Abstract
Critical sociologists argue that reproductive self-tracking applications (apps) intensify existing norms regarding the female body. Yet, we have little empirical data on how self-care practiced with such apps relates to existing norms regarding the reproductive body in practice. Drawing on data from interviews with and solicited dairies from Dutch app users, I analyze contraceptive self-tracking practices as a form of self-care that renegotiates social norms. This study asks: In their everyday tracking, how do users of contraceptive apps grapple with social norms and expectations surrounding their body? Results reveal that self-care includes practices of attunement to and appreciation of the body that provide strategies to negotiate, navigate, and mitigate social norms and expectations. App users uphold ideals of femininity, the “natural” body, and “natural” cycles while also mobilizing them to thwart other norms and expectations, such as pressure to be productive and the expectation to take hormonal contraception. In what I call strategic nostalgia, users play social norms off each other to shape their lives in meaningful ways. This article aims to deepen understanding of everyday self-care practiced with reproductive self-tracking technologies through a praxiography of self-care that countervails analyses of reproductive self-tracking focused on discourse and app design.
Introduction
Jasmina, one of the app users in this study, described how she sometimes performed what she called a type of “soft” “meditative dancing” alone in her living room during her menstruation. Tracking her cycle, she explained in the interview, made her realize that staying at home while menstruating felt best for her. This type of self-care was part of the cycle-tracking activities that enabled Jasmina to decide her activities according to her cycle phase. An image of Jasmina making “lulling” movements in her living room stayed with me as it vividly illustrated a practice of everyday self-care with a contraceptive self-tracking app. Jasmina spoke very appreciatively about cycle-tracking, valuing how it shaped her life in meaningful ways.
Contrary to advertisement discourses that celebrate such apps as “self-empowerment” (Hendl and Jansky 2022; Novotny and Hutchinson 2019), literature in critical sociology on reproductive self-tracking—particularly for pregnancy prevention—stresses how these apps limit users’ agency, put them at risk of privacy infringement, and amplify gendered and health-related social norms, stereotypes, and expectations placed on the female reproductive body (Grenfell et al. 2020; Lupton 2015). Yet, we have little empirical data on how self-care practiced with contraceptive self-tracking apps relates to existing norms surrounding the reproductive body in everyday practice. And despite the aforementioned criticism, we do not know how these practices may be meaningful to users themselves. To answer these questions, this study asks: In their everyday self-tracking, how do users of contraceptive apps grapple with social norms and expectations surrounding the body?
My analysis frames Jasmina's self-tracking practices, her meditative dancing included, as a form of self-care that goes against the grain. This refers to how in everyday self-care, self-tracking contraceptive app users negotiate, navigate, and mitigate social norms and expectations about their body. “The grain” in this metaphor refers to cultural currents, ways of doing, and expectations that users may wish to question or self-distance from—albeit without the ability to fully subvert or eliminate them.
As a praxiography (Kingod 2020; Mol 2002), this study foregrounds the everyday practices of users. Its aim is to deepen our understanding of reproductive self-tracking, accentuating the embodied, sensory practices involved in its daily practice. Highlighting this intimate dimension does not negate the possibility that self-tracking technologies may amplify social norms, social inequality, gender stereotypes, and gendered expectations on the reproductive body, as argued by some of the literature I cite. It means that, in practice, users have more complex ways of negotiating social norms and expectations, and do so in ways that are embodied, sensory, and intimate.
This study draws on feminist research on science and technology that thematizes tensions in feminist positioning toward emerging reproductive and contraceptive technologies (Gomez, Mann and Torres 2018; Thompson 2005; Tone 2012). Such scholars draw attention to how reproductive and contraceptive technologies pose paradoxical tensions for feminists, as the technologies may simultaneously allow for and infringe on women's self-determination. In the analysis, these tensions become more fine-grained. I show that users may strategically employ contraceptive self-tracking practices to navigate these tensions in their everyday self-care. I highlight how self-tracking technologies came to be understood as “natural” vis-à-vis other methods for dealing with the reproductive body (e.g., hormonal contraceptives). In addition, I show how users strategically use normative ideals (e.g., “natural” cycles and femininity) to thwart other norms and expectations, playing various social norms off each other.
Norms and Reproductive Self-Tracking
Reproductive technologies pose paradoxical tensions for feminists; a technology may at once contribute to women's reproductive self-determination while also infringing on their agency (Gomez, Mann and Torres 2018) or amplifying gendered norms and expectations (Thompson 2005; Tone 2012). This same tension is apparent in a growing body of literature focusing on reproductive self-tracking, including menstrual cycle and period tracking, tracking to achieve pregnancy, and tracking for pregnancy prevention. This literature is critical of the apps’ gendered design and intended usage (Grenfell et al. 2020; Lupton 2015); and of neoliberal discourses of health responsibilization employed by the apps and their users alike (Fox and Spektor 2021; Ford, De Togni and Miller 2021; Lupton 2016; Sanders 2017). Analyses from feminist STS scholars emphasize that self-tracking technologies reinforce existing norms and ideologies. Mularoni (2021) argues how self-tracking reinforces scientific ideologies originating from medical practice and the exploitative conditions of capitalism and social hierarchies. Dolezal and Oikkonen (2021, 3) argue that self-tracking practice “feed into the production of highly normative bodies, extending neoliberal and patriarchal … mechanisms.”
