Too Fast, Too Fragile? The Governance Dilemmas of Digital Contraception in Canada

This case explores the governance dilemmas posed by digital contraceptive technologies through the lens of Health Canada’s 2024 decision to approve the Natural Cycles app as a Class II medical device. Framed around a fictional policy analyst, Dr. Amara Singh, the case situates algorithmic contraception within broader debates about digital regulation, the tension between innovation and governance, and reproductive justice. Students are invited to grapple with complex regulatory questions: Should algorithmic fertility apps be governed as traditional medical devices? How should equity, transparency and risk be incorporated into digital health oversight? How can public regulators meaningfully examine apps without access to industry data or post-market surveillance? Drawing on comparative regulatory practices, the case underscores the limitations of existing medical device frameworks to address the sociotechnical and demographic contingencies of femtech. It invites students to think critically about institutional responsibility, algorithmic opacity, and the symbolic power of state endorsement in legitimizing emerging digital health tools.