Natural Cycles was hailed as a stress-free, hormone-free contraceptive. Then girls began reporting unwanted pregnancies

Last summer I had an abortion. Statistically unremarkable, yes, but mine wasn’t because of a split condom or a missed pill. I was four months into a tense relationship with a much-hyped Swedish” digital contraceptive “, a smartphone app announced Natural Cycles. I had invested my 20 s on the pill, but hated not knowing whether my emotional state was down to artificial hormones or not. My boyfriend and I had been together for eight months, and I was urgently searching something new, something that wouldn’t make me feel so anxious.

That’s when the adverts started adhering me around on social media: glowing wives reclining in Scandi bedrooms, all pallid gray-headed sheets and dappled light, brandishing basal thermometers and tell people how great it felt to” get to know yourself better “. Natural Cycles’ ads predicted the” world’s first contraceptive app”, something” natural, hormone free& non-invasive “. I could start using it without a two-week wait for a doctor’s appointment and so, in a fug of hormones and exasperation, I bought a subscription. I was sold on shiny promises, a elegant user interface and the fact that a former Cern physicist, Elina Berglund, was at the company’s helm. But four months in, it neglected. Berglund helped discover the Higgs boson; but it turns out her algorithm couldn’t map my menstrual cycle.

Femtech, or female health engineering, “ve been through” a thunder phase, with an estimated $ 1bn of such investments elevated worldwide in the last three years. Apps such as Clue, Dot, Glow and Spot On are all favourite date trackers, but Natural Cycles is the only one certified as contraception. In 2017, it was approved for use across the EU, going the green light from the German inspection and certification organisation, Tuv Sud.

How does it make? It comprises an app, an annual subscription of about PS60, and a thermometer accurate to two decimal point( free in the upright ). You input your temperature as soon as you wake up, and the app realise prophecies about your fertility each day: green for” get-up-and-go have unprotected sex”, red for” not unless you crave a babe”( you can also use the app to strategy teenage pregnancies ). No hormones , no implant and, supposedly , no stress. It has its own language: consumers are known as ” Cyclers”, and useful information is available via a “Cyclerpedia”. It seems as easy as prescribing a takeaway or a taxi from your phone; of track there’s an app for fertility, too.

Natural Cycles have already been registered more than 700,000 useds from more than 200 nations, 125,000 of them in the UK. But its certification as contraception is under review in Sweden, where the corporation and its married co-founders are based. Starting in january, a major Swedish hospital reported that 37 of the 668 women who had sought an abortion there between September and December 2017 were use Natural Cycles as their sole birth control, and the Medical Products Agency of Sweden began to investigate. Natural Cycles has responded that the number of pregnancies is proportional to the registered number of Swedish users and” in accordance with our anticipations “; but as someone who didn’t report my own maternity last year, saving it secret even from my parents, I wonder how many more “and theres”.

It wasn’t the stigma that hindered me quiet, or the sadness, though that trailed me all summertime like the malevolent melody of an ice-cream van. It wasn’t the fact that being 28, in a stable-seeming relationship and game for motherhood in a couple of years, I scarcity an explanation other than perilous finances and a relationship exactly shy of its first anniversary( those are excellent intellects ). No, my silence was because I felt colossally naive. I’d exploited the app in the way I do most of the technology in “peoples lives”: not quite knowing how it labours, but taking for granted that it does. Speaking to others who bought the app as contraception( about 75% of Natural Cycles’ total consumer base, according to its CEO ), it seems that numerous feel the same.

I spoke to Amy, 29, who was fed up with hormones when she started employing the app as her sole family planning. Three months later, she was pregnant, a” massive collapse “. Though she admits she may have made a mistake, she can’t pinpoint the error.” You’re told all you need to know is yourself. I believes in it the same way I did the pill and saw I did exactly what right .” Having already booked her marriage, she went onward with the pregnancy, giving birth weeks before she trod down the alley.” It’s supposed to prepare you feel like you have more govern, but in fact it did the opposite: when I descended pregnant it felt like a decision was taken out of our hands. It wasn’t how we’d have contrived it, and I don’t recommend weds two weeks postpartum, but I’m lucky it was something we wanted in the long run .”

Marie, 30, first hear about the app when she saw an Instagram post about it( search for Natural Cycles and you will find hundreds of posts by influencers telling you how it reformed their own lives ).” I didn’t recognize the hashtag following the end of the caption which said that it was a sponsored post ,” she says. She had been taking Yasmin, a usually prescribed contraceptive pill, for six years old when she made the switching, hoping that the app would be a dependable and easy alternative. A time into a relationship, and eight months into using Natural Cycles, Marie realised she was pregnant. She had an abortion that testified painful, contributing to the breakdown of the relationship and producing her into what she describes as” a quarry of desperation “.

