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Why some women are ditching the birth control pill for an app

CBC Radio with Catherine Macnab 19 December 2017

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At a time when the popularity of the birth control pill is waning, the European health regulator has just approved a contraceptive app that pairs technology with the age-old rhythm method.

With a 10 per cent drop in birth control pill prescriptions in Canada alone, more women are opting for hormone-free, non-invasive birth control methods.

Earlier this year, Natural Cycles became the first and only app in Europe to receive certification as a medical device for contraception. The app has its sights set on getting certified in North America next.

“With Natural Cycles, you don’t actually need to understand how the system works,” says Catherine Macnab, executive director of Planned Parenthood in Ottawa.

“It’s tracking what’s really the oldest form of birth control which is a fertility awareness.”

The number of prescriptions for oral contraceptives has steadily dropped over the past five years. Canadian pharmacies dispensed 1.17 million fewer prescriptions in 2015 than 2011, according to data from health information company QuintilesIMS.

But she worries that promising a more natural form of birth control is a bit misleading.

“We really need to reframe the question … are they moving toward more natural methods or are they specifically moving away from hormonal and moving away from the pill?”

One thing Macnab is certain of is the side effects from the birth control pill are a major deterrent for women, let alone the issues surrounding having to take a pill every day.

“There are a lot more options out there than there was even 10 years ago. And I suspect what we see is people moving toward more options, to give them a better sense of control or that they feel that they can use more consistently than the pill.”

What’s the success rate?

Macnab says European regulators have numbers to back up their research of the Natural Cycles app.

“What they’ve been able to show is the green days are very, very accurate. So in terms of device failure, if you only have unprotected sex on the green days, there’s a very slim — I think it’s one in a 1,000 people that will get pregnant on it.”

This is compared to what Macnab calls user failure with the app where someone on a red day has unprotected sex despite warning, or use the withdrawal method and don’t get the timing right.

“So the real failure rate happens when people have a red day and, you know, whatever it is that they do, ends up with pregnancy.”

Consulting doctors when using the app

Dr. Dustin Costescu, an assistant professor in the department of Obstetrics and Gynecology at McMaster University, supports what the Natural Cyles app offers, which is to provide education and opportunities for women to use as many tools at their disposal as a form of contraception.

But he says there’s still value in consulting with a doctor in terms of contraception, including natural family planning methods.

“When I offer to provide some advice or insight, often the response is one of resistance and that [patients] really are looking for non-medical,” Costescu tells Tremonti.

He argues if people are going to use an app, use science to back up what is being offered.

“So it’s a bit of a paradox, but we have to be very careful as health-care providers if we’re not vetting the technology, you know, it’s not enough to say Google it … and download an app.”