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More Abortions Tied to Natural Family Planning or Fertility Awareness Methods

Medically reviewed by Carmen Pope, BPharm. Last updated on Jan 14, 2025.

By Dennis Thompson HealthDay Reporter

TUESDAY, Jan. 14, 2025 -- Relying on natural and fertility awareness methods to prevent pregnancy might be linked to an increase in abortions, a new study suggests.

Use of hormonal birth control methods like the pill has declined by nearly half among women seeking an abortion in the United Kingdom, researchers reported in a study published Jan. 13 in the journal BMJ Sexual & Reproductive Health.

Instead, women seeking abortion are more frequently using less reliable methods to avoid pregnancy such as fertility awareness methods (FAM) that encompass a wide variety of techniques with varying degrees of efficacy.

“Significantly fewer abortion patients report using effective methods of contraception, while also reporting an increased use of fertility awareness-based methods,” the research team led by Dr. Rosie McNee with NHS Forth Valley in Stirling, UK, wrote.

For the study, researchers analyzed data on women seeking an abortion at the British Pregnancy Advisory Service in 2018 and 2023.

“Recent research has suggested a move away from hormonal methods of contraception due to a preference for more natural methods and in particular hesitancy around hormonal methods,” researchers noted.

More than 55,000 patients sought an abortion in 2023, compared with about 33,500 in 2018, results show.

There was a decline in the number of women reporting they had no history of a prior abortion, from 62% in 2018 to 59% in 2023, the study says. Reported use of the fertility awareness methods increased from 0.4% to 2.5% during that period among women seeking abortion.

At the same time, the use of the pill and other hormonal-based contraceptives declined from just under 19% to around 11%, researchers reported.

The use of long-acting reversible contraception like an IUD also declined, from 3% to 0.6%.

About 14% more women seeking abortion were using no contraception at the time of conception -- 70% in 2023 compared with 56% in 2018.

Researchers don't know what caused the trend toward natural methods; more research is needed. Within the umbrella of FAM are variations on the rhythm method which use calendars, as well as mobile phone apps, where an algorithm is used to combine an individual’s calendar tracking of menstrual cycles and their daily body temperature to predict fertile days,

“The accuracy of these apps in predicting the window of fertility has been reported as low as 21% and in some cases as low as 8%,” the researchers noted.

Reasons for the trend away from hormonal contraception are not known either, said authors. While women might be turning to the fertility awareness methods because it became more difficult to access more effective methods of contraception during the pandemic, researchers said, distrust of hormones may be a factor too.

Hesitancy to use hormonal based contraception, such as the pill or the patch, has been attributed to social media in other European countries.

Unfortunately, the typical use failure rate for FAM can be as high as 23 in every 100 women, compared with 7 in 100 for the pill and less than 1 in 100 for the IUD.

“The possible relationship between these less effective methods of contraception and unplanned pregnancy requires further investigation,” researchers added.

In the U.S., abut 14% of women of childbearing years use the pill and another 10% use long-acting reversible contraception, according to the Centers for Disease Control and Prevention (CDC).

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

© 2025 HealthDay. All rights reserved.

Posted January 2025

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