There has been a “significant increase” in the proportion of women seeking abortions who are using natural methods to prevent pregnancy rather than hormonal contraceptives, a study has suggested.
Anecdotal evidence suggests the increase in natural birth control methods, which include fertility tracking apps, has been influenced by the rise of “hormone hesitancy” on social media, new research highlights.
Researchers from the University of Edinburgh have highlighted a shift in contraceptive use across the UK in the last five years, from “more reliable” hormonal contraceptives such as the pill, to “fertility awareness-based methods”.
The researchers looked at data from the British Pregnancy Advisory Service (Bpas) to explore what methods of contraception women who requested abortions were using and compared two periods of time: January to June 2018, which included 33,495 women, and January to June 2023, which included 55,055 women.
Researchers found reported use of fertility awareness-based methods at the time of conception increased from 0.4 per cent in 2018 to 2.5 per cent in 2023, while the age of the women using these methods also fell from almost 30 to 27.
These natural methods involve tracking menstrual cycles or symptoms of ovulation, such as changes to cervical mucus or basal body temperature, usually using smartphone apps.
This helps to estimate a woman’s fertile window, with couples avoiding sex on these days to prevent pregnancy.
However, researchers from the University of Edinburgh said these methods can be “less reliable”, with the potential to “increase unintended pregnancies”.
The proportion of women seeking abortions who were taking hormonal contraceptives such as the pill, the mini pill, patches and vaginal rings declined from 18.8 per cent in 2018 to 11.3 per cent in 2023.
Researchers said the findings, published in BMJ Sexual & Reproductive Health, show a “shift in contraception use from more reliable hormonal methods of contraception to less reliable fertility awareness-based methods of contraception among abortion patients”.
They added: “There appears to have been a significant increase in the proportion of individuals attending Bpas for abortion who use fertility awareness-based methods as a form of contraception and are using no method of contraception.
“This may be a result of preference or it may be related to difficulties with access to more effective methods of contraception in the preconception and post-abortion periods.”
It was also suggested that “hormone hesitancy attributed to the influence of social media has been reported in other European countries”.
The team added that further research is needed to explore the reasons for the change, but warned: “The decline in use of effective contraception and increase in abortion rates have wider implications for healthcare services.”
Use of the contraceptive implant – a small rod placed under the skin which releases a hormone to stop the ovaries releasing an egg each month – also fell, from 3 per cent to 0.6 per cent over between 2018 and 2023.
Dr Patricia Lohr, director of research and innovation at Bpas, said a separate Bpas survey of the general population found that almost half of women (49 per cent) faced barriers to accessing contraception such as long waits for appointments.
She said the new study “… may indicate women are making different contraceptive choices or can’t get the methods they want.”
Dr Lohr said abortion “remains a vital option” either as a back up when contraception fails or when there is none available, but at the same time, women needed access to “modern, innovative contraceptive methods” that suit their lives.
“Women deserve a full range of options that meet their needs without compromise,” she said.
Bekki Burbidge, information specialist at the Family Planning Association, said years of underfunding had made access to the broad range of contraceptive methods much more difficult.
“There are now fewer appointments available and fewer health professionals trained in providing the most effective long-acting methods of contraception,” she said.
Ms Burbidge agreed there seemed to be a greater interest in fertility awareness-based contraceptive methods as people shift away from wanting hormonal-based methods.
“Fertility awareness-based methods can work well for some people but they’re typically less effective at preventing pregnancy,” she said.
“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.”
With additional reporting from PA