Empirical studies on the everyday use of reproductive self-tracking technologies (Hamper 2020; Karlsson 2019; Levy 2018) find that users negotiate, modify, question, or subvert their design or intended use. For example, Mamo (2007) shows that lesbians who self-track ovulation negotiate and resist biomedicalization in strategic ways to meet their own goals. Ford, De Togni and Miller (2021, 60) argue that these technologies invite a compulsion for user self-surveillance; while also, locally, being empowering. In a study on app use to achieve pregnancy, Hamper (2020, 12) shows how app pushiness gets questioned, citing the case of a user who brushes off as patronizing notifications about alcohol consumption while trying to conceive. Similarly, Levy (2018) reveals how users question the standardization and regimentation processes dictated by the app design. Karlsson (2019) and Campo Woytuk et al. (2020) observe how cycle-tracking practices invite awareness and negotiation of cultural stigma surrounding menstruation and the female reproductive body. These empirical works suggest that while technologies may impose or amplify (gendered) norms and expectations, users are not passive recipients, but rather negotiate and co-shape technologies and norms in various ways.
Empirical research on the use of apps to prevent pregnancy has also recently started emerging. This work (Algera 2023; Chen 2017; Della Bianca 2021; Dudouet 2022) highlights how users, with their apps, cultivate awareness of or attunement to the menstrual cycle. Contraceptive app users report engaging with their reproductive body through practices of “listening to the body” that they associate with empowerment and agency (Algera 2023; Chen 2017; Dudouet 2022). Della Bianca (2021) and Chen (2017) also emphasize that everyday tracking practices both uphold and unravel ideas of “natural” and regularly cycling bodies while showing how users are prompted to act as reproductive citizens responsible for contraception. These studies echo concerns about other forms of reproductive self-tracking—on the prevalence of gendered disciplinary norms surrounding health, wellness, and reproduction—while highlighting how these technologies configure and reconfigure modes of embodiment and agency.
This study takes the tensions elaborated here as a starting point. Feminist analyses of digital reproductive self-tracking emphasize that gendered norms, taboos, and reproductive burdens are amplified when reproductive health is digitized (Ford, De Togni and Miller 2021; Hendl and Jansky 2022; Kressbach 2019; Lupton 2016). Yet we also know that technology users negotiate and question a technology's discourse and intended use (Mamo 2007) or imposed norms (Hamper 2020), thereby manifesting agency (Cussins 1997). In the case of contraceptive self-tracking technologies, we do not have much empirical understanding of how users navigate norms and manifest agency in their everyday practices. Neither do we have insight into how norm negations relate to the digital-sensory practices (Maslen and Harris 2021) of users of contraceptive apps (Algera 2023). Based on empirical data of everyday practices, this study analyzes how users grapple with social norms and expectations and shape their lives in ways they find meaningful in and through their digital practices.
From Discourse Analysis to Praxiography
In its exploration of everyday self-care with tracking technologies, this article draws attention to the difference between discourse analysis and praxiographic analysis (Kingod 2020; Mol 2002) of everyday self-care. Praxiography examines what people do, and the stories people tell about what they do (Mol 2002). Focusing on discourse can yield different insights from focusing on what people do. To understand how these technologies were productive and meaningful in their everyday use, I go beyond user and advertisement discourse.
To unpack what people do with their bodies and their tracking practices, I began by examining users’—often celebratory and appreciative—language. Inspired by work on aesthetic appreciation in everyday care (Pols 2019, 2013, 2023; Skeide 2022), I took participants’ words as a practice. Their celebratory language was viewed as a way of doing the body (Mol 2002). By looking at what users valued and appreciated in and through their everyday self-tracking, I understood how they aspired to do the body differently (Pols 2023).
Researching Everyday Contraceptive Self-Tracking
Setting
A growing number of smartphone apps marketed for women's health can be used to track menstruation, to achieve pregnancy, and to prevent pregnancy. The contraceptive efficacy and thus use of self-tracking apps remain controversial (Algera et al. 2024). Medical professionals generally dismiss cycle-tracking methods as outdated and ineffective for pregnancy prevention (Austad et al. 2016). The prevailing medical dismissal is significant in situating the use of these technologies. Often prompted by advertisements or individually shared social media content, the participants in this study engaged with their app in a domestic setting without guidance of medical professionals, but with peer support through social media communication.
The uptake of self-tracking for pregnancy prevention has coincided with growing wariness of hormonal contraceptives in the Netherlands and beyond (Algera et al. 2024; Le Guen et al. 2021). Like other types of self-tracking, contraceptive self-tracking can be situated in the context of growing popularity of self-tracking and the commodification of home health practices. Yet, contraceptive self-tracking practices differ from other types of reproductive self-tracking (e.g., to track menstruation, to achieve pregnancy) in that users often frame their practices as a move away from hormonal medical contraceptives (Dudouet 2022). Both app marketing material and users themselves frame this move as opting for “natural” contraception or the “natural cycle” (Dudouet 2022; Natural Cycles 2016). In Koskenniemi's (2022) analysis of menstrual self-help, the discourse of naturalness is also prominent in self-help literature promoting non-hormonal ways to manage health and contraception.
