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Contraceptive App Natural Cycles Blamed For String of Unwanted Pregnancies (standard.co.uk) 423

An anonymous reader shares a report: A contraceptive mobile phone app used by tens of thousands of British women has come under fire after reportedly sparking a string of unwanted pregnancies. Swedish birth control app Natural Cycles, which costs $55, tracks body temperature to accurately predict when in the month a woman is more likely to fall pregnant. The period monitor was hailed as a non-mood altering alternative to the pill and, if used perfectly, was found to be 99 per cent effective by researchers. But the app has come under fire after the Sodersjukhuset hospital in Stockholm lodged a complaint with the Swedish Medical Products Agency, the country's government body responsible for regulation of medical devices. It claimed staff at the hospital had recorded 37 women who had fallen pregnant in the last quarter of 2017 after using the app. One midwife said the hospital had a duty to report all side effects.
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Contraceptive App Natural Cycles Blamed For String of Unwanted Pregnancies

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  • Swedes get burned by marketing. Who would have thought an unverifiable, exceptional claim of 99% efficacy for what's basically a fancy rhythm method, also known as "safe days", wouldn't pan out like they said?

    Lucky that abortions are free in Sweden.

    • by xpiotr ( 521809 ) on Tuesday January 16, 2018 @11:30AM (#55939095) Homepage

      Who would have thought an unverifiable, exceptional claim of 99% efficacy

      You good sir might want to Reread The Friendly Article. The article clearly states that at an average the success rate is estimated to 93%.
      7% of the women report getting pregnant, so the number seems to fit very well
      93% is also stated on their home page : https://www.naturalcycles.com/ [naturalcycles.com]
      (99% was a number stated if the app was used in strict compliance, but they know it isn't.)

      • by guruevi ( 827432 )

        Women are only fertile 20% of the month with an average 'success rate' of fertilization being ~15-20% per month, especially when you practice abstention during your fertile period. So the app at 93% actually seems to have a slight increase or at very best a zero-effect for the chance of pregnancy.

      • its a swedish company and pay swedish tax's - a good thing

        their thermometer is incredibly basic for what they claim to be doing and I'm going to guess the calibration is non existent or outsourced to china.
        They do not seem to provide any information on the thermometer supplier I would have thought it was at least like the nokia and bluetooth...

        regards

        John Jones
        p.s. poor harry
             

      • by Blymie ( 231220 )

        Even at 99%, that's a boatload of misses heh.

  • 99% effective? (Score:5, Insightful)

    by Wulf2k ( 4703573 ) on Tuesday January 16, 2018 @11:14AM (#55938925)

    So, you'd expect that if at least 3700 women used it. ...Ignoring every other aspect of why it's stupid to count on this if you didn't want to get pregnant, anyway.

    • by AvitarX ( 172628 )

      You'd expect that every year.

      Not every quarter.

      Also, this is only one hospital.

      • You'd expect that every year.

        Not every quarter.

        Also, this is only one hospital.

        Really, you'd expect people not using any actual contraception not to get pregnant?

      • OK, so 14,800. What is the user base?
      • by kenh ( 9056 )

        How do the statistics differentiate between women that use the app but don't have sex - between relationships, etc, and women who use it because they have sex so often they can't keep things straight and need an app to manage a simple periodic cycle. If you want to increase the statistics have a bunch of celibate nuns install the app on their smartphones.

        • by Cederic ( 9623 )

          ..and men. They have a nearly 100% success rate in avoiding pregnancy among male users of the app.

    • So, you'd expect that if at least 3700 women used it.

      Not quite, this is just one hospital, so discounting a local phenomena that's 3700 app users who would be attending that hospital.

      And 37 is the cases they know about, depending on how they got this number there could be a lot more at just that hospital they don't know about.

      I'm also not sure what 99% means in this context. Per year? Then you need to multiply those quarterly positives by 4. 99% effective per sexual encounter? You're going to end up with a lot of pregnancies. 99% less than absolutely no prote

    • The Google Play Store [google.com] pages mentions between 100'000 and 500'000 installs, and there are around 6'000 evaluation.

