Shift to less reliable ‘natural’ contraception methods among abortion patients over past 5 years?
13 January 2025.
Shift to less reliable ‘natural’ contraception methods among abortion patients over past 5 years?
The BMJ has new research showing changing contraceptive habits and the “possible’ shift to fertility apps.
We’ve added the BMJ press release below – and for once an organisation has issued an interesting press release! Thanks.
The full research can be found on the BMJ website here “Self-reported contraceptive method use at conception among patients presenting for abortion in England“.
FPA response to the new research
By Bekki Burbidge, Information Specialist, FPA:
“Years of underfunding has made it much harder for people to access the full range of contraceptive methods.
“There are now fewer appointments available and fewer health professionals trained in providing the most effective long-acting methods of contraception.
“There certainly seems to have been a greater interest in fertility awareness-based contraceptive methods over the last few years.
“This is probably for a range of reasons including a lack of access to other methods, a shift towards wanting non-hormonal methods with fewer possible side effects, and the wider availability of fertility awareness apps.
“Fertility awareness-based methods can work well for some people but they’re typically less effective at preventing pregnancy.
“To be most effective they require all partners to be committed to using the method, an understanding of what makes them less effective, and a commitment to using additional contraception or not having sex at certain times of the menstrual cycle.
“It’s also important to know that hormonal contraception side effects can be positive as well as negative e.g. the hormonal IUD often means lighter and less painful periods.
“Having clear information about the advantages and disadvantages of each method of contraception is essential.
“Likewise, improved access to contraception is vital – this needs to go hand in hand with investment in health services and a new national Sexual and Reproductive Health Strategy.
Original BMJ Press Release below
(links added by FPA)
Use of the Pill/implants has given way to fertility awareness methods in England and Wales
Trend corresponds to abortion rate rise, with implications for healthcare services, say researchers
There has been a shift away from the use of more reliable hormonal methods of contraception to less reliable fertility awareness methods among women requesting abortion in England and Wales over the past 5 years, reveals research published online in the journal BMJ Sexual & Reproductive Health.
Use of the Pill, mini Pill, implants, patches, and vaginal rings has given way to more ‘natural’ methods, such as period tracking apps that highlight monthly peak fertility/ovulation, the findings indicate.
While further research is needed to understand the reasons driving these changes, the trends correspond to a rise in abortion rates, with wider implications for healthcare services, conclude the researchers.
Worldwide, women seem to be increasingly reluctant to use hormonal methods of contraception, note the researchers. In 2010 around half of women of reproductive age in the UK were using the Pill, since when its use has steadily declined.
Anecdotal evidence suggests that women are increasingly turning to more ‘natural’ fertility awareness methods of contraception, largely influenced by social media, say the researchers.
But the typical failure rate for these methods ranges from 2 to 23 in every 100 women in the first year of use compared with 7 in 100 women for the Pill/implants and less than 1 in 100 for the coil (intrauterine devices), they explain.
To find out what contraceptive methods women requesting abortion in England and Wales were using when they fell pregnant, the researchers compared data from the British Pregnancy Advisory Service for the periods January to June 2018 (33,495 women) and January to June 2023 (55,055 women).
Fewer young women (aged 25 or below) requested an abortion from a BPAS facility in 2023 than in 2018. But the proportion of women who hadn’t had a previous abortion fell from 62% in 2018 to 59% in 2023.
The proportion of women of minority ethnicity rose between 2018 and 2023, as did the proportion of medical abortions requested. And the proportion of women who were at 7 or fewer weeks of pregnancy was significantly higher in 2023 than in 2018, rising from nearly 37% to just over 59%.
A sizeable shift in the methods used for contraception occurred between 2018 and 2023, the data showed.
Reported use of fertility awareness based methods around the time of conception increased from 0.4% in 2018 to 2.5% in 2023, while the age of those using these methods fell from nearly 30 to 27.
The use of hormonal methods fell from just under 19% in 2018 to just over 11% in 2023. Use of long-acting reversible contraceptive implants also fell from 3% to 0.6% over this period.
And those who said they hadn’t used any form of contraception when they fell pregnant significantly increased by 14%, rising from 56% in 2018 to nearly 70% in 2023.
This is an observational study, precluding firm conclusions to be drawn about cause and effect. And the researchers acknowledge that abortion patients may not reflect the sexually active population in general. They also highlight that the precise fertility awareness method used wasn’t recorded, so the rise in the use of app technologies can only be assumed.
Researchers point out:
“The shift in preference towards [fertility awareness methods] is coupled with reported increases in difficulty in accessing the more effective methods of contraception following the COVID-19 pandemic due to workforce changes and a reduction in primary care and sexual healthcare capabilities.
“The amalgamation of a shift in attitudes and difficulty in accessing certain methods has led to increasing use of less reliable methods, which, in turn, has the potential to increase unintended pregnancies
“While the rise in abortion rates is multifactorial, one aspect that needs scrutiny is any change in contraceptive use, and particularly this surge in the use of ehealth, including fertility apps, period tracker apps, and natural family planning apps.
“The possible relationship between these less effective methods of contraception and unplanned pregnancy requires further investigation. However, informing the public about the efficacy of such methods in order to facilitate informed contraceptive choices is needed.”