Recruitment and Sampling
This article is part of a broader study of the daily practices of users who employ self-tracking technology to prevent pregnancy in the Netherlands. To collect data on app users’ self-care practices, I recruited participants through local and international social media networks between January and April 2020. Participants were approached through direct message, email, or a call for participation made on social media. Of the thirty-one people who responded, eight chose not to participate, most often due to time constraints. I excluded six respondents because they did not use any cycle-tracking app or did use such an app but not for the purpose of pregnancy prevention. The seventeen respondents who participated in an in-depth interview with me used or had used a menstrual cycle-tracking app to prevent pregnancy.
Participants were between ages twenty-three and thirty-six (average was twenty-nine), and all but one lived in the Netherlands at the time of the interview. Participants were not asked about their racial or gender identity, though all but two referred to themselves, their bodily anatomy, and their peers using terms such as “female,” “feminine,” and/or “woman.” Six participants were born and raised in a country other than the Netherlands. Most resided in larger Dutch cities, had finished or were in the course of obtaining a higher education degree, and were in a long-term relationship. All participants spoke of experiencing pressure from professional or educational obligations. Two were recovering from a work-related disability (e.g., burnout); four others were experiencing or had experienced mental health issues (e.g., depression, stress, performance anxiety). Three participants mentioned structural insecurities (concerning finances and employment); the remaining participants had relatively stable occupations that generated income, or received state support. Four participants mentioned having general or menstrual health conditions, such as irregular cycles or polycystic ovary syndrome. All cited mild-to-severe side-effects from previous contraceptives, hormonal or otherwise. Almost all recounted feeling dismissed or disregarded by health professionals with respect to their reproductive health issues.
Sampling methods yielded a group of highly engaged self-trackers. Recruiting users from online communities may have indexed for users who were highly involved in and committed to their tracking practices. High user engagement may also be explained by the explicit focus on contraceptive tracking given that users are required to track daily to minimize contraceptive failure. Several users commented on the importance of these practices as part of their life or lifestyle and expressed their wish to share their practices and knowledge with other women, sometimes in activist terms. These users gave me insight into the particular self-care practices they had developed and how their self-care related to their desire for change.
Interview and Diary Procedure
Interviews lasted between 33 and 114 min (median 52 min) and centered on users’ daily self-tracking practices. We spoke in Dutch, English, or in some cases both languages, depending on participants’ preferences. After some general background questions, I asked users to explain how they had come to use their app, which would often prompt their sharing background on prior contraceptive use. To focus on their daily self-tracking practices, I asked users to describe and demonstrate what they did with their app, on what occasions and how they engaged with it, what other devices they used, and other practices relevant to daily tracking, including participation in online user communities. Interviews were semi-structured, allowing for other topics related to tracking practices to arise. I did not directly inquire into how respondents negotiated norms or asked about practices of appreciation; these themes arose inductively.
Nine of the seventeen interviewees accepted my invitation to keep a solicited diary (Bartlett and Milligan 2015) of daily self-tracking practices. All diaries were in Dutch. I sent these participants a general prompt, asking them to send me textual, visual, audio, and/or audiovisual material of their practices, and of anything else they deemed relevant or related to contraceptive self-tracking. Sent via email or an instant messaging service, the diaries included personal writings, photos, screenshots, and links. Unlike other modes of photo or screenshot elicitation (Carter and Mankoff 2005; Gorm and Shklovski 2017; Reade 2021), the diaries and visual materials were not used as prompts later in interviews. Instead, I asked participants to share visual or other material that was meaningful to them with written or recorded descriptions about what it meant for them in the diary. This allowed them space to reflect on their everyday practices and relate them to other aspects of life. Participants chose their preferred mode of communication, which shaped my interaction with them over the duration of the diary (e.g., instant messaging afforded a more interactive dialogue style than email diaries). The mode and level of interaction in some cases resembled an intimate conversation with a friend, which may have been due to participants’ knowledge of my own personal user experience with contraceptive self-tracking apps. Diaries varied in length from just a few screenshots of recent cycle charts to a two-month-long series of several entries per week.
Data Analysis
Interviews were transcribed verbatim. I anonymized the interviews as well as the diaries, and coded them inductively with qualitative data analysis software (Atlas.ti). All data were coded in the original language inductively, using both English and Dutch codes. I coded users’ everyday self-tracking practices as well as salient themes that were generated (e.g., looking for alternative contraceptive methods, user activism, appreciating the body, cultivating awareness, taboo, stigma). Codes were clustered in a code forest; a paper code map was made to aid the analysis. The last interview was conducted after the code forest was made, to ensure saturation was reached. I translated the data excerpts in Dutch for this article with the help of AI and a language editor. Excerpts in English have been published verbatim. Excerpts are interview quotes unless diary is indicated as the data source.
