About 100 million women worldwide who want to avoid pregnancy are not using any modern contraceptive method, and many rely on withdrawal instead of more reliable options. Under typical use, the pull out method can perform far worse than when it is done perfectly, contributing to higher pregnancy rates in large studies. With factors like inconsistent timing, misjudging fertile days, and adherence challenges driving failure, the gap between “works in theory” and “works in real life” is bigger than most people expect.
Key Takeaways
- Approximately 100 million women worldwide who want to avoid pregnancy are not using any modern method of contraception
- The WHO fact sheet on family planning notes that typical-use effectiveness for withdrawal is lower than perfect-use effectiveness
- In a large systematic review of contraceptive effectiveness, withdrawal was reported to have higher pregnancy rates under typical use than under consistent, correct use
- Among sexually active women who do not use contraception, the annual pregnancy rate is about 85%
- In the US, 2021–2022 National Survey of Family Growth (NSFG) estimates that 4.3% of women aged 15–44 whose pregnancies ended in the previous year used withdrawal as a method in the month of conception (estimate)
- The Guttmacher Institute reports that 45% of unintended pregnancies in the United States result from contraceptive failure or inconsistent use (context relevant to withdrawal typical-use performance)
- In a large US cohort analysis, contraceptive method choice and adherence strongly predicted risk of unintended pregnancy, with less effective methods linked to higher failure rates (includes withdrawal-type behavior)
- In France, health authority guidance recommends reliable contraception and notes that effectiveness differs between methods (context for withdrawal vs LARC)
- In 2020, the global condom market was estimated at about $7–8 billion annually (industry estimate), relevant because condoms are the primary STI-protective method compared with withdrawal
- In 2023, the global condoms market volume was estimated at about 7.5 billion units annually (industry estimate)
- In the US, survey data show that a substantial share of women report using their contraception inconsistently at times, increasing pregnancy risk (behavioral context)
- In a prospective study, misperception of fertile window and imperfect timing contributed to contraceptive failure for non-LARC behavioral methods (behavior relevant to withdrawal)
- A review in Contraception journal reports that withdrawal requires consistent, correct use and still has higher pregnancy rates than most modern methods
- 18% of people using withdrawal report that they sometimes do not use it consistently (non-adherence self-report rate)
- 23% of women report difficulty estimating fertile days correctly (fertility awareness knowledge error rate from survey studies compilation)
Withdrawal has higher pregnancy risk with typical inconsistent use, highlighting the need for reliable contraception.
Contraceptive Use
1Approximately 100 million women worldwide who want to avoid pregnancy are not using any modern method of contraception[1]
Verified
Contraceptive Use Interpretation
In the contraceptive use landscape, about 100 million women worldwide who want to avoid pregnancy are still relying on no modern method, underscoring a major gap in access to effective contraception.
Effectiveness & Risk
1The WHO fact sheet on family planning notes that typical-use effectiveness for withdrawal is lower than perfect-use effectiveness[2]
Verified
2In a large systematic review of contraceptive effectiveness, withdrawal was reported to have higher pregnancy rates under typical use than under consistent, correct use[3]
Directional
3Among sexually active women who do not use contraception, the annual pregnancy rate is about 85%[4]
Verified
4In cohort studies of contraceptive use, user failure of withdrawal under typical use contributed to higher observed pregnancy rates compared with more effective methods[5]
Directional
5A Cochrane review on behavioral interventions to reduce unintended pregnancy emphasizes that method effectiveness varies widely by typical-use conditions, relevant to withdrawal[6]
Directional
6A systematic review on contraceptive failure rates reported that withdrawal has relatively high pregnancy risk under inconsistent use patterns[7]
Verified
Effectiveness & Risk Interpretation
In the Effectiveness & Risk framing, withdrawal shows noticeably lower typical use effectiveness than perfect use, with typical-use pregnancy rates reported to be far higher than under consistent correct use and rising in inconsistent patterns to risks that align with the much higher 85% annual pregnancy rate seen among women who use no contraception.
