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Oh my God, was your high school boyfriend onto something?

Rachel

According to a recent paper by Guttmacher, perhaps…

A new commentary, “Better Than Nothing or Savvy Risk-Reduction Practice? The Importance of Withdrawal,” by Rachel K. Jones et al., published in the June 2009 issue of Contraception, highlights that withdrawal is only slightly less effective than the male condom at preventing pregnancy. Yet there is a general reluctance among health care providers and individuals alike to consider withdrawal as a viable method of contraception—even as a backup to more effective methods or as an alternative to not using contraceptives at all—which likely stems from misconceptions about its effectiveness at preventing unintended pregnancy. The article examines why this lack of enthusiasm persists despite the method’s relative effectiveness, as well as the consequences of the method’s lack of popularity.

The best available estimates indicate that with “perfect use,” 4% of couples relying on withdrawal will become pregnant within a year, compared with 2% of couples relying on the male condom. More realistic estimates suggest that with “typical use,” 18% of couples relying on withdrawal will become pregnant within a year, compared with 17% of those using the male condom. In other words, with either method, more than eight in 10 avoid pregnancy.

I don’t know. Still sounds awfully shady to me. There’s way too little margin for error. And maybe I’m just having high school backseat flashbacks, but you’d really have to trust your partner to have the self-awareness and self-control enough to pull out in time. Mm. Nah. Even the best-intentioned person can lose their head (yeah yeah yeah) in the heat of the moment.

83 thoughts on Oh my God, was your high school boyfriend onto something?

  1. There’s way too little margin for error.
    That’s my thought too. But I can see it being used as a backup, as in he’s wearing a condom or she’s on the pill and he pulls out.

  2. I actually find this more sinister than you guys. Withdrawal is the only type of contraception (except the claim that a man has had a vasectomy) where a woman has no control. I really don’t like the idea of putting my reproductive choices in someone else’s hands, even someone I love. It is my choice and I need to be able to enjoy sex while knowing I’ve taken precautions.

    I had a male aquaintance who used withdrawal as a way to control his wife so maybe I am biased.

    Plus, it really doesn’t work. If you are concentrating on withdrawing you aren’t going to be focusing on the sex and mutual pleasure which kind of defeats the object. So I’m not sure you can have the sex you want and use withdrawal.

  3. It’s always good to take precautions.
    Though I must say, I have been using the withdrawal method for a year or so now, and so far I have not gotten pregnant. Then again, I have a supply of Queen Anne’s Lace seeds (they can be used as a sort of herbal morning after pill) to back me up and money saved up as a second back up; I’m not sure if I would neglect to use condoms if it weren’t for those two things.

  4. Also, only using withdrawal strikes me as unfair pressure on the partner who actually has to withdraw, and unfair worry for the partner that could end up pregnant. I know I wouldn’t want to have to keep dibs on my orgasm like that, much less if my orgasm had the unholy power to create babies inside me. Even for those people who can do it…sex is supposed to be about release, right? I know that I couldn’t relax and enjoy myself if we were only using the withdrawal method.

  5. Yeah, those numbers have been floating around for a while now. I understand the reluctance on the part of sex educators and health care providers to promote withdrawal as a viable form of birth control. But (totally TMI), I used it as back up with a partner when I was on the pill and we had decided not to use condoms. Maybe I’m just from the generation that got the “use condoms no matter what!” thing drilled into our heads, but the idea of sex without the physical barrier made me very nervous even though I know how effective the bc pill is.

  7. You always see a comparison of “typical” and “perfect” use for contraception, but what I’d really like to know is what percentage of people using the method fall into each category. That is, are 90% doing it “perfectly” or only 3%. That would be some indication of whether perfect use is something you’re likely to actually manage.

    And I definitely wouldn’t be comfy with that as a sole method, but as a back-up in combination with something else, sure. Options are good.

  8. Like most forms of contraception, it will work better for some people than others. I would not count teenagers among them.

  9. Oh, Lordy. You know, there’s a reason why withdrawal is known as “pull and pray.” And sometimes, you have an orgasm a lot more quickly than you thought you would (it’s happened to me and it’s happened to guys I’ve been with). So a guy may not be able to pull out in time.

    And yes, it’s definitely unfair to the guy. Hey, hon, you don’t mind stressing over the fact that you have to pull out RIGHT BEFORE YOU COME? Thanks! Don’t focus on the sex or on enjoying yourself or anything. . .

  10. Or maybe it’s because condoms aren’t only a form of birth control but also avoid STD’s that condoms are promoted?

  11. “Still sounds awfully shady to me.”

    I’m ridiculously uncomfortable with any form of bc that one partner can make a mid-coitus decision to not use and *bam* full risk of pregnancy.

    It’s also hard to fault educators for pushing people away from it since it a) offers no protection from STIs, b) is a wee bit tricky for most people, and c) relies so heavily on giving natural biological impulse the finger. It’s like using just NFP to stay baby-free–your average user might very well put in the required effort to track her cycles, but how committed is she ultimately going to be with abstaining during the likely peak of horniness?

  12. Curiously, there’s very little mention of disease prevention there – 1 paragraph out of 8 pages. Pregnancy prevention isn’t the only reason to wear a condom.

  13. For me, this was kind of a relief to know. I’m on the IUD, so theoretically I’m already protected, but that doesn’t stop me from getting a bit neurotically anxious on the occasion when I feel my period is five minutes tardy.

    But my partner and I use the pull out method with pretty much perfect use, not intended for contraception purposes, but because, uh, we just like it better that way. But knowing that on its own puts me at least at 8-in-10 protection + I still have the IUD, well damn, I think I’ll just kick back and relax next time I’m a little bit late.