During data collection, my identity as someone who has been using apps to prevent pregnancy for several years likely contributed to rapport-building and the sense of a safe environment, where users felt comfortable sharing their knowledge, practices, and perspectives. The argument in this article is grounded in interview and diary material that I collected, yet it inevitably also bears the mark of my past personal engagements with such apps. Participants would sometimes address me as an expert or fellow expert on contraceptive app use, as I had shared that my research project stemmed from my own experience self-tracking. Other times, I was confronted by differences between my self-tracking practices and those of participants—which I stayed aware of in making choices about data analysis and writing. The Ethics Advisory Board of the Amsterdam Institute for Social Science Research at the University of Amsterdam approved this study. Data was stored according to University of Amsterdam research data management guidelines.
Negotiating Norms in Contraceptive Self-Tracking
The everyday self-tracking activities of participants consisted of daily data collection and input in their app. This could include physiological data (e.g., basal body temperature, menstrual and/or cervical fluid) and a wide range of embodied experiences (e.g., headache, breast pain, ovulation cramping, energy level, mood). The app helped users aggregate data in a cycle visualization, which could take the form of a chart or a calendar that displayed day-to-day changes of their menstrual cycle. Users understood the menstrual cycle as consisting of several sequential phases: standardly as menstruation, the follicular phase (in which an ovum develops), ovulation (the release of an ovum), and the luteal phase (the period between ovulation and menstruation) with its associated hormonal fluctuations. Based on the general pattern of menstrual cycle phases, users constructed a cycle pattern that was individual to themselves and might not be consistent with most other cycles or those in textbooks. Drawing on this individual cycle pattern, users compared or correlated their experiences by “placing” or “linking” them to their cycle phases and patterns. A user could experience, for example, a specific type of headache or breast pain at certain points in the cycle and then understand these embodied experiences as a result of hormonal changes taking place in that particular phase. I have described the daily self-tracking practices of users in more detail elsewhere (Algera 2023).
To understand how contraceptive app users grappled with social norms and expectations, I first explored which norms and expectations they identified as salient. I then analyzed their self-tracking and self-care practices in relation to these norms. I found that in everyday self-care, users practiced self-validation, which cultivated self-relation as well as relations to their social environment in strategic ways. I also found that self-care was strategic in that it opened up new repertoires of thinking, feeling, and doing the reproductive body. These new repertoires helped users go against cultural currents, ways of doing, and expectations regarding the reproductive body. They enabled what I call self-care against the grain.
Identifying Salient Norms and Expectations
In the interviews, users contrasted their present-day self-care and self-tracking practices with ways they were hitherto engaging with their reproductive body. Past engagements were construed in rather negative terms as something users wished to leave behind. Throughout the analysis, I came to understand this negative past as comprising the cultural currents, ways of doing, and expectations that users wished to question or self-distance from. These cultural currents, or grains, centered on:
an unquestioned use of hormonal contraceptives; taboos, shame, and dismissal of the reproductive body; a knowledge deficit about the reproductive body; productivity norms and social expectations; a general feeling of disconnect from the body.
These grains were interconnected; they all related in some way to salient social and cultural norms of the reproductive body identified by participants themselves.
The Unquestioned use of Hormonal Contraceptives
Several participants cited the regular, unquestioned practice of using and prescribing hormonal contraception. In the interview, Antonija mentioned how “it's more than normal” and “everyone does it…if you have a boyfriend, you start with [hormonal] contraception.” Hester contrasted the way her healthcare provider prescribed contraception with the provider's approach to addressing her brother's hair loss. [Discussing her brother's hair loss] the doctor said: “Well, there are medications you can take, hormones, but I won’t actually recommend that, because you are still in puberty.” Well, I, afterwards I was like: at 14, I was also going through puberty! Why was I allowed to take hormones? You know, it is an essential period for your body to mature in a normal, natural way. And if you then use hormones and you start messing around with that…that's just not right.
Hormonal contraceptives were generally seen as interfering with the physiological cycle. Contraceptive hormones could “turn off” or “shut down” the “natural cycle” in the words of the participants. Renske described hormonal contraception as “tinkering with a healthy system,” and as something that did not allow her, “as a woman, with her fertility” to fully exist. The hormones would “disturb” and “mute” the “natural” hormonal body, linking the “tinkering” to societal views on the female reproductive body. “You just get the message: there is something wrong with you. Um, because you’re fertile and you don’t want that, so you better suppress it. That's pretty much the message [you receive from society]” Renske said. She associated the use of hormonal contraception with devaluating herself as a person with a menstrual cycle, and understood repressing ovulation as dismissing the reproductive body.
Taboos, Shame, and Dismissal of the Reproductive Body
Users described how through self-tracking they became aware of negative discourses about their body. Hester relayed a kind of awakening from a past in which her bodily engagement was negative. “I was brought up, like many women, with the idea that you, yeah, you kind of have to…hate your body. Or that it's something that is disconnected from you and kind of sabotages you,” she said. Other users recounted once viewing the reproductive body as “dirty,” “evil,” “a nuisance,” or something “to be suffered” or “to feel shame about.”
A Knowledge Deficit About the Reproductive Body
Users correlated taboos and shame around the reproductive body with a lack of understanding and knowledge. Marijn expressed wanting body awareness to be given more attention in primary and secondary education, noting that “the pelvic area” was particularly neglected, she said, because “it is an area of your body that is very taboo.”
