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The Truth Behind the Pullout Method

Among the various forms of birth control, perhaps the one that ranks lowest on the totem pole when it comes to safety, but arguably one of the highest when it comes to popularity, is the pullout method.

It’s not difficult to understand why this contraceptive technique — also known as the withdrawal method and coitus interruptus — would be a popular one despite also being the riskier option. For those who don’t know, Planned Parenthood defines the pullout method as “pulling the penis out of the vagina before ejaculation.” Simple enough, right?

Pulling out requires no condom to be used by the man and no contraception to be used by the woman. However, there are still some major considerations to be taken. Chiefly, you and your partner need to have a lot of trust in the capability of the male partner and hope he knows himself well enough to know when he needs to pull out. Also, pulling out requires each of you to be totally honest about your sexual health. Not using a condom means both partners increase their risk of contracting an STI from the other — that’s not something to be taken lightly.

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So, considering the high-risk nature of this method of birth control, who exactly qualifies when it comes to considering it? Believe it or not, there are some factors you need to consider in order to know if your chances of becoming pregnant from the pullout method are greater.

According to the Centers for Disease Control and Prevention, the pullout method is best for people who: 

  • are highly motivated and able to use this method effectively
  • have religious or philosophical reasons for not using other methods of contraception
  • need contraception immediately and have entered into a sexual act without alternative methods available
  • need a temporary method while awaiting the start of another method
  • have intercourse infrequently

Interestingly, the CDC also notes that pulling out “does not affect breastfeeding” while also reiterating something important: “coitus interruptus involves no economic cost or use of chemicals and has no directly associated health risks.”

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This last fact, which you may have guessed to be true anyway by mere virtue of knowing what the pullout method is, might be contributing to its increased popularity over the last 15 years. According to a study released in August 2017 by the National Center for Health Statistics, between 2011 and 2015, 18.8 percent of men chose the pullout method as their primary form of contraception. As Inverse notes in their follow-up report on this study, that’s a massive increase from the reported 9.8 percent in 2002 and 14.5 percent between 2006 and 2010.

But just because there is an increased popularity in using the pullout method, it doesn’t mean there aren’t serious risks of failure. In fact, a February 2017 report released by the Guttmacher Institute cites the most recent percentages of failure rates for commonly used forms of contraception. And folks, the stats aren’t working in favor of the pullout method.

  • Within the first 12 months of typical use, long-acting reversible contraceptives (the IUD and implant) have the lowest failure rates of all methods (1 percent).
  • The failure rate for a condom is 13 percent (but this is still a significant decline from 18 percent in 1995)
  • The failure rate for pulling out, also referred to as withdrawal, is 20 percent

Additionally, Aparna Sundaram of the Guttmacher Institute conducted a study wherein she found that contraceptive failure could also be linked to certain demographic groups. For instance, the study found that the contraceptive failure rate was much lower among child-free users of any method with no children (5 percent) than among those with one child (14 percent) or with two or more children (15 percent). Overall, women of color fared the worst, with black and Hispanic women having higher probabilities of method failure than white women for all methods combined. Lastly, the research found that women of lower socioeconomic status had significantly higher failure rates than women whose incomes were at least twice the poverty level.

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So, if after all this, you are still seriously considering using the pullout method (and I’m not saying you shouldn’t or that it’s completely off the table!), at least consider Planned Parenthood’s advice to use the pullout method in conjunction with another form of contraception, like the pill or an IUD. It’s better to have extra protection than no protection at all, right?

The truth about the pullout method
Image: Tory Rust/Design: Ashley Britton/SheKnows

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