The basic goal of using birth control is to lower your risk of pregnancy by as much as possible, right?
No form of contraception is foolproof. But if you have an IUD, use a condom properly, take your pill as directed, or use your ring, patch, or another method correctly, your chances of getting preggers are indeed way lower.
Trusting your partner will pull out before any swimmers get out the gate, though, is less like birth control and more like taking a gamble. There’s a reason it’s called “pull and pray.” Here’s what the experts and failure rates say about coitus interruptus.
“People do think of this as being contraception — but it’s not,” says Lauren F. Streicher, M.D., clinical associate professor of obstetrics and gynecology at Northwestern University and author of “Sex Rx: Hormones, Health, and Your Best Sex Ever.”
Contraception, by definition, is a method used to prevent pregnancy, but pulling out has such a high failure rate, you can’t even really consider it a viable option, she argues.
According to Planned Parenthood, among partners who pull out perfectly every time (before any semen comes out), only 4 percent of those women will become pregnant over the course of one year. Not too bad, right?
That’s in a perfect world, though. There’s another kind of failure rate, called the “actual” rate, that takes user error into account — in other words, not pulling out in time.
Including partners who don’t time withdrawal perfectly, the actual failure rate is 25–30 percent over the course of one year.
Meanwhile, male condoms have a typical use failure rate of 13 percent, and female condoms 21 percent, according to the CDC. That’s better than the pull-out method. And if your aim is to prevent pregnancy, don’t you want the better odds?
Also, consider this: Typically a condom fails because partners don’t put it on until after intercourse starts or don’t put it on correctly, Streicher says.
You can eliminate the first reason by getting the right type of condom for you into place before penetration. While condom tearing or breakage does happen, you can reduce chances of this with proper application and accurate condom size.
For the sake of comparison, most hormonal forms or contraception, like the pill, patch, or ring, have a 7 percent typical use failure rate, according to the CDC.
And if you have an IUD, you have a less than 1 percent chance of getting a bun in the oven. That failure rate makes the IUD the most effective form of temporary birth control.
“Withdrawal is at the bottom of the barrel when it comes to methods of not getting pregnant,” Streicher adds.
When it comes to the pull-out method, timing is pretty darn important. That’s because when someone ejaculates, the first portion of semen is the most potent.
That first shot — not counting pre-cum — has the faster swimmers, a higher number of them, and sperm with better quality DNA to boot.
But a number of reasons might make pulling out with precision complicated. First, it’s easy to forget. The height of pleasure can hinder the desire to pull out, too. And substances like alcohol or weed can slow one’s reaction time for halting the action.
Plus, pull-out timing doesn’t even account for the pre-cum that exits the penis. That’s an alkaline fluid that comes from the Cowper’s gland during arousal and before ejaculation.
Pre-cum consists of enzymes and mucus. Research on whether pre-cum can cause pregnancy is lacking, but an often-cited study from 2010, shows that it can be contaminated with live sperm.
“The idea that anyone can pull out fast enough to prevent a pregnancy is just not true, making withdrawal not an appropriate form of contraception,” Streicher emphasizes.
A potential unplanned pregnancy isn’t the only concern with using the pull-out method. “Withdrawal is in no way going to protect you from STIs — period,” Streicher explains.
You’re exposing yourself both to those transferred from skin-to-skin contact, like herpes, as well as those spread through fluids, like gonorrhea and chlamydia. It’s imperative to get tested regularly if you use the pull-out method.
The other risk? Having a generally bad sexual experience, Streicher says. “When you’re constantly worried about pulling out in time — or if the guy will pull out in time — that doesn’t make for satisfying sex,” she offers.
And to top it all off, you have the post-coitus stress of not being 100 percent sure no sperm escaped or if you’ve exposed yourself to an STI.
Yet a shocking number of women are relying on what is the contraceptive equivalent of keeping your fingers crossed.
A new survey from Glow, a menstrual cycle tracking app, found that 18 percent of women use the withdrawal method as their primary form of birth control. And the CDC estimates that 60 percent of women have relied on pulling out at least once.
That same Glow survey found that pulling out was the third most popular form of birth control — more than an IUD! Participants of the Glow survey said their top reasons for depending on it is that it feels the best and is the easiest contraception to use.
There’s no denying pulling out is more convenient than other birth control options. No drugstore run required, and it’s free. Plus, it lacks the side effects and potential risks of hormonal contraception.
But ask yourself if you would rather pay the price of a condom or that of an unplanned pregnancy or a lifelong STI.
If you’ve used the pull-out method, but you’re worried about it after the fact, check out our morning-after action plan for unprotected sex.
A lack of planning often plays a role in the use of the withdrawal method for birth control. “A lot of people pull out as a last resort if they weren’t planning on having sex but have no other contraception available,” Streicher says.
It’s still best to halt the action and head to the condom aisle or opt for an old-school dry hump. But if you’re going ahead with penetration, then the pull-out method has its place.
“While it may not be the most reliable method for all couples,” says sexologist Jessica O’Reilly, “I wouldn’t want to discourage people from using it as opposed to using nothing at all.”
And it should be noted that the pull-out method is a great practice in combination with other methods of contraception to increase their effectiveness.