When discussing the knowledge deficit that they themselves experienced, users displayed outrage. In her interview, Michelle exclaimed: “I was not at all familiar with the ovulation cycle or what it does to your body. No way, just no. I didn’t know anything!” She added that in hindsight she found it strange not to have learned anything about the reproductive body whatsoever before, including in school. Julia similarly said: “Why, why didn’t I know [how the menstrual cycle works]? Why is this not general basic information? I’ve wondered that.” When I asked if she had an answer to this question, she responded: “No, yes, I don’t know, that might be a bit taboo or something.”
Productivity Norms and Social Expectations
Work-related demands, stress, perfectionism, fitness norms, and relationship expectations were prominent factors impacting users’ self-care practices. Users discussed feeling the pressure to meet productivity standards, making statements such as: “I have to be productive all week” or, “I have not reached my productivity goals yet,” as Hester said. Hester sent me a photo of her work desk and referred to her “social perfectionism and fear of rejection” when describing in her diary the stress she experienced regularly. Marijn cited a similar dynamic when reflecting on a period in her life where she overworked and was “getting my self-esteem too much from my performance and not from who I simply am without achieving anything.”
Users discussed norms and expectations in terms of boundaries and limitations with phrases such as “crossing boundaries” or calling a norm “too much” or “extreme.” For example, Katia described her diet and fitness plan as “very ambitious body goals” that turned out to be so extreme that it caused her ovulation to stop. Boundaries could also be challenged when, for example, Michelle suddenly felt overwhelmed by a tired mood experienced during menstruation at a time she shared responsibility for a project with her partner. “You suddenly think like aaaargh! [I’m too tired!] And then [your responsibilities] still have to be met. And then you cross your own boundaries.” Michelle described her energy levels as being rather unpredictable before she started self-tracking, causing some anxiety and the need to negotiate with her partner.
Meeting expectations of their role as a partner was a recurrent theme in interviews with interview respondents. Camilla recounted how while being on a contraceptive implant, she had no interest in intimacy with her partner and generally felt unwell. Finding out that other users of the implant dealt with similar problems made Camilla realize, as she put it, “It's like it's not me, it's not something in my head. It's not something about my relationship. It's the hormones…causing a lot of problems in my relationship.” Michelle noted that before cycle-tracking “it sometimes felt strange that [her libido] was on [activated] at random times and at other times it would be off again.” She had a sense that these fluctuations were not “normal.” Not always feeling a desire to be intimate, but also feeling “that it [her libido] is something that always ought to be on” made Michelle question her relationship.
A General Feeling of Disconnect from the Body
In the interviews users referred to a feeling of being disconnected from the body, or a culture of disconnecting from the body. Deborah noted a “disconnect” that she recognizes throughout society. Like Marijn, who lamented the lack of body awareness education, Deborah referred to the educational system's approach and its ramifications for embodiment. I think our education systems just divorce us from our bodies, really. We are very…we don’t have a…we’re schooled out of being connected to our bodies and we are schooled in a very, like, cerebral way. So that is one way I think that disconnect starts. And there is a sort of distrust of the body, and the body is a vehicle for our heads, and that's [in the head] is where the focus is.…We relate to our bodies in a very kind of extractivist…productivity-focused way, [as is] the way we relate to other people in terms of our relationships and also the kind of wider body that we are all on, the Earth, and our…environment, and it's very extractivist and it's focused on productivity.
In the way participants articulated these cultural currents they identify, sometimes explicitly, feminist issues regarding reproductive technologies, women's health and the disciplining of the reproductive body. They questioned the hormonal imperative (Tone 2012) by pointing out how, in The Netherlands, it is expected and unquestioned to take hormonal contraception consistently and from a young age. They point at cultural taboos regarding the reproductive body and bodily disconnection (Bobel 2020; Bobel and Fahs 2020; Martin 1989); and draw attention to a knowledge deficit and the need for accessible information on women's health and reproduction (Boston Women's Health Book Collective 1973; Murphy 2010). They identify a mis-match between the demand for constant productivity and fitness, and the cyclical physiology of women's bodies (Martin 1989). Users framed these cultural currents in terms of disregard or depreciation of the body, while their self-care comprised practices of appreciating and self-valuation that countervailed these currents. In short, their self-care set out to go against the grain.
Self-care Against the Grain
In the participants’ everyday self-care, I identified multiple interrelated practices of appreciation. This set of practices consisted of habits and modes that in and of themselves provided ways for participants to appreciate their body and that, at the same time, were something the participants expressed appreciation to be able to do. I distinguish these practices as:
appreciating data and hormonal physiology; reading bodily signs; embracing the reproductive body; following physiological needs; practices of attunement.
As with the aforementioned cultural currents, these practices were interrelated, all being key components of everyday self-tracking practices. I elaborate how these practices go against the grain by enabling users to question or express a wish to self-distance from cultural currents, ways of doing, norms, and expectations about the body. These practices also entailed other norms—of femininity, naturalness, and being “in touch” or “attuned to the body” as participants phrased it—that carry a nostalgic weight. I see this nostalgia as strategic because it enabled users to change repertoires of thinking, feeling, doing the body, and embodiment.