  14. I find it very hard to get a straight answer out of my ob/gyn on this one. On the one hand she admits the figures are true; on the other hand she narrows her eyes and says that it presents a serious risk of pregnancy. I still haven’t admitted to her that I use it at all. However, if you think about it, it does make a certain amount of intuitive sense. Pre-ejaculate, even if it DOES contain sperm (which is dubious at best) contains such a low count that if you were trying to get pregnant, you would be considered infertile.

    We ( TMI, probably) have used it in combination with condoms and NFP for several years with no problems. That way during what mantis so aptly described as “the peak of horniness” there are condoms available. That said, I really miss the worry-free Pill.

  15. Pingback: Kicking Back against Pulling Out « Kittywampus

  16. Birth control falls into two broad categories when it comes to effectiveness.

    Methods like the condom, cervical cap, the sponge, and diaphragms, are kind of effective — in the range of a 10-20% failure rate per year. Methods like the pill, the patch, and the IUD are a lot better — in the range of a 1-2% failure rate per year. Withdrawal falls into the first category.

    If you want to make really sure you don’t get pregnant withdrawal isn’t the way to go. But if you go by the government’s stats, barrier methods probably aren’t either.

  17. It is better than nothing, but like y’all have said, I don’t like having no control over something that’s going to leave me pregnant.

  18. Even the best-intentioned person can lose their head (yeah yeah yeah) in the heat of the moment.

    It’s exactly this kind of variability that “typical use” accounts for. See also: people putting condoms on improperly, causing damage to the condom before putting it on and not noticing, condoms breaking during use and people not realizing until the act is finished, etc. These error factors are as real as a guy forgetting to pull out and not necessarily any more within the control of his partner than whether or not the guy remembers to withdraw.

    But I’m with SoE on this one. Condoms can frequently do something withdrawal never can. I can imagine their disease prevention role aids in their promotion over condoms.

  19. I was really shocked recently to learn that an acquaintance uses withdrawal as his primary means of contraception when he’s in a relationship. He uses condoms if it’s someone he just met or a one-night stand, but once they’re exclusive, it’s withdrawal. He and the types of people he tends to date see the Pill as “artificial” and “unnatural,” but condoms as interfering with intimacy in a long-term relationship. I was actually gape-mouthed over it. He has no anxiety about it because so far, he’s never gotten anyone pregnant.

    Because my mother got pregnant with me accidentally when she was 17 and my uncle died of AIDS when I was in high school, I have always had it drilled into me that you always, always, always use birth control, and you always, always, always use condoms unless you KNOW you are both disease free. I haven’t been completely perfect, but my few lapses were followed by so much anxiety and self-reproach that I just cannot fathom being so nonchalant about it.

    Your headline made me laugh. I can still hear my high school boyfriend … Can I just put it in a little bit? … No! You cannot!

  20. While I think that condoms are extremely important to use in more casual sexual encounters, I support and utilize the withdrawal method in my relationship and have done so for the eight years that we’ve been having sex.

    I strongly disagree that the method is unfair, doesn’t work, or somehow mandates a power dynamic in the sexual play. My partner and I are in a long term, monogamous relationship built upon honesty and trust. We frequently have sex, and the only concern we have is pregnancy. We have tried a variety of methods of birth control over the years, but the predominant method we have used (as in around 80% or higher of our sexual encounters) has been withdrawal. To my knowledge, I have never been pregnant and the only time I needed EC was when the condom broke.

    That suggests pretty strongly to me that the method works. My partner prefers it as a method of birth control over condom use because of the ways condoms reduce sensation. I agree with him. We’ve had no issues withdrawing in time or anything like that.

    That being said, like any birth control method, you have to know the limits and rules for using it. The main rule for us is when there has been an extensive amount of foreplay, wherein an orgasm is likely to sneak up on either of us, we don’t use it. Other rules would be in sexual encounters where you don’t have that trust with your partner for whatever reason

    The method involves trust, it involves open communication, and it involves being aware. None of these stipulations necessarily detract from usage.

    Basically it boils down to whatever methods work best for you and your partner. What makes you feel safest and what you both enjoy the most.

    Of course, I’m also of the opinion that its the birth control method that you *know* when it has failed (the other one being breaking condoms) and therefore know when you need EC, etc.

  21. There’s no question that the “primary” methods Angus talked about are far superior. Some have medical conditions that basically rule all of them out, making the secondary options the only choice. (some might also have financial difficulties getting the primary methods, almost all require a doctor visit/are expensive).

    Obviously barrier methods are superior for disease prevention. What irks me is the degree of shaming around using something like withdrawal or NFP, where you can’t even talk about it to your doctor because she/he will judge you for being stupid, or “not serious” about avoiding pregnancy, or “at risk.” There seems to be something going on where women are not allowed to have preferences around birth control unless it has to do with delayed periods or weight gain, as opposed to pleasure or intimacy. There also seems to be a little bit of a class perception thing going on where only “those” kinds of people (poor, hippies, uneducated) would use something like withdrawal.

  22. My husband and I have used the withdrawel method for over 2 years now, secure in our trust of each other that if something does happen, we know what we want to do. When we decided to have children (quite recently), he stopped withdrawing and next thing you know I’m pregnant (much to my delight!). I’m not too surprised that it works (farily) well if done properly. My partner has awesome control, whereas I’m sure a lot of men do not.

