Delay or Danger: 3 Contraception Choices Couples Face in Family Planning -

For many newly married couples in Nigeria, delaying pregnancy or making contraception is not about rejecting children, but about timing.

Rising living costs, unstable jobs, unfinished education, housing pressures and the desire to “settle first and know my spouse better” have made immediate childbearing less automatic than it once was. As a result, couples often turn to discreet, everyday birth-control options — most commonly the withdrawal method or the contraceptive pill.

According to the Nigeria Demographic and Health Survey (NDHS), only about 12–15 per cent of married women use modern contraceptive methods, while reliance on traditional methods like withdrawal remains common, especially among young couples and first-time marriages.

Contraception Effectiveness, Health and Real-Life Use

The withdrawal method appeals because it is free, natural and does not involve hormones or clinic visits. But medically, it is unreliable.

“With typical use, withdrawal has a failure rate of about 22 per cent within a year,” says Dr. Amina Yusuf, a consultant obstetrician and gynaecologist in Abuja. “That means roughly one in five couples will experience an unintended pregnancy.”

The contraceptive pill, on the other hand, is far more effective. When taken daily and correctly, it prevents pregnancy in over 99 per cent of users. However, consistency is key — missed pills are one of the leading causes of unplanned pregnancies in Nigeria’s urban centres, according to hospital-based reproductive health data.

Side effects such as nausea, headaches or mood changes can occur, and doctors caution that women with certain conditions — including a history of blood clots or heavy smoking — should be properly assessed before use.

What About Implants and Long-Acting Methods?

In recent years, implants have become more visible through public health campaigns. While global medical bodies consider implants safe — including for women who have not given birth, however some Nigerian health practitioners still advise caution about this method of contraception for couples who are yet to conceive, largely due to fears, cultural beliefs and concerns about delayed return to fertility.

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“There is no strong scientific evidence that implants permanently affect fertility,” Dr. Yusuf explains. “But in practice, some couples feel more comfortable starting with short-term contraception methods like pills, especially before their first child.”

This perception, whether medical or cultural, continues to shape contraceptive choices across the country.

The Bottom Line

If avoiding pregnancy is the priority, the pill is significantly safer and more reliable than withdrawal. If avoiding hormones is the concern, withdrawal may seem appealing — but it carries a much higher risk of unintended pregnancy.

Neither method protects against sexually transmitted infections, and no single contraception option fits everyone. Health experts stress that informed choice, honest communication between partners, and professional medical guidance remain essential.

In a country where unplanned pregnancies still account for a significant share of maternal health challenges, choosing wisely — not silently — matters.