Recently, the British Medical Journal published a study using self-reported data from women who had opted to get an abortion.
It found a “shift” towards increased use of “fertility awareness-based methods” of contraception, like tracking your period on an app and avoiding sex on the days the app tells you is your “fertile period”, among participants.
The topic of fertility awareness-based methods, which may include the use of apps, have certainly performed well on social media sites.
But Alice Felton, CEO and founder of sexual and reproductive health company The Lowdown, doesn’t think this data is as straightforward as it can sometimes be presented.
On LinkedIn, she stated some issues she had with the way the information is being shared, stressing that among other issues, the real “shift” was not the small but notable uptick in women using fertility tracking methods as contraception (up 1.1%), but rather the far sharper rise of women eschewing any contraception at all (up 14%).
So, HuffPost UK spoke to the founder about her thoughts.
Period cycle apps aren’t meant to be used for fertility tracking
The CEO told HuffPost UK: “Anecdotally we know that women are using tracking apps like Flo and Clue as a contraceptive, and at The Lowdown we think it’s important that more women and healthcare professionals are aware that these are not regulated, digital contraceptive medical devices”.
As there are almost no FDA/EU-cleared digital contraceptive apps available in the UK market ― one of which has itself had complaints ― most people using tracking apps for contraception are not doing so with a specially-designed product.
In the study, which looked at women who had already presented for an abortion, the original figure of 129 women using “fertility awareness-based methods” (FABM), 0.4% of the sample, rose to 1,364 women (2.5% of the sample) over five years.
That meant an additional 1,235 women using FABM in 2023 vs 2018 in this research. The NHS says FABM is 76% effective if done imperfectly, while contraceptives like the pill are over 90% effective.
While Felton acknowledges the risks of this rise, however, she doesn’t feel this, or apps specifically, should be the main focus of the information.
“The biggest increase in real numbers was of those women using no contraceptive method at all; this increased from 18,730 (59% of the sample) in 2018, to 38,336 (69% of the sample) in 2023”, the founder told us.
“That is an additional 19,633 women not using a method of contraception in the second period,” or “almost 16 times more women not using a contraceptive method, vs women using FABM by 2023″.
She added that the “relatively small” study was limited by the participants it used, who she says “are in a particular situation, and may be skewed towards certain demographics and influenced by various other factors”.
“The study does not actually demonstrate there is a causal relationship between ‘fertility tracking apps’ and the rise in abortion rates, but most of the media coverage has taken this as their headline”, she added.
The paper itself didn’t claim to prove tracking apps definitely caused more abortions, to be clear, and they stated that difficulties accessing contraception thanks to Covid and post-Covid changes may have been a contributing factor to the “shift.”
So... are menstruation apps changing abortion rates at all?
It’s possible, but it’s hard to say from this data ― which didn’t differentiate tracking on apps from other forms of FABM ― whether or not it definitely creates a rise.
“If we wanted to really understand or quantify the use of FABM and decline in use of contraception overall, we should be running a wide scale study or research project that asks thousands of women what method of contraception they are using, similar to the way that the WHO or NATSAL do every couple of years”, Felton told HuffPost via email.
“This study would ask women to specify exactly which type of FABM, and the name of which app they are using”, she added (the authors of the paper say in their own study that grouping all FABM methods together was a limitation ― again, they did not ask those using “natural methods” whether those methods included an app).
This is not necessarily to contradict the study’s lead researcher Dr Rosie McNee, who told the BBC: “Something that really needs scrutiny is the surge in the use of ehealth, including fertility apps and period trackers.”
Nor is it to go against NHS leaders who have shared concerns about rising misinformation regarding women’s health.
As Dr Melanie-Hall, also from The Lowdown, told the BBC, “The key here is to reduce the spread of misinformation and the use of apps and methods that are not approved fertility awareness methods so people know they are equivalent to not using contraception.”
“Then we need to address why people are ditching hormonal and non-hormonal contraception and the role the spread of misinformation plays in this.”
A British Pregnancy Advisory survey found 49% of women face barriers to accessing contraceptives in the UK, including long wait times and financial challenges.