      As it's a method with a non-zero failure rate, and given the significantly huge number of women using it, *pregnancy are bound to happen*.

      Duh.

      (Also note that the 99% is if the method is used always perfectly. Actual real-world result are going to be worse due to mis-use)

    • Re:99% effective? (Score:5, Informative)

      by B1ackDragon ( 543470 ) on Tuesday January 16, 2018 @02:55PM (#55940841)
      We gave NFP a shot; I don't get too many opportunities to share my real experience with it, which is a shame. A little over a year ago my wife was sick of her birth control (subdermal implant), and being from a very Catholic family she wanted to at least learn about and try NFP. I reluctantly agreed (we were stable enough that starting our family a bit earlier than planned wouldn't have been a disaster).

      We signed up for a class through SymptoPro through our local church, an organization that provides workshops and materials about it. In summary, I'll the say method is definitely more scientific than old "rhythm" methods, but still leaves a lot to be desired. According to their materials (and duly backed up by studies, as far as I can tell), time between menstruation and ovulation can be quite variable (hence failure of rhythm methods), but time after to the next menstruation is be fairly predictable for a given woman, and further the time of ovulation should be roughly predictable from physical symptoms, and thus also the likely times of fertility, taking into account other factors such as sperm lifetime etc. (the materials are adamant they don't try to predict ovulation per se).

      The rules are very complex, but the basic "intro setup" is this: Each day the woman should take her basal body temperature. This must be done in the morning right after waking (ideally still in bed) to avoid noise from other activity. [Work swing shift? Have an over- or under- active immune system? Good luck with that.] Each day she should evaluate her vaginal discharge (character and amount), and for extra accuracy also her cervical opening (yup, you read that right). Each cycle, the last day of these fertile "signs" is taken to be "peak day" (I presume correlated with ovulation, but they don't come out and say it directly). After this peak day is met, she looks for three temperature readings all higher than the previous six; if the third is 0.4 degrees F higher than the highest of the 6, then you're good to sex it up that evening (assuming avoiding pregnancy). There are special cases involved if the third day doesn't reach the 0.4 above level, etc. There are also more advanced, less conservative rules available once 6 to 12 months of individual data have been gathered. It's really the kind of thing that should be handled by software, because it's so difficult to remember and apply. (I could also see it being fertile ground for software bugs. Pun intended.)

      Is it scientific, and is it effective? I'll say "kinda" to the first, and "mostly" to the second. There have indeed been studies on pregnancy rates, and results seem comparable to condoms (though condoms have come a long way; high-90s% is about what is claimed by symptopro for perfect use; results vary across studies, YMMV, etc.) What bothers me is that I have yet to identify any science behind the rulesets themselves. Why three days after six, and where does this 0.4 degrees magic number come from? I'd love to be proven wrong, but I think these are essentially someone's hunch.

      As to effectiveness, I think it's reasonably effective primarily because it's so conservative. According to the rules, we got on average maybe 6 days per month we *could* have sex and avoid pregnancy (aside from menstruation days); a couple of months we had 0 available days. We ended up using condoms quite a bit anyway. On the plus side, via all this charting we learned that this isn't quite normal: many women get closer to 10 days/cycle of infertile time (even with the basic ruleset), and my wife may have a mild "luteal phase defect." Now that we're actively trying to start our family, we'll be talking to a doctor about it.

      In the end, I'd say it's not a terrible program and it's nice to have options. But, more research is needed, and it's far from the easy, one-size-fits-all solution NFP proponents tout.
  • A pregnancy is a hell of a side effect of a birth control method.
    • Long ago, in an episode of The Simpsons, there was Crusty The Clown Birth Control, with a warning: May Cause Birth Defects.
    • It is the side effect of EVERY form of birth control except for abstaining from vaginal intercourse completely.
    • by kenh ( 9056 )

      It's about the only side effect possible, and as is stated in the article, on every box for every birth control, and in every pamphlet in the Planned Parenthood waiting room- "No method of birth control is 100% effective.".