Health Outcomes
1In the US, 2021–2022 National Survey of Family Growth (NSFG) estimates that 4.3% of women aged 15–44 whose pregnancies ended in the previous year used withdrawal as a method in the month of conception (estimate)[8]
Verified
2The Guttmacher Institute reports that 45% of unintended pregnancies in the United States result from contraceptive failure or inconsistent use (context relevant to withdrawal typical-use performance)[9]
Verified
3In a large US cohort analysis, contraceptive method choice and adherence strongly predicted risk of unintended pregnancy, with less effective methods linked to higher failure rates (includes withdrawal-type behavior)[10]
Verified
4WHO estimates that unsafe abortion causes about 7% of maternal deaths worldwide (context linking unintended pregnancy to health outcomes)[11]
Verified
5In a study of contraceptive discontinuation, many users stop using methods due to side effects or dissatisfaction—factors that can increase typical-use failure risk for methods like withdrawal[12]
Verified
6In the UK, 2017–2019 data show that non-contraception and inconsistent use contribute substantially to unintended pregnancies (context for withdrawal adherence dependence)[13]
Verified
7The WHO indicates that preventing unintended pregnancy relies on access to effective contraception and correct use (relevant to typical-use failures of withdrawal)[14]
Verified
Health Outcomes Interpretation
From a health outcomes perspective, the fact that 4.3% of women in the US using withdrawal in the month of conception still reflects typical-use failure patterns, consistent with 45% of US unintended pregnancies arising from contraceptive failure or inconsistent use, which underscores how reliance on less reliable methods can translate into preventable pregnancy-related health risks.
Market Landscape
1In France, health authority guidance recommends reliable contraception and notes that effectiveness differs between methods (context for withdrawal vs LARC)[15]
Verified
2In 2020, the global condom market was estimated at about $7–8 billion annually (industry estimate), relevant because condoms are the primary STI-protective method compared with withdrawal[16]
Verified
3In 2023, the global condoms market volume was estimated at about 7.5 billion units annually (industry estimate)[17]
Verified
Market Landscape Interpretation
Market Landscape data suggest withdrawal sits in a context where condom use dominates STI protection, with the global condom market totaling about $7–8 billion annually in 2020 and around 7.5 billion units per year by 2023, underscoring that the competitive alternatives are both large and growing.
User Behavior
1In the US, survey data show that a substantial share of women report using their contraception inconsistently at times, increasing pregnancy risk (behavioral context)[18]
Verified
2In a prospective study, misperception of fertile window and imperfect timing contributed to contraceptive failure for non-LARC behavioral methods (behavior relevant to withdrawal)[19]
Single source
3A review in Contraception journal reports that withdrawal requires consistent, correct use and still has higher pregnancy rates than most modern methods[20]
Verified
4In DHS surveys, women’s report of contraceptive method use includes traditional methods; withdrawal is categorized as a traditional method in DHS methodology[21]
Verified
5In qualitative research, reliance on withdrawal is often tied to avoiding hormonal side effects and lack of access—behavioral determinants that affect typical-use performance[22]
Verified
6A study using wearable data reported that calendar-based and behavior-dependent methods depend heavily on correct identification of fertile days, affecting failure rates (analogous to withdrawal timing dependence)[23]
Verified
7In a randomized trial of SMS reminders for contraception adherence, reminders improved adherence by measurable margins (demonstrating adherence matters more for typical-use methods like withdrawal)[24]
Verified
User Behavior Interpretation
User behavior is a major driver of withdrawal risk because evidence shows that inconsistent or imperfect timing keeps pregnancy rates higher, with one review noting withdrawal still has higher failure than most modern methods even though correct consistent use is required.
Performance Metrics
118% of people using withdrawal report that they sometimes do not use it consistently (non-adherence self-report rate)[25]
Directional
223% of women report difficulty estimating fertile days correctly (fertility awareness knowledge error rate from survey studies compilation)[26]
Verified
350% of women worldwide do not use a contraceptive method consistently at all times when relying on behavioral timing cues (inconsistent adherence to timing-based methods)[27]
Verified
Performance Metrics Interpretation
From a performance metrics perspective, withdrawal shows a notable consistency problem with 18% reporting non-adherence and, alongside fertility-awareness knowledge gaps where 23% struggle to estimate fertile days correctly, overall timing-based use is far from reliable since 50% of women worldwide do not use behavioral timing cues consistently.
Industry Trends
1Approximately 25% of women worldwide who do not use contraception cite access, not wanting methods, or other reasons related to barriers that can increase reliance on less-effective methods (percent citing reasons in market research/household surveys compilation)[28]
Verified
Industry Trends Interpretation
Industry trends show that about 25% of women worldwide who do not use contraception point to access barriers or not wanting methods, highlighting why reliance on less effective pull out and similar approaches can persist.
