A Global Perspective on Trends in the Use of Withdrawal and Periodic Abstinence for Pregnancy Prevention

Periodic abstinence and withdrawal (the dominant methods in the “traditional methods” category) have been used to prevent pregnancy in both historical and contemporary contexts and, in some countries, continue to be used despite increased availability and use of modern methods. Yet research on family planning programs and contraceptive methods often focuses solely on modern contraceptive methods, thereby overlooking trends and patterns of traditional method use. In this study, we analyze population‐level survey data from 1990 to 2020 and find a global decline in the share of overall contraceptive use accounted for by these traditional methods (e.g., withdrawal and periodic abstinence), a slight decline in traditional method prevalence rates, and an overall increase in the absolute number of traditional method users. We then examine geographic and temporal variation in levels and patterns of withdrawal and periodic abstinence method use. Finally, we identify countries that have reached low levels of fertility since 1970 with higher levels of withdrawal or periodic abstinence use, or where these methods account for a substantial portion of overall contraceptive use. We find that while reported use of withdrawal and periodic abstinence is low in many settings, they remain important tools for pregnancy prevention in a number of countries.