She didn’t want to tell anyone about it. She’d had an abortion once before, when a morning-after pill didn’t work, but this time she felt ashamed:” I felt like I’d played alone in the decision to use the app and had been too trusting. But I was also angry that I’d been treated like a consumer , not a patient .”

Like Marie, I didn’t going to see my GP before I switched to the app, probably because I subconsciously knew he’d advise against it. In numerous lanes he knows me better than any algorithm can. He set me on the pill at 18 because I had an irregular repetition. I later learned I had polycystic ovary disorder, which I now know stimulates me a frightful candidate for Natural Cycles, because my ovulation is erratic and erratic.

A year earlier, before I’d heard of the app, I had been to see a gynaecologist to discuss birth control, concluding I wanted a non-hormonal coil equipped. It was the first time a medical professional had helped me to truly understand the scale of my options. She described me a create of coordinates and plotted each option available( no app got a mention) to show me the benefits and drawbacks. Spotting v cramps, feeling v maintenance, long- v short-term.

I’d speak frightful happenings about the hormonal vaginal doughnut- a widely shared article about a young, fit lady who died after a blood clot- but agreed, based on what she felt would suit me best, to try it. We laughed at how it’s impossible to experiment any birth control online without encountering horror legends. I told myself I would trust a professional and cease my Googling as it simply generated feeling; but after a few paranoid weeks wearing tighten socks to avoid blood clots, I was done.

None of the posts on my social-media feed suggested that being a ” Cycler ” would be such a frustrating, often daunting commitment. One paid-for post I met boasted a still life of a puppy, a duo of on-trend headphones, a self-help book and a thermometer, with a 250 -word caption starting with” 5 occasions I required in the morning. Cuddles from Bee[ the dog ], tea, music, positive mentions and the first thing I do when I wake up- my Natural Cycles thermometer .” But I found that taking your temperature regularly is not so easy. The number of times I leapt out of bed bleary-eyed and needing to pee, then realised I hadn’t first taken my temperature, necessitated I started waking up in the middle of the night to pre-emptively urinate, panicked about missing my quantify space in the morning. On the pill, it didn’t matter if I’d just woken up, was lying down or standing up when I took it. With Natural Cycles, the slightest action seemed to count. It was comedic until it became tragic; I got pregnant when the predictions of fertile and infertile varied back and forth in one day, turning from light-green to red, after I had unprotected sex.

I now know that the ideal Cycler is a narrow, instead old-fashioned category of party. She’s in a stable relationship with a stable lifestyle.( Shift-workers, world-travellers, the sickly, the stressed, insomniacs and sluts be advised .) She’s about 29, and rarely experiences excitements or hangovers. She is savvy about birthrate and committed to the effort required to track hers. I could add that her phone is never lost or divulged and she’s never late to work. She wakes up at the same time every day, with a charged phone and a thermometer within reach.

” From the information supplied by Natural Cycles, I was hoped that my body temperature would follow a clear pattern and that I would be able to pinpoint five days in every four-week cycle that I was fertile ,” says Lucy, 32. She switched from the pill after becoming concerned about an increased risk of breast cancer, after one of her friends was diagnosed.” I did feel like I was getting to understand my torso better, but soon realised that I can’t pinpoint when I wake up each day. Some mornings I conjure at 5am, roll over and try to sleep for another hour or two, sometimes I toss and turn from 2am to 6am and then fall asleep, and so on .” Her interprets were erratic.” I couldn’t see a blueprint and this undermined my confidence. After using Natural Cycles for three full cycles/seconds, I spotted I was still having eight to 10 red[ ie perhaps fertile] daylights per cycles/second .” After four months, she decided it was no better than using a docket and went back on the pill.

No form of contraception is 100% effective; most are assessed according to two metrics: usual use and perfect use. “Typical” manifests a margin for human error; “perfect” is when it’s used absolutely correctly. With perfect employment, Natural Cycles scores as 99% effective, with exactly 1% of women becoming pregnant. With regular give, according to clinical learns be put into practice by the company( self-selecting, rather than randomised power tests ), that lowers to 93%. This is often cited by the company as favourable compared with the pill( 91% effective with” regular help “). But, unlike the pill, you’re not covered for every day of the month. You have to abstain or use other contraception on fertile daylights. And in the first few months, as the app “gets to know you”, these are pretty near continuous.

