Recently, Bloomberg released an in-depth interview of the creators of the “birth control app,” Natural Cycles, checking in after a recent PR crisis that shook their reputation. This has brought increased attention to an entire array of fertility monitoring apps — including our own CycleProGo — and period tracking apps that don’t provide fertility awareness tracking at all.
So what do we at CCL think about all this?
First of all, we’re thrilled to see fertility awareness becoming a more prominent part of public discourse. The popularity of Natural Cycles (NC) comes in part from ever-growing secular dissatisfaction with traditional hormonal contraceptives, especially the Pill, and that’s a movement we can get behind.
The entire concept of a smart phone application as all-natural birth control is prompting women to ask questions about the contraceptives they’re using, and use of NC requires a degree of bodily awareness that other contraceptives just don’t. This tiny bit of exposure to the incredible mechanisms of human fertility could be all it takes to capture the interest of some women and lead them to discover the intricacies of a system they’ve been merely placating for so long.
But Natural Cycles isn’t perfect.
The education problem
The minimal fertility education users receive from NC isn’t nearly sufficient. Basal body temperature (BBT) is the only thing required and users receive none of the valuable information they should about the significance of abnormal BBT readings. Additionally, no mucus or cervical symptoms are recorded, eliminating two important crosschecks which can provide accurate fertility readings and critical hints about reproductive issues that would otherwise go undetected.
Certainly, the app doesn’t prevent users from digging up such information on their own, but it doesn’t encourage research, either. If a woman hasn’t learned about cervical mucus already, what grounds do we have to assume that NC will suddenly make that happen for her? The exceptional few will perhaps learn about other symptoms and follow them to more comprehensive charting apps, but that’s money NC loses.
It’s just more marketable to minimize user involvement in the ”success” of their contraception. So where NFP users are thoroughly educated on the mechanics of fertility and offered regular accompaniment, NC users just trust the app, follow directions and hope for the best.
Ignorance like that is the fuel of a contraceptive society.
The contraception problem
Natural cycles is both a fertility tracker and a contraceptive. The program itself recommends use of “protection” during fertile phases, unless users have specifically switched to “Plan a pregnancy” mode. NC’s website and app store descriptions list abstinence as an option, but that’s not what the calendar screen says when users check their status each day. Legally speaking, the app is approved by authorities in the US and UK as a certified method of birth control.
Or, at least, it’s indirectly contraceptive. Gynecologist Lena Marions, when interviewed by Bloomberg’s Esmé Deprez, made a good point about the app:
“It’s not a [contraceptive] device. It’s software. Condoms on red days — that’s the contraceptive,” she said.
So while NC has changed the game by bringing fertility science into the mainstream consciousness, it doesn’t encourage any real change from the contraceptive mindset that’s so pervasive in today’s culture.
In fact, a noticeable number of the women who publicly reported unintended pregnancies from NC ended up receiving abortions. While devastating, the information is unsurprising. The app recommends use of condoms (with a failure rate of approximately 20%) during the users’ most fertile days, so pregnancies were bound to happen. In such a secularized society as Sweden where the product was piloted, abortion is the obvious next step after failed contraception.
Natural Cycles doesn’t challenge society’s way of thinking about sex and babies — it’s just more of the same culture of death.
The science problem
NC relies on a generally true scientific concept: there’s a direct correlation between BBT and fertility. We at CCL require BBT input in our own method for this very reason.
While the general premise is the same, however, the implementation is not.
In their own clinical study, NC concluded that the app had a typical effectiveness rate of about 93%. However, about 70% of the participants dropped out before the full year expired (most of them contributing less than six months of data), and a significant number of participants could not be positively identified as either pregnant or non-pregnant, creating an uncomfortable margin of error in the study.
Citing fear of copycat competitors, NC won’t disclose their algorithms. This means that the scientific community cannot assess the algorithm itself, instead they must use the app and compare the results to established fertility awareness-based methods. One such study, presented in September at the Catholic Medical Association conference, found that about 20% of NC’s interpretations identified the end of the fertile phase before Peak Day had even occurred. (The study is set for publication in a peer-reviewed journal in the coming months.)
Finally, no studies on the efficacy of NC have been done without simultaneous use of a barrier method, so scientists have no idea how effective the app is by itself. Vice chair of the CCL Board, Dr. Mike Manhart, pointed out that “…the developers of NC are focused on limiting the need to use condoms to as few days as possible in a woman’s cycle. In other words its really designed to provide targeted condom use for its users.”
The morality problem
As more details about NC emerge, NFP users are increasingly disappointed. CCL volunteer Pamela Bernardi Birdsall shared the Bloomberg article on social media and commented,
“This is our secular competition. This article is disturbing and enlightening. I guess I’m naive but it is disturbing to me that this method leads to abortion if it ‘fails’. I guess the devil distorts everything good!”
There’s truth to that.
But the thing that sets CCL apart from NC is what we believe and what actions those values prompt us to take.
— CCL Staff Member