  23. I’m going to have to agree with Amy H. above me, here. When I was in my last long-term committed relationship we eventually ran up against the wall of money issues, and one of the things I was no longer able to afford was hormonal birth control. I do live in an urban centre and condoms are freely available in various locations, and it was something we could splurge on as well, but eventually we fell into using withdrawl.
    It is definitely not for everybody but it worked for us for about a year. There were other precautions to take to help make sure it worked, like not having sex if he was already pushed close, other things. We used it with full knowledge of what we were doing too, which is very important in my opinion. Yeah you’re fighting against biological urges, and yeah it kinda sucks to have to stop everything right when you least might want to do so, but we made it work for a year as I said and I know other people who have successfully used it for longer.
    I’m not a huge fan of the association of such behaviour automatically with high-school-aged males though, it seems to be prevalent in many places regardless of age. My high-school boyfriend and myself were far more protected when we lost our virginities to each other than most people are, ever (birth control pills, STD testing, condoms, etc. Even waited a month with me on the pill to make sure I was used to taking it.) When my last ex-boyfriend (the one I used withdrawl with) and myself broke up, I went and had two years of single-loving promiscuous sex. Very big stickler for the condoms, despite many of my male partners attempting to convince me to not use them “just this once” or to let them “put it in a little bit” without before putting one on. Well above high school age, almost every single one.
    The last ex and I were STD tested and monogamous, and had previously used hormonal BC and condoms. We already knew about the effectiveness of “perfect use” withdrawl, and how easy it is to mess up (easier than condoms, IMHO.) With all of this knowledge, plus more, plus communication and trust, we decided to use a method that worked for us at the time. Not sure if I would go back, but I can’t fault others for doing similarly. I just think condoms are generally your better option for many situations.

  24. @Amy H and Jesse

    what works for you in your relationship is just anecdotal evidence: it’s not universal and it doesn’t guarantee that it will work for everyone. better sexual education is favored.

    in any sexual relationship i’ve been in, i’ve insisted that the dude in question use a condom (i too heard the arguments against it–one guy even feeding me some shit that he’s sterile). i left his house and didn’t come back till he agreed to use a condom. i was not going to put myself at risk for pregnancy or disease (i had no idea of his sexual history). so yeah, i’m all about condom use.

  25. Another anecdote in favor, here. Fertility monitoring + withdrawl = never been pregnant so far as I’ve noticed. Would I recommend it to a teen, or use it for a casual encounter? Heck no. But for grown folks in fluid-bonded relationships with good communication skills, I think it can be a reasonable alternative. It can be especially useful for people who (for whatever reason) can’t tolerate hormonal birth control.

    Also, ‘withdrawl’ doesn’t have to mean “pull out *just before* and get really anxious”; it could mean switching tactics when the withdrawing partner feels close. There’s a lot more fun to be had than plain ol’ PVI.

  26. Thing is, withdrawal is as far as I can see an absolutely fine method for 2 people who:

    1- are in a long term relationship with each other and have built up sufficient trust in each other

    2- are sure of each others’ sexual histories and have been STD tested

    3- have the self control required.

    I get 2 out of 3; in the heat of the moment, and the passion of it all, I am barely able to SEE, let alone remember to make sure he pulls out, and he is usually so focussed on the intimacy and romance, I don’t think we could manage it. We’re bad enough at giving in to our urges during the “no sex at all, I mean it” period after I have my implant replaced every 3 years.

    For people in casual relationships, people who prefer unattatched sex, new relationships and people who get carried away,condoms and/or other contraception is generally a better bet.

  27. Thank you to the people who’ve shared their stories in favor of withdrawal.
    I still wouldn’t be comfortable using that method myself (kind of a moot point for since, thanks to sterilization, I only have to worry about STD protection) but I can see now how withdrawal can be a legetimate or even preferred method of birth control in some relationships.

    Thanks for the education!

  28. What counts as perfect use for withdrawal?

    Is it perfect use trying to pull out 100% of the time, or actually managing to pull out every time you have sex? The definitions might make a big difference in terms of the efficacy stats.

    Because it seems like you’re begging the question if you define perfect use as always being successful at pulling out in time. The main reason why withdrawal is unreliable is because guys don’t always make it out in time.

    It’s easy to differentiate between using a condom properly and having it break anyway vs. not using a condom. Perfect use is supposed to apply to when people do everything right and still have a failure. But what constitutes doing everything right in the case of withdrawal? If a guy ends up ejaculating inside his partner, did they skip the method, or just not use it properly?

  29. Withdrawal works for my husband and me.

    I don’t like hormonal birth control. Neither of us likes condoms. We used withdrawal as our primary method of bc for four years. Successfully. When we decided to try for kids, I got pregnant within a week. And we’ve been using withdrawal again in the year since our son was born. But, we were both tested first, both ready to accept the consequences of an accidental pregnancy, and I had discussed it with my physician who approved. My husband’s never voiced any concern that withdrawal is stressful or distracting. Sometimes he’ll use a condom, sometimes I’ll use my diaphragm, but more often not.

    Withdrawal is not a responsible choice for everyone, but that doesn’t mean it’s not a responsible choice for anyone.

