'Pregnancy is a risk I'm willing to take': Why some women are ditching the pill

Recently, some women are choosing to forgo pills and IUDs for birth control, instead opting for fertility tracking apps. The BBC reports that some women seeking abortions are switching from "hormonal" options like birth control pills to "natural" fertility tracking apps for contraception. This phenomenon has prompted many other women to share their experiences.

These women's stories reveal how difficult it can be to find a method of contraception that fits their lifestyle and has acceptable side effects. Health experts point out that all types of contraception have their pros and cons. Paula Baraitser, medical director at SH:24, a free sexual health service partnered with the UK National Health Service (NHS), says that what works for you at 18 might not work at 28, 38, or 48.

Fertility tracking apps are a relatively new option that some people are using. These apps predict ovulation by measuring indicators like body temperature, allowing users to understand when they are most likely to get pregnant each month or menstrual cycle, and can avoid sex or use condoms on those days. Dr. Baraitser says that some of her patients have switched to these apps after trying hormonal treatments like birth control pills.

Dr. Baraitser explains: "Taking hormones changes your body, and people react differently, both positively and negatively. For example, estrogen can often reduce acne, while combined hormonal methods, such as the combined pill, patch, or ring, can help control bleeding. On the other hand, people may experience mood changes or changes in libido." She also says it can be a trial-and-error process, requiring switching between different methods until one is found that works. Condoms are the only form of contraception that both prevents pregnancy and protects against sexually transmitted infections.

The BBC interviewed some women to learn about their experiences. To protect their anonymity, their identities or photos were not included in the article. Georgia, 25, from Bristol, has been using a fertility tracking app for seven months. She says her mental state has improved dramatically after stopping birth control pills she had been taking for about ten years. Georgia is aware that there is a risk of accidental pregnancy if not used carefully, but she says, "I'm willing to take that risk to get my body back to where it should be."

Georgia stated: "(While taking birth control pills) my moods were all over the place, and I felt completely out of control. After I decided to stop taking the pill, I noticed a huge change in how I regulate my emotions and how I feel about life and myself." She also said, "I considered using a copper IUD, but the heavy bleeding put me off. I already have heavy periods, so using something that could make it worse didn't feel right. I realized that I had been altering my body's hormones for a long time. That bothered me, and I didn't want to keep doing it."

Emily, 39, from Glasgow, had an abortion in 2021 after discovering she was pregnant while using a tracking app for contraception. In 2018, she stopped taking birth control pills, which she had been taking since she was 17, initially to control acne. Emily said: "I was depressed, gaining weight, and couldn't lose it. I had symptoms such as low libido. I took a break, and once I stopped, I felt much better."

In search of a non-hormonal alternative and to avoid the experience of getting an IUD fitted, she chose to use the period tracking feature on her iPhone's health app. In 2021, she found out she was two months pregnant, at which time she had been dating her now-husband for four months. Emily said, "I got a urinary tract infection, which threw my cycle off a bit. Unbeknownst to me, months went by, and I didn't have my period. One day I felt really unwell and thought I either had COVID or was pregnant. I went home and did two tests. The pregnancy test was positive."

Freya, 26, stopped hormonal birth control to see if it would improve her mental health. She said, "I've been on the pill since I was about 15, so I really 'don't know' myself without it." She chose to use condoms when the app indicated a risk of pregnancy. As a result, she became pregnant within three months and chose to have an abortion, which was very distressing for her mentally and physically. She said that the experience has made her not want to use natural contraception again because "the risk is too high."

Alice, 41, from Farnborough, experienced side effects while taking birth control pills, including low libido, weight gain, mood swings, and bleeding. She said: "I now have a daughter, and I feel sad for her future. Why do women and girls have to take responsibility for not getting pregnant? Right after giving birth, you get asked what kind of contraception you want. Fortunately, my husband has no problem with condoms...Now I just use a fertility app to track my period, but I don't rely on it."

For those interested in fertility tracking apps, there are some things to consider: only one fertility app is licensed for contraception in the UK; period trackers are different from fertility trackers, they are not designed to predict ovulation or when you are likely to be fertile; if your menstrual cycle is not the same length each month, the days of your cycle when you are fertile can change; if your cycle is very irregular, the app may have more difficulty predicting your fertility; you must follow the app's instructions correctly for it to be as reliable as possible; and if you are monitoring your temperature, how you monitor it is very important.

Dr. Baraitser explains: "After ovulation, your temperature rises, but by a small amount. To detect such a small difference, you have to measure your temperature when the app tells you to, usually daily, and you need to do it in the morning before you get out of bed, before you eat or drink anything. If you have a busy life, if you work night shifts, if you have young children, this can be difficult to do." She says that new technologies that can monitor temperature continuously, such as wrist temperature measured by smartwatches, may help. The app can only tell you when you can have sex and when you cannot. Whether you remember and act on it is up to you.

Anatole Menon-Johnson, clinical director at Brook, a sexual health clinic across the UK, says it's important to weigh the risk of an unplanned pregnancy. He advises: "Find a provider who is willing to listen to you and allow you to explore and try out contraception methods. Sometimes it takes several attempts to find the method that works best for you." The company says that when used correctly, apps can be up to 93% reliable, which means that 7/100 women will get pregnant each year while using fertility tracking. This is slightly better than the 91% reliability of the typical or imperfect use of birth control pills and mini-pills. Perfect use of the pill can increase success rates to 99%, which is similar to hormone-releasing IUDs or implants that do not rely on the user remembering to take them.