Appreciating Data and Hormonal Physiology
When describing their self-tracking activities in interviews or diaries, users expressed how “amusing,” “cool,” and “interesting” it was to collect data and gain knowledge about hormonal processes. As Renske wrote in her diary: “I think: this is so cool [smiling face with hearts emoji] that you can keep track of all this as a woman!” They expressed a sense of fascination with data collection and wonderment to see their temperature curves and be able to confirm ovulation. Laura wrote in her diary: “Haha, today I had a beautiful dot of EW discharge [cervical fluid that has the appearance and consistency of egg white] and I am so happy! I look at that with great admiration. [laughing emoji] #nerd.” Users appreciated their fluid samples, measurements, and data visualization.
Participants stressed how they valued gaining knowledge about their hormonal patterns. Michelle, for example, found it “amusing” to gain insight into her libido. I found out [because of self-tracking] that in the phase around ovulation, my libido was really much higher. And right before my period. It was very amusing that I gained insight into that. At first, I felt like it was very random. And then I was able to confirm: no, that's right, it's in line with my hormonal pattern.
Reading Bodily Signs
When talking about their physiological data, participants often used the words “signs” or “signals.” Specifically, they recounted having been hitherto unaware of certain bodily signs. For example, Laura, who wrote in her diary with wonderment of her cervical fluid, noted how her experience of her cycle was less defined before she began tracking. By tracking her cervical fluid, moods, and other embodied experiences, Laura came to understand her cervical fluid as a sign of fertility, saying: “Quite literally, I can see the fertility [in the fluid].” Or in Renske's words, this embodied practice of “being in touch with my cycle, its signals” was experienced as though it “is really a gift” for her.
Based on bodily signs, users reported developing attentive practices, articulated as “doing a kind of check-in,” “just taking a moment to think about how I am doing,” and “listening” to “what the body needs.” Users cultivated attention to their well-being (bodily or otherwise) to respond to any needs or preferences they might uncover through their attentiveness. Jasmina, from this article's opening vignette, described how she came to accept that…well, my cycle works in such a way that when I have my period it is best to just do nothing. That that works best for me, that I suffer much less from, well, mood swings, not necessarily, but the deep valleys, and then you know, I’m like that. Well, I find things like that are very interesting to discover.
Embracing the Female Reproductive Body
Respondents’ practices of appreciation extended to the reproductive body as a whole and, as demonstrated by Renske, to a sense of feminine self. While hormonal contraception would “suppress” her fertility, Renske saw her contraceptive app as a welcome alternative, stating: I, as a woman, with my fertility, am allowed to exist fully [in my self-tracking practices with the app]. The fact that I now embrace fertility is truly a gift to me. I don’t have to suppress that [anymore] and [not] mess with a healthy system. Because that is of course what we always do. That I am in touch with my cycle, its signals, the fluctuations on an emotional level, and that just makes me feel feminine.
Like Renske, Hester described discovering new ways to talk and think about her body in terms of a “shift.” Although she had been brought up “like many women” to hate her body, Hester relayed experiencing a shift from negative thinking and thinking badly about my body, so having the idea that it is worth nothing, or that it just holds me back or things like that, to interpreting it much more positively and having a lot of respect and love for [my body]. And yes, yes, be impressed by how it works, so to speak.
Following Physiological Needs
Users referred to embodied experiences that are usually considered negative (e.g., headaches, mood swings, having little energy) when speaking of “listening to” or “embracing” the body. Certain cycle phases could be correlated with more positive experiences for most users (e.g., feeling more energetic and outgoing prior to or during ovulation) while other cycle phases were accompanied by headaches, moods, and lack of energy. “Embracing the body,” as Jasmina put it, thus entailed accepting “all the physical sensations and emotions and the thoughts that come with [the cycle].”
“Listening” was also framed as a shift in behavior. It meant no longer challenging or condemning the fact that sometimes participants experienced more or less energy. “It is what it is,” Hester said in our interview. “I [better] move along with it [the body/the cycle].” But following the body did not just concern Hester's cycle or menstruation; it also “seeps into how I deal with work situations or relationship situations,” she shared on a positive note. She did not want to dismiss her body as “a nuisance” or something that sabotages her. When her body gave “signals”—for example, “neck pains, headaches and jaw clenching, and general stiffness”—she took them seriously as signs of stress. Hester described trying to make space for rest and to “recover from things” by taking walks or doing gardening when she felt overwhelmed. Hester thus let the day's plans be determined in part by her body's physiology. This allowed the body to be a subject; her bodily needs played a role in dictating how she spent her time.
One way to “follow” or “move along with” the body was having fewer expectations of oneself and “maintaining boundaries” with regard to work-related and social demands. Femke, for example, urged the female patients she cared for in her health practice to be “gentle” toward themselves, stating: “The only thing that you can do as a woman is understand what your needs are and listen to these needs, instead of beating yourself up about it.” In a similar spirit, Katia had given up her “very ambitious body goals” when her diet and fitness plan led to anovulation.
