Many women in Nigeria desire to space their children but remain hesitant to adopt modern contraceptive methods due to persistent myths and misconceptions. Cultural norms, spousal opposition, and misinformation continue to limit acceptance, even as worsening economic hardship and food insecurity heighten the need for effective family planning.

As a result, some women resort to traditional methods such as periodic abstinence, withdrawal, and lactational amenorrhoea. Health experts say these approaches are unreliable, with failure rates exceeding 50 per cent, making them ineffective for preventing unplanned pregnancies.

Nigeria’s fast-growing population, combined with inflation-driven economic challenges, raises concerns about increasing poverty levels if population growth is not better managed. Unmet need for family planning therefore remains a significant public health issue.

Available evidence indicates that unmet family planning needs in Nigeria have remained high over the past 15 years, despite various policies and programmes aimed at encouraging contraceptive use. Experts describe contraception as a scientific means of preventing unintended pregnancies by spacing or limiting births.

The World Health Organisation defines family planning as the ability of individuals and couples to determine the number of children they want, as well as the spacing and timing of births, including a woman’s right to decide whether or not to have children.

Access to contraception reduces unplanned pregnancies and lowers the risk of unsafe abortions, a leading cause of maternal deaths. Studies suggest that increased contraceptive use could prevent up to 33 per cent of maternal deaths globally.

An Associate Professor and Consultant Obstetrician and Gynaecologist at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Dr Uche Agu, cautioned women against relying on the withdrawal method for birth control, describing it as unreliable and prone to frequent failure.

He explained that the withdrawal method, commonly known as the “pull-out” method, has a high failure rate and should not be considered a dependable family planning option.

According to the Nigeria Demographic and Health Survey (2023–2024), contraceptive prevalence stands at 20 per cent among currently married women and 50 per cent among sexually active unmarried women. However, only 15 per cent of married women and 38 per cent of sexually active unmarried women use modern contraceptive methods.

Among married women, implants (6 per cent) and injectables (4 per cent) are the most commonly used modern methods. Among sexually active unmarried women, male condoms (26 per cent) and withdrawal (9 per cent) are most frequently used.

Agu noted that while withdrawal may work for a small number of people, it is fundamentally flawed. He said the method aims to prevent sperm from entering the vagina, but in practice, it often fails. About one in five couples who rely on withdrawal consistently for a year are likely to experience an unintended pregnancy.

He explained that many men lose control at the point of orgasm and ejaculate before withdrawing. Even when withdrawal occurs on time, sperm cells may already be present in pre-ejaculatory fluid, which can still lead to pregnancy.

Data from the National Bureau of Statistics shows that only 12 per cent of Nigerian women were using modern contraceptive methods as of 2021, while more than 83 per cent were not using any form of contraception in 2018.

Further explaining the risks, Agu said withdrawal is typically chosen by people who avoid standard contraceptive methods such as condoms, injectables, intrauterine devices, or implants. However, he stressed that the method is unreliable due to loss of control during climax and the presence of sperm in early secretions.

World Health Organisation data from 2020 shows that even with perfect use, four per cent of people relying on withdrawal will become pregnant. By comparison, condoms have a pregnancy rate of about two per cent with perfect use.

The WHO lists contraceptive methods such as pills, implants, injectables, patches, vaginal rings, and intrauterine devices as safe, effective, and thoroughly tested. Long-acting methods like implants, IUDs, and sterilisation are highly effective, while short-term methods work well when used correctly. Condoms also provide protection against sexually transmitted infections, including HIV.

Agu emphasised that withdrawal requires exceptional discipline on the part of the man, noting that loss of control and early sperm release are key reasons for its high failure rate. He urged women to embrace modern contraceptives and called for improved access to accurate information on family planning options.

Also speaking, a public health physician with over 25 years of experience, Dr Salma Ibrahim-Anas, said family planning and fertility education are vital to sustainable development and national security.

Ibrahim-Anas, who serves as Special Adviser on Health to the President, said inadequate family planning and poor access to fertility education contribute to insecurity in the country.

She explained that proper child spacing enables parents to provide better nutrition, education, and moral guidance, improves child survival, and reduces pressure on health facilities.

According to her, families with more children than they can adequately support may struggle to provide proper upbringing and education, making children more vulnerable and increasing the risk of social instability and insecurity.