Withdrawal - Not As Stupid As We Thought?

by Alanna Shaikh

category: Contraception

Published May 16, 2009 @ 09:50PM PT

(photo credit: cecilanne)

A new study indicates that the withdrawal method may not be as stupid a method of birth control as we thought. Historically, health professionals have scoffed at withdrawal. It's seen as the province of teenagers and people who don't really care about contraception. Many studies of contraception don't even count withdrawal. The Guttmacher Institute, however, has published a new study saying that it works as birth control. They may be right, but I still think it's stupid.

Withdrawal, for those unfamiliar with the word, is the time-honored method of trying to prevent pregnancy by having the man pull out before he ejaculates. There are a lot of serious flaws with the method - among other things, it requires a lot of self-control on the man's part, and it provides no protection against HIV and sexually transmitted infections.

But it is actually much better than doing nothing. A new study from the Guttmacher Institute found that if the male partner withdraws before ejaculation every single time the couple had intercourse, about 4% of couple will become pregnant over the course of a year. When a couple manages "average use" - they use withdrawal most times - about 18% of couples will get pregnant in a year. Those numbers aren't much worse than the male condom. I also remember a study a few years ago that found many Pakistani communities effectively use withdrawal to limit family size, but I can't find the reference now.

The Guttmacher study recommends that family planning researchers pay more attention to withdrawal as a method. They also have some interesting insights into the method itself. It's often used in conjunction with the male condom, and it's more commonly used in younger populations. There is also a great quote from a young American woman about why she likes withdrawal as a method "Withdrawal is a great form of birth control. You can still keep going, you can still have sex, it doesn't smell bad, [and] it doesn't have chemicals in it."

Myself, I remain unconvinced. Withdrawal probably does warrant more research. I can get behind that. And it would be nice if there was an effective, free, non-hormonal method of birth control. But withdrawal requires a level of reliability from the male partner that is very often lacking, and the interviews in the Guttmacher study indicate it's most often used by people who misunderstand or are unaware of more effective methods. Our efforts are better spent making modern methods more accessible and comprehensible to the people who need them most.