Pulling Out Is In

Pullout Method of Contraception

Hold on now. Wait a minute. Don’t get too excited. If you thought “pulling out” was a feeble and ineffective method of contraception for the reckless and unprepared, well it is. At least at first glance. But given that at least 38 million couples use it worldwide, coitus interruptus warrants a second look.

With its ancient yet undistinguished history, coitus interruptus is very easily dismissed as ineffective because of the widely accepted belief that the pre-ejaculate contains sperm. There is no conclusive evidence that this is the case. No one has found sperm in pre-ejaculatory fluid. In addition, it is all-natural, organic, and hormone and side-effect free — not to mention affordable. It needs no tool that nature hasn’t already given us, except rigorous and unerring self-control. Well, in fact this is the big downside. Who has rigorous and unerring self-control? We are men, not robots.

Effectiveness of Coitus Interruptus

That said, a recently published study has shown for the first time in the modern era that withdrawal is a more effective contraceptive than one might think. Maybe we should look at the pullout with a little more respect. The withdrawal method, when used with perfect technique, has a 4% failure rate. This falls behind vasectomy (0.1%), birth control pills (0.3%), IUDs (0.6%), and condoms (2%), but not by much. “Perfect” pullout technique requires a man to be able to identify when he is about to ejaculate with enough time to fully remove the penis. The impending ejaculation must occur away from the vagina to be effective. If sex is planned again soon after, the man should urinate and thoroughly wash and clean the penis to prevent accidentally transferring sperm.

Perfect technique is not what we find in the real world, however. The actual (real life) failure rate is likely 15-25%, which is not far behind the failure rate of condoms, at 10-18%. So, withdrawal is not that bad after all — only a little less effective than condoms. Perhaps men deserve a pat on the back for this. Well done.

Let’s take a different point of view here: If this were a contraceptive pill, a 15% failure rate would send its inventors back to the drawing board. Thus, coitus interruptus is inherently flawed, and women who seek more control over whether or not they become pregnant are more likely to reject this method over the long term. One study revealed that women of higher economic status and education are more likely to insist upon a more surefire method of contraception. It appears that women simply don’t trust men’s timing, their control, and perhaps even the male sense of responsibility when it comes to contraception. They want more control over the matter.

Combining Contraceptive Methods

Maybe this is why many couples who use the pullout method do so in combination with another type of birth control. With a condom, pullout method is much more effective, as any premature sperm spillage is contained. Recall, too, that pulling out does nothing to prevent the spread of STIs. More reason that sexually active individuals should consider condom use rather than placing all hope on pulling out.