Visualization of the cycle played a role in granting gravitas to what participants viewed as their “natural” physiology. It validated physical and mental needs by linking them to natural physiological processes. Her cycle chart helped Hester decide, she explained, “whether I should give myself more peace and space or whether I can take it up a notch.” If ovulation was delayed or did not occur, users would reflect on possible contributing factors. The cycle chart became, according to Nedelya, a “health map” or, as Hester said, an “essential yardstick to measure how I am doing.”
To “follow” the “body's needs” was a strategy to go against self-imposed or social expectations—such as to be productive, energetic, fit, or outgoing—when the body's “signs” or “signals” pointed in another direction. This was exemplified in Hester's case, by resting when she needed, as well as by Katia, who gave up body goals for being too “extreme.” When expectations or obligations were at odds with what participants identified as their body's own “natural” needs and preferences, they had the choice to “follow” the body rather than strive to fulfill expectations.
Practices of Attunement
Users describe how self-tracking their cycle provided means to become more attuned to the body. Julia talked about the effects of self-tracking in terms of a stronger mind–body connection. Well, I mean, yes, I do have [the idea] that my body and mind are very connected, that, that's how I actually started to look at it more that…they are just very connected, instead of two separate things. And that I also listen a little more to [my body] if I feel a certain way, either physically or mentally, just that I take it easy…that I understand that link between the two [body and mind]…that I have started to believe in that [there is a link between the two] a little more, so to speak, or…that I have become more aware of that.
Users framed such intimate attunement as providing the sense of “just feeling well in [my body].” “Feeling well” was multivalent, referring to feeling well within one's body (by caring for it in responding to its needs) as well as feeling well, which entailed cultivating awareness and attunement to the body by sensing it (Algera 2023; Harris 2020; Maslen and Harris 2021).
For Deborah, who had cited “the capitalist system” as disregarding bodily needs, practices of attunement could hold the potential for more fundamental societal change. Attunement through self-tracking, she stated in our interview, might imply a move away from “extractivist” and “productivity-focused” ways of relating to the body toward “a reconnection with the body and a sort of elevating of the body, in terms of our considerations and priorities and the way we live our life, that could perhaps ripple out to how we relate to other people, other bodies and the environment.” Deborah emphasized that the more “embodied, intuitive benefits” of self-tracking were not only individually but also politically relevant. She felt that a shift in how the body was dealt with on a personal level could have positive implications for how humans embed and are embodied in the world.
Strategic Nostalgia
Participants’ self-care practices reflected several shifts they had reported undergoing. Users inverted discourses from shame to celebration of the reproductive body. They switched from a type of hormonal contraceptive that worked to “turn off” fertility (largely understood as ovulation) for a method that enabled them to be “attuned” to it. They filled a knowledge deficit with new insights and awareness of their cycle co-constructed with their app. They validated their physiological needs despite social expectations that prescribe otherwise. They moved away from “a culture of disconnect” (as phrased by Deborah) toward practices of attunement. These shifts reflected forms of self-validation and validation of the reproductive body reminiscent of earlier feminist projects to celebrate and appreciate female reproduction and sexuality (Boston Women's Health Book Collective 1973; Murphy 2010). The reproductive body was not “dirty” or “a nuisance” but “beautiful” and “wonderful” in the words of the participants. Expressing how personal boundaries and needs got validated, 2 Renske said: “I as a woman, am allowed to fully exist.”
There was a strong sense of nostalgia in these shifts. They enabled a lost connection with the body as a living organism to be, as users saw it, restored. The violence and injustice of taboo and shame were alleviated. The value of femininity could be restored in the face of a patriarchal system that denies it. Users actively mobilized ideals of naturalness, femininity, and attunement to negotiate and thwart other salient norms and expectations. As Thompson (2005) shows, with the use of reproductive technologies users strategically naturalize, in this case the feminine body. By mobilizing the ideals of the “natural” and feminine body, they opened up ways to go against the grain. Demarcating the “natural” allowed users to draw distinctions between what belongs to their personal sphere (“natural,” physiological, bodily needs) and what was imposed or infringed upon them from the outside. Granting gravitas to what was “natural” allowed them to shape their lives in ways that were meaningful to them.
And yet, this nostalgia obscured the daily labor, negotiations, and uncertainty involved in pregnancy prevention with self-tracking technologies. It also neglected the incessant use of technologies and methods required to enact this “natural,” “feminine,” and “attuned” body. It hid the fact that salient norms persisted; the expectations to be productive, healthy, fit, and fulfilling social duties still carried weight though they were weighed against personal needs constructed by bodily “signs” or “signals.” These needs were personal because they were each body's and each individual's own needs. However, they were co-constructed with tracking technologies and self-experimentation (Algera 2023), alongside cultural narratives concerning menstrual physiology, nutrition, sleep, the effects of stress, and self-care habits.
Self-Care as Strategic Norm Negotiation
This study explored the self-care practices of contraceptive self-tracking technology users. I have documented how these practices were productive for users, particularly relating to prevailing social norms surrounding the reproductive body. Users grappled with what I termed “grains:” cultural currents including unquestioned hormonal contraceptive use, taboos, knowledge gaps, productivity norms, and a disconnection from or disregard of the reproductive body.
