Ambivalences in Digital Contraception: Designing for Mixed Feelings and Oscillating Relations

Park, Joo Young; Campo Woytuk, Nadia; Yadav, Deepika; Huang, Xuni; Blanco Cardozo, Rebeca; Ciolfi Felice, Marianela; Lampinen, Airi; Balaam, Madeline

doi:10.1145/3563657.3596062

Cited by 6 publications

(7 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, the role of the digital contraceptive as an algorithmic mediator has to do with the perceived objectivity of the algorithmic data over the subjective nature of the user’s embodied experiences [ 85 ]. Although also compatible with the finding by Grenfell et al [ 21 ] on Natural Cycles privileging disembodied data, our work adds nuance as topics 8, Body or algorithm , and 9, (Dis)trust in BBT method , show that some users have learned when to trust their own bodies, similar to participants in the study by Algera [ 26 ] appropriating menstrual and fertility trackers for contraception and to the analysis by Park et al [ 8 ] of ambivalences in digital contraception. Some partners apparently also needed the confirmation provided by the technology (theme 5).…”

Section: Discussionsupporting

confidence: 89%

“…Here, it is worth wondering whether users could become so expert that the technology is no longer needed. Cases such as the user who was expecting the digital contraceptive to warn them after inputting that they had had unprotected sex during a red day show that users might still expect to see even more interactivity from the digital contraceptive, seeing it as a source of guidance that could continue to educate them—or even “scold” them [ 8 ]. Future research could explore appropriate interactions (including their timing and ethical implications) for the digital contraceptive to also play a “warning” or “scolding” role.…”

Section: Discussionmentioning

confidence: 99%

“…Although these works provide a valuable foundation, they do not explicitly examine the experiences of users of a digital contraceptive. The most significant explorations in this particular space can be found in the studies by Park et al [ 8 ] and Chen [ 9 ], both of which are based on Natural Cycles. We expand on these 2 cases in the following section after providing the necessary background on this digital contraceptive.…”

Section: Introductionmentioning

confidence: 99%

“…Recent company-funded (but independently run) interview studies with users of the Plan Pregnancy mode in the United Kingdom [ 21 , 22 ] showed that the app supported self-knowledge, which aided users’ preconception and conception work and health care while also reproducing highly gendered roles in this context [ 21 ]. In total, 2 studies have looked instead at the contraceptive experiences of Natural Cycles users in Birth Control mode [ 8 , 9 ]. The Master’s thesis by Chen [ 9 ] contains 12 interviews from 2017, before the product was cleared in the United States.…”

Section: Introductionmentioning

confidence: 99%

“…It is also clear from the study by Chen [ 9 ] that avoiding hormonal contraceptive methods and biomedical interventions was a key motivation for participants to use a digital product. More recently, Park et al [ 8 ] conducted design workshops with 14 users (mostly situated in Scandinavia and other parts of Europe). The analysis highlighted the ambivalent feelings that participants had developed toward their digital contraceptive over time.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Analyzing User Reviews of the First Digital Contraceptive: Mixed Methods Study

Ciolfi Felice,

Søndergaard,

Balaam

2023

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

Background People in Western countries are increasingly rejecting hormone-based birth control and expressing a preference for hormone-free methods. Digital contraceptives have emerged as nonhormonal medical devices that make use of self-tracked data and algorithms to find a user’s fertile window. However, there is little knowledge about how people experience this seemingly new form of contraception, whose failure may result in unwanted pregnancies, high health risks, and life-changing consequences. As digital contraception becomes more widely adopted, examining its user experience is crucial to inform the design of technologies that not only are medically effective but also meet users’ preferences and needs. Objective We examined the user experience offered by Natural Cycles—the first digital contraceptive—through an analysis of app reviews written by its users worldwide. Methods We conducted a mixed methods analysis of 3265 publicly available reviews written in English by users of Natural Cycles on the Google Play Store. We combined computational and human techniques, namely, topic modeling and reflexive thematic analysis. Results For some users of digital contraception, the hormone-free aspect of the experience can be more salient than its digital aspect. Cultivating self-knowledge through the use of the technology can, in turn, feel empowering. Users also pointed to an algorithmic component that allows for increased accuracy over time as long as user diligence is applied. The interactivity of the digital contraceptive supports mutual learning and is experienced as agential and rewarding. Finally, a digital contraceptive can facilitate sharing the burden of contraceptive practices or highlight single-sided responsibilities while creating points of friction in the required daily routines. Conclusions Digital contraception is experienced by users as a tamed natural approach—a natural method contained and regulated by science and technology. This means that users can experience a method based on a digital product as “natural,” which positions digital contraceptives as a suitable option for people looking for evidence-based nonhormonal contraceptive methods. We point to interactivity as core to the user experience and highlight that a digital contraceptive might allow for collaboration between partners around contraceptive practices and responsibilities. We note that the user diligence required for the digital contraceptive to provide accurate and frequent data is sometimes not enough. Future research could look at designing (and redesigning) digital contraceptives with primary users and intimate partners, enhancing the experience of tamed naturalness; exploring how trust fluctuates among involved actors and in interactions with the technology; and, ultimately, designing more inclusive approaches to digital contraception.

show abstract