Introduction: The increasing use of traditional contraceptive methods in Indonesia may raise the risk of unintended pregnancies, while modern contraceptive use has stagnated and often experiences discontinuation. Nevertheless, contraceptive choice is an individual right and should guide family planning programs. This study aimed to estimate contraceptive effectiveness based on pregnancy risk and dropout rates and to examine the socio-demographic characteristics of users. Methods: This cross-sectional study with a retrospective cohort approach used calendar data from the 2017 Indonesia Demographic and Health Survey (IDHS). The study population included all contraceptive use episodes within five years, resulting in 46,461 episodes. Data were obtained from the 2017 IDHS socio-demographic questionnaire and contraceptive calendar. Multivariate logistic regression was used for analysis. Results: There was no significant difference in dropout rates between traditional and modern contraceptive users (OR = 0.92; 95% CI = 0.79–1.05). However, users of traditional methods had a 2.46-times higher risk of pregnancy compared with modern method users (95% CI = 2.19–2.76). Traditional contraceptive use was more common among women aged 40–49 years, with parity ≥ 5, higher education, and higher economic status, living in urban areas, and residing in Sumatra, Kalimantan, and Sulawesi (p = 0.001). Conclusions: Traditional contraceptive use is associated with a higher risk of pregnancy. Strengthening counseling services through comprehensive, pluralistic, and participatory approaches is essential while respecting individuals’ rights in contraceptive choice. © 2026 by the authors.