This article, “Fertility apps, datafication and knowledge production in reproductive health” by Alina Geampana, published in Sociology of Health & Illness in 2024, offers a critical examination of the increasing proliferation of commercialized digital technologies in reproductive health, specifically focusing on fertility applications (apps). With millions of downloads, fertility apps have become ubiquitous digital health tracking technologies. While previous scholarship has addressed their problematic design and surveillance features, Geampana’s research expands this conceptualization by employing critical data studies to analyze how these technologies shape broader patterns of datafied knowledge production.
The central question addressed in this research is: How does the proliferation of fertility apps shape knowledge (and associated practices) in reproductive health?. Geampana argues that fertility apps act as mediators between stakeholders, data, and datafied outputs, thereby facilitating several key processes.
The article contributes significantly to the understanding of digital health in reproduction by detailing how fertility apps facilitate:
- The datafication of fertility awareness knowledge and the production of new datafied knowledge. Fertility apps leverage decades-old medical knowledge about menstrual cycles and fertility indicators, digitizing and automating this knowledge to offer personalized predictions with increased accuracy, especially through integration with wearable devices like the Oura Ring. They enable the collection of unprecedented amounts of data (e.g., millions of data points for PCOS research by Flo), which is then used to produce novel insights into reproductive health conditions. This process integrates reproductive health data into wider health data assemblages.
- Legitimation discourses and practices. Given the historical skepticism and perceived high failure rates associated with traditional Fertility Awareness Methods (FAM), fertility app companies engage in systematic legitimation practices. This includes seeking and obtaining regulatory clearances from bodies like the FDA (e.g., Natural Cycles and Clue for contraception, Ava for conception accuracy) based on “real-world evidence” collected from users. These apps “technologise” and secularise FAM by datafying them, aiming to present them as science-based, precise, and backed by advanced technology, thereby challenging the “woo-woo, unscientific” perception.
- The remaking of private/public expertise and knowledge production networks in reproductive health. Fertility apps have become key stakeholders in disseminating information and research by collecting vast amounts of user data, traditionally gathered by researchers or medical practitioners. They foster public/private partnerships, where app companies control the use of their user data for research. The article highlights how these companies co-opt medical and scientific expertise (e.g., advisors with medical degrees, founders with complex data expertise like a PhD in physics) to present themselves as scientifically credible. However, this also raises concerns about the undermining of independent scrutiny, as evidenced by lawsuits against experts critiquing app efficacy. Furthermore, fertility apps can diminish the importance of clinical expertise by bypassing the need for prescriptions and offering direct-to-consumer solutions. Conversely, they also amplify users’ role in knowledge production through community features and encouraging data sharing for collective learning.
The methodology for this research involved an in-depth case study of fertility apps through an analysis of various online document sources collected over an extended period (May 2020–March 2023). These sources included news articles, social media presence of popular apps, newsletters from femtech networking groups, company websites, published medical and scientific literature, regulatory approval documents (FDA, NICE), and online media commentary/op-eds. The analysis was guided by grounded theory principles, with a specific focus on references to data uses and datafied, scientific, and legitimation knowledge.
In conclusion, Geampana’s work moves beyond a simple risk/benefit framework to show how commercialization processes, especially private/public knowledge production networks, are deeply entrenched and sustained through these data assemblages. It calls for a more nuanced understanding of digital health technologies as platforms that connect various actors and knowledges within broader data assemblages, rather than isolated artifacts, to effectively critique and understand their societal implications in reproductive health.
APA Reference: Geampana, A. (2024). Fertility apps, datafication and knowledge production in reproductive health. Sociology of Health & Illness, 46(6), 1238–1255. https://doi.org/10.1111/1467-9566.13793.
