“What if it's wrong?” Ovulation and fertility understanding of menstrual app users

Abstract

Menstrual apps offer opportunities for self-knowledge through their personalised predictions of ovulation and fertile window, but these opportunities may not be possible if predictions are inaccurate or misinterpreted. The understandings of menstrual app users were investigated through 25 qualitative interviews with women in Aotearoa New Zealand who were using a variety of period tracking apps and who were not trying to conceive. How do app users perceive app predictions of their ovulation and fertile window? Reflexive thematic analysis found that app users value their app ovulation predictions, and although the app users are unclear how apps make predictions, they perceive that menstrual variability may cause inaccurate app predictions and infer that app predictions can be used to prevent pregnancy. How do app users act on app predictions of their ovulation and fertile window? Analysis found that participants who were not using other forms of contraception were using the ovulation predictions of their general-purpose menstrual apps with the expectation of preventing pregnancy, but were not identifying this use as contraception. Among all app users, the risk of relying on general-purpose menstrual app predictions is deemed more acceptable when there is not a strong intention to prevent pregnancy. This research shows the need for menstrual app use to be included in reproductive health care and education, and for app predictions to be evaluated and explained.