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How effective is the pull-out (withdrawal) method of birth control? How to pull out correctly

Does pulling out work if you want to avoid pregnancy? It does to some degree — if it’s done correctly. Learn how effective the pull-out method really is and how to decrease your chances of unwanted pregnancy below.

What is the pull-out method? 

The pull-out method, also known as the withdrawal method, is a way to prevent pregnancy. Although not reliable, it’s a better option than taking no precautions. It’s also an option for couples who are open to the possibility of pregnancy. 

As the name implies, in pulling out, one partner takes his penis out of the other partner’s vagina before he ejaculates. By doing this, fewer sperm travel through the vagina and cervix. The male partner can then deposit the sperm anywhere else. Although this may sound easy, it does require control and timing. If the male partner can’t feel that he’s about to ejaculate or if he’s too caught up in the moment, he might not pull out in time. 

Whether pulling out is a legitimate form of birth control is the topic of extensive debate. However, it does lower the likelihood of pregnancy to some extent. If you want to avoid getting pregnant and catching an STI, the safest option would be using a condom and pulling out simultaneously. 

How to pull out correctly 

For the pull-out method to work correctly, it has to be done right every time you have intercourse. Before the male partner orgasms, he should pull his penis from the female partner’s vagina and ejaculate elsewhere. This is essential, as even a small amount of semen can lead to pregnancy. 

Here are some tips for how to pull out correctly: 

  • Use a spermicide cream, gel, or foam to kill the sperm before they can swim toward the uterus. Place the spermicide deep in the vagina, close to the cervix. Follow the instructions to make sure spermicide is applied properly before sex.
  • Keep track of your fertile days using an ovulation calendar. During these days, it’s best to use something besides the pull-out method to avoid pregnancy. Ovulation calendars can also help you to get to know your body by detecting physical and emotional patterns. 
  • Before intercourse, have your partner pee to clear out any sperm. 
  • After your partner ejaculates, make sure there’s no semen on your upper thighs or groin. Sperm on these areas of your body may migrate inside your vagina. 

If ejaculation isn't properly timed and you're concerned about pregnancy, consult your health care provider about emergency contraception. 

Does pulling out work? How effective is the pull-out method when done correctly? 

For the pull-out method to be effective, both partners should keep sperm away from the vulva and vagina every time they have sex. Pull-out method statistics show that out of 100 women who use the pull-out method perfectly, four will get pregnant. In general, 27 women whose partners pull out get pregnant out of 100. (To compare, roughly 15 out of 100 couples who use condoms get pregnant.) Couples who don’t use any birth control method have an 85-percent chance of pregnancy. 

In general, the pull-out method is unreliable, and health care providers consider it ineffective compared to other options.

If you are on birth control, do you have to pull out? 

Birth control pills protect against unwanted pregnancy. These pills can be up to 99.9 percent effective when taken correctly. According to the Centers for Disease Control and Prevention (CDC), mini pills and combination pills have seven-percent failure rates with typical use. This means that seven out of 100 women will get pregnant while using birth control pills. 

Although birth control pills are statistically more effective than pulling out, there’s no harm in using both. However, birth control pills and the pull-out method can’t prevent the spread of STIs. 

Using a condom and pulling out

As we mentioned earlier, neither pulling out nor birth control protects against sexually transmitted infections (STIs). The most common types are HIV, chlamydia, genital herpes, genital warts, and gonorrhea. Scientists have documented 357 million new infections each year with one of four STIs — chlamydia, gonorrhea, syphilis, and trichomoniasis — worldwide. 

In some cases, STIs can have serious reproductive health consequences beyond the immediate infection (e.g., infertility or mother-to-child transmission).

The safest option is using a condom and pulling out to protect against both infections and pregnancy. You can even use condoms to practice pulling out on time. 

Benefits of the withdrawal method 

There are several benefits of the withdrawal birth control method, which include: 

  • It is free and available at all times. When you use the pull-out method, you and your partner don’t have to spend money or prepare anything before having intercourse. Anyone can use it at any place and at any time. Although most people need some practice to get it right, pulling out is always available when needed. It also might be an option if you forgot to buy a condom or left your birth control pills at home. 
  • It has no side effects. Unlike some prescribed birth control options, pulling out involves no nausea, vomiting, or increased appetite. 
  • It makes other forms of birth control more effective. When combined with a condom or birth control pills, the pull-out method can decrease the chance of an unplanned pregnancy. 

Risks and disadvantages of the pull-out method

Of course, the pull-out method does come with some disadvantages too: 

  • It’s not effective. Other birth control methods can be more effective (e.g., birth control pills and IUDs). 
  • It requires practice. Men often have trouble pulling out when they’re close to climaxing. 
  • It’s tricky to do correctly. Many couples can get caught up in the moment and fail to pull out in time. Men, especially if they’re younger or inexperienced, can lack the self-control needed to pull out at the height of sexual pleasure. 
  • It can only prevent pregnancy, not protect against STIs. Many STIs like herpes or genital warts can spread via skin-to-skin contact. Moreover, chlamydia and gonorrhea can be transmitted by the penis before ejaculation. As a result, it’s always prudent to use a condom. 
“Table of Contents - 2018 Sexually Transmitted Diseases Surveillance.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 July 2019, www.cdc.gov/std/stats18/toc.htm.

“Contraception.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 13 Aug. 2020, www.cdc.gov/reproductivehealth/contraception/.

“Understanding contraceptive failure”, James Trussel
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638203/

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