To Pull-Out or Not to Pull-Out…

This article is part I of a series on “Contraceptives” by POKA app.

Most women have been met with this  popular saying during sex. “Don’t worry, babe! I’ll pull out. I’ll be careful. ” The question here isn’t whether or not the man can pull out, the question is, how effective the pull-out method is at preventing unintended pregnancy? The answer, which should come as no surprise, is, not very effective, at least not in practice. Are any of  you a testament to its success – or lack of?

The pull-out method, also known as the withdrawal method, is a form of contraception where a man withdraws his penis from the vagina during penetrative sex, prior to ejaculation, to prevent sperm from reaching the vagina, and therefore prevent pregnancy. It’s the oldest known and most basic method of contraception, but it’s debatable how effective it is. While some swear by it –  individuals and healthcare professionals alike – research hasn’t shown much effectiveness.

The Center for Disease Control and Prevention (CDC) records that out of 100 couples relying solely on the pull-out method for contraception, about 22 will typically experience an unintended pregnancy within the first year of use¹! This is a much higher rate when compared to other contraceptive methods such as condoms, the pill, etc. 

The success of the pull-out method as a contraceptive method depends largely on the consistency and accuracy with which it is practised. When performed perfectly – that is, when withdrawal occurs well before ejaculation and no sperm comes into contact with the vagina – it can be relatively effective – we don’t have numbers for this. However, since we live in an imperfect world, the pull-out method is rarely practised perfectly in real life and even a small mistake can lead to an unintended pregnancy.

So, why do so many people practise the pull-out method given its track record at preventing pregnancy? For one, it’s cost-free and requires no devices or equipment. Also, compared to other hormonal contraceptives, there are no side effects (except maybe a baby?). Other reasons may include religious beliefs and relative pleasure compared to other methods such as condoms. 

The pull-out method is often not as effective as it can be, because the pre-ejaculate fluid, commonly called pre-cum, may contain some sperm – meaning that even if there is successful withdrawal before ejaculation, there may be unintended pregnancies. Again, this method of contraceptive depends heavily on a man’s self-control, level of arousal, and perhaps prior experience, to be able to time withdrawal precisely, all of which are factors that may not be reliable.

Finally, the pull-out method does not prevent sexually transmitted infections (STIs) the way that barrier methods do. It will have to be paired with other contraceptives such as condoms, to prevent infections.

To conclude, we say that in theory, the pull-out method when practised perfectly by an experienced man is effective at preventing pregnancy from unprotected sex. In practice however, this is rarely the case. While the pull-out method can be used as a contraceptive, it has a high rate of failure and can lead to unintended pregnancies and/or STIs. 

If for religious or personal reasons, this is your preferred method of contraceptive, it may be worth it to speak with your healthcare professional about ways to increase its effectiveness, perhaps by pairing it with alternative options such as cycle tracking etc. If you’re concerned about STIs, the pull-out method is not an option as it does not guard against or prevent sexually transmitted infections. 

What is your experience with the pull-out method? Share with us and read about other’s experiences in the Poka Community Group. Join the conversation.

 

References:

1. Center for Disease Control and Prevention. Contraceptive Effectiveness. Published April 25, 2014. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6304a5.htm