pregnant pause: why women need to (properly) think over the withdrawal method

In high school, we’re taught all about different methods of birth control. There’s the oral contraceptive pill (a winner for women since the 1960s), condoms, Implanon, diaphragms, IUDs, and many more options that I can barely remember because we’re so spoilt for choice. Oh, and sterilisation! In the US, heterosexual Generation Y women are reportedly choosing to abandon traditional contraceptives in favour of the withdrawal method. I can’t quite remember being told “pulling out” was a popular – let alone effective – method of preventing pregnancy, and there’s good reason for that.

In a New York Magazine feature, it’s claimed getting a partner to pull out before orgasm is an en vogue birth control method for women in their early twenties to early thirties when in a trusting relationship. And it’s backed up with new technologies. The gist is, you track your menstrual cycle on an app and when there’s a chance you could get pregnant only then do you use a condom. Author Ann Friedman cites a number of things contributing to women’s rejection of more reliable contraception: the negative side effects of hormonal birth control, a fear of having to put foreign bodies way up inside you and then have them taken out, and condoms affecting women’s pleasure.

The method is being utilised by younger women as well. A recent study of US women aged 15-24 found that at least one in three participants had used the withdrawal method before. In this age group, finances and accessibility of more reliable contraception have been cited by doctors as key issues influencing decisions.

Every woman has the right to choose what’s right for her body. This is particularly the case when contraceptives can cause side effects like depression, or when accessibility to other forms of contraception is an issue (in this situation it’s naïve to say to someone ‘don’t do it: women are agents and should always exercise agency in their sexuality’). Furthermore, it’s wonderful that technology is accommodating women who wish to track their menstrual cycle and share the burden of birth control with their partner. It’s reassuring to know (in the US, and here) that there is emergency contraception and abortions for when shit happens. But with Sex Ed a distant memory for most women*, it begs the question: are all women aware of the exact risks of their decision to abandon traditional birth control?

It’s concerning that the withdrawal method is becoming a first choice – or worse, is the only choice – for women. The withdrawal method supposedly puts just pressure on men to be as cautious with their body as women have had to be for decades. According to Planned Parenthood, the withdrawal method requires a man to know exactly when he’s going to ejaculate or when it can no longer be delayed. The withdrawal method is ineffective as soon as a drop of semen is anywhere near a woman’s genitals because sperm are better swimmers than Michael Phelps. Regardless of whether orgasm occurs in or near the vagina, pregnancy can still occur if there is even a single trace of sperm in pre-ejaculate fluid, which men produce prior to climax. That is a lot of pressure. If I was a guy, I dare say it might get in the way of my orgasm. As a girl, I dare say it would get in the way of my orgasm.

Four per cent of women utilising the withdrawal method perfectly will become pregnant in the first year of pulling out, whereas the figure for typical use is 27%. The failure rate of perfect calendar-based birth control (i.e. monitoring the menstrual cycle, regardless of combined use with the withdrawal method) is anywhere from 5% – 12% in the first year of use depending on the exact procedure followed. Comparatively, the failure rate of perfect oral contraceptive use in the first year is 0.3% and perfect condom use results in only a 2% failure rate first year out.Of course, these numbers increase exponentially with improper use and it has been suggested a fifth of unplanned pregnancies occur due to incorrect usage of the contraceptive pill.

There’s certainly a risk of pregnancy with all birth control methods. I don’t want to promote abstinence because sex positivity is much more fun, but it’s pretty true that the only 100% sure way to not get pregnant is to not get laid… unless you believe the tale of the Virgin Mary. Nonetheless, “perfect” pulling out and cycle timing is far riskier than perfect use of other contraceptives – it has even been compared to Russian roulette. But an unplanned pregnancy isn’t the only bullet being dodged here.

Women who actively pursue the withdrawal method as contraception may not be worried about sexually transmitted diseases as they’re with a trusted partner. But trust can always be betrayed. The only way the withdrawal method should be used is after adequate blood, urine, swab and pap testing to ensure both partners are “clean” – or at least aware of and accepting of any issues with their partner’s sexual health. However, it can’t be anticipated that a trusted partner can’t always be trusted to not pick something up from a third party. We’re privileged to have the morning after pill and abortions when we’ve underestimated a partner’s body or our own, but there aren’t similar options to free ourselves of HIV/AIDS, Herpes, HPV (including Genital Warts), Hepatitis, and the latent stages of curable infections.

As someone with polycystic ovaries (and I’m sure anyone with a similar condition that causes them to go through oligomenorrhea would feel the same) AND hypochondria, the thought of relinquishing my reproductive control to someone who could literally blow it scares the shit out of me. It also gives me temporary vaginismus. Each to their own, though.