A new study highlights a troubling trend among Gen Z: many are delaying parenthood while relying on withdrawal as a primary contraceptive. This method has a documented failure rate of about 20-22 percent with typical use, raising the risk of unintended pregnancies in the interim. In Thailand, where birth rates have fallen to historic lows, the findings underscore an urgent need for stronger reproductive health education and accessible family planning services.
The survey, commissioned by a leading pregnancy test brand and conducted with a women’s media platform, shows that nearly 37 percent of young adults favor withdrawal as their go-to method. Although most respondents say they are well informed about sexual health and support access to contraception, the gap between knowledge and practice is evident. The reliance on a high-failure method occurs alongside a desire for children in the future, with many considering starting a family around age 28.
Thailand’s demographic context makes these trends especially consequential. Latest data indicate fewer than 500,000 births in 2024, and the total fertility rate has dropped to around 1.0 child per woman. Analysts warn that if current patterns persist, the country could face workforce and service delivery challenges in the coming decades. Consequently, policymakers and health professionals are closely examining how to improve youth sexual health education and ensure broader, stigma-free access to effective contraception.
Across the globe, youth attitudes toward contraception are shaped by a mix of factors. Many Gen Z individuals express skepticism toward hormonal methods due to perceived side effects and prefer “natural” approaches pitched on social media. Yet non-hormonal options such as copper intrauterine devices and reliable barrier methods remain underutilized, especially when not integrated with strong sexual health support and counseling.
In Thailand, social determinants strongly influence contraceptive choices. Behavioral health factors, peer networks, and experiences of bullying or violence can affect young people’s willingness to seek and use contraception consistently. While the 2016 Act for Adolescent Pregnancy Prevention supports comprehensive sexuality education, real-world implementation remains uneven, with gaps in teacher training and updated materials.
Home pregnancy tests are a common tool among Thai youth, with many using them for reassurance during periods of anxiety. When used correctly at the right time, these tests offer high accuracy, though reliability declines when taken too early. The focus should remain on primary prevention through effective contraception rather than relying on testing after unprotected sex.
Economic considerations also drive method selection. Long-acting reversible contraceptives (LARCs) have the lowest failure rates but come with higher upfront costs and the need for clinical insertion. Withdrawal requires no cost and no clinical visit but offers no STI protection and higher pregnancy risk. Expanding access to affordable LARCs and reinforcing education about dual protection can help close the gap between knowledge and practice.
Thailand’s healthcare system offers one of its strengths in improving youth contraception access. Pharmacies can dispense emergency contraception without a prescription, and public hospitals provide family planning counseling and LARC services. Efforts to reduce stigma and boost youth-friendly services are essential to ensure young people use contraception consistently and safely.
Thai culture adds further nuance to reproductive health decisions. Concepts such as kreng jai can influence conversations about contraception within partnerships, particularly for younger women negotiating with older partners. Peer support networks correlate with higher condom use, while stressors like mental health challenges and exposure to violence can hinder protective behaviors.
The broader implication is clear: delayed parenthood and inconsistent contraception pose challenges for Thailand’s population strategy. Solutions require a holistic approach—investing in childcare, expanding parental leave, improving housing affordability, and strengthening school and community health programs to support informed choices.
Key recommendations for Thai youth and families:
- Emphasize consistent use of effective contraception, prioritizing LARCs and reliable hormonal methods, while maintaining condoms for STI protection.
- Ensure ready access to emergency contraception as a backup, coupled with clear guidance on appropriate timing.
- Promote confidential, youth-friendly health services and comprehensive sexuality education that reflects modern options.
- Integrate mental health and bullying prevention with reproductive health programs to support healthier decisions.
- Address cultural barriers with sensitive, respectful communication and peer-led education.
Thailand’s path forward lies in blending evidence-based health information with culturally aware, accessible services. By strengthening education, expanding healthcare access, and supporting families, the country can address both individual well-being and long-term demographic stability.