Ding! Time to get it on.
Puja was worried. She and her husband were having unprotected sex. After arriving in New Delhi just a couple months ago at 22, she’d found work in a tailor shop. She’d never lived in a big city before, never had a job, but here she was, helping provide for her husband and 4-year-old daughter.
The problem was, he didn’t like condoms and the pill made her feel sick, so they were using the “Standard Days” birth control method?—?having sex on days she wasn’t ovulating. Puja wasn’t sure they were doing it right, and she was terrified of getting pregnant again. Then it would be “goodbye, job.” She’d be back to square one, and with yet another mouth to feed.
Then at a community meeting she heard about an app sponsored by the United Nations. It was called CycleTel Humsafar (cycle + telephone + the Hindi word for “helper”) and it apparently could stop girls getting pregnant. Puja didn’t have her own phone, so she gave the UN outreach worker her husband’s number. The worker visited the couple’s house, explained the plan to Puja’s husband and the two registered together on her husband’s phone. They provided the length of her menstrual cycle and her period days. Now the app sends her husband an SMS on days when it’s safe to have sex.
CycleTel app uses a higher tech version of the Standard Days method. Normally, couples using the method track safe days by sliding beads along a bracelet. If you do it perfectly, it’s 95% effective. But many couples don’t, which reduces effectiveness to 75%. CycleTel moves the burden of tracking days from the couple to the app, removing human error from the process.
“There are no side-effects, no health concerns,” Ramya Kancharla, who manages the project for the UN, tells Dose. “There are no visits to the doctor required. It’s a great method for women to understand their cycle and plan or prevent pregnancies.”
Condoms are about 82% effective in real-life usage, but many men (like Puja’s husband) won’t wear them. Birth control patches, shots and implants are more than 99% effective?—?but expensive. CycleTel costs nothing, and while there are lots of apps that let you monitor the Standard Days method on a smartphone, smartphones are too expensive for many rural Indians. And because CycleTel relies on SMS, it works with cheap regular cellphones, which also don’t require wifi or a data plan to send and receive texts.
Also, consider that about 70% of CycleTel users have never used any birth control before.
Ramya has spent time traveling in rural India studying the circumstances under which poor women have babies.
“This was when I learned that many women in this country don’t necessarily have a choice,” she says, adding that the husband and the in-laws determine when the woman will have a baby, how many she’ll have, and even whether to deliver in a hospital or at home.
“I think this was one of those moments when I realized exactly how privileged I was,” she says. “I met this 19 year old who had just delivered her second child. She’d been pulled out of school at around 15–16, married off, and she had a baby girl within a year of marriage. And then her mother-in-law wanted a grandson, so she was pregnant a second time. I asked her if she was going to have another child in the future, and she shrugged. It wasn’t up to her and she knew that. For me, this was extremely troubling.”
For Puja, CycleTel has provided some control over her future. She continues her work at the tailor shop and the family is able to save. The couple plans to have another child in a year or two, when they’ll be in a better financial position. And with two years experience, it’ll be easier for Puja to find another job after her maternity break.
“It may seem like a small thing, but the SMS basically helped her confidently take a step towards achieving the dream she wanted,” Ramya says.
About 7,000 users are connected to CycleTel. Ramya hopes to get that number up to 100,000. India’s rate of cellphone ownership is high and rates are cheap, so CycleTel has advantages there that might not translate to other countries. The UN has promoted a similar app in Africa.
CycleTel proves that even modest technologies like “dumb”-phones can be harnessed to help people live more fulfilling lives.
Ramya Kancharla told Puja’s story to Dose, not Puja herself.