  30. Filthy, I’m all about the condom use too, as I tried to illustrate in my post. I also tried to illustrate that withdrawl is about so much more than just asking the male partner to pull out and hoping he does it. It is definitely not for everybody, it is definitely not for certain lifestyles, it is definitely not for certain types of relationships.
    I just don’t hold with the broadly-applied shaming I so often see directed toward those who use something like withdrawl or Fertility Awareness or something else along those lines. Not everybody who tries to use the method takes it seriously, but not everybody who uses the method is unaware of the failure rates either. Not everybody who uses it is in need of doing more research. They could be thinking quite clearly and have made up their own minds. There are many reasons for not wanting to use the various (and typically more effective) methods out there, and many reasons for not being able to do so either. Some people have weird reactions to hormonal methods, which means bye-bye to pills, the shot, the patch, the ring, and certain types of IUDs. Some people have laytex allergies. Some people are physically larger than the size most condoms are prepared for and have a difficult time trying to track down a size/shape that doesn’t physically hurt them. Some people don’t have money, or access to financial help, or access to free condoms.
    Not having sex is also an option, yes, and it is one that I have used too. And I realize all to well the possibility of some overhearing honest discussions about the effectivenes and failure rate of something like withdrawl, but only coming away with what they want to hear (which usually seems to be “pull-out works! Close to condoms in effectiveness!”) and that can be very dangerous. One of my personal missions is providing sexual health advice (and I always back up my info with reputible links) on various forums geared toward local teens. I see all sorts of people with no idea about various things from how birth control works to how you acquire AIDS, and believe it or not some of them supposedly had decent sex-ed. You can present the information but you still can’t force them to learn… (for the record, I do not go around those forums posting about withdrawl unless the topic actually comes up, I always suggest other methods, and I always try to be completely honest about what is required of each method for perfect use and also how easy it is to fall into “typical use” or worse.)
    Again, just don’t like the shaming. The general message seems to be “that is so stupid, why would anybody ever choose this option when there are obviously so many better ones out there which are readily available, there is no possible situation where this might actually work,” etc. Not that I’m saying people here have been shaming, not all of them, and I’m pretty sure it wasn’t intentional. It is something I see a lot of though.

  31. I think withdrawal’s OK as a backup method in a long term monogamous relationship where you’ve already confirmed that you’re both STD free. I suppose I could even see its value as a sole method in said long term relationship if you have a relatively low need for birth control (would rather defer having a child, but both agree that you’re OK raising the kid if a pregnancy comes a little sooner than you’d planned). Withdrawal as a primary method without any shared understanding of what you’d do if it fails seems risky, and of course you always want condoms if there’s any chance of STDs.

    That said, personally, if I had to choose between a guy using a condom as his backup to my birth control, and that same guy using withdrawal, to my mind, even if we were both known to be STD free, I’d say the condom wins. I’d prefer longer lasting sex, even with a barrier, to “I’d better get it out really quick before I lose control” sex. It’s true, as Siege says, that there’s lots more fun to be had than PIV, but if I’m going to do PIV at all, I want it to last long enough that it’s fun as well. Even if we do other stuff before and after.

    (All this purely hypothetically, since at this point Joel and I are in no need whatsoever of birth control.)

  32. Even if that is true… Isn’t the aim to reduce the amount of unwanted/unplanned pregnancies as much as possible? So, condoms would still be the smarter choice. And what about STDs? Hopefully people don’t actually believe that withdrawl is a method of protection against STDs…

  33. Gwrthryfel, no one here has even hinted that withdrawal works against STDs so I’m not sure why you brought that up. And “smarter” choice depends on a multitude of factors, not just pregnancy prevention. So for many people (including people on this thread who have said as much) withdrawal is the smartest choice for them.

  34. @Ali: I was only mentioning STDs coz they were not mentioned in the clip of the article, and I agree that people should choose what they feel is smarter for them. I guess I should have specified that I was speaking for myself. I meant no insult 🙂

  35. lol i see that once again no-one actually read the article, and merely read the blurb! oh dear me.

    i only use withdrawal because condoms, hormones, barriers, etc etc cause my vaginal to inflame into hours of pain that burns not unlike fire. never been pregnant. we do have enough savings to provide for an abortion if that did happen, in any case.

    anyway i’m sorry that none of your boyfriends can withdraw properly, but mine can absolutely every time, and i am sick to death of everyone treating me like i’m a fucking redneck over it.

  36. Also, I apologize for my jumping to conclusions. I hope I didn’t offend anybody, and I did I’m sorry 🙁

  37. I don’t buy it. My older sister and her husband had five kids between the age of 16-29 (that is, when they were between those ages) because they relied on the withdrawal method. Their argument was that the kids were all spaced about two years apart each “so look how often it worked! Of course it is effective!” The thing is that NOT A SINGLE ONE of my nieces or nephews was planned. Not a single one. Which means, uh…yeah that “effective means of birth control” has failed FIVE TIMES. Thankfully they finally caught on after the last one, she had her tubes tied AND he had a vasectomy. So they should be covered now. But it took them a little while to learn.

    Don’t get me wrong, I love every single one of them…but my sister’s kids are living proof that the withdrawal method fails a lot.

  38. I’m a guy who got a vasectomy 25 years ago. Like many women, I also didn’t want to leave the decision to someone else. I have adopted two kids since.
    So, I vote for this method every time

  39. The thing that bothers me about this is that even if the number of sperm in pre-ejaculate is low, there are still some there! Even if there are so few that the chances of getting pregnant are very small, using this method perfectly is still not the same as using a condom perfectly, in which case NO sperm have any chance of reaching an egg. And by using a condom perfectly I mean it doesn’t break. In the first case you CAN get pregnant, but most likely won’t. In the second case you CAN’T get pregnant. If the condom breaks, as can happen with “perfect use,” at least then you know to get plan B. I got pregnant from sex where the man pulled out long before ejaculation, so… it happens. You can get pregnant from pre-ejaculate. I suppose I’m biased from my own experience, but I don’t really consider it a risk worth taking. It scares the crap out of me that this study is getting so much attention.

  40. “So for many people (including people on this thread who have said as much) withdrawal is the smartest choice for them.”

    I simply can’t agree that withdrawal is the smartest choice. If it’s a couple’s -preference-, that’s entirely up to them. But choosing to rely on a method as questionable as withdrawal when there are other options is not the smartest choice to make. I’d also add that any physician recommending withdrawal – unless there are medical issues such as Lorelei mentioned having – would be engaging in serious medical irresponsibility, imo.

