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Birth Control Bingo: Withdrawal

  • 96% effective with perfect use; 4 out of every 100 women will become pregnant each year
  • 73% effective with typical use: 27 out of every 100 women will become pregnant each year

Additional Sources for Effectiveness Ratings and Use:

  • 73% typical use/96% perfect use: Contraceptive Technology, 18th Revised Edition; Hatcher, Trussell, Stewart, Nelson, Cates, Guest, Kowal: Ardent Media, 2004.
  • 73% typical use/ 96% effective perfect use: Feminist Women's Health Center
  • 73% typical use/96% perfect use: Planned Parenthood

For several reasons (which I'll explain in a bit), withdrawal is strongly discouraged for teens young adults, as a few factors, some of which cannot often be controlled, make it far more likely to be ineffective.

The What, the Why, the Where, the When, and the How-to: Withdrawal is sometimes called "pulling out" or coitus interruptus latin for interrupted intercourse: it's when, during intercourse and just before ejaculation, a man withdraws his penis from the vagina and ejaculates elsewhere -- and not anywhere near the womans genitals or pelvis. For those who like to geek out on this stuff, coitus reservatus is the latin term for a man trying to reserve ejaculation entirely or who withdraws from intercourse without ejaculating at all.

Withdrawal is (as may be obvious) one of the oldest methods of birth control there is. The pros are that it doesn't cost anything, it is something which can be used by those whose religions or partnerships prohibit them from using hormonal or barrier methods, and -- save pregnancy when it fails -- it doesn't have any side effects. It's also one of the few methods of male-directed birth control. The cons are that many couples find it frustrating to have to cease sex at the peak of it, and especially at the moment of orgasm, it is a method which the person who will become pregnant if it fails -- the female partner -- has no real control over, and it does fail often in typical use.

Some questions and answers about withdrawal:

  • I didn't want to go without protection, but could I be pregnant?

    • Or, click on the tag for withdrawal for a larger list.

    When Good Birth Control Does Bad Things: When withdrawal fails, it is most often because a man does not withdraw at all, withdraw in time, or because even if he does, he still ejaculates somewhat or entirely on a woman's genitals. Secondarily, pre-ejaculate can contain sperm, and when the timing is right in terms of female fertility, those sperm can create a pregnancy. Pre-ejaculate is thought to be very unlikely to contain sperm if a man has urinated before sexual activity, but we don't have a whole lot of studies on the fluid, so the jury is still often out on that issue.

    Withdrawal is usually less effective for young adults than it is for older adults, which is worth paying attention to since even for older adults, this is not a very reliable method. While I do not know of an actual study on this (because of legal issues and privacy concerns, we have very few adolescent-specific studies on contraception), we do have plenty of studies on teen pregnancy saying withdrawal is common method in those pregnancies, and that pregnancy among teens has been declining in large part due to increased use of far more effective methods of birth control, or in pairing withdrawal with other, more effective methods.

    I also have had years of experience in hearing and reading quite a lot of different accounts of pregnancy for young people: in my ten years running Scarleteen, we've observed that withdrawal simply is often a highly ineffective method for younger people. That's not surprising, after all, younger men tend to ejaculate much more quickly, sex with partners is newer to them so it's tougher for young men to anticipate when their orgasm is going to happen or has even started happening, and young people are also more fertile than their older counterparts. In fact, simply because young men usually ejaculate so quickly, and have so little sexual experience, even advocates for withdrawal overall will tend to make clear that it is not a great choice for young people.

    Think or know you used this method improperly, or know that you have had a pregnancy risk due to unprotected sex? It might not be too late for you to prevent an unwanted pregnancy with a method of emergency contraception.

    Younger people also tend to be more impulsive (the nice word for that is spontaneous, and it is a cool thing about y'all when it's not endangering you or others), and for plenty of young couples using withdrawal, it doesn't take long to get to a time when a male partner decides to go without withdrawing on purpose -- often without consulting his partner -- or wait until what seems like the very last minute -- and turns out to be too late -- "just this once." Anyone practicing withdrawal has got to have a lot of self-control, something that tends to be difficult for people of any age at the same moment they're having a big orgasm.

    Anecdotally, I'm a withdrawal baby myself, from two young adult parents. My parents stayed together for as short a time as they could get away with, and throughout my life have agreed on things so infrequently that if I try and count them on one hand, I always have most of my fingers left over. But one of the very few things I've ever heard them agree on was that they practiced withdrawal perfectly, and yet...here I am. I also have a nephew I love to bits that I've got a perfectly practiced withdrawal to thank for, and come from two large families steeped in Catholicism, so I know all too well about typical results of withdrawal. While in daily life, at Scarleteen and in the clinic I work for there are certainly plenty of times I hear about pregnancies due to user error with all methods, withdrawal is the only method I can think of where I hear about so many failures, especially among younger folks, when it's apparently been used perfectly. Some of that is probably because there is a difference between misusing a method because someone has not had the information on how to use it properly, and failure because a person's age and developmental state makes it difficult or impossible to use a method properly.

    But it's sage to remember that there are situations -- be they financial or situational -- where for couples, it's withdrawal or no method at all, or when the most a male partner can be talked into at a time is withdrawal. When that is the case, it is absolutely better to use withdrawal than to just take a chance with a full ejaculation. Of course, when that is the case, we feel it's even more ideal to skip genital intercourse and just do something else, but acknowledge that some partners do not always get a say in what goes on, or lack the assertiveness or agency to draw a limit and boundary.

    Other methods which can be used as a backup method with withdrawal:

    Other methods you might like if you like withdrawal:

    Why would withdrawal be a good option for me? If any of the following are true:

    • You are male
    • You or your partner are currently unable to pay anything at all for birth control, and are unwilling to abstain from intercourse
    • You are Roman Catholic, Protestant or of another relgion which prohibits hormonal or barrier methods of birth control
    • If it is a matter in the moment of choosing between withdrawal or nothing, or if you are in an abusive partnership where your male partner refuses other methods but accepts withdrawal
    • You are combining it with another method
    • Your male partner (or you, if you're the male partner) is older and considerably experienced in both knowing his own sexual responses with a partner and at timing withdrawal, and he takes the risk of pregnancy very seriously
    • You are not bothered by, or prefer, a lack of ejaculation into the vagina
    • You are looking for a method you only have to think about at the time you're going to have sex
    • You are currently breastfeeding

    For a brief overview of all BC methods, have a look at Margaret Sanger's Disneyland: Choosing Contraceptives. Want to start over with Birth Control Bingo? Click here.