A story that inspired me to move to the UX Design (Part 1)
There were several stories that led me to change my career and become a UX Designer. This was the very first one that ignited my interest in the field.
It is a story of how American medical scientists introduced the first oral birth control pill for women called Enovid, and how the packaging design of this pill completely changed several pharmaceutical practices and lives of countless women.
Enovid was introduced in 1960. And like all prescription drugs at the time the pill was packaged in a simple glass bottle of loose tablets. There were small and large bottles, containing 50 and 100 pills respectively.
The first birth control pill, Enovid, by G.D. Searle, from 1960. The Percy Skuy Collection, Dittrick Medical History Center, Case Western Reserve University. Photo by Carrie Eisert.
The manual said: take one pill every day for twenty days, starting on the fifth day of the period, and then give it a five-day break for menstruation. Sounds easy. To take control over when and if to start a family, a woman just needed to follow the schedule.
The trouble was that pharmaceutical companies at that time treated patients as perfect receivers of the medicine and did not think about the way the patient interacts with the drug. The user research didn’t go further than was medically necessary, which is to prove that the benefits of the drug outweigh its known and potential risks. So once the benefits have been proven and the manual written, the job was considered done. The companies didn’t account for how the pill fits into daily lives of the women, what surrounds them, what they think and feel before, during, and after they take the pill.
If they had done that, this is what they would have found out.
Imagine a busy married woman (the pill was initially prescribed only to married women), say a mother of 4 - fairly typical at that time - and her daily life. Managing a house full of kids means chaos most of the time. Remembering to take a pill every day for 20 days at the same time of the day and then taking exactly 5 days break is anything but “easy”.
If a woman lost track of her cycle or forgot whether she already had taken the pill on that day, she was instructed to take all the pills out of the bottle, calculate how many are left, subtract it from the original total and check the calendar. The initial total of 50 or 100 pills in the bottle was not helping the matters. This provided a lot of room for error and brought much of a concern to married couples. If a woman misses the pill, she might become pregnant again.
One of those concerned couples were Doris and David Wagner from Illinois. After having four children the Wagners decided it was time for birth control. So Doris, started taking Enovid. Her husband David was surprised to see his wife often confused about the drug, counting and recounting her pills. It was supposed to be the easy solution.
At this point, if the pharmaceutical companies would have come across this scenario, they would have probably thought that the patient simply was’t capable enough to follow the instruction. However, David saw that it was not his wife, but the glass bottle with loose pills that cased the confusion. He was concerned with Doris mixing the pill schedule as much as she was, and wanted to help her have a peace of mind.
With a mechanical engineering background, he came up with a system that would simplify the pill-taking process, created six prototypes and tested them with his wife. Some failed, but after several improvements he made something that worked. In August 1964, almost four years after the pill was introduced, David received a patent for his invention and soon after came to the pharmaceuticals with the proposal.
Medication dispensing means, patent US 3143207 A (1954 D. P. WAGNER)
Initially, none of the companies he approached took his idea on board seeing it as gimmicky and flashy. But eventually it became the norm across the industry and it is followed by most brands of birth control pills to this day.
The main idea was to organise the total supply into the daily doses, so a woman could immediately see when was the last day she took the pill. Wagner used three plastic disks: The bottom one displays the day of the week, the middle one holds 20 pills and rotates to match the first day of the current pill taking cycle, and the top one works as a lid with a single hole for taking out the pill. The round shape also reminds us of the meaning of cycle - a series of events that are regularly repeated in the same order.
Original prototype, 1962. Wagner Collection, Division of Medicine and Science, National Museum of American History, Smithsonian Institution. Photo by Carrie Eisert.
With such design taking the pill and keeping track became a much more intuitive process. Doris not only can immediately see when was the last day she took the pill, but is also able to customise this device for her next cycle, rotating the middle part. Speaking in UX language, the end-users now has a more controlled experience with less room for error.
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When I first learned this story (on the wonderful 99 Percent Invisible podcast), the main fascination for me was that finding a solution to a problem is only part of the story. One also has to design it in a way that would work. With Enovid, pharmaceutical companies introduced a scientific solution to a societal problem. But it was Wagner’s design that actually made taking the pill so easy to use and seamlessly fit in the daily lives of so many different women.
As I would later learn, these two halves of the story together make the famous UX double diamond: One first finds the right thing to design, and then designs it right.
But this is not where the story ends. Wagner’s design didn’t just help women stay on track and have a peace of mind. It also had a huge effect on changing cultural norms and stigmas about contraception and drugs in general! I will tell you more in Part 2 of this post.