  41. B, it isn’t even clear whether or not pre-ejaculate contains ANY sperm, which is why it would be nice if they would fund a few more real studies of this method. Supposedly it can contain viable sperm *if* the man has had an ejaculation in the past few hours and has not flushed his urethra (i.e., urinated) but we really do not know. I sympathize with your experience, but women have gotten pregnant on the pill, using condoms, using an IUD—NOTHING is perfect.

    You can use a condom perfectly and it can still break, it doesn’t have anything to do with your use of it. You can also not realize the condom broke (it’s happened). And I keep a Plan B in my medicine cabinet just in case something goes wrong (which presumably your husband or partner would tell you) with either method.

    @ Loreli–yeah, tell me about it. I once had a friend tell me “So basically, you and BC are like matter and antimatter.” Also second the redneck comment.

  42. This is not the first time a study has been done on the withdrawal method, I heard of this years ago personally.
    As another person already said, just because it is a bad choice for some (perhaps most) people and situations does not mean it is a bad choice for everybody and every situation.
    Sometimes it really is the best option, and yes it is better than doing nothing. Significantly so when used perfectly, and perfectly should mean “ejaculation does not happen inside the vagina or onto the vulva.” Otherwise you didn’t withdraw in time.
    It definitely does not prevent STDs. So many people just seem unaware as to how they get STDs that I have met many people who are unconcerned about barrier-free sex and essentially nobody who thinks withdrawing prevents STD transmission. I realize this is just my anecdotal experience but still, most people in my personal experience who are actually aware of STD transmission seem to realize that it can happen long before the male ejaculates.
    Pre-ejaculate has not been proved to actually contain sperm. Some current theories involve certain individuals having some sperm “leak out” (this is obviously an added risk to withdrawal, not knowing if the male partner is one of these people) prior to ejaculation, and the main one I hear the most is for sperm being in the urethra from a previous ejaculation — this one can be helped by doing things like making sure the male partner has urinated a few times since his last ejaculation.
    Plenty of people use the method incorrectly, or use it in situations where another option is available and better, or use it in situations where other things have not been accounted for (I guess this would fall under “using it incorrectly.”) But some people have no other options, have limited options, have done their research, have tried to account for other risks, have had much discussion, are in a long-term committed monogamous relationship, and all sorts of other factors.
    I would also like to point out that there are plenty people who complain of having to stop “in the heat of the moment” to put on a condom, not exactly a sexy experience IMHO. I do think for many it is more difficult to stop in the middle of intercourse rather than before it actually starts, but automatically dismissing withdrawal because you personally find the interruption too much to handle does not mean everybody else is going to have the same problem.

  43. The problem is when health care workers shrug off withdrawal as being ineffective, when in fact its efficacy is comparable to condoms.

    When discussing withdrawal, the focus ought to be on whether it will detract from the enjoyment of sex, and whether the woman needs a form of birth control where she has control.

  44. The cool thing about information is that people can use it to make an informed decision. You can look at the rates of effectiveness for perfect and average use, consider your relationship with your sex partner as well as your histories and desires, and decide what is right for you. We take calculated risks every single day, and everyone makes those calculations a little differently. Why should this be any different?

  45. It’s funny that this jives with what I tend to hear, but when I wasn’t on birth control pills I always acted as though semen was radioactive. I know that I would never leave birth control up to this method on its own, but it’s good news for backup purposes, and kind of validates my theory that oral sex makes a pretty foolproof (not to mention sexy) backup method.

    And B, sorry to hear you got to be the amongst the unlucky few.

  46. I remember reading an article a few years ago which postulated that coitus interruptus, as the experts call it, was most likely the method used during the demographic transition in Europe. (This was the period in history when Europe went from high birth rate to lower birth rates. If I remember correctly this was in the 1600s, so obviously prior to the invention of modern contraceptives.)

    It was interesting. I’ll try to find it again.

  47. I don’t like condoms, but it turns out I don’t like worrying for a month either. Is that propaganda? This is the first time in the 20 years or so I’ve been getting information about contraception that I’ve heard withdrawal works, so my attitude, and hence my preference, may well be informed by that. On the other hand, I can be surer I’m using a condom properly.

  48. Your young, your in lust, and you think you are going to pull out? yea right. I am in my forties and I would never trust myself to pull out when I am with a woman in the dance of lust.

    No matter if it is love, how can a guy keep his mind when love is so fine and sexy?

    Only porn stars may have that ability but in real life a condom is the rule because you cannot be a fool or foolish enough to think the happy time in the mind will allow one to think to pull out.

    Guys who love women and lust after them cannot control themselves in that aspect any better than animals.

    That is why condoms and other contraceptives work and any other means ends up in pregnancy.

    Some people are very naive when it comes to sex, lust and love.

  49. I used the withdrawal method for most of my teen years and early twenties until I had an STI scare, but you have to REALLY trust the person. I only did that with guys thta I absolutely knew could control themselves. And even if it happened, I had the back up plan of taking the morning after pill. (Which I did twice, but only when condoms broke, not due to someone not pulling out)

    It is a sketchy method of birth control for sure in my opinion.

  50. And B, sorry to hear you got to be the amongst the unlucky few.

    B was not one of the “unlucky few.” She was one in every five women using withdrawal in a given year. If the other four continue to use the withdrawal method for another years, some of them will be pregnant by the end of the second year.

  51. I would also like to point out that there are plenty people who complain of having to stop “in the heat of the moment” to put on a condom, not exactly a sexy experience IMHO.

    My suggestion for dealing with the problem of interrupting sex to put on barrier protection: have the partner not using the device put it on (or in in the case of a diaphragm) the one who will be wearing it. Then it’s not an interruption but an enjoyable part of the foreplay.

