Contraceptive contestations Digital contraceptive practices and the renegotiation of knowing and caring in reproductive health

This dissertation explores contraceptive care and knowledge practices in the context of emerging digital contraceptive self-tracking technologies. While medical experts express scepticism toward contraceptive apps, citing concerns about effectiveness and user reliability, app users describe their practices in terms of empowerment, self-knowledge, and intimate engagement with their bodies. Drawing on feminist science and technology studies, which emphasize relational, embodied, and situated knowledge, the dissertation investigates how users and healthcare professionals know and care for the reproductive body differently. Understanding these differences can enable collaborative knowledge-making.
Based on ethnographic fieldwork in the Netherlands, the dissertation examines how app users cultivate sensory and affective knowledge through daily self-tracking. Users also employ self-tracking as a form of self-care that challenges social and gendered norms as well as cultural expectations. In contrast, care professionals often prioritize risk minimization in contraceptive counseling, which limits the inclusion of fertility-awareness-based methods and apps in clinical practice. Barriers include a lack of differentiated clinical evidence and assumptions about users’ abilities. By comparing the knowledge practices of users and care professionals, the dissertation investigates epistemic tensions around side effects, showing how users and providers validate knowledge differently. Professionals who dismiss online information may contribute to patients’ growing distrust of biomedical authority, while collaborative tinkering can provide common ground for providers and patients to co-create knowledge.
The dissertation concludes by a call for broadening our approach of contraception beyond effectiveness. It advocates an approach to contraceptive care and knowledge that is attentive to the affective dimensions of knowing and caring.