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Commentary Contraception

Fancy Birth Control Technology Can’t Solve Everything

Chanel Dubofsky

Apps to track contraceptive use are plentiful, often free or cheap, user-friendly, and undoubtedly helpful to some individuals. But that doesn’t mean that perfect birth control use is a forgone conclusion for everyone.

Lest you think Apple didn’t have enough of a foothold in our lives—often dominating how we communicate, entertain ourselves, and find our way around—it’s now getting involved with reproductive health. Last month, the creators of My Cycles, a free app that includes a birth-control use tracker, announced they would be integrating their program into HealthKit, which has been included with all iPhone software updates since mid-2014. My Cycles also includes an Apple Watch-compatible version. In practice, this means that nearly everyone with an iPhone can access their “symptoms, medications, mood, and more,” as My Cycles’ page in the app store puts it, with the tap of a thumb.

Of course, this isn’t the first example of technology companies using apps to “improve” people’s contraceptive use. In addition to My Cycles, there are approximately eleventy billion other birth control apps available (many of them, naturally, illustrated with pink flowers). You can download programs that will remind you to take your pill or remove your NuvaRing, assist you in locating the nearest condom for sale, and more. MyPill, for example, provides a visual model of a birth control pill pack, a pill disappearing along with your pill cycle (the way it does in your physical pack). The daily alarm will snooze until you mark that you’ve taken the pill—so no absentmindedly turning it off and forgetting to take it. The app also keeps track of symptoms, refills, and doctor’s appointments. NaturalCycles, meanwhile, utilizes an algorithm to monitor the body for signs of fertility based on basal temperature. Multiple platforms are getting in on it too: Lady Pill Reminder is a Google app that asks you to enter the type of pill you use and when, and the app will notify you when it’s time to take it.

So these apps are plentiful, often free or cheap, user-friendly, and undoubtedly helpful to some individuals. But that doesn’t mean that perfect birth control use is a forgone conclusion for everyone. For starters, not every birth control user owns a smartphone, can afford one, or knows how to use one. Some apps do cost money, and while $2.99 might seem like a paltry amount, it can be the difference between being able to travel to work on the train or not. (If you live in New York City, for example, the cost of subway fare for a one-way ride is $2.75.)

Furthermore, they may not be all that effective: It might seem like a simple matter of uploading information, but the reality is that people with vaginas are often not socialized to be deeply in touch with our bodies and their inconsistencies. Irregular periods, for example, can be caused by many things, such as stress, travel, or changes in weight, none of which can be resolved by setting an alarm on your phone. The apps assume that you’ll keep track of these symptoms—many include a space specifically to record them—but they don’t tell you when to call the doctor, other than to refill your pack. This could potentially lead to users failing to contact their physicians when necessary; in practice, it could also just mean that users’ lives aren’t getting any simpler with the aid of such apps. And of course, if you can’t afford to refill your birth control or see your doctor, these apps are moot.  

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They also put the onus of those who use contraceptives to bend over backwards to make sure they’re using them properly—reproducing a narrative that is counterproductively shameful. People who use birth control are often derided when it fails, even by other birth control users. It’s easy to preach if you have never had a birth control failure, even though statistically, you are due for at least one over the course of your reproductive life. When birth control is used “perfectly,” (correctly and consistently), the rates of failure are low, especially for the IUD and implants. But, not surprisingly, when fallible humans are in charge of remembering to get shots, take pills, use barrier methods, and insert devices, failure rates are higher.

These apps make it easier for folks to ignore the complexities of both bodies and birth control, and to shame birth control users for being imperfect humans and consumers. After all, if you can access an app that will remind you, it must be really easy to follow through, right? You have no excuse to mess up. But if you do—and you might, with or without the app—this narrative suggests that perhaps it’s useless to even try, given that even technology can’t guarantee your 100 percent success rate. This is an echo of the frequent watchword of abstinence-only education, “If you don’t want to get pregnant, don’t have sex.” It’s a kind of shame that denies the control that readily available contraception gives individuals: the choice to have sex without submitting to pregnancy, and the dignity to weigh the risks associated with doing so, including the risk of birth control failure.

So while they might certainly helpful to some, in terms of fixing the problem of birth control accessibility, apps are not an equalizer. Apps won’t solve the socioeconomic issues of obtaining birth control or the stigma that surrounds the use of it. Nor will they address the misogynist anti-choice movement’s frequent attempts to block it, which would make it even harder to obtain.

What’s the solution, then? Well, here’s what it’s not: creating policies that prevent folks from having access to free and safe birth control, including emergency contraception, and abortion. Nor is it using innovations in technology as an excuse to not take further action. The solution lies in a push for health care and education, perhaps even spearheaded by tech companies. (The existence of these apps doesn’t negate the fact that education and health care is desperately needed.) Such a strategy would take into account class, race, gender, and sexuality, wouldn’t rely on shaming as a tactic, and would extend to people using non-oral contraceptives as well, taking into account any possible complications.

Apps can be great—but energy also needs to be paid toward enacting policies that will encompass contraception users’ variety of experiences. Downloading an app is not a solution for a larger, innately unequal system.

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