"So Doc, how effective is withdrawal as a birth control method?" - my 22 year old patient asked. "My boyfriend really wants us to use it all the time, but I'm worried." This was her second visit to the clinic to discuss birth control. At the first consultation, she informs me she does not like the contraceptive coil, implant or injection methods.
As I start to explain how the method works, I think about how many other couples will show interest in natural birth control methods for one reason or the other. Using the method succesfully means understanding very clearly how well they work.
What's On This Page
What is Withdrawal Birth Control Method?
First, let's admit - hormone-based birth control methods are not for everyone.
This may be due to issues like:
- bleeding problems - heavy menstrual bleeding or spotting (some of which you can learn about here); bloating or acne;
- religious and cultural beliefs;
- health reasons where you may not be able to tolerate hormones safely
- or a philosophy/preference - you just do not want hormones in your system.
So it's helpful to have an effective alternative natural birth control method that you can use reliably and comfortably.
Natural Birth Control Methods
There are three main natural methods to avoid an unplanned pregnancy without using hormones or medical devices in the womb.
- Pull Out method, also known as the 'Withdrawal' method; Pull and Pray; and 'Coitus Interruptus'.
- Rhythm method for Natural Birth Control relies on using the calendar to mark your safe and fertile days. Knowing these times helps you work out when you are most likely to get pregnant, which can be used for planning a pregnancy or birth control.
- Lactational Amenorrhoea Method (LAM) is a method used by women within 6 months of childbirth while exclusively breastfeeding.
The Pull Out Method (Withdrawal method) is the birth control method where a man withdraws his penis from his partner's vagina during sexual intercourse - before he ejaculates to reduce the amount of sperm deposited in the woman.
Now, Is the Pull Out Method Safe or Not?
Well, the withdrawal method is not 100% safe.
The two main risks that you may encounter using this method are unplanned pregnancy and sexually transmitted infections.
Firstly, with skin to skin contact and the exchange of fluids during vaginal penetration; either partner is at risk of contracting a sexually transmitted infection if the other is infected.
Secondly, how well the method prevents pregnancy relies on individual control - and how much can you rely on that?
How Effective is Withdrawal As A Birth Control Method?
This is a common question - you could also say: what is the failure or success rate for coitus interruptus?
But before answering that - let us explore a concept that scientists use to describe birth control methods - Perfect Use and Typical Use.
Perfect Vs Typical Use of Birth Control Methods
Very simply, perfect use of a birth control method is all about its highest level of effectiveness which happens without relying on changeable human factors like forgetfulness, differences from one person to another, a person's willingness to use it and so on.
Typical use, on the other hand, describes the level of effectiveness you get with everyday use. Of course, this will be subject to human practices and habits.
Can 'Pulling Out' Get The Job Done?
The Pull Out Method does work. In fact, some doctors will say it's better than using nothing.
However, how well it works depends on how well it is used.
According to studies, the Pull Out Method has a 4% failure rate in a perfect world.
And this means that for every 100 people (couples) who use the pull out method perfectly, 4 will get pregnant.
However, in real life (typical use), about 22 out of 100 people (failure rate 22%) who use withdrawal get pregnant every year — that's about 1 out of every 5 couples will get pregnant.
This makes it about 78% effective.
Now let us put this in context and compare it with other methods - this will help us make a lot more sense out of the numbers.
In this table, you can see other common methods lining up against the Withdrawal method to see where it falls from Most to Least Effective:
The Place of Coitus Interruptus in Birth Control
The reality is that withdrawal isn't as effective as other types of birth control, but it's definitely better than not using anything at all.
When you don't use any form of birth control, the chances of falling pregnant can be anything from 84% upwards (as a young health couple having sex three times a week).
When you add birth control, your risk of pregnancy reduces.
What do you think about the method - what do you think is the biggest reason it fails?
In the next post on withdrawal method, we look at the reason for failure as we explore the benefits and disadvantages of using the method.
Make sure you check it out to learn some tips for how best to use the method.
Editing by AskAwayHealth Team
All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
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