I framed participants’ everyday self-care as practices of appreciation and self-validation that served to go against these grains. Self-care was thus a strategic tool, helping users navigate conflicting social norms. It could entail simply asking “How am I doing today?” or “What does my body need?” Asking these questions challenged the prevailing normative prescriptions and expectations of productivity, utility, sociability, acceptability, fitness, fertility, and sexuality identified by participants. For many interviewees, cycle-tracking practices granted gravitas to personal needs while navigating and weighing the multiple norms and expectations at play. Some practices might have aligned with one grain while conflicting with another. Going with one grain—the idea of naturalness or femininity, for instance—could also enable going against another—the idea that one needs to always be productive. By making room for friction against prevailing cultural currents, self-care became an intermediary between internalization and resistance.
Consistent with studies by Chen (2017) and Della Bianca (2021), the ideals of “natural” and regularly cycling bodies played a central role for participants. They praised the “natural” body and the regular cycle, using language infused with a celebratory tone—how “wonderful,” “beautiful,” and “admirable” their reproductive bodies were—reiterating the advertising discourses around these apps. Users also echoed social expectations. Productivity standards and work-related demands weighed on them and users described how they attempted to eat healthily, sleep enough, drink water, exercise, meditate, and plan responsibilities around their personal needs. This finding was in line with Koskenniemi's (2022, 14) work showing that menstrual self-help books promote new wellness and health norms, as well as uphold an idea of a “natural” body while “overlook[ing] the sociocultural construction of ‘naturalness’ as an aspect of the female body.” Participants’ pursuit of well-being arguably pandered to societal pressures on the individual to discipline, monitor, manage, and optimize their own health and well-being, thereby perpetuating gender stereotypes, norms of health, wellness, and reproductive responsibility that feminist critics of reproductive self-tracking technologies have pointed out (Della Bianca 2021; Ford, De Togni and Miller 2021; Hendl and Jansky 2022; Kressbach 2019; Lupton 2016, 2015).
Yet, the praxiographic analysis of these user practices also complicated an understanding of self-care that a discourse analysis alone might have offered. Ideas of “being in touch” with the “natural” and “feminine” body were not just norms, ideals, or discourses. They were enacted as strategic nostalgia. They were part of practices of self-validation. Participants used self-tracking to identify points of tension between social norms and the self. This was achieved by making self-tracking about more than collecting data—it was a matter of feeling and sensing the body together with tracking technologies. Doing so, users granted gravitas to their personal needs and boundaries. And while they grappled with various norms and expectations at once, constantly weighing them, the idea of the “natural” allowed them to validate their personal needs in a context that infringes on them. The “natural” body opened up new repertoires of thinking, feeling, doing the body, and embodiment, thereby attempting to question these infringements.
In this praxiography, I show how the ambiguity of reproductive self-tracking, at once empowering and disempowering (Ford, De Togni and Miller 2021, 60), plays out in practice. My analysis highlighted that self-care cannot be understood simply as internalization of imposed norms or pressures. Users were not passive recipients of technologies, internalizing norms imposed on them by self-tracking apps. Nor were they constantly resisting norms and expectations. Rather, they were juggling—in the form of weighing, negotiating, and questioning—different, sometimes contradictory, values and norms at the same time. Participants’ strategic norm negotiation offers a new perspective on agency and normativity with these digital reproductive technologies. People can manifest agency and enact their subjectivity (Cussins 1997, 576) by enactments of “natural” physiology through technological practices.
By drawing on work in the field of STS on aesthetic appreciation in everyday care (Skeide 2022; Pols 2019, 2013, 2023), this article contributes to our understanding of the embodied and sensory dimension of agency. The analysis of the aesthetic practices shows how self-care practices included embodied practices of self-appreciation and self-validation. This self is not only cultivated by tracking the body with digital means, but also through digital-sensory and affective practices (Lupton and Maslen 2018; Algera 2023), as exemplified in Jasmina's dance in her living room. Jasmina's dance is a striking example of the embodied nature of agency. Jasmina's dance drew a boundary, saying “no” to social obligations and staying home during her menstruation. In this sense, she went against the grain. At the same time, the dance allowed her to “embrace” and “follow” her body, cultivating attention to the body. This embodied practice also went against the grain because it validated and attended precisely to what is often dismissed or disregarded: the menstruating body.
Footnotes
Acknowledgments
I thank all the participants in this study for sharing their experiences and knowledge with me. As the writing of this manuscript began in 2021, I offer special gratitude to Jeannette Pols, Trudie Gerrits, Jan Hindrik Ravesloot, and Machiel Keestra for their patience, continued feedback, and unwavering support. I also thank the editors of ST&HV and the journal's anonymous reviewers for their careful feedback which helped to improve this manuscript. Special thanks to the ANT reading group at the Amsterdam UMC, as well as Bagas Wicaksono, Kurt Cassar, Bram Gootjes for their feedback on this manuscript. Karina Hof, Gili Yaron, Sydney Howe: thank you for your feedback, inspiration and support in writing this article and beyond.
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
