Show HN: Birth Control As A Service | Hacker News Reader

Show HN: Birth Control As A Service

readytogroove.com

38 pointsjaldoretta70 comments

For everyone wondering about this method, it's called the sympto-thermal method and is not the same as the rhythm method. Planned Parenthood lists it as 99.6% effective with perfect use. See the "What is the Sympto-thermal Method" section in the link below:

http://www.plannedparenthood.org/health-topics/birth-control...

The 99.6% effectiveness statistic comes from the planned parenthood website and I'm assuming they quoted it from this study since they do not cite their source http://humrep.oxfordjournals.org/content/22/5/1310.short

99.6% is the method-effectiveness (i.e. the efficacy if used properly) or 0.4 unintended pregnancies per 100 "women years" (13 cycles)

Other interesting results from the study: - the method-effectiveness rate found for this method is comparable to oral contraceptive - 9.2% stopped using the method due to dissatisfaction - Couples that had intercourse during the fertile period had an increased pregnancy rate of 7.5% - This study was done in European countries and the pregnancy rate was lower than similar studies performed in developing countries

It's pretty spot on. My wife did this so we could avoid pregnancy for first few years of our marriage, and once we decided to try for one, only took one month for her to get pregnant.

Albeit a great app, this method is less reliable than having proper birth control at hand.

I see mentions of "But it's 1.8% failure rate!" - thing about Cumulative Probability is, that is a pretty high number of failure after about 10 years.

After 10 years you have a Cumulative Probability: P(X = 1) of about 15% of getting pregnant.

If you don't want to be a dad/mom - use a condom. Or go double dutch.

Fortunately, probabilities for birth control methods aren't presented in this way. Generally, when an organization like Planned Parenthood says that the symptothermal method is 99.6% effective, what they really mean is:

"Of 100 couples who use the symptothermal method correctly for one year, 0.4 (fewer than one) will have a pregnancy." (Source: http://www.plannedparenthood.org/health-topics/birth-control...)

So after about 100 years of using this method, you've got a .4% chance of becoming pregnant. Seems like decent odds to me.

> So after about 100 years of using this method, you've got a .4% chance of becoming pregnant. Seems like decent odds to me.

No, after one year you've got a 0.4% chance of being pregnant. Assuming this stays steady over 100 years, you'd have a 33% chance of being pregnant (1 - (0.996 ^ 100))

Their maths for a 1.8% failure rate over 10 years is right, it's about 15%.

Your argument lacks on two levels:

1. The same logic must be applied to condoms. They have a failure rate of 0.6 - 12% per year, depending on the study.

2. You mix perfect-use with imperfect-use. Even sterilization doesn't have a 0% failure rate, because sometimes things don't work out properly. The perfect-use index of sterilization should be 100% safety, but in reality, it's 99.9% I think.

Definitely use both. I feel like this app is supposed to replace the pill rather than all methods of birth control. Which I am completely behind since I would forget to take the pill every other day. Which is why I'm now pregnant. Not to mention the crazy hormones, weight gain, and general misery the pill brought on. Yeah, I'll be switching to this.

Congrats, I guess? :)

Or the NuvaRing. Low hormone, can't forget it.

http://en.wikipedia.org/wiki/NuvaRing

Haha, thank you! Yeah, surprise babies are (eventually) the most wonderful surprises. The only reason I never got a NuvaRing is because I wasn't comfortable with something being implanted in my body. It just didn't feel right. Granted birth control is just as unnatural, but it's slightly easier on the conscience to take a pill a doctor prescribes you than insert a plastic ring that releases hormones into your vagina.

The pill is exactly the same. "Lower hormones" is just marketing fluff. All hormonal birth control methods work with more or less the same principle (suppress ovulation, make cervical mucus less fluid and thus reduce survivability and movability of sperm).

That means that if you have problems with one pill, you're very likely to have problems with other pills/hormonal methods as well.

I'm a little bit confused. The title mentions birth control but the website is talking mostly about fertility. Is this a tool to help women get pregnant or prevent pregnancy?

Both. It lets them know when they are likely to get pregnant, and when they're aren't. They can use that information to choose when to have unprotected sex (or protected) depending on what they want to happen.