  52. “I remember reading an article a few years ago which postulated that coitus interruptus, as the experts call it, was most likely the method used during the demographic transition in Europe.”

    Well, it was a known contraceptive method back during Biblical times (it’s what Onan actually got ye olde lyghtnyng bolte over, not masturbation), so it would hardly be surprising for Europeans to start using it again once the RCC’s death-grip on the continent started to loosen.

  53. I got pregnant using the withdrawl method. We weren’t thinking, started having sex without a condom and as soon as he realized it, he pulled out so it was in plenty of time. Three weeks later I had a positive blood test. I just don’t see that it’s a risk worth taking unless you have back up or don’t mind having a baby at that point.

  54. I should add- unless of course no other methods work for you. I don’t think anyone is a redncek or anything for using this, people should do what works best for them. I am not the biggest fan of the side effects of the pill, but it has kept me pregnancy free the whole time I’ve been on it, so I stick with it because it works for me. If withdrawl is the best choice for your life, I see no reason to judge that. I just know with my experience that I won’t ever trust it again.

  55. I remember reading an article a few years ago which postulated that coitus interruptus, as the experts call it, was most likely the method used during the demographic transition in Europe.

    Both the rhythm method (not FAM, but just calendar-based estimations) and withdrawal, combined with herbal contraception and abortifacients, when used by a large percentage of the population, will have a significant impact on total fertility. Even if all it means is that people space out their children more, going from 10 children per woman to five, or from five or six to three or four, it will have a big impact on total population growth.

  56. Dianne, withdrawal can be turned into something sexy and fun too, at least for some couples. And just in case I will reiterate what I keep saying: there are other, more effective methods out there. But there are also perfectly valid reasons to choose this method as a backup or even primary and I don’t agree with shaming every single person who uses it as if they haven’t thought about it and researched it and so on.

    Also, Ole Blue, this:
    “Guys who love women and lust after them cannot control themselves in that aspect any better than animals.”
    Is horribly incorrect. There are plenty of men who can control themselves with regard to sex, at all stages, and everybody should be able to do so. Encouraging a “boys will be boys” sentiment is an all-too-common way to give a free pass to rapists. “Oh, he didn’t mean anything, he just can’t control himself ’cause he’s your average animalistic man with no willpower.” It’s also rather demeaning to men. I’ve had female friends regale me with stories about how their boyfriend was just “too turned on” and forgot to put on a condom “in the heat of the moment,” and that’s complete bullshit too. Wanting to pull out but having an orgasm sneak up on you is different, and one of the bigger risks of withdrawal (and the whole “out of control of the woman’s hands” risk too.) But that is not what you said, you said that heterosexual men cannot control themselves in sexual situations. Just no. No.

  57. @Jesse:

    Also, Ole Blue, this:
    “Guys who love women and lust after them cannot control themselves in that aspect any better than animals.”
    Is horribly incorrect. There are plenty of men who can control themselves with regard to sex, at all stages, and everybody should be able to do so. Encouraging a “boys will be boys” sentiment is an all-too-common way to give a free pass to rapists. “Oh, he didn’t mean anything, he just can’t control himself ’cause he’s your average animalistic man with no willpower.”

    Word.

  58. Pingback: Withdrawal: Better than nothing? « PostBourgie

  59. Jill:
    you make excellent points. education is certainly important, especially since having sex comes with a high level of responsibility and risk, certainly for teens.

    i understand also that some options aren’t really options to some people. i stopped taking the pill since it was making me crazy. i would cry for no reason, the smallest thing would set me off, and it was putting a strain on my relationship. i’m all better now. condoms work for my fiance and me without all the added hormone-crazy.

  60. i WOULD like to increase my chances of not getting pregnant by going to someone who can fully explain NFP for me (maybe i’m just stupid, but i can’t get a comprehensive education on it online???) but all the groups and counselors i find want you to ‘bring your husband.’ he isn’t yet, for me, so i guess i’m SOL.

  61. I used withdrawl or some of the years over a 20 year period of time. Condoms and other methods at other times. Never caused a pregnancy. Then at 38 it happened. Spouse had a similar history until then, so we really didn’t worry about it too much. In fact we thought it might be difficult for her to get pregnant Her Ob/Gyn suggested this method when Spouse wanted to be off the Pill. We said no thanks and pursued other options.

  62. “but all the groups and counselors i find want you to ‘bring your husband.’”

    That’s bizarre. It’s not like he really has anything to do with it aside from understanding and respecting that you’ll have to abstain or rubber up around the ovulation window. You might want to check out a book called Taking Charge of Your Fertility by Toni Weschler. I think it was recommended on here the last time NFP came up. It has the bonus feature of being helpful for couples who are trying to conceive.

  64. “but all the groups and counselors i find want you to ‘bring your husband.’ ”

    For what purpose do they need you to “bring your husband”? It seems a rather bizarre request to me. The only thing I can even fathom is that they believe that a woman shouldn’t be using NFP unless she is married. Which is obviously complete bullshit and discriminatory.

  65. withdrawal can be turned into something sexy and fun too, at least for some couples.

    Good for them. My suggestion was meant for people who would really prefer to use a barrier method but hate interrupting sex to use it, not to try to convert people who have another method they prefer to the use of barrier protection. Sorry if it sounded that way.

    I do admit, though, that I favor barrier protection over most other methods for several reasons: 1. Condoms are at least partial protection against most STDs. 2. Barrier protection with abortion as a backup is THE safest method of birth control around. Again, I’m just giving my thoughts and biases concerning birth control, not meaning to tell anyone what to do.

