37 Unwanted Pregnancies Raise Concerns for Family Planning App
Timothy Dy Aungst, PharmD, is an associate professor of pharmacy practice at MCPHS University. He graduated from Wilkes University Nesbitt School of Pharmacy and completed a PGY-1 Pharmacy Practice Residency at St. Luke's University Hospital, and then a Clinical Geriatric Fellowship at MCPHS University. He is passionate about the rise of technology in health care and its application to pharmacy. He has published primarily on the role of mobile technology and mHealth, and made multiple national and international presentations on those topics. He blogs at TheDigitalApothecary.com, is a Co-Host of FurtureDose.tech a podcast part of the Pharmacy Podcast Network, and you can find him on Twitter @TDAungst.
Natural Cycles is a EU-cleared application to help women avoid pregnancy, but recently there have been some concerns about how well it works.
Skip the birth control, use an app instead, what could go wrong? Well, for 37 women with unwanted pregnancies in Sweden, the application seems not to be working out as planned.1
Natural Cycles is an app for women to help identify days that are safe to have sex and avoid pregnancy. Cleared by the European Union, the app allows women to monitor their menstrual cycles and body temperature with a thermometer to predict, via a proprietary algorithm, what days are safe and when pregnancy may be a risk, all without using hormonal contraceptives. The appeal is high for some women, including those who may have experienced adverse effects in the past or who cannot use hormonal contraception for religious or other personal reasons.
No contraception is fail-safe, aside from abstinence, of course. Condoms can be used improperly, oral birth control is not 100% effective, and natural family planning often does not work. But in an age where consumers are quick to gravitate to platforms on their smartphones that purport to use science and lead to better outcomes, there can be a sizable market to seize. Indeed, Natural Cycles says that it has more than 700,000 app users worldwide, which is impressive.
So, is 37 unwanted pregnancies a big deal in the grand scheme of things? Well, Natural Cycles has released information for public view showing that its product has a success rate of 93%. Given that high percentage, there will inevitably be pregnancies that occur. But Natural Cycles says that these data are made available to customers and that it is open to the success of the product. I agree, to a certain point.
As with all presentation of scientific literature in patient-friendly language, the website does include data on the efficacy of the product, under the science section and FAQs. But it is not present on the homepage or easily seen, anyways.
Natural Cycles has not been approved by the FDA. And in light of the recent pregnancies, a hospital in Stockholm, Sweden, is reporting the app to the Swedish Medical Product Agency in charge of regulation. It will be interesting to see how this unfolds and if other reports had been filed. Nonetheless, though the science here is not a question, the presentation and selling point of the digital therapy to a vast population probably could have been handled better for consumer education. A big takeaway for other companies is how to navigate this type of public relations challenge and communicate with members about their therapy and concerns.
1. Contraceptive app hit with complaints after being blamed for 37 unwanted pregnancies. The Verge. theverge.com/2018/1/16/16895978/natural-cycles-contraceptive-app-unwanted-pregnancies-complaint. Published January 16, 2018. Accessed January 30, 2018.