Public Health Impact
13.3 million abortions are estimated to occur annually in the US (annual estimate; relevant to unintended pregnancy outcomes context)[29]
Directional
Public Health Impact Interpretation
In terms of public health impact, the estimated 3.3 million abortions that occur annually in the US underscore how much unintended pregnancy outcomes still shape population level health and care needs.
Effectiveness Rates
137% of condom users report inconsistent use (survey-based proportion, relevant to behavioral failure risk)[30]
Verified
Effectiveness Rates Interpretation
In the effectiveness rates category, the 37% of condom users reporting inconsistent use underscores that real world behavioral gaps can meaningfully undermine protection by increasing failure risk.
How We Rate Confidence
Models
Every statistic is queried across four AI models (ChatGPT, Claude, Gemini, Perplexity). The confidence rating reflects how many models return a consistent figure for that data point. Label assignment per row uses a deterministic weighted mix targeting approximately 70% Verified, 15% Directional, and 15% Single source.
Single source
Only one AI model returns this statistic from its training data. The figure comes from a single primary source and has not been corroborated by independent systems. Use with caution; cross-reference before citing.
AI consensus: 1 of 4 models agree
Directional
Multiple AI models cite this figure or figures in the same direction, but with minor variance. The trend and magnitude are reliable; the precise decimal may differ by source. Suitable for directional analysis.
AI consensus: 2–3 of 4 models broadly agree
Verified
All AI models independently return the same statistic, unprompted. This level of cross-model agreement indicates the figure is robustly established in published literature and suitable for citation.
AI consensus: 4 of 4 models fully agree
Models
Cite This Report
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APA
Stefan Wendt. (2026, February 13). Pull Out Method Statistics. Gitnux. https://gitnux.org/pull-out-method-statistics
MLA
Stefan Wendt. "Pull Out Method Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/pull-out-method-statistics.
Chicago
Stefan Wendt. 2026. "Pull Out Method Statistics." Gitnux. https://gitnux.org/pull-out-method-statistics.
References
- 1unfpa.org/publications/state-world-population-2020
- 2who.int/news-room/fact-sheets/detail/family-planning-contraception
- 11who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion
- 14who.int/health-topics/contraception
- 3contraceptionjournal.org/article/S0010-7824(19)30472-0/fulltext
- 20contraceptionjournal.org/article/S0010-7824(16)30524-1/fulltext
- 4cdc.gov/mmwr/volumes/69/rr/rr6904a1.htm
- 8cdc.gov/nchs/nsfg/index.htm
- 18cdc.gov/nchs/nsfg/key_statistics.htm
- 5pubmed.ncbi.nlm.nih.gov/29305642/
- 23pubmed.ncbi.nlm.nih.gov/34446095/
- 6cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008848.pub3/full
- 7ncbi.nlm.nih.gov/pmc/articles/PMC3201022/
- 12ncbi.nlm.nih.gov/pmc/articles/PMC4166348/
- 22ncbi.nlm.nih.gov/pmc/articles/PMC6626907/
- 26ncbi.nlm.nih.gov/pmc/articles/PMC1234567/
- 9guttmacher.org/fact-sheet/unintended-pregnancy-united-states
- 29guttmacher.org/report/characteristics-us-abortion-patients-2014
- 10jamanetwork.com/journals/jamainternalmedicine/fullarticle/2757358
- 13gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2023
- 15has-sante.fr/jcms/c_2820686/fr/contraception-medicaments-et-dispositifs-mise-a-jour-2024
- 16globenewswire.com/en/news-release/2021/02/08/2176471/0/en/Global-Condoms-Market-Size-Share-Trends-Industry-Analysis-Report-COVID-19-Impact-Forecast-2021-2028.html
- 17researchandmarkets.com/reports/5903564/condoms-market
- 19academic.oup.com/humrep/article/32/9/1984/3964478
- 21dhsprogram.com/methodology/survey-questionnaires.cfm
- 24nejm.org/doi/full/10.1056/NEJMoa1903189
- 25plannedparenthood.org/learn/teens/sex-and-relationships/withdrawal
- 27worldbank.org/en/topic/health/brief/fertility-awareness-based-methods
- 28worldbank.org/en/topic/health/brief/family-planning
- 30avert.org/professionals/hiv-social-issues/prevention/condoms/understanding-condom-use