Contraception app still being probed by medical agency over unwanted pregnancies

Is there such a thing as bad publicity? It’s an interesting and contested question.

To wit: Self styled ‘digital contraception’ app, Natural Cycles — which relies on a set of proprietary algorithms and women inputting their morning body temperature to predict fertility levels each day — has claimed that negative headlines generated after a clinic reported a number of unwanted pregnancies among users of its app has actually led it to gain users.

Which might suggest that negative publicity (reported product failure) can actually be net positive for a business (claimed user gain). Or else it’s 100% pure surfactant spin.

“What’s positive is that our users don’t seem scared by these sorts of articles,” co-founder Elina Berglund told Business Insider last week, discussing the news that 37 unwanted pregnancies had been reported by a concerned Swedish clinic to the country’s Medial Products Agency this month.

“We’ve actually gained many new users. Instead, many are annoyed by the fact that their ability to use our app is underestimated, and they often respond to articles in the comment sections,” she added.

Trolls and other agents of misinformation also often contribute to articles in the comment sections. But I digress.

Sadly Berglund did not quantify exactly how many new users Natural Cycles has onboarded as a consequence of “these sorts of articles”.

So we can’t attempt to measure how helpful this particular exposure episode might have been for Natural Cycles’ business, even if some of the headlines didn’t sound, well, great for a business in the contraception business.

But here’s the thing: If reportage of 37 unwanted pregnancies is actually net positive for Natural Cycles, the company, why was its UK PR agency so quick and alacritous to push claims the probe had already run its course (and the app been given the “all clear”)?

It really makes you pause and wonder. Maybe bad publicity is a thing after all?

Or — at least — where failure of the product in question can have such grave and unwelcome consequences as an unwanted pregnancy.

Gerald Ratner trinketry this really is not.


Not so all clear

Natural Cycles ‘all clear’ following investigation” read the subject of an email sent to my inbox today, by Hot Cherry — the aforementioned UK PR company for Natural Cycles.

A press release attached to the email, and headlined with the same phrase, contained the following opening para:

Earlier this month, Natural Cycles, the first app to be certified as a contraception in Europe, was reported to the Swedish Medical Product Agency (MPA) after a hospital found 37 cases of unintended pregnancies among women relying on the app for contraception. Now the MPA has closed all individual reports related to unplanned pregnancies concluding that there are no implications on behalf of Natural Cycles or the way the product is being marketed.

If you read carefully you’ll see the body text wording actually specifies that the MPA has “closed all individual reports related to unplanned pregnancies” (emphasis mine). Not that it’s closed its entire investigation.

Although the PR does go on to make the grand and linked claim that the MPA has concluded “there are no implications on behalf of Natural Cycles or the way the product is being marketed”.

“Following your recent piece about Natural Cycles we thought you’d be interested in running this as follow-up. Let me know,” added Harry Cymbler, who lists himself as “founder” of Hot Cherry, dashing off a pithy email to which he’d attached the full PR.

“Details and imagery attached. Pls let me know if you can run this,” he added.

I certainly ran the claim past the Swedish MPA.

I also contacted the referring clinic in Stockholm which had originally raised the concerns about the app’s efficacy — to ask whether they were aware of there being such a swift resolution to the investigation?

Reader, they were not.

In fact they immediately pointed me to this notice (in Swedish) posted by the Lakemedelsverket (aka: the MPA) which seeks to quash media rumors that their investigation has been closed. Spoiler: It really is ongoing.

A spokeswoman for the MPA also confirmed to me, via email, in English, that there is no ‘all clear’ for Natural Cycles as yet.

“That is not correct,” she told TechCrunch. “The investigation is still ongoing.”

“We are now asking the company behind the product for more information,” she added.

She also pointed to the notice the MPA had felt moved to post on its website as a result of incorrect media rumors the company was in the all clear.

The agency does not speculate on what could have triggered these false media rumors.

In the notice, the MPA specifies that while they have completed the “first phase” of their probe, they have now moved on to next steps — such as asking Natural Cycles to see clinical data, risk analysis and aftermarket control — i.e. before they will be in a position to be able to decide whether or not any further action is needed.

Here’s a Google Translate version of the anti-rumor notice in English:

There are reports in the media that the Swedish Medicines Agency would have closed the investigation on the Natural Cycles contraceptives app. That’s not right. The investigation proceeds in the form of a supervisory case, where the Swedish Medicines Agency now requests additional information to find out if there are shortcomings in the product, product information or how the manufacturer follows up the product’s performance and use.

“The investigation of the Natural Cycles contraceptive is most ongoing. We have completed the first phase where we have requested the manufacturer’s response to the accident reports. Now the investigation goes on to the next step, which means that we collect information to be able to decide if any action is needed. Among other things, we want to see clinical data, risk analysis and aftermarket control,” says Ewa-Lena Hartman, Group Chief, the Medical Products Agency.

The background to the supervision is an increased number of healthcare reports of unwanted pregnancy when using Natural Cycles. The preventive drug certification has been performed by a third party and has not previously been reviewed by the Swedish Medicines Agency.

If you as an individual are worried about or have questions about which contraceptives you should use, turn to your care for help and advice.

Curious to sort out these crossed wires, I went back to Harry at Hot Cherry — to ask why his PR appeared to imply the MPA’s investigation was over, when in fact the process remains “most ongoing”.

In an era replete with hair-trigger claims of ‘fake news’, any professional messaging that seeks, even inadvertently, to blur the lines of truth and fiction by encouraging time-strapped journalists to “run” unchecked claims seems, well, ill advised to say the least.

And maybe especially so for Natural Cycles — whose product relies so acutely on users trusting the efficacy claims its business makes because it hasn’t yet conducted a randomized control trial to be able to robustly prove out those claims via the standard science.

Harry’s first response came quickly: “We’ll discuss this with Natural Cycles and get back to you.”

A couple of hours later, thanking me for my patience, he emailed the following statement (emphasis theirs):

Läkemedelsverket (the MPA) are commenting on what the media is writing. We agree with what MPA states. The individual reports have been dealt with and are now closed, but we continue to work with the MPA in what is called trend reporting to make sure our data is in line with what is being reported from the public. We appreciate the fact that we now going forward will get data from both the public and our own sources, which will only strengthen our clinical claims further.

So, after all that, I’m very happy to confirm there is in fact no new news here: Natural Cycles remains under investigation over a number of unwanted pregnancies among users of its app.

And on the other matter of interest — the question of whether all publicity is good news in business growth terms, i.e. even when it’s attached to ongoing concerns about your product’s efficacy — well, I’ll leave you to be the judge of that.

Feel free to leave your thoughts in the comments.