Sex & Relationships

Pillow Talk: How ineffective is the pullout method, really?



The first time I sought birth control, I was in high school and I was nervous.

It wasn’t so much that I was embarrassed to talk about sex. I’d been having sex for a few months with my long-term boyfriend. It was that I dreaded answering the question I knew my doctor would ask: What form of birth control had I been using prior to that day?

When I told the nurse we’d been using the pullout method, her expression was exactly the one I feared: a mixture of horror, distaste and extreme disappointment.

She told me nothing I didn’t know before — how my boyfriend and I were at a very high risk for pregnancy. How pulling out in time was a risky feat.

That day, my face grew red as I took the birth control pills from her while berating myself for having not come to her office sooner.

Today, I would argue with the nurse: The pullout method isn’t perfect, but it’s not completely ineffective — that is, if you’re doing it right. After all, the folks over at Planned Parenthood call the pullout method “safe, easy and convenient.” Are they a bunch of crazy lunatics wishing unwanted pregnancy on us all? No. They’re just being honest.

Effectiveness of the method relies on a few factors: trust, self-control and pre-ejaculation fluid. 

Men: How well can you gauge your sexual excitement? Do you think you’ll be able to pullout before you orgasm? Are you so afraid of pregnancy that you’d probably pullout well before you orgasm? Then the withdrawal method might be right for you. Obviously, if the guy doesn’t any have self-control whatsoever, the pullout method will be much less effective. 

But, it’s the fear of pre-ejaculation fluid containing sperm that prevents most people from pulling out. In fact, it wasn’t until about a year ago or so that I found out that sperm in pre-ejaculation fluid is very rare. According to the Feminist Women’s Health Center, “it is likely that pre-ejaculate fluid will enter the vagina, but this should not contain sperm nor lead to an unplanned pregnancy.”

That’s because sperm rarely exists in the man’s urethra tract if he has urinated anytime after his last ejaculation. If he has urinated anytime since his last ejaculation, he has (very, very likely) flushed out any leftover sperm hanging out in his urethra tract. 

The pullout method has another benefit: It’s easy. There are no pills to remember, no hormones to inject. If you’re like me, you especially like the latter. I’m wary when it comes to putting hormones into my body. Plus, it’s free.

But the pullout method, like many forms of birth control, does have its downsides. For instance, it doesn’t protect against sexually transmitted diseases, so it’s not an effective form of birth control if you’re hooking up with people whose sexual histories you’re not familiar with. 

And, it does require a certain amount of trust (that the guy will pullout), so that should definitely be taken into consideration, too. As Planned Parenthood says on their website, “Couples who have great self-control, experience, and trust may use the pull out method more effectively.”

And, sure, it might not be as effective as other forms of birth control, even if you do it perfectly. According to Planned Parenthood, 4 in 100 women who use the withdrawal method, correctly, will get pregnant — compared to less than 2 in 100 women who use condoms correctly.

But, still, a 2009 study found that when you compare typical condom use to typical use of the pullout method, using the withdrawal method is only slightly less effective than using a condom.

Why is this important to know? Because knowing your body is important. Because it’s not helpful to perpetuate fear and shame and myths surrounding a method that is, in fact, quite effective. Because, if you’re going to use the withdrawal method, it’s important to know how to most effectively use it.

The withdrawal method is by no means perfect. Sperm in pre-ejaculation fluid is rare, but not impossible. The guy might not pullout in time (meaning you’d have to take an emergency contraceptive). It doesn’t protect against sexually transmitted diseases.

But for the right couple and the right situation, it might be more effective a method than your high school nurse made it seem. 


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Katherine Marrone

Katherine Marrone

Katherine Marrone is the sex and relationships writer for the Emerald. A feminist and activist, she likes writing about gender issues and social justice.