Getty ImagesThere has been a rise in the proportion of women seeking abortions despite using “natural” methods to prevent pregnancy, like fertility tracking apps, a study in England and Wales suggests.
The data, published in BMJ Sexual and Reproductive Health, shows a “shift” in contraception use in the last five years, from “more reliable” hormonal contraceptives such as the pill, to “fertility awareness-based methods”, say researchers.
Hormonal methods, including the mini pill, fell from 19% in 2018 to 11% in 2023 among tens of thousands of women.
Use of natural methods, meanwhile, increased from 0.4% to 2.5% – still a minority but a significant rise that “needs investigating”, say experts.
Fertility apps help track fertile days so a woman can know when she would be most likely to get pregnant each month or menstrual cycle.
They rely on measurements like body temperature to predict ovulation (when an egg is released from the ovary).
Companies say they can be as much as 93% reliable when used correctly.
However, they require people to take readings and control when they have sex, avoiding intercourse on days when the app tells them that they may be fertile.
The NHS says if you do not follow the instructions exactly, the method is only 76% effective. This means 24 in 100 women will get pregnant when tracking their fertility for a year.
In comparison, the pill and the mini pill are 91% effective with “typical use” and 99% effective with “perfect” use.
Hormonal coils or implants, which do not rely on the user remembering to take them, are 99% effective.
For the study, researchers from 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 if contraceptive use changed.
As well as the shift to natural methods, more women reported using no contraceptive at all in 2023 – 70% compared to 56% in 2018.
It is impossible to say what is driving the trends, but difficulty accessing sexual health services during the Covid pandemic may be a factor, say the study authors.
Lead researcher Dr Rosie McNee told the BBC: “Something that really needs scrutiny is the surge in the 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 may not get all the information you need.”
Abortion provider MSI Reproductive Choices UK told the BBC it too has seen more women using fertility awareness methods.
Tanya Lane, contraception lead, explained: “This could be a result of the rise in popularity of social media platforms like TikTok, which has seen more people sharing their experiences…and content creators doing paid partnerships with brands of fertility awareness methods that might be influencing people to choose this option.
Long waits for appointments at GP surgeries and sexual health clinics could also be a factor.
“People are waiting months for appointments in some areas of the UK, especially for long-acting methods like the coil and implant.”
She said that any woman thinking of switching to fertility tracking should speak to a medical professional.
“Dispel any myths and misconceptions and have a discussion on risk of failure so you can make an informed decision,” she advised.
Paula Baraitser, medical director of the NHS-partnered free sexual health service provider SH:24, said there could be many reasons why women are switching, including concerns about future fertility and possible side effects.
The risks can range from mild side effects to rare but potentially serious complications.
She told the BBC: “Many people will use contraception for 30 years of their lives.
“People’s experience of hormonal contraception is highly variable and ultimately we need a larger choice of methods to enable people to find one that suits them.
“There have been few new methods of contraception in the last 50 years, reflecting a lack of investment in research in this area.”
The sexual health charity Brook said many women use hormonal contraception not simply to prevent pregnancy, but to manage their menstrual health, to make periods lighter and more predictable.
“These benefits need to be part of the wider conversation about hormones,” said spokeswoman Lisa Hallgarten.