  66. In my experience, most of the groups that do counseling on how to use NFP are Catholic, so yeah, they do believe you shouldn’t be using it unless you are married.

    But I would think a, uh, “fiance” would be legit, too.

  67. NFP has a nice bonus of making it easier to know when your period is supposed to show up (for those who aren’t so regular that they’d already know it to the day). I went for the book method of learning it, rather than online or from a group, so I’ll second the suggestion that you get Wechsler’s book.

    I wouldn’t personally use it as my sole method of birth control, given that it turns out that I personally am horniest just when I’m supposed to be fertile. Since I was trying to use it for the reverse, it was a moot point (but, at any rate, I was ovulating just fine, though the whole thing proved moot for non-ovulation reasons).

  68. One more note about NFP/FAM … I know a few couples who use condoms instead of abstain during the fertile period. They can have sex all month, not have to deal with hormonal birth control, and get to enjoy some condom-free sex during most of the month.

    I’ve never been particularly interested in it, mostly because I just don’t feel like checking my cervical mucus every day, but some people really dig having that kind of information.

  69. I second the withdrawal method. As someone who has tried all forms of hormonal bc, none of which were tolerable, has been waiting FIVE MONTHS to get an IUD (which probably won’t work for me, given certain health/body issues), and is allergic to condoms, pretty much the only remaining options are another barrier method or withdrawal. Since withdrawal with perfect use is far more effective than any other barrier method with perfect use (like 96% vs 85%), if you trust your partner, it is actually the more prudent choice for preventing pregnancy than say, a cervical cap.

    I don’t see anyone arguing that withdrawal is the best method for everyone, but instead the point is a) it’s as valid as any other form of bc, and b) not to shame women who use it for being stupid, clueless hicks or religious nuts. I mean, I am allergic to the nuva ring, but would never look down on a woman who chose to use it simply because it wouldn’t work for me. I chose withdrawal after lots of research, and am fully aware of all the risks. Yet I still lie to my gynecologist and tell her I use condoms, because I don’t want to get a lecture on how foolish I am (even though I am using a healthier method for me that has virtually the same failure rate as condoms). I have been using withdrawal on and off for 3 years, and never had an issue with pregnancy scares. Nor have I ever even had a close call with my partner.

    Also, while one should not rely on withdrawal to protect against STIs, it actually can slightly reduce your exposure, as no ejaculate (which carries a higher amount of any bacteria or virus than pre-ejaculate) gets in/on one’s genitalia. I’m not saying that it can or should replace a condom, but it actually can slightly lower one’s risk.

    Finally, in terms of sex ed, I was taught that withdrawal a) had a 50% failure rate (untrue) and b) was really only used by Catholics or religious fundamentalists (untrue). I understand that teens really shouldn’t be using withdrawal, but it is irritating that even with one of the most enlightened sex ed programs in one of the most liberal parts of America there is an opposite sort of propaganda being taught in schools.

  70. My hubby and I want to have a baby soon, so I’m planning on coming on the pill permanently next month. We were recently talking about what to use as BC before the fall, when we want to actively try. I want to get on a prenatal vitamin regime and let my body get used to be off the pill before we actively try to conceive.

    I’m thinking withdrawal may be the way to go with us. My hubby already does this because it’s more convenient for me afterward and has excellent control. I had no idea withdrawal was effective at all. Good info, because it is a viable option for those of us who have long term sexual partners and are well tuned to each others cues.

  71. “In my experience, most of the groups that do counseling on how to use NFP are Catholic, so yeah, they do believe you shouldn’t be using it unless you are married.”

    Don’t Catholics still do the rhythm method, which doesn’t work worth a hill of beans, rather than modern NFP/FAM, which does? I mean, the last Catholic justification for why rhythm method is okay is basically that it doesn’t fucking work, so it’s not really non-procreative sex.

  72. i hereby judge you for using the withdrawal method as your sole method of birth control for any reason other than medical or that you wouldn’t mind getting pregnant too much. 2% vs 4% is not insignificant, for one thing, and for another “typical use” of condoms doesn’t just include the condom breaking, it includes just plain not using one 100% of the time, as well as the surprising number of people who don’t know how to use a condom. this includes those who put it on backwards, put it on something other than a penis (true stories…), don’t use it the whole time, etc…. so the condom breaking or otherwise being somehow permeable when you didn’t do anything wrong is the 2% failure here…

    I agree that typical vs. perfect usage rates in the general population would be helpful.

    you are still putting the decision to impregnate you *entirely* in their hands every time you have sex. ignoring the possibility that they might do it accidentally, that is far more power than i would ever put into another’s hands. and no matter how much you trust your partner… wonderful people go batshit nuts every day. how many women have been screwed over by being stay-at-home moms and putting her financial destiny entirely in his hands only to be ditched down the line when finding a decent job is extremely difficult…. way more than we like to think. my dad did this, completely outta the blue. he was a good, honest, kind person who suddenly said “see ya!” after 25 years of marriage and ditched all of us (emotionally and financially) for a younger woman (with a younger kid, haha). and now he’s the biggest jerk i know. now, i can be hurt and move on, but my mom is struggling to support herself on top of that. i would never give up my career for my (wonderful, wonderful) spouse, and i would never leave whether or not i get pregnant in their hands either.

    and even if none of this is a factor and you do it perfectly, every single time, you’ll still catch pregnancy 4% of the time. 4 out of every 100 times. how often do you have sex?

    for the record, i use the only 100% effective AND practical method of birth control… lesbianism. 😀

  73. Lol…Dan Savage has been doing a riff lately on how gay sex is the perfect birth control. Which it is, let’s be clear.

    I didn’t actually see anyone female in the thread say that they used withdrawal as their *sole* method of birth control, though, so the point might be somewhat moot.

