Risks of Using the Withdrawal or Pull-Out Method

A common question women ask is if they can get pregnant when using the withdrawal method of birth control (also known as "pulling out"). The technique involves withdrawing the male penis from the female vagina prior to ejaculation to avoid pregnancy. The answer to the question depends, in part, on whether or not the couple is using the withdrawal method correctly.

Sometimes called the "pull out method" or coitus interruptus, the withdrawal method is a technique that is sometimes used during intercourse to decrease the chances of a pregnancy.

Many doctors advise that the method is very risky if you are actively trying to avoid pregnancy in particular because prior to male orgasm and ejaculation, there is a small amount of pre-ejaculate semen that is released, which contains sperm. Even this small amount of semen can still lead to pregnancy if you are ovulating.

The calculated risk of pregnancy using the pull-out method is believed to be about 4% for couples who pull out correctly each and every time (meaning out of every 100 women whose partners use the pull-out method perfectly every time, 4 will still get pregnant). For couples that don't use the technique correctly, which is much more common, almost one-third, or 27%, will get pregnant (27 out of 100 women using the method will become pregnant).

Exhibiting great self-control and being aware of timing are required for correct use of the pull out method. Men must be able to know exactly when they are reaching the point where ejaculation can no longer be stopped or delayed. Accurately estimating this point of sexual excitement is required in order to pull out before ejaculation. But even a tremendous level of self-control on behalf of your partner will not guarantee that you will not get pregnant.

When using the withdrawal method on its own, it is especially important to note that pregnancy can still happen even if your partner pulls out in time, as pre-ejaculate fluid may still contain traces of semen. Pregnancy can also happen if semen or pre-ejaculate fluid is spilled on the external opening of the vagina (vulva).

The pullout method may decrease your chances of a pregnancy slightly, but it does not protect you from sexually transmitted diseases or infections (STDs and STIs). Using a condom is your best bet for reducing the risk of an STD or STI.

While it is one of the riskiest forms of birth control, there are a few benefits to using the withdrawal method as a form of contraceptive, such as:

• Pulling out is safe, simple to do, and convenient for both the man and woman
• When no other form of contraceptive method is available, the withdrawal method can always be used
• There are no reported medical or hormonal side effects to using the withdrawal method as a contraceptive
• The method doesn't require a prescription
• Very cost effective as it is free
• Can make other forms of birth control more effective when used in conjunction with other contraceptive options

That said, using the withdrawal method as your only form of birth control comes with a few major disadvantages and risks, such as:

• Risk of unwanted pregnancy
• Risk of being exposed to or transmitting STIs
• High likelihood of using the withdrawal method incorrectly (especially among teens and sexually inexperienced men)
• Requires great self-control, practice, and experience (and is still not guaranteed effective)
• Not to be used by men who experience premature ejaculation

If you are trying to avoid getting pregnant, using additional methods of birth control like condoms, birth control pills (oral contraceptives), intrauterine device (IUD), spermicidal foams, Depo-Provera injections, or hormonal patches are all options that can be used in conjunction with withdrawal. If you are concerned about protection from STIs, you should consider using condoms, as they provide the highest level of protection for sexually active adults. Be sure to ask your midwife, doctor, or local health department for advice on the method that is best for you.