Women seeking abortion after using ‘natural’ contraception

A study in England and Wales shows that the proportion of women having abortions has increased despite using “natural” methods such as fertility tracking apps to prevent pregnancy.

data, published in BMJ Sexual and Reproductive Health, Researchers say the past five years show a “shift” in contraceptive use from “more reliable” hormonal contraceptives such as the pill to “fertility awareness-based methods”.

Prevalence of hormonal methods, including the mini-pill, among thousands of women fell from 19% in 2018 to 11% in 2023.

Meanwhile, use of natural methods rose from 0.4% to 2.5% – still a minority but a significant increase that “requires investigation”, experts say.

Fertility apps help track fertile days so a woman can know when she is most likely to get pregnant each month or menstrual cycle.

They rely on measurements such as body temperature to predict ovulation (when an egg is released from the ovary).

Companies say that if used properly, they can be up to 93% reliable.

However, they require people to take readings and exercise control when having sex, avoiding intercourse on days when the app tells them they may be fertile.

The NHS says that if you don’t follow the instructions exactly, the method is only 76% effective. This means that 24 out of 100 women will become pregnant after tracking their fertility for a year.

in comparisonThe pill and mini pill are 91% effective with “normal use” and 99% effective with “correct” use.

Hormonal coils or implants, which do not depend on the user remembering to take them, are 99% effective.

For the study, researchers at the University of Edinburgh compared data from the British Pregnancy Advisory Service for the periods January to June 2018 (33,495 women) and January to June 2023 (55,055 women) to see whether changes in contraceptive use. Has come.

Along with the shift to natural methods, more women reported not using contraception at all in 2023 – 70% compared to 56% in 2018.

It’s impossible to say what’s driving the trend, but the study authors say difficulty accessing sexual health services during the COVID pandemic may be a factor.

Lead researcher Dr Rosie McEnany told the BBC: “What really needs to be investigated is the increase in use of eHealth, including fertility apps and period trackers.

“The market has exploded. There are hundreds of them and some are more reliable than others. Plus you don’t need a prescription, and so you can’t get all the information you need.”

Abortion provider MSI Reproductive Choice UK told the BBC it had also seen more women using fertility awareness methods.

Head of contraception Tanya Lane explained: “This may be a result of the rise in popularity of social media platforms such as TikTok, which have seen more people sharing their experiences… and content creators entering into paid partnerships with fertility awareness methods brands. There are some factors which may be influencing people to choose this option.

Long waits for appointments at GP surgeries and sexual health clinics may also be a factor.

“In some areas of the UK people are having to wait months for appointments, particularly for long-term procedures such as coils and implants.”

She said any woman thinking of switching to fertility tracking should talk to a medical professional.

“Dispel any myths and misconceptions and discuss the risks of failure so you can make an informed decision,” he advised.

Paula Baraitser, medical director of SH:24, a free NHS-partnered sexual healthcare provider, said women may have a number of reasons for switching, including concerns about future fertility and potential side effects.

The risks can range from mild side effects to rare but potentially serious complications.

“Many people will use contraception for 30 years of their lives,” he told the BBC.

“People’s experience of hormonal contraception is highly variable and ultimately we need a greater choice of methods to enable people to find the option that best suits them.

“Few new methods of contraception have emerged in the last 50 years, which reflects the lack of investment in research in this area.”

Sexual health charity Brooke said many women use hormonal contraception not only to prevent pregnancy, but also to manage their menstrual health, making periods lighter and more predictable.

“These benefits need to be part of the broader conversation about hormones,” said spokeswoman Lisa Hallgarten.