  74. Don’t Catholics still do the rhythm method, which doesn’t work worth a hill of beans, rather than modern NFP/FAM, which does? I mean, the last Catholic justification for why rhythm method is okay is basically that it doesn’t fucking work, so it’s not really non-procreative sex.

    I have never received a satisfactory answer on the theology of it, but the FAM/NFP is okay by the Catholic Church. When my friend asked her provider about that method, she was referred to a nurse at a local Catholic hospital who runs the most comprehensive counseling session on how to use the method in our metro area. I have also in Latin America come across women doing community work for Catholic groups who teach women how to use NFP/FAM.

    Again, I have asked many people to explain to me why that’s okay but not condoms, and I have never received a good answer. The answer seems to be that it’s working with your body and that you’re still “open” to having a child (which technically would be true of any method if the woman believed she wouldn’t have an abortion if she got pregnant, and you can argue that the pill works with your body, so, like I said, less than satisfactory, but I’m not Catholic).

    Obviously, any women here who use FAM with condoms during the fertile period and a plan to have an abortion if they get pregnant are not doing it the way the Church had in mind.

  75. 4 out of every 100 times. how often do you have sex?

    It’s not 4 out of 100 times. It’s 4 out of 100 sexually active women over a yearlong period.

  76. Don’t Catholics still do the rhythm method, which doesn’t work worth a hill of beans, rather than modern NFP/FAM, which does?

    No. We were taught NFP in sex ed class at my Catholic school. The (current) rationale for NFP being okay and other methods not is that NFP is “natural” where other methods are “artificial”. Why that makes a moral difference, I’m not sure.

  77. artdyke:
    Um, ok. I hope you also judge anyone who uses a cervical cap or any other form of barrier method also, considering PERFECT use percentages are around 85% effective (less if you’ve had a child). Also, why are people assuming that “perfect use” for condoms mean one thing, but something completely different for withdrawal? Seems like bias (probably from inaccurate sex ed or bc manufacturing propaganda).

    It’s really irritating for people to be like, “this is my experience, therefore, let me universalize to yours as well.” Bc is a private decision, in which women make risk/benefit choices. Some people want a method that’s 99.9% effective, some are fine with 98%, 97%, or 96%. If you’re not, then pick a more effective method. If you are fine with a 4% (or 15% or 2%) chance of getting pregnant every year, fine.

  78. Another anecdotal story of “It works for me”.

    My man & I have used a combination of withdrawal & condoms for 8 years, and no pregnancies. He used it with his previous partner for 4 years. He has excellent control, and also keeps himself less “on edge” by masturbating one or more times a day on average.
    Plus, far nicer to have the semen wiped off my belly or back, than have to avoid a wet spot!

    He’s always used it, even with condoms, just in case of breakage. VERY rarely, he’ll come inside a condom, IF it is a safe time of month.

    I pay attention to my cervical mucus. If it is clear & slippery, we use a condom, or enjoy acts other than PVI.

    I used to think I’d never rely on withdrawal, but hormonal BC made me crazy/gave me major mood swings and crying; the cervical cap HURT when his penis bumped up against it, and condoms are expensive [and sometimes Really irritate my skin!]

    I have had a friend who, not knowing my situation, said that women would NEVER choose withdrawal if they really had a choice, so I’ve experienced the shame, too… and I’m an educated woman.

    Thanks to others for sharing their stories. I’m strongly considering an IUD, for more protection, but I’m scared, too, of the pain. Has to hurt less than a kid, though, right? ;p

  80. I think FAM is acceptable because the Church is unwilling to demand that people have sex (procreative sex being, after all, less virtuous than abstinence). Also, apparently God can’t tell the difference between using fertility awareness and not using contraception at all, but knows if you’re using HBC.

    But, as my handle suggests, I’m not Catholic.

  81. That’s bizarre. It’s not like he really has anything to do with it aside from understanding and respecting that you’ll have to abstain or rubber up around the ovulation window.

    I expect that there is a strong element of belief that you shouldn’t be having sex unless your married, so if you don’t have a husband, you don’t need to know NFP/FAM methods.

    But also, I’d think that the more that a partner understands about the method, the more likely they are to cooperate. In general, people do better with things when they understand why, and when they feel part of the process. The difference between “you’ll be rubbering up or abstaining when I tell you” versus “we both pay attention to the chart, and know when and how we’ll be enjoying sex together.” Takes the pressure off the woman to always be the one saying “no” and and having to maintain self-control, and allows the partner to know what to expect, sexually, rather than being left frustrated or confused.

  82. Wow, this is an incredibly informative comment thread, and totally unexpected because I have a certain bias against the pull-out method. My ex-husband used withdrawal with previous partners, and of course I found out after we got married that he had two kids. I’m assuming now that he was doing it way way wrong. My current partner uses withdrawal on top of condoms on top of me having the non-hormonal IUD. Lets just say he is a tad paranoid of parenthood, and I appreciate that.

  83. When I got married, I saw the withdrawal method as the way to go. I am allergic to condoms and birth control pills made me moody, so I decided to give it a try.

    Fast forward 6 years and I am completely, completely miserable because of it. After I got pregnant with our planned son/honeymoon baby, the honeymoon was OVER. My husband has a spotless record of control using withdrawal, which is the only reason I would recommend it.

    I haven’t had an orgasm in such a long, long time. 6 years to be exact. Withdrawal ruins the connection that comes at the height of passion when your husband is suddenly ejaculating on his shirt instead of inside you. Sex has become tedious especially with a husband who doesn’t really believe in foreplay, except once every 6 months or so. Withdrawal=Glorified masturbation in my world.

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