This seems like a really bold claim to put on the back of a smartphone app.

So our app doesn't actually do any sort of predictions at this point. We just give users the tools to practice a highly-effective and natural method, and they do whatever they see fit with their data.

It's a tool that can be used for either one. It helps women detect the fertile time of their cycle (which is typically about 6-8 days), so it can be used for both pregnancy prevention and achievement.

Apparently both. On this page http://www.readytogroove.com/app/, it explains how you can learn which days you are or are not fertile.

Is this really a reliable birth control method though?

This is one of the most thorough studies that has been done: http://www.ncbi.nlm.nih.gov/pubmed/17314078

This is Fertility Awareness / Natural Family Planning[1], branded in a way that will be more palatable to a secular Silicon Valley audience.

My wife and I use NFP. This is actually the slickest app I've ever seen.

It's pretty reliable if you want to use it for birth control, provided the woman has at least somewhat regular cycles. Even with irregular cycles, there's useful information that can be gleaned from cervical mucus and basal body temperature.

It's probably not for people who absolutely cannot tolerate one or two "surprise" children, but it will at least prevent you from becoming the Duggars if that's not your thing.

[1] http://en.wikipedia.org/wiki/Natural_family_planning

Sorry to say so, but you're wrong about two things:

1. A women doesn't have to have a regular cycle for this method to be safe. Why? Because if the cycle is irregular, the cycle cannot be evaluated / charted and you have to assume fertility.

2. The method is as safe as the pill. The risk for getting "surprise children" is the same as with the pill.

For your objection to (1), you'd be right if we were talking about the rhythm method, but we aren't. There are other signs of impending fertility that can be tracked.

I think jaidoretta's comment is a bit too optimistic about fertility-awareness methods.

The CDC has an information sheet about the effectiveness of different methods of contraception[1] which cite on the order of 18 pregnancies a year for these methods. Interestingly, newer fertility-awareness methods appear to be more effective than this estimate[2].

[1] http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/PD...

[2] http://www.sciencedirect.com/science/article/pii/S0015028204...

The effectiveness of the sympto-thermal method (STM), like other methods, obviously depends on a number of factors. One of the big problems is that fertility awareness-based methods are a whole category of methods, which also includes the rhythm method and others that are much less effective that STM.

There haven't been a ton of studies done, but the ones that have been carried out all show a perfect-use effectiveness of over 99%. But that definitely depends on how careful users are.

The sympto-thermal method is researched since the 1950s by an Austrian gynecologist. There have been A TON of studies.

Misleading title.

It's a fertility tracking app. There are dozens of those.

When I see "{physical thing} as a service", I expect some sort of monthly fulfillment service, like Dollar Shave Club.

Agreed on the title, there is an old joke, "Question: What do you call people who are using the rhythm method for birth control? Answer: Parents." As a fertility timer to help people maximize their chance of conception though I think it is probably a useful tool.

Scroll all the way down in the comments here, that joke has been told before and downvoted for its unrelatedness. This app is based on the symptothermal method, not the rhythm method.

Fair enough. Various folks seem to put it slightly above the rhythm method in practice [an example [1]] and pretty much less effective than any mechanical system [2]. The original joke was a statement on the variability of trying to gauge the internal state of the system versus mechanically disarming the system. And in that analysis it still holds.

Nothing is quite so impresses as a natural system that has evolved through selective pressure to be effective in so many adverse situations.

[1] http://www.fertility.com.au/Docs/Contraception/Contraception...

[2] http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/PD...

Please check this long-term study: http://humrep.oxfordjournals.org/content/22/5/1310.short

It's as effective as the pill. But you're right that it doesn't provide birth control during the fertile days.

It depends on how you define birth control. Is it something that enables you to have sex during fertile days or is it something that enables you to know more about your fertility?

So, seen in the first way, the sympto-thermal method is just a method for observing natural processes. Nothing that prevents pregnancy during the fertile window.

If you want mechanical birth control, there are really only three reversible options: condoms, IUD, diaphragm. Everything else that's reliable is based on hormones. In that light, I think it's a good idea to use the sympto-thermal method to be at least 50% less dependant on other mechanical tools.

