Things are always too good to be true, aren’t they? The headline of Jezebel’s report of an incredible new birth-control app being FDA-approved in the US includes the caveat: “But it’s being investigated for unintended pregnancies.” That does rather bring you back to earth with a bump.
I felt for US women today, scrolling through their morning news alerts and having their interest pricked by the promise of problem-free contraception. No life-altering side effects, agonising insertions or uncontrollable bleeding? “Sign us up!” I could hear them cry, as they skipped towards contraceptive utopia.
But we’ve been here before. In countries where – this seemingly incredible new app – Natural Cycles has already signed up 900,000 users, we have ridden the wave of optimism right through the looking glass to a reality where, in its country of origin, the app has been reported to authorities after a hospital found that 37 out of 668 women who sought an abortion at one Swedish hospital between September and December 2017 had relied on it as their sole method of contraception.
It turns out that the algorithm, which uses body temperature and period cycles to determine whether users are fertile or not by showing users green or red days to indicate whether they can safely have sex without getting pregnant, is the age-old calendar-counting technique given a futuristic Silicon Valley makeover – and about as effective.
Beyond the initial jubilation that technology might have finally addressed the needs of women ignored for decades by medicine is Olivia Sudijc’s viral account of her own abortion after entrusting her contraception to her smartphone and an investigation by the Advertising Standards Agency.
The bubble might not be completely burst, but it is certainly deflating, as The Pool’s Caroline Donoghue wrote last month – the battle to be a healthy, sexually active woman who does not want to be pregnant, continues.
So, it’s rather disconcerting to see things repeat themselves with such efficiency over in the States. A Google News search for “Natural Cycles” shows virtually no break between headlines condemning it in Europe and those announcing its newly issued Green Card.
As it was in Europe, this is the first time that a fertility-tracking app has been approved to be marketed as birth control in the USA. The FDA press release cites clinical trials that show that when the app is used perfectly, the failure rate is 1.8% although this rises to 6.5% “typical use” rate when it is not used exactly as instructed.
It might be the same old story: women bearing the burden of contraception without any guarantee that it works, but the stakes are far, far higher in countries where an unintended pregnancy becomes an unintended parenthood
The dubious morality of the way Natural Cycles works with social-media advertising and influencers has already raised some eyebrows in America and medical professionals have voiced concerns. Lauren Streicher, a professor of clinical obstetrics and gynecology, told Vox: “What we know about reliable contraception is that it can’t be user-dependent. Long-acting ones like IUDs and implants will be the most reliable. The minute you rely on action, the efficacy goes down.”
But when asked about the Swedish investigation into the app, the FDA commented: “We reached out to the Swedish authorities and feel that the information regarding the pregnancies in Sweden is consistent with our knowledge concerning the pregnancy risks associated with use of this device.”
The spokesperson followed up with the repeated catch-all excuse that no method of contraception is 100% effective. Condoms split, women forget to take pills and an app that requires strict and regular temperature data is sensitive to subtle changes to women’s bodies that may render it inaccurate.
And thus Natural Cycles will be sold to American women as an effective method of birth control, just as it was here, and it’s hard not to see the cycle (pardon the pun) repeating itself: excitement, hope and optimism replaced by concern, disappointment and very real distress.
But there is one key difference with the FDA approval in the US: that the reproductive rights of women are continuing to be curtailed and restricted by a government that refuses to acknowledge the importance of access to safe and legal abortion. A second Trump-appointed candidate to the Supreme Court could legitimately threaten Roe v. Wade as federal courts are handling almost monthly hearings over attempts to tighten abortion laws in states such as Indiana and Kentucky.
It might be the same old story: women bearing the burden of contraception (from cost to side effects to the tax on their time) without any guarantee that it works, but the stakes are far, far higher in countries where an unintended pregnancy becomes an unintended parenthood.