Healthy Living

Tuesday, December 8, 2009

Is pulling out in?

"What birth control method do you use?" I'll ask every new patient. Some will guiltily answer, "Nothing." "Not even condoms, or withdrawal?" I'll reply. "Oh, yeah, he pulls out. But we don't use real birth control."

The withdrawal method of contraception (also known as coitus interruptus, or pulling out before ejaculation) has never received much respect from doctors. Withdrawal as a method requires awareness of imminent orgasm by the guy - and the ability to pull out in time. It's a method classified as "coitally dependent" - you need to use the method when you have sex instead of planning ahead of time...and lust doesn't always allow for clear thinking in the moment. And pre-ejaculatory fluid, or pre-cum, has long been though to contain a small amount of sperm, enough to render the pulling out action virtually useless at preventing pregnancy.

Withdrawal often isn't even considered birth control by its practitioners. It's commonly considered to be better than no method of birth control - but not by much. Many women consider it a last resort, during unplanned sex without a condom, or during a month with missed pills or a forgot-to-replace ring. And even more women may use withdrawal as a back-up to another method. It's estimated that at least one-third of women use withdrawal for some sexual encounters.

Researchers have difficulty estimating exactly how many couples use withdrawal as a method, since if they're not directly asked, women don't often report it - making it difficult to assess its effectiveness. But it may be time to take another look at withdrawal as a viable birth control option. Why?

  • It's actually pretty effective. Compare pulling out to condoms - both methods are very effective when used perfectly (about 4% vs 2%)...and less good in real practice (about 18% vs 17%). Scary numbers for condom users, maybe, but many couples rely on condoms alone at least sometimes.
  • Not all sex is planned. And when sex is gonna happen, and there's no condoms around, it's the only option available at the moment (until plan B the next morning).
  • Pre-cum may be clear, after all. Recent studies indicate that pre-ejaculatory fluid does not contain sperm (your high school boyfriend may have been right!)...increasing the effectiveness of the method when he withdraws in time.

The usual disclaimers: Withdrawal will not protect you against STDs - only condoms will.

It's not nearly as effective as an IUD or hormonal methods of birth control.

And it puts the responsibility for her not getting pregnant squarely in his hands (or his hips, as it were), which many women may not feel comfortable with.

But as a back-up to another method, or for infrequent or surprise sex, consider pulling out to be much better than nothing at all.

Do you use withdrawal as your birth control method sometimes? Why?

Read more about contraception and sexual health at Gynotalk.
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From the Community…

Comments 1-10 of 267
  • Clairessa's Avatar
    Posted by Clairessa Mon Aug 31, 2009 8:27pm PDT

    I got pregnant with my son using this so called birth control method.

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  • Karrie H's Avatar
    Posted by Karrie H Tue Sep 1, 2009 11:01am PDT

    I was on the depo birthcontrol and my husband was pulling out and we got pregnant with twins. So i dont believe any method is 100%. IF your ment to have a child then it will happen no matter what!

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  • Tessy's Avatar
    Posted by Tessy Tue Sep 1, 2009 11:34am PDT

    My husband and I used this form of birth control for 15 years. I always thought he had amazing control. I don't think I would have been able to interupt my pleasure like that for anyone. I think it depends on the people involved.

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  • another hockey fan's Avatar
    Posted by another hockey fan Tue Sep 1, 2009 12:08pm PDT

    My hubby and I have intercourse without using anything up until the point he is ready to ejaculate and then we put a condom on. I am 44 and have used this method in past relationships and have never been on any kind of birth control (I don't believe in putting harmful things into my body) and have never gotten pregnant. I never wanted kids so not a problem. I think it's a great alternative for those who do not want to be on birth control.

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  • Linda W's Avatar
    Posted by Linda W Tue Sep 1, 2009 1:03pm PDT

    Genoveva now 2 years old is a product of Depo Provera. I had her at 38 years old. My son was 8 years old when she was born. Once I had "Neva" I got my tubes tied and had the clamps put on them too. That surgery was expensive but necessary. I now have 4 children and two of them I was using birth control...Hmm...So, pull out if you want too, but babies are a blessing...They might come as a suprize...Have a nice day...

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  • Maribel's Avatar
    Posted by Maribel Tue Sep 1, 2009 1:26pm PDT

    I am 18yrs. old and ive been in a relationship for 3yrs. Since the first day ma boyfriend and i started having an intimate relationship he has never worn a condom and i have not been on birth control. I agree with one of teh girls above i dont want to put harmful things into my body.But yet ma boyfriend and i are risking it to get me pregnant.it hasnt happen and yet we dont want it to happen we are to young.

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  • Apple's Avatar
    Posted by Apple Tue Sep 1, 2009 1:54pm PDT

    1st one: pull out method. 2nd one: The Pill. 3rd one: Condom... Hubby got fixed after that.

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  • Jasmine's Avatar
    Posted by Jasmine Tue Sep 1, 2009 2:21pm PDT

    I have been with my boyfriend for ten years. We have always used the pull out method, and this works for us fine. No kids, and not one pregnancy scare.

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  • Irene's Avatar
    Posted by Irene Tue Sep 1, 2009 2:26pm PDT

    Um...this article truly bothers me. It bothers me because it suggests to inexperienced young people that coitus interruptus may actually be an okay form of birth control. It suggests that in the heat of the moment(and yes, I understand that this happens), that withdrawal is better than nothing, but gives no other alternatives when no birth control is available. If you have no condom or other form of birth control or you missed a few pills and you just can't control yourself...well, wouldn't suggesting alternate means of sexual satisfaction, like shared oral or manual stimulation be preferable to suggesting withdrawal? And suggesting that "your high school boyfriend may have been right" shows a complete lack of responsibility for the effect that particular comment may have on high school girls who may be reading this. It also suggests that a teenage boy might actually have enough self control to pull out in time.

    It may be correct that pre-ejaculatory fluid does not contain sperm, but this lack of sperm may also depend upon how long it has been since the guy had his last ejaculation. In a world where there are so many different birth control options readily available to most people, suggesting that withdrawal is a viable alternative seems downright irresponsible.

    I would also like to comment on the post by "another hockey fan" ....Have you or your husband ever been tested for fertility? Have you ever considered that you may have gotten away with withdrawal as a form of birth control for so long because there may actually be an underlying fertility issue involved? You might want to have that checked out...if it turns out that you are infertile..well..yippeee!, then you won't have to interrupt the pleasure to put on the condom. : )

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  • laura's Avatar
    Posted by laura Tue Sep 1, 2009 2:32pm PDT

    MY BOYFRIEND AND I NEVER REALLY USED NE PROTECTION...HE HAS ALWAYS PULLED OUT..BUT WHEN HE DIDNT...I GOT PREGNAT!! :0

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Comments 1-10 of 267

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