are three issues at work that are systemic, environmental, and personal that cause friction, outside of doulas.

SN: Yeah, definitely. It feels like the design industry has, a lot of the times, addressed issues by coming up with a cool gadget, but the systemic issues are still not tackled.

VA: Exactly. And it’s only until hours of mapping, after hours of interviews and discussions with real people and subject matter experts that you start to connect these dots. And you can try to address the low hanging fruit as you can. Like pregnancy tests could work, but it only gets you so far if by the time you do seek care, you still end up with complications. It’s very wicked, but I’m hopeful because healthcare design is starting to become more recognized. I think there’s a lot of opportunity there.

SN: Where do you see Kindred going?

VA: I don’t have any expectations. I feel like no matter what, success to me means inspiring even just one person to do something with this work. If someone sees this, and they see an opportunity to even improve on it, that would be amazing. Because at the end of the day, my goal is to see more women thriving and more women going to the hospital to give birth and coming home with their babies. I would just be remiss to hold all of that to myself. So I try to get as much support for this as possible. I think about where I can collaborate, who I can collaborate with, and if I can secure funding for this. It’s been put on the back burner a bit because of my 9–5 and my personal life, but the idea isn’t going anywhere. The more people know about it, the more we can collaborate and make an impact.

SN: So what is it like going from your 9–5 to thinking about issues like this?

VA: Yeah, it’s not that bad. It’s hard because of the time difference, but I’m lucky to work for a company that really supports what I did. It’s interesting living in Sweden, because it’s a socialized country.

My first healthcare experience here was this past week. I went to the OB/GYN to get birth control for the first time here, and I was recommended to a midwife, which would have never happened in the States. It was incredibly easy just to do something for my sexual wellness, which would have been a hassle in the States, and not to mention, expensive. It was free here! Imagine that, as opposed to getting an appointment once a year and fighting to get another one if for some reason you don’t feel right.

Living here and having this experience of what’s possible really only helps me with what I want to do with Kindred as well. I’d like to take what I’ve learned and experienced in Sweden and at Spotify with me and apply it to my own company. And I really want to make that company healthcare and design focused.

SN: I love that. And it’s so cool that you live in Sweden and get to navigate their healthcare process and get those experiences yourself.

VA: I know! I was shocked because I called to schedule an appointment, expecting a three month wait. But I got an appointment for the next week. I was expecting to get there and wait hours in the waiting room, but they called me in right away, and prescribed me what I needed. And then the doctor said, “come back in three months, and we’ll see how this is affecting you.” I just thought, “This is amazing.”

Obviously, Sweden’s smaller than the US, but seeing what’s possible just helps us dream more as designers. Because that’s what we do, that’s our profession. We’re like, professional dreamers. We just have to see what things are like now and ask, “What could this really be?” And we need those people in society.