The FemTech industry, or female health technology, is experiencing exponential growth worldwide, with an estimated $1 billion of investment in the last 3 years. Dozens of period tracking apps are now available, with apps now being developed to also act as contraception. Yes, there are now iPhone apps claiming to replace all forms of hormonal contraception - but how accurately can an app prevent pregnancy?
The method being promoted by these apps is the fertility awareness method (FAM), or natural family planning (NFP). This involves documenting a range of factors and symptoms in order to establish when someone is fertile and able to fall pregnant. Then, on fertile days, choosing to either abstain from sex or use barrier protection (such as condoms).
Women have practiced this method for centuries, but with the availability of medical contraception, barrier protection and sexual education, it is widely known methods such as “withdrawal” and other “natural” techniques are nowhere near as effective.
However, alongside the growth of the FemTech industry is a growing wave of younger women seeking non-hormonal contraception, and there is now a revival of tracking one’s cycle to avoid pregnancy.
There are many reasons behind these women gravitating towards an app to replace contraception - the most common one being to avoid the side effects of medication. Evidence shows women typically choose a birth control option with the least amount of bad side effects, and with the promise of eliminating them, it’s no surprise more people are interested in using a FAM app.
This growing trend should be a concern, as the FAM method is the second least effective method of contraception, with a failure rate of 24% according to World Health Organisation data. That’s 24 women unintentionally falling pregnant out of 100 in the first year of using the fertility awareness method. For perspective, an implant (such as Implanon) is 0.05% in the first year - the most effective method.
In a Stockholm hospital, Sweden, 5.5% of women presenting for abortions stated they fell pregnant while using the top Swedish fertility app Natural Cycles. That’s just one hospital in one city.
In fact, one of the cofounders of the app claimed its ideal user is “a woman in a stable relationship who is planning to have children at some point, and who would like a break from hormonal contraception ahead of trying” - not someone wanting to avoid pregnancy entirely.
Despite this, Natural Cycles was approved as a form of contraception across Europe, with the United States also recently approving the app.
With the high failure rate of the fertility awareness method, should it be presented as a reliable form of contraception?
No form of contraception is 100% effective, but the margin for human error in the fertility awareness method is extremely high. Natural Cycles claims even with imperfect use, the method is still 93% effective, compared to the contraceptive pill at 91% with imperfect use. This is often quoted by the company, but it’s important to remember unlike the pill, the user is not protected every day of the month. Furthermore, in the early months of use, the app is still “getting to know you”, having little data to accurately predict your fertile windows.
Essentially, this 93% effectiveness statistic is questionable when taking other factors into account.
Finding the right method of birth control for you is dependent on many factors, and should be chosen with the guidance of a medical professional. If you’d like to read up on your options (including the FAM) before speaking to your doctor, a great resource is the Jean Hailes contraception guide.
References:
https://medicalxpress.com/news/2019-07-fertility-apps.html:
https://www.theguardian.com/society/2018/jul/21/colossally-naive-backlash-birth-control-app:
https://time.com/5365564/fertility-apps-contraception/
https://www.wired.com/story/natural-cycles-contraceptive-apps/
https://theconversation.com/an-app-to-prevent-pregnancy-dont-count-on-it-119922