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Comment by jessriedel | Hacker News Reader

What is with scare quotes? It's a non-pharmaceutical method with only passive intervention (i.e., measurements and abstaining). The word "natural" seems at least as appropriate here as "organic" and "processed" foods; all of these are oversimplifications, but they communicate something that's not meaningless with reasonable fidelity to an unsophisticated user.

I understand most reporters are going to bring an existing set of political beliefs to the table, but I wish they felt a higher duty to present an objective account. (Like a judge.) This doesn't mean pretending there's no fact of the matter and all sides must be given equal time uncritically, but cooly assessing arguments is different than weaponizing the words on the page.

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The quotes refer to other "natural" methods that were once pitched but are now bunk. "Natural" also has religious connotation in the US. Rhythm method was the church-approved means of family planning. It doesnt work, with a per-year failure rate of at least 10%. So anyone talking of natural birth control is eyed with sucpicion.

The rate is significantly higher than 10%. https://www.cdc.gov/reproductivehealth/contraception/uninten...

And for that matter many other methods are a lot higher than many would guess

> It doesnt work, with a per-year failure rate of at least 10%.

That's on par with condoms, which per Planned Parenthood have an effective annual failure rate of 15%[0]. Oddly, folks don't eye talk of condoms with suspicion.

0: https://www.plannedparenthood.org/learn/birth-control/condom...

As your own link shows, the main problem with condoms is people failing to use them properly (the 98% figure given for proper usage is actually one of the lower values I've seen for effectiveness in that case). Part of it is not putting them on right. The other part is much closer to one of the problems this app has: people getting caught in the moment and making an impulsive decision to proceed at least partially against the app/without a condom, then pull out (and either stop/apply a condom).

So why single out the app and the natural birth control method if the same problem (people using it incorrectly) applies to condoms as well?

> As your own link shows, the main problem with condoms is people failing to use them properly

This just shows that condoms have a UI problem.

> So anyone talking of natural birth control is eyed with sucpicion.

Right, so the author is suggesting something is inaccurate about the word "natural" (in the specific sense that if you quote the word in this context, it means you are disavowing its correctness and attributing it to someone else) -- even though it's not -- simply because the author disagrees with the other persons conclusions, politics, or methods. But the author does this in a way that isn't technically disputing the word usage, so that if they are challenged they can always back track. (See "motte and bailey": slatestarcodex.com/2014/11/03/all-in-all-another-brick-in-the-motte/ ) This is a textbook example of a dark-side persuasion techniques rather than honestly engaging with arguments.

Right, so the author is suggesting something is inaccurate about the word "natural"

Would it be more accurate if the title were - natural “birth control” app...?

Because it is “natural”, the argument is it actually “birth control” since it doesn’t work.

None of these apps are the rhythm method. That being said, they are also not the time-proven methods approved of by 'religious organizations'. That is their danger. The church dedicates a lot of time to educating couples in actually proven methods. Both the sympto-thermal method and the various mucus only methods (billings and creighton) have been demonstrated effective by large studies. Studies on the sympto-thermal method report a 99.4% efficacy rate, and similar for billings and creighton.

source: https://academic.oup.com/humrep/article/22/5/131/2914315

The religious organizations you mention (like the couple to couple league, the largest provider of fertility awareness education in the united states) have never taught the rhythm method. The rhythm method was used before the 1950s, but we've had significantly better methods since then. In fact, the Billings method has -- in the pas at least -- been endorsed by the government of china as a way to enforce the one-child policy.

The main failure from these apps is lack of education. Most people using them have never had a formal education in them, despite such things being available. My wife and I are glad at having taken an actual course, rather than learning from an app or book. Our experience has been perfectly acceptable

Good point.

The scare-quotes should actually be around the term "birth-control" since this app clearly has no solid supporting evidence from unbiased 3rd party researchers.

So it's not really birth-control, it's "birth-control."

90% effective "birth control" still controls birth.

You just end up with 6 kids instead of 18.

Thermometers, let alone ones with 0.1°C precision, do not grow on trees.

Maybe not on trees, but certainly around them.

https://en.m.wikipedia.org/wiki/Dolbear%27s_law

While amusing, I'd like to point out that the accuracy stated for this law doesn't meet the precision that the parent poster stated (0.1°C).

Supposedly accurate to within a degree Fahrenheit (which I think is .6 to .7 Celsius). With the more reliable snowy tree crickets, it might just approach .1 Celsius accuracy. It could be interesting to read more about this, but there doesn't seem to be a plethora of scientific research that I can find easily.

Even with 0.1°C precision, time of day makes an insanely huge difference.

Taking temp at the same part of your daily schedule, e.g., on awakening, will still show substantial variation based on just waking up earlier/later, or if something skews your sleep cycle -- and by substantial, I'm talking about >1.2°C.

Take temp at different times of day, and you're looking at >2°C normal variance between early morning low and mid-afternoon high.

Source: while training & competing at an international level, I took resting Temp/HR/BP readings 2x per day to regulate the training intensity schedule (unusual increases in resting values provided early warning for overtraining or illness, so could back off a smaller amount earlier rather than being forced to a larger rest later). What I found was that the temp numbers were extremely sensitive to the huge daily temp cycle, and that I had to constantly compensate reading that value.

It's really interesting, but unless you're very consistent and understand the daily cycle and variability, really hard to base anything on it (and I'm not even considering the F hormone cycle which is what they're apparently trying to measure).

That's not the point! The point is that the intervention is natural, i.e, just abstinence. The person isn't consuming pharmaceuticals or inserting a mechanical device.

Likewise, if I use sophisticated ML techniques to identify young students who have attention problems, but then the actual treatment is 1-on-1 tutoring (rather than, say, drugs), this is still a natural intervention. And it is reasonable to suspect that it has fewer side-effects on account of being natural, which must be traded off against it's lower effectiveness.

Personally, I generally find the distinction between natural and unnatural interventions mostly unhelpful (since there are plenty of natural ways to hurt yourself), but it's a meaningful distinction and one that can plausibly provide useful guidance to someone who is very risk adverse.

> is natural, i.e, just abstinence.

No, it specifically isn't abstinence. It's a combination of mostly non-abstinence with a window of abstinence timed with a thermometer.

A method can be called "natural" if it could successfully be practiced by cavemen. Selective abstinence based on counting days since menstruation could be called natural; cavemen could conceivably figure that out.

Needless to say, total abstinence is also natural.

It could also have been "scare-quoted" with "birth-control" since, IMO, there is not much "control" going on here. It's at best "birth-guidance" or something equally inefficacious (as compared to, say, IUD). Just my opinion.

Personally, I would never recommend this to my minor daughter, sexual partner or frankly anyone who wants actual control in their "birth-control."

My wife and I talked about this, we've used trackers to increase our chances of conceiving and prior to that I had never really thought about how effective timing could be. That said, if you absolutely need to not get pregnant, it's not useful. I would also never suggest this to my minor daughter.

The best use case is for someone who would prefer to have like 5 kids over 20 years rather than 10 kids.

I also think people really underestimate differences in fertility at different ages. An 18 year old is way more likely to get pregnant than a 35 year old. I'd bet if a 35 year old woman was reasonably careful with natural planning, she could avoid getting pregnant until menopause, but I think there's no chance that an 18 year old with average fertility could make it to 25 without having at least one pregnancy.

> It could also have been "scare-quoted" with "birth-control"

Yea, and I would have agreed with that usage! Indeed, the author could have said explicitly something like "it's called "birth-control", but the inherent imprecision of the method means it's more aptly described as "birth-partial-hindrance".

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