The app looks great. Does it work for the Creighton Model (http://www.creightonmodel.com) as well?

Also, you may want to get added to this list: http://contraception.about.com/od/naturalmethods/tp/fertilit...

I suppose you could technically use the Creighton Model with our app, though it's not the method we provide educational info for.

> Upgrade your account to practice natural and effective birth control, get pregnant easily, or take control of your reproductive health.

"Get pregnant easily" is not something you should be advertising. There are tons of reasons why someone can have trouble getting pregnant that are completely external to your app. Just a heads up.

Yes, very true. Perhaps the wording should be revisited. Thanks for the feedback!

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So when methods like the rhythm method are used, it's a pretty bad idea (because it predicts fertility). But the sympto-thermal method is based on scientifically-backed signs of fertility and allows women to pinpoint the fertile time instead of guessing. Here's a study about this particular method's effectiveness: http://www.ncbi.nlm.nih.gov/pubmed/17314078

Is there anyway boyfriends can get access to this?

We don't have that feature currently, but it's definitely a possibility!

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Ah...thanks for pointing that out!

Yeah! Would be great if it synced so that I could get a "Go" or "No Go" signal!

Maybe on the significant others device, it could have a sort of "defcon" system. To let me know that I should bring home chocolate and keep my opinions to myself!

^that would be a dream come true.

Go or no go where? Am I missing something?

The app is designed to provide birth control by letting you know when have sex, or when to not have sex. He was asking for a companion app without all the management, just the current status.

He's talking about sex!

The Bone-signal

After having read the HN headline I had an impression of someone hiring someone else to carry a bucket of water around during dates...

This doesn’t seem to be available in any of the worldwide stores except the US store. Is a worldwide release coming?

Kudos to you, it's alway great so see people talking about natural birth control methods without mentioning God or religion in the same sentence. It's virtually impossible to find good resources about the sympto-thermal method in English without landing on a very Christian-oriented website.

But I'm wondering: What's the business model you have?

I'm asking, because I'm in the same space. Mostly in Germany, but I also have an app for the English-speaking population: http://mynfp.net/

It costs 5.99$ and it's certainly nothing I can live from alone. However, the app is just an "appendix" to my SaaS business which is the same thing, but bigger and better, which generates revenue to be sunstainable in the long term.

You can't find secular versions of NFP because the hormonal birth control and sterilization industry created what they felt was the perfect no muss, no fuss solution, and couldn't imagine why anyone but the "religious crazies" could possibly want an alternative to it.

You can thank the religious people for continuing to develop the science over the decades when the world went absolutely bananas for the pill.

So if I'm understanding you right, industry as a whole chose a method which though it has benefits also has drawbacks – so much so that they ignored research?

And it was religious people who continued fundamental research?

Very interesting! And not what I've seen in other cases. I'm happy to have my stereotypes challenged.

He's at least partly right. Most studies in this area are directly or indirectly sponsored by the church. This doesn't make the sympto-thermal method a religious thing and the studies are still scientific, but the church was one of the few who gave financial aid.

Thing is, the method can be done on a piece of paper. So far, not many people had commercial interest in further research. The few who had, used their finances to build birth-control monitors (a piece of hardware) and tied their studies to their specific products.

So, yeah, the church definitely put money in it whereas not many corporations or investors did.

And I don't want to discount the secular contributions to the research, because they have been there the whole time.

But especially in the Catholic church, after Humanae Vitae, there was a lot of motivation to be able to offer an acceptable alternative to contraception.

I'm glad this is becoming more popular in secular circles. I always figured it would, given how health conscious people have become. Women don't want to eat GMOs or gluten, but are just fine with taking hormones that shut down a major component of the body?

In Humanae Vitae, after the Pope reaffirmed the ban on contraception, he urged scientists to continue researching and improving natural methods. Some Catholic scientists and Catholic universities (Creighton, Marquette, Georgetown, etc.) took him up on it. This is not to belittle non-Catholic contributions, but that's a big reason why so much of the research is from Catholic sources.

