A recent study published in BMJ Sexual and Reproductive Health reveals a growing trend in women opting for natural methods of contraception, such as fertility tracking apps, over traditional hormonal contraceptives like the pill. However, this shift is accompanied by rising abortion rates among users of these methods, raising concerns about their effectiveness and the potential consequences for women’s health.
A Growing Trend
Between 2018 and 2023, the use of fertility awareness-based methods, including apps that track ovulation and fertile windows, rose from 0.4% to 2.5% among women in England and Wales. While still a minority, this represents a significant increase. Meanwhile, the use of hormonal contraceptives, such as the mini pill, declined from 19% to 11%.
During the same period, there was also an increase in women reporting no contraceptive use at all, from 56% to 70%.
Why Are Women Choosing Natural Methods?
The reasons behind this shift are complex and multifaceted. Experts point to several potential factors:
Access Issues: Difficulty accessing sexual health services, exacerbated during the Covid-19 pandemic, has made it harder for women to obtain long-acting reversible contraceptives (LARCs) like coils and implants.
Social Media Influence: Platforms like TikTok have played a significant role in promoting natural contraception. Content creators, often in paid partnerships with fertility app brands, have shared their experiences, influencing women to adopt these methods.
Concerns About Hormones: Many women report concerns about the side effects of hormonal contraception, ranging from mood changes to rare but serious complications. Others worry about the long-term impact of hormonal contraceptives on fertility.
Misinformation: The rise of e-health tools like period tracking apps has led to some confusion. Many apps are designed for menstrual health rather than contraception, and some users may not be fully aware of their limitations.
The Effectiveness Debate
Fertility tracking apps rely on measurements such as body temperature and ovulation predictions to estimate fertile days. While companies claim these methods can be up to 93% effective with perfect use, the NHS cautions that real-world effectiveness drops to 76%—meaning 24 in 100 women could become pregnant in a year.
In comparison, the pill is 91% effective with typical use and 99% with perfect use. Long-acting methods like coils and implants are 99% effective and don’t rely on user behaviour.
The Consequences
As more women turn to natural methods, abortion providers like MSI Reproductive Choices UK report seeing an increase in women seeking abortions after using fertility awareness-based contraception.
Tanya Lane, contraception lead at MSI, explains, “This trend could be driven by social media influence, but also by long waits for appointments at GP surgeries and sexual health clinics, particularly for LARCs like coils and implants.”
The Need for Better Education and Choices
Medical professionals stress the importance of education around contraception.
Dr. Melanie Davis-Hall, Medical Director at The Lowdown, a women’s health review platform, says, “We need to reduce misinformation and ensure people understand that some fertility apps are equivalent to not using contraception at all.”
Paula Baraitser, Medical Director at NHS-partnered sexual health service provider SH:24, highlights the lack of innovation in contraceptive options:“There have been few new methods of contraception in the last 50 years. Women need a broader range of choices to find what suits them.”
Lisa Hallgarten from the sexual health charity Brook adds that hormonal contraception offers benefits beyond pregnancy prevention, such as regulating periods and reducing menstrual pain. “These benefits need to be part of the wider conversation about contraception,” she says.
Moving Forward
The rise in natural contraception methods underscores the need for accessible sexual health services, comprehensive education, and innovation in contraceptive options. While natural methods may appeal to women seeking hormone-free alternatives, understanding their limitations is crucial to making informed decisions.
Women deserve a wide range of reliable options and better access to care to manage their reproductive health effectively and confidently.
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