Effective birth control methods are critical for a key reason—unplanned pregnancies can be an overwhelming surprise for couples who aren’t trying for a baby. But what if the method you’re using is less effective than you think it is? Lots of myths exist about non-hormonal and non-barrier birth control methods like the pull out method, so today, we’d like to talk about the pros, cons, and key facts surrounding this contraceptive tactic.
What is The Pull Out Method?
The pull out method is also known as the withdrawal method. This happens when the penis is removed from the vagina before ejaculation so that ejaculation happens outside of the vagina. The goal is to keep sperm from entering the vagina and triggering conception.
The pull out method is popular for a number of reasons. For one, it is free; if you’re limited on health care funds and you’re looking for an affordable method of birth control, this method can be incredibly appealing. Also, if used correctly, the pull out method does not affect breastfeeding and is always available.
Another big advantage for women is the non-invasive nature of this method. The pull out method doesn’t involve any use of chemicals that can be associated with health risks and side effects. Many hormonal birth control methods come with side effects that are difficult to manage for many women and couples.
But the withdrawal method isn’t perfect and can come with a number of disadvantages—unlike some other contraceptive tactics, the pull out method doesn’t protect against sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Additionally, some couples report feeling diminished sexual pleasure when using the pull out method, as using this method for birth control requires self-control and awareness.
Aside from the method’s lower effectiveness during the woman’s fertile window, some other factors affect the effectiveness of the pull out method, including:
- Accidentally missing the opportunity to pull out—sometimes it’s difficult to pinpoint the exact moment when ejaculation will happen. Even if the guy can usually predict when he’ll ejaculate, distractions like stress or the influence of alcohol can lead to poor timing and errors.
- Pre-ejaculate, also known as pre-cum, is the fluid that’s excreted from the penis during arousal. Pre-ejaculate may contain sperm which can enter the vagina during sex and lead to an unplanned pregnancy. Most men are unaware of their pre-ejaculation.
- During withdrawal, semen can land on a woman’s upper thigh and, though uncommon, can lead to pregnancy. If there’s a fluid passageway leading from thighs to your vagina, sperm swim their way into the vaginal canal.
But Does It Work?
The short answer is—not well and not consistently. It’s estimated that one in five couples who use the withdrawal method for one year will get pregnant. As with any contraceptive method, the pull out method is unforgiving of incorrect use and has a lot of room for error, especially since the risk of pregnancy is higher if the woman is in her fertile window (five days leading up to and during ovulation).
Given the relatively higher failure rate of the pull out method, it’s not appropriate for many couples. If you have a condition that makes pregnancy a dangerous health risk, we highly recommend trying other methods of birth control based on your doctor’s advice.
Reduce Your Risks
Ultimately, the full proof method to reduce risk of pregnancy and sexually transmitted infections is abstinence. Although it can be difficult to set boundaries with partners, this method provides physical and mental protection.
Should you decide to use the pull out method as a form of contraception, we would recommend the following to reduce your risk of unwanted pregnancy:
- Use a long-acting contraceptive like an IUD or hormonal implant as an additional form of birth control. Most IUDs and implants have a 99% effectiveness rate as a backup to any errors or misses with the pull out method.
- Avoid this method while ovulating since you’re more likely to get pregnant in the days leading up to ovulation. Use an ovulation calendar to track your most fertile days and use another contraceptive method such as condoms during that time.
- Flush out semen from pre-cum by having your partner pee before sex. It doesn’t guarantee that there’s no sperm in the pre-ejaculate but urinating beforehand reduces the risk.
- Keep condoms or other forms of contraception on hand to decrease your reliance on the pull out method.
There are many different ways to prevent an unplanned pregnancy so we recommend exploring other contraceptive methods as a back up for the pull out, or withdrawal method. Talk with your doctor about your options and be sure to discuss them with your partner as well! They can work with you to help prevent an unplanned pregnancy, and in some cases, they will need to participate in the birth control method chosen to ensure it’s used correctly every time.
To explore your options with a medical professional today, we encourage you to visit our virtual or in-person clinic for a free or low-cost appointment!