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Western Myths Of Technological Birth Control

This article is more than 5 years old.

Over the past few months there has been a rash of articles about the marketing of a birth control app, Natural Cycles.  One such article incredulously making the claim that skydiving is less risky than pregnancy.  I have been a paratrooper and been pregnant many times and I wouldn’t even dare to compare a nine-month physical ordeal where so many variables are simply uncontrollable with a highly controlled environment of even a low altitude jump (eg. 1,300 feet).  The metaphor fails and becomes the very hyperbole that the article seeks to critique about marketing methods of birth control.

In reading these critiques, I had to wonder about why the anger over an app that is essentially offering two services: a more scientific reading of the rhythm method and an ovulation calendar.  Anyone who knows about trying to get pregnant through basal temperature readings or conversely, to avoid getting pregnant through the same calculations, knows that these are not 100% fool-proof methods.  Well, let’s be frank: high school sex education courses teaches that fertility awareness-based methods (abstinence or condom use on fertile days) are the least reliable methods.  So, why are well-educated women falling for what is a well-known unreliable form of birth control when women all over the continent of Africa with far less education are aware that these methods are simply dice throws?

First, let’s start at the information about birth control where the rhythm method as a means to avoid unwanted pregnancy is one of the various recognized methods by the WHO with a 91% to 75% success rate depending on consistency. This is why the common joke about this method goes like this: “What do you call people who use the rhythm method for birth control?” The answer: “Parents.” 

Still there are regions of the world where women do not have easy access to modern contraception and the additional boost for those seeking a contraception method without hormones or medication. It is risky as a means of birth control, but way better than none.  The Mayo clinics lists, among the reasons for women using this method are “complex medical history limits traditional birth control options, or for religious reasons” with the caveat that “In general, as many as 24 out of 100 women who use natural family planning for birth control become pregnant the first year.”

So aside from the lack of medical intervention, why the attack on Natural Cycles? And why not a more concerted critique of the rhythm method in the first place given that there are many other such technology-driven apps such as DOT, CycleBeads, and Kindara?  There seems to be a severe disconnect where privileged western women missing basic information about the rhythm method which women around the developing world have known for years?

We know that as of 2010, only 22 percent of women used “periodic abstinence” (a term to mean the rhythm or calendar method) as a means of birth control. This number is nothing to dismiss given that in 2008, the doubling of the cost of birth control in Chile resulted in between 183 and 265 more babies born per week due to this price hike.  This is very well detailed in “The Children of the Missed Pill” which estimates that between 183 and 265 “extra” individuals were born in Chile per week due to the hikes in the price of birth control.  In addition to these numbers, we are quite aware of the relationship between lack of access to contraception and abortion to poverty.   So if you are going to make the argument that being pregnant is riskier than skydiving, wouldn’t you want to ensure that 80% fewer casualties are realized over the complete annihilation of this method?

As I read on through the critiques of these online apps—many of which were more balanced—it became clear that birth control is highly politicized even amongst women. That women who cannot take the pill due to negative side-effects or who cannot have an IUD due to problems stemming from the Dalkon Shield which left the notion that IUDs were forever dangerous, potentially causing infertility or even death. Yet somehow between the 1970s and today, birth control has become almost as controversial as the breastfeeding versus formula debate that is often seen in online forums. 

Shouldn’t the point of birth control be about educating women and girls about all types of methods to include the pros and cons to each such that they can make the best decision for themselves? Certainly, in this day and age with STIs at an all-time high globally and the rationing of contraception in specialist clinics in England, we know that the most accessible contraceptive method which will protect the health of females is the condom. Yet, bizarrely, the most educated seem to miss what most high school teenagers are taught: that the fertility awareness method is the least effective of all contraceptive methods.

With almost 100 fertility apps on the market and about 3% of women who use contraceptives  employing some form of fertility awareness with or without other contraceptive methods, it seems odd that Natural Cycles has come under fire for its marketing.  After all, it is simply marketing what is a well-known form of birth control predating most modern hormonal methods.  It is also appealing to a demographic of women who can afford its services and who for personal reasons want to try a hormone-free method as stand-alone birth control or in collaboration with another type of contraception. The reality that an app which tracks basal temperatures and can mark “fertile days” will never be a perfect science.  It’s just the rhythm method with an app calculating the smaller integers. 

All in all, I have to wonder if these apps are appealing to a largely upper-middle class, white demographic who themselves seek to project a notion of “empowerment” over their bodies, when the reality is that most women in the world have little say into their pregnancies?  Might we be better off understanding the limits of technology and fertility tracking and instead attempt to understand those 6 percent of women globally or the far higher percentages in countries like Congo, Libya and Gabon who benefit from such methods due to economic impoverishment and lack of other forms of contraceptive resources?  

We need to stop pretending that any single type of contraception will be 99% safe, reliable and accessible for all women. There is an imperative to understand the political and technological limitations that women face which leave them far less empowered over their reproductive lives and very much at the mercy of a media that pretends that most women in the world can afford most forms of contraception in the first place.  

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