When I talk to Raoul Scherwitzl, the CEO and co-founder of Natural Cycles, he is charming and sincere and calls at accurately the appointed hour , not a second early or late.” My wife and I represent a typical user-couple ,” he says.” Elina was on hormonal birth control for 10 times and we knew we wanted brats, but in a couple of years. We both had PhDs in physics and were working at Cern, dealing with messy, fluctuating data, trying to look for the Higgs boson, which is basically looking for a signal amid racket. We started working the same statistical methods to pinpoint my wife’s ovulation amid her depart temperatures. We read up on the literature and developed an algorithm which our colleagues started applying, very. We were loping it on the Cern servers and then exploiting Google spreadsheets. We watched it as an unmet need. There was a lack of choice and we wanted to innovate in an important field .”

Natural
Natural Cycles founders Elina Berglund and Raoul Scherwitzl.

I tell Scherwitzl that, though the need is real, after purchasing the app, caveat after caveat divulged itself. I didn’t know it would take months to become dependable.” The algorithm is cautious by design ,” he shows.” It returns red periods unless it’s sure .” I tell him how I got pregnant, when the prophecies altered after I’d had sex. Scherwitzl empathises (” I am sorry to hear that “) but says that as well as ” downsides”, there is” a huge upside with all the happy useds” and that” the most important thing is to use protection on red daytimes: it relies on that “.

Has the company adapted its communication strategy to reflect the experience of users who have become pregnant?” At the core, our messaging has always been sanded on information but we do advance what we say. We used to state the 93% digit but without the right context, so there were certain expectations on the concoction .” The 93% illustration comes from existing useds responding to the company’s calls for players, investigate that has been criticized by a reproductive health expert as “inappropriate and misleading”, and more like ” marketing research” than a medical analyze. But Scherwitzl contends the data is robust, and preferable to a medicalised dominate experiment.” The following is pros and cons to that type of study, and in our opinion this reflects the world better .”

What about the targeted advertising? Isn’t it strange to get social-media influencers( one prominent Swedish blogger is now overseas investors) to promote a medical make? He doesn’t think so.” Social media allows us to control the narrative because there’s lots of misinformation out there , not just with us but with every type of birth control. We can also be used target the right age group .”

The investigation by Sweden’s medical guardian is now six months in, and has started its second phase, inspecting marketing cloth, past clinical learns and fresh customer data. Reports of unwanted maternities has not been able to, however, had any negative effect on the business.

In a 2016 interview I bid I’d speak, Scherwitzl’s partner and business collaborator Elina Berglund described her ideal consumer as a woman who is planning to have children at some detail, and who would like a terminate from hormonal contraception before trying. It’s not a good alternative for women who want to altogether scaped a pregnancy, she said. But somehow this word has got lost in Natural Cycles’ market; this is very much not what the word “contraception” are meant to me.

Indeed, on the section of the Natural Cycles website is targeted at medical professionals there is a” decision tree” for physicians considering prescribing the app as birth control. Is individual patients over 18? Is she satisfied with her current family planning? If the answers to those questions are yes and no, then the third largest is: would she be “devastated” to get pregnant within the next year? If the answer is yes, the doctor is told not to prescribe the app. Perhaps those questions should be compulsory when you click through on a Natural Cycle link.

An
An likenes from the Natural Cycles Instagram note.

Instead, the app expects the insinuate singer of a trusted physician, mingled with the sort of gamified messaging you find on other apps. You might get an update saying,” Nice curves! You have a nice and smooth temperature curve with small day-to-day fluctuations. Keep up the good work !” The company’s social media is peppered with hashtags such as # yourcyclematters and # wakeupmeasuregetup. The perkiness is grating- even the thermometer brings the motto “Good morning!”- and can be pressurising, very. One wife I is talking to who bought Natural Cycles to try to scheme teenage pregnancies told the company she wanted to leave after six months, as the daily tracking was too stressful. She emailed to ask for a interrupt,” for psychological wellbeing “. A customer service manager responded to say she could cancel, and reactivate when she craved, but that” I took a quick look at your data, and in terms of ovulation everything watches good !”, lending,” You do not need to worry about losing any data- we never delete anything !” Those exclamation distinguishes don’t make such reassurances any less creepy.

Perhaps this untrue feel of friendship is why it felt more like a betrayal to find myself pregnant than if the pill were at fault. After the abortion, the honeymoon period of my tie-in ceased hurriedly. It felt like we’d begun our nostalgic race with a false start. I stopped expending the thermometer and went back on the pill, but it took me a while longer to fraction behaviors with the app. I removed it from my phone, simply to realise the direct debit was rolling and non-refundable. I has only just been been moved another PS60 bill, for a contraceptive app I no longer use, that got me pregnant. But it’s not just the money that bothers me – it’s the remember that I set so much faith in a technology that in the end relied on something as inaccurate as my body. What’s the hashtag for that?

* If you would like your comment to be considered for inclusion on Weekend magazine’s notes page in etch, please email weekend @theguardian. com, including your name and address( not for booklet ).

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