Warning: Your Fertility App Could Be Funded By Anti-Abortion Campaigners
Fertility apps are booming in popularity—there are now more than 100 of them on the market. Some simply track ovulation symptoms, while others get more technical using portable devices to measure basal body temperature and cervical mucus. Despite their different features, fertility apps typically all aim to help women understand their cycle and plan for pregnancy.
But a recent Guardian investigation revealed one in particular—the Femm app launched in 2015—is being funded by anti-abortion groups. The article said the company receives most of its money from private donors, including more than $1 million in three years from the Chiaroscuro Foundation, which has backed politicians and organization that oppose abortion and birth control. Two of Femm’s medical advisers are also “not licensed to practice in the U.S. and are also closely tied to a Catholic university in Santiago, Chile, where access to abortion remains severely restricted.”
Anna Halpine, CEO of the Femm Foundation, told the Guardian: “Femm has never commented on the abortion issue. And doesn’t work in that area.” The company, which says its app has been downloaded more than 400,000 times in 161 countries, also released a report saying it doesn’t buy, sell, or share private data. It insists it is helping women “understand their own unique health patterns, improving health education, and informed choice.”
The news, however, has brought the app’s intention and messaging about contraception into question. Should women be concerned?
Erin Stevens, M.D. isn’t too surprised by the funding news since anti-abortion groups are generally against hormonal birth control. “They are trying to promote methods that don’t include hormones to be able to plan and prevent or try for pregnancies,” says Dr. Stevens, an ob-gyn at Clinic Sofia located in both Edina and Maple Grove, Minnesota.
Yet women, experts say, shouldn’t put all their trust in fertility apps when preventing or planning for a pregnancy. “We have to understand that with a human error involved those might not be the most reliable and effective methods for people,” says Dr. Stevens, who has a number of patients using fertility apps. “And we are going to end up with potentially more unintended pregnancies.”
Studies confirm fertility apps don’t have a high success rate. Research published in the Journal of the American Board of Family Medicine in 2016 found up to 60 percent “of women express interest in using natural or fertility awareness-based methods (FABMs) to prevent pregnancy.” (Also called "natural family planning," FABMs rely on tracking the menstrual cycle to detect fertile days.) But most fertility apps, it concluded, could not be trusted as a form of birth control—only 6 apps out of dozens had a perfect score on accuracy or no false negatives.
Language on Femm's website also promotes avoiding hormonal birth control, which can be the wrong advice for some women. Lindsay Rerko, D.O., a physician practicing family medicine in Ohio, is featured on the site, writing, “fertility awareness models are the key to preventative medicine” and contraceptives have “side effect profiles that they are causing illness and degrading health.”
When talking to patients about birth control, Dr. Stevens says she goes through every method available, including fertility awareness, barrier methods, and hormonal options. “Not every method is perfect for every person and every person has to figure out their perfect method,” she says. “If fertility awareness is the best method for someone that is great, but I think trying to steer entire populations into this method, which may not be the best for them without a strong medical understanding of why, is really problematic.”
Menstrual tracking through fertility apps could be an effective tool for women with normal menstrual cycles. “The way that most of these apps work is they take an average of the lengths of the cycles that have been reported and come up with an average estimated fertility window based on that,” says Rashmi Kudesia, M.D., a reproductive endocrinology and infertility specialist at Houston Methodist and CCRM Houston in Texas. “If a woman has regular cycles that fall within what we consider a normal menstrual cycle, which is one that occurs every 21 to 35 days, they can be fairly accurate in terms of helping to pinpoint the most fertile days.”
But most women have menstrual cycles that fall outside of that window. The days when ovulation occurs can also change each month, sometimes because of diet, stress, and activity changes. There are also women who don’t ovulate at all, commonly because of polycystic ovary syndrome (PCOS). “If somebody is truly aiming for reliable contraception, there are so many better options [than fertility apps],” says Dr. Kudesia. She points to long-acting reversible contraception like intrauterine devices, which can last 3 to 10 years depending on which type, the birth control pill, patch, and ring, as well as barrier methods like condoms.
“I think [fertility apps are] a good idea for women that are trying to learn their body, trying to learn their cycle. But if it’s becoming onerous, if they feel like they are not getting consistent data or they don’t know how to interpret their results, then I would say it’s much better to speak with [a doctor] about it,” says Dr. Kudesia. “We have so many other ways of verifying whether somebody is ovulating or not.”
