The pull out method: everything you need to know

Is it safe? Is it effective?

What is the withdrawal method?

The withdrawal method - also known as ‘pulling out’ - is a technique used to prevent pregnancy. In the pull-out method, during sex, the man pulls his penis out of the vagina before he ejaculates, reducing pregnancy chances.

How effective is pulling out?

Health authorities, usually do not consider pulling out to be a means of contraception, because it can be unreliable. But, if you can use the method correctly and pull out before ejaculation every time you have sex, the withdrawal method can be about 96% effective. 96% might seem like a lot, but this is actually quite low compared to many other contraceptives (see table below). 96% effectiveness means that 4/100 women who use the pulling out method would get pregnant per year.

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But there’s also another more realistic measure of effectiveness: typical use. This statistic considers human error to show how effective a contraceptive method is in the general population. In reality, few men have the control needed to always pull out every time they have sex. Therefore, the typical effectiveness of withdrawal is only about 78%, meaning that 22/100 women who use the pull out method get pregnant per year. If you compare this to other methods of contraception, this makes pulling out very unreliable.

Pulling out vs other common methods of contraception

 

How likely am I to get pregnant if he pulled out?

So, if you’ve had sex and your partner pulled out, the chances of being pregnant can depend upon several different factors:

  • If your partner pulled out successfully before any ejaculation - with perfect use, such as this, the withdrawal method is 96% effective at preventing pregnancy. Therefore, it is unlikely that you would become pregnant; however, there are other factors you should consider, as the withdrawal method is not as reliable as other methods. If your partner did not pull out before any ejaculation, there is the same chance of pregnancy as with any form of unprotected sex.
  • If your partner has any sperm in pre-ejaculate fluid (pre-cum) - studies have produced mixed results about the number of sperm cells present in pre-ejaculate fluid. It is thought that approximately 40% of men may have sperm in their pre-cum. These sperm cells may be damaged or in low numbers, making pregnancy unlikely, however, the statistics have not yet been confirmed. You should take this uncertainty into account when making choices about the withdrawal method.
  • If you are using any other form of contraception - The withdrawal method can be a good secondary form of contraceptive, if you want to be extra careful. If you use the pull out method, you create a safety net for yourself if your other contraception form fails.
  • Which stage you are at in your menstrual cycle - You can actually only get pregnant during ovulation. This occurs at around 14 days before the start of your period and lasts for 1-2 days. However, it is worth keeping in mind that sperm can survive inside the vagina/uterus for up to 5 days, so you could still get pregnant if this overlaps ovulation. It’s also important to recognise that it can be very difficult to assess the different stages of your menstrual cycle accurately and they can vary a lot from person to person. Therefore, there is still a risk that you may miscalculate when you ovulate, meaning you are fertile during a slightly different time period.

Does pulling out prevent STIs?

Pulling out is not an effective means to prevent getting an STI or passing one on. STIs can be spread through skin-to-skin contact and through pre-ejaculate fluid (pre-cum). In addition, the withdrawal method does not protect you against STIs carried in vaginal secretions.

How can I make the pull out method more reliable?

Pulling out is only 78% effective in the general population, but there are steps you can take to try and improve the reliability of this method:

  • The best way to make the pull-out method more reliable is to use it with another form of contraception i.e. condoms or the contraceptive pill. That way, if one method of contraception fails, the other is still there to protect you.
  • If you intend to use the pull out method, it is also a good idea to work on the control of your ejaculation. You can practice this during masturbation, or by using condoms and pulling out of your partner during sex. This way, you can get used to the sensation just before you ejaculate and you can improve your control, making it more likely that you will be able to pull out when you need to.
  • Some men do not realise that you should also avoid ejaculating near the vagina. Ejaculating outside the vagina, but close to it, could make it more likely that some sperm would enter the vagina, potentially causing pregnancy.
  • Just because you use withdrawal, you shouldn’t forget about the morning-after pill. You can buy the morning-after pill in advance, in case you do not pull out in time. This way, you can give you and your partner the best chances of preventing pregnancy if you do ejaculate inside the vagina. 

Why isn’t the withdrawal method a recommended form of contraception?

Much like natural family planning, the withdrawal method is not a recommended form of contraception, because it can be very unreliable. If used perfectly every time you have sex, it can be up to 96% effective at preventing pregnancy. But, in reality, it is very difficult to pull out perfectly every time, therefore in the general population, the withdrawal method is actually only 78% effective, meaning that every year, almost 1 in 5 women who use the withdrawal method will get pregnant.

Religion and the withdrawal method

Some religions, including Islam, Judaism and Catholicism have rules that govern the use of contraception. These rules can vary between specific denominations, however generally the withdrawal method and natural family planning (monitoring of the menstrual cycle to only have sex when you are least fertile) are accepted forms of contraception within religious communities. Many religions are also open to all forms of contraception. If you are religious, you may wish to speak to a religious leader for guidance on this subject.

Conclusion: The Pros and Cons of withdrawal

Pros

  • Inexpensive - the withdrawal method does not cost money, although it is a good idea to have a morning-after pill available in advance in case you do not pull out in time.
  • Does not require preparation - if you have no other contraceptives available, the withdrawal method is better than nothing. It can be used more spontaneously than contraceptive pills, which need to be taken every day.
  • Does not interfere with sexual sensation - many men report that condoms can reduce the sensation felt in the penis during sex. As there is nothing between the penis and vagina, the sensations would not be diminished.
  • About 96% effective is used perfectly - If it is used perfectly, it does offer some protection against pregnancy, but it is still not as effective as other methods.
  • Can provide an extra safety net when used with other forms of contraception - This is the main strength of the withdrawal method - it can make sex much safer if your other form of contraception fails.
  • Accepted in most religions - most religions are accepting of the idea of withdrawal as a means of contraception.

Cons

  • Typically unreliable - In the general population, withdrawal is only 78% effective, meaning that every year about 1 in 5 women who use the pull out method will get pregnant.
  • Difficult to do perfectly - The withdrawal method can be difficult to master. It can be challenging to gain the level of control needed to ensure that you do not ejaculate inside the vagina.
  • Does not protect against STIs - Only barrier methods of contraception i.e. condoms protect against STIs.
  • Not as effective as other forms of contraception - other forms of contraception are much more reliable.

 

Sources

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