  • The "less likely" time of the month does not mean probability == 0.0.

    There is still a probability greater than zero during the "less likely" time. And that positive probability may be significantly higher than other methods of birth control.
    • by jabuzz ( 182671 )

      And no none permanent method has a probability of zero, including abstinence because people have a habit of not stopping to abstain.

  • by Gunnery Sgt. Hartman ( 221748 ) on Tuesday January 16, 2018 @11:17AM (#55938955) Homepage

    Do you know what they call couples that use the rhythm method for birth control?
    .
    .
    Parents

    • by Thud457 ( 234763 )
      93% of the time it's 100% effective!

      Geeze, was this app written by the Catholic church?!
    • by cyn1c77 ( 928549 )

      Oh man. I had to clean my monitor after drinking coffee and reading that one! Nice!

    • by tlhIngan ( 30335 )

      Funny enough, but there was a similar app on iOS a few years ago (right when the App Store was new and novel on iOS).

      At the time, piracy on iOS was big, and easily detected by apps who could see their application XML file was modified (it required an extra line to tell iOS it was unsigned, so apps would check for the element).

      One developer of such an add simply offset the calendar 14 days in "pirated" mode. If you bought it, it gave correct dates. If you pirated it, you got erroneous dates.

  • "I was ovulating and was totally horny and had to get some and my boyfriend didn't pull out fast enough, so the app didn't REALLY work for me."

    Or maybe the whole, "I cut it too close to my ovulation time and my man's sperm must've been really hardy. It's the app's fault for not knowing that," possibility?

    In the end, there is no non-artificial, bulletproof method of birth control that works for everyone that is sexually active because there are way too many variables.

    • Re: (Score:2, Funny)

      by Anonymous Coward

      You're right. Abstinence didn't work for Mary the mother of Jesus.

      • by kenh ( 9056 )

        Abstinence also fails when a woman is raped.

        • by mark-t ( 151149 )
          Technically speaking, the woman hasn't abstained in that case... volition impacts abstinence only to the extent that one is actually in control of their own body (which in day-to-day experience is so much of the time as to typically be taken for granted).
  • What can I say. That's fucked up.

  • "One mistake, and you'll provide support for a lifetime."

  • by Major_Disorder ( 5019363 ) on Tuesday January 16, 2018 @11:21AM (#55939003)
    is that this results in stupid people having babies.
    Idocracy was not supposed to be a documentary.
    • is that this results in stupid people having babies. Idocracy was not supposed to be a documentary.

      I'd rather be stupid than mean.

  • by xxxJonBoyxxx ( 565205 ) on Tuesday January 16, 2018 @11:23AM (#55939019)
    >> contraceptive mobile phone app...has come under fire after reportedly sparking a string of unwanted pregnancies.

    Really, that's not where the phone goes, ladies.
  • by Necron69 ( 35644 ) <jscott.farrowNO@SPAMgmail.com> on Tuesday January 16, 2018 @11:24AM (#55939037)

    There's a special, scientific term for women who use the rhythm method of birth control. They're called 'mothers'.

    - Necron69

  • Birth Control. And it didn't work back then. We wouldn't have put research into chemicals if this was 100% effective.

    --
    One, Two, Three...Infinity

  • As Robert Heinlein once observed, the medical term for women who use the rhythm method is "mother."

  • I know it's a lot harder (there's a dirty joke in there somewhere) but still, you'd think there'd be enough demand. I worked shit jobs for a long time and I couldn't tell you how many dads weren't ready to be dads and would have killed for better / more reliable options.
  • Getting to hear what a bunch of Slashdotters think about natural planning ... is like asking Kalahari bushmen what stocks to short this week.

    Or something.

  • As a person who used to build software under the different global health regulations (think the FDA in the USA) - I totally understand this. Sounds situation normal.

    First - 99% had to be proven during pre-market. Actual - 37 women out of how many using the app?

    All hospitals are supposed to report back to the vendor and FDA any issues. Later on "actual vs expected" is compared and the 99% claim will be reevaluated. In the USA the vendor is responsible for deciding when to change this (although the FDA can

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