Did unreliable period apps drive up abortions?

A short update on TVB

Dear friends,

You may have seen news stories with headlines saying “unreliable menstrual cycle tracking apps blamed for rise in abortions.”

In The Vagina Business, I pointed out that the idea that we can track our periods digitally has spawned a generation of over 300 apps.

What began as “period tracking” has moved on to “fertility tracking” and “digital contraception”: from when to expect our next period to when to increase the chances of conception to when to avoid pregnancy—each claim bolder and riskier than the previous.

But did apps actually drive up abortion rates?

The news story, which appeared in The Times, was based on a study analysing a survey conducted by the British Pregnancy Advisory Service (BPAS) which is the biggest abortion provider in the Great Britain.

The study compared the self-reported contraception used by 33,495 women seeking abortions in 2018, to 55,055 women seeking abortions in 2023.

The finding? The proportion of those using “fertility awareness based methods” (FABMs) increased from 0.4% in 2018 to 2.5% in 2023.

The news story also noted that there were 251,000 abortions in 2022, up from 201,000 in 2018.

And that’s the first problem. Abortions increased by 25%. Meanwhile, the use of FABMs increased by over 500%. So it seems like there are other factors at play.

The second problem is that the study did not differentiate between digital and non-digital FABMs. And the thing with FABMs is that they can be highly effective—or not effective at all.

The WHO defines FABMs as “methods for planning or avoiding pregnancies by observation of the natural signs and symptoms of the fertile and infertile phases of the menstrual cycle.”

There’s a huge difference between someone who simply writes down the dates of their period on a sheet of paper, someone who occasionally uses a random period app and someone who meticulously uses Natural Cycles, the only an app that’s regulated as a digital contraceptive in the EU and US.

We don’t know what proportion of women, who were seeking an abortion, used a digital contraceptive app. So we can’t blame apps for the rise of abortions.

A short while later, a new story emerged about this study. This time it focused on another data point: The proportion of those who were not using any form of contraception when they became pregnant increased from 56% in 2018 to 70% in 2023.

“Something big is happening in the world of contraception. It’s going backwards,” said the Guardian.

But is that something we can actually conclude from the study? I’m not convinced. Why? Because of the sample.

What many people don’t know is that it’s the same procedure is used for those who want an abortion out of choice and those who need to have an abortion because their pregnancy is not viable. And BPAS provides both.

How many women in the survey had an abortion because their pregnancy was not viable? It doesn’t say. But of course those women were trying to get pregnant—and did, therefore, not use any contraception.

So I’d want to know more about the sample before drawing any strong conclusions about apps or contraception from this study.

In other news, I had so much fun speaking at an event hosted by Ladies Who Crunch and The London Girl's Bookclub.

Here’s what Nancy Best, the founder of Ladies Who Crunch, wrote in her newsletter:

There were *many* revelations across the evening, but I wanted to share just a few with those of you who missed it...

• Trials into the male contraceptive pill stalled because men were struggling with symptoms of bloating, mood swings and acne. Stop right there, John! No man should have to suffer through that!

• A 2018 study found that when VC investors are talking to male founders about their business, they tend to pose encouraging questions like, "What is your aspiration? What does success look like?" In contrast, when talking to female founders, the questions are more sceptical, such as ”Can you talk about the competitive environment? How long will it take you to break even?” Unfortunately, even if the investor was a woman, the gendered discrepancy within the questions didn't change.

• Forget bank fraud - hackers can get into your period apps and even your bluetooth vibrator. Femtech needs to evolve its data infrastructure to protect women's privacy.

I’m currently in the US to give talks about my book. I loved speaking at Rice University and at the Icahn School of Medicine at Mount Sinai in New York.

The good thing about having a divisive book title is that it attracts and repels, which means wonderful people come to my talks.

Overall, having vagina in the title continues to be a challenge. It feels like I have to work much, much harder to get this book out into the world.

That’s why I was very honoured and happy that The Vagina Business has won the Porchlight Business Book Award. I’m hoping that will help it get noticed by more readers.

Up next, you can hear me speak in Buffalo, NY on February 12. I’m speaking throughtout the US, finishing with my book talk at SXSW on March 10th, so if you want me to speak at your company, university, event etc while I’m here, let me know.

Until next time,

Marina