(FWIW, the Catholic Church does not consider FABMs to be contraception, but "well-timed abstinence". Some of the Catholic sources can be really confusing if you're not aware of this terminology.)

Thanks! It's awesome to hear from another person in this space. We're still working out our business model (right now we're planning a subscription-based app to practice FAM/NFP, but that could change). But we have plans to add more features and perhaps another product. Hardware may also be in our future =)

Well, good luck to you then :)

There are a few more people in this space, especially in the app market. Recently, "Glow" was released, which is more aimed towards women who want to conceive, but they might go into the birth control segment. Although I think they will fail with their current product in this market.

There's Clue (helloclue.com); Ovuline; TrueCycle (seems to be dead?); and all the gibberish period calendar apps.

Since the developer and I are both here in Austin, I was planning on pitching them with our product price comparison API so that they can receive commissions on any products sold through it.

Despite the ridiculous nature of some of the products in the sexual health niche (ie "Ejaculoid"), there are indeed several vitamins and supplements that promote increased sperm volume and sperm mobility for men. I haven't personally looked into the women's side, however.

It wouldn't be a huge form of monetization, but it's extremely well-targeted and ethical (since we send users to good deals). It could help with a piece of the pie instead of standard advertising.

Interesting suggestion, but I'd use affiliate as the icing on the cake, not as the main business model.

I know several people who have used this book/site, and as far as I know, there are no religious connections:

http://tcoyf.com/

That book is actually how I first learned, and it's an awesome read.

Seriously, rhythm method is not effective birth control (24% failure rate/year). Please don't rely on it!

http://en.wikipedia.org/wiki/Comparison_of_birth_control_met...

See the "What is the Sympto-Thermal Method" section: http://www.plannedparenthood.org/health-topics/birth-control...

EDIT: posted the wrong link before...sorry =)

This is not the rhythm method. It's the sympto-thermal method and 99.4% effective

Sympto-Thermal Method. Not rhythm.

Q: What do you call a woman who depends on the rhythm method for birth control?

A: A mother.

As a tool to help you get pregnant, awesome, kudos, very well done.

Promoting it for birth control? Not very clever.

http://www.plannedparenthood.org/health-topics/birth-control...

It's a common misconception that the method our app relies on is the same as the rhythm method, which it is NOT. The rhythm method predicts fertility based on cycle length, which is a really BAD idea. The sympto-thermal method pinpoints the fertile window using scientifically-backed signs of fertility.

Planned Parenthood lists an effectiveness of 99.6% (see the "What is the Sympto-thermal Method" section: http://www.plannedparenthood.org/health-topics/birth-control...

I apologize for conflating the rhythm method and the sympto-thermal method.

It's still a bad idea for most people.

All from the same Planned Parenthood site:

Twenty-four out of every 100 couples who use fertility awareness-based methods each year will have a pregnancy if they don't always use the method correctly or consistently.

whereas:

Vasectomy is the most effective birth control for men. It is nearly 100 percent effective.

and

Less than 1 out of 100 women will get pregnant each year if they use an IUD.

---

I want to control my systems. I have many choices: Puppet, Chef, cfengine, writing my own system... you're offering me a system that requires maintenance every single day, I can't pay someone else to do it for me, and if I screw up, it's 76% likely that I won't have unintended consequences. But there are a bunch of other systems on the market where I configure them once and they work for years without attention, and even systems where I just have to be picky when I'm conducting operations, not every single day.

The 24% failure rate cited by Planned Parenthood includes ALL couples who claimed to be using fertility awareness, from those who had taken classes and were using a modern method, to those who were just guessing. IIRC, over 80% of the couples were not properly trained in a modern method of fertility awareness. Not surprisingly, they had very high pregnancy rates. Someone did the math (can't find the article) and figured untrained users had about a 28% pregnancy rate while trained users had a 7% pregnancy rate. (80 * .28 + 20 * .07) = 23.8 The 7% pregnancy rate is comparable to the real-world use of the Pill.

As for your system analogy, if your automated system was a significant resource hog or ran the risk of corruption of data or crashing the system, would you use it? You focus on efficacy without factoring in side effects.

btw, I think those are both birth control.

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