I know, right? Shocked the hell out of me, too.
Today’s New York Times Health section ran a startling article about a new study that measured how effective the withdrawal method was at preventing pregnancy. It was sent to me by friend and frequent commenter Elibard, who knows entirely too much about my sex life, including that I am a strident enemy of withdrawal (as a method of contraception, that is. Otherwise, it can be fun). I simply know too many children conceived as a result of “Oh, I’ll pull out in time.” When asked, I will always loudly proclaim: USE CONDOMS. WITHDRAWAL DOES NOT WORK.
Turns out, I may be wrong. Well, sorta:
Reproductive experts were taken aback by a paper in the June issue of Contraception magazine. Based on an analysis of studies, the paper pronounced withdrawal “almost as effective as the male condom — at least when it comes to pregnancy prevention.”
“If the male partner withdraws before ejaculation every time a couple has vaginal intercourse, about 4 percent of couples will become pregnant over the course of a year,” the authors write.
For condoms, used optimally, the rate is about 2 percent. But more significant, the authors say, are the rates for “typical use,” because people can’t be expected to use any contraception method perfectly every time. Typical use of withdrawal leads to pregnancy 18 percent of the time, they write; for typical use of condoms 17 percent of the time.
Researchers on this study knew that health educators have always held the party line that withdrawal is the worst and most unreliable method of birth control. I know that every sex ed class I ever attended and every women’s health book that I ever read said as much. But they thought that withdrawal might be worth reconsidering:
“We had all noticed that social science researchers and health care providers just kind of dismiss withdrawal and don’t seem to realize that it can prevent pregnancy,” Ms. Jones said. “Most people seem to be under the impression that you might as well do nothing.”
But Ms. Jones said the intention was not to advocate withdrawal, but to advocate talking about it.
“Health care providers and health educators should discuss withdrawal as a legitimate, if slightly less effective, contraceptive method in the same way they do condoms and diaphragms,” the authors write. “Dismissing withdrawal as a legitimate contraceptive method is counterproductive for the prevention of pregnancy and also discourages academic inquiry into this frequently used and reasonably effective method.”
Ms. Jones and her co-authors said they were dismayed to see that withdrawal had not been exhaustively studied. (ed: heh heh)
There’s a big BUT here:
Some educators and physicians said they worried that putting out a message that withdrawal is effective would just give teenagers encouragement to have unprotected sex. And many underscored what the authors themselves point out: that unlike condoms, withdrawal does not protect against sexually transmitted diseases, a strong reason to encourage condoms.
Very true. There’s also the issue of whether consistent, responsible withdrawal is a practicable method for everyone:
“Those data don’t necessarily translate to youth today,” said Dr. Melissa Gilliam, chief of family planning and contraceptive research in the University of Chicago’s Department of Obstetrics and Gynecology, who is on the board of the Guttmacher Institute. “In terms of a reliable method used over and over again, the risk of failure is quite high.”
Martha Kempner, vice president for information and communications at the Sexuality Information and Education Council of the United States, said withdrawal, while less problematic for married or long-term monogamous couples, is not as acceptable in other circumstances because “well-intentioned young men can get it wrong, or somebody can just not do it after they said they would.”
Spirited comments on blogs largely agreed. “I wouldn’t want to trust a dude to get it right every time,” read one comment on the blog CollegeCandy.
Preach on, young sister! Teenagers? Twentysomethings? Don’t try this at home.
It seems highly unlikely to me that men in their teens and 20s can control their ejaculation well enough to use the withdrawal method successfully. I’m not gratuitously slagging on young dudes, mind you. The simple truth is, learning how to delay ejaculation takes time and practice, and ladies, you don’t want to be the woman he’s learning on.
If you are in a monogamous relationship where there is absolute trust, and where you are very familiar with each other’s sexual responses, you might be able to get away with withdrawal as a method of contraception (at least, you could get away with it around 82% of the time, according to this study). Even with this study’s surprising results, I still wouldn’t chance it, but I’m so risk-averse I use condoms and the Pill. I’ve always been a total nervous Nelly about contraception (which has paid off; I’ve never gotten pregnant).
Elibard–who, like me, is in mid-thirties and, ahem, not a novice in the ways of love–said the same thing when we were e-mailing about this article:
No teenage boy (or early 20s) should even attempt this, in my opinion. Nor should any girl trust that he can do it. But I could see an older, more experienced man being able to swing it, so to speak. But it would also depend on personality. The more type-A, the better, I’d think.
Yes, all those focused, driven, goal-oriented men out there are strong candidates for withdrawal excellence! Sign them up! Get them practicing!
Despite my personal skepticism about the withdrawal method, I commend these researchers for this study. Investigating the success rates of any form of contraception is always a worthwhile pursuit. Women do not have enough reliable methods of contraception available to them, especially in the developing world. We can always use more active inquiry and unbiased studies in this field, even ones that seem counterintuitive and go against long-held judgements.
heh (tmi alert) I’m not surprised
I think that the use of condoms which prevent stds vs. withdrawal which does not, ought to be stressed in sex ed classes.
But I don’t think that withdrawal as a pregnancy preventative should be avoided as a topic in these classes because there is a possibility of abuse.
In general I think that students should be armed with all the information we have, in this topic and in all others. Holding back information that the public, whatever public, can’t absorb is the kind of patronizing (there’s that root again) logic that I reject.
I know I used it for literally years (along with figuring out my fertile days) with my ex husband and never got pregnant. But it’s the NOT knowing, the stress and strife, every month, that I would have with a monogamous boyfriend, (now that I am done with kids), that would wreak havoc on my brain and peace of mind.
And not all guys are good at it.
I can’t say I haven’t employed it, but I really really wouldn’t recommend it.
The troubling thing about teens is that they’re the ones who are probably most likely to use withdrawal, because they’re embarrassed about getting condoms or BCP, or because the excitement-newness-willingness to get carried away means that they’re less likely to correctly use the contraceptive devices at hand.
This info has been on Planned Parenthood’s website for quite a while, but I was also surprised at how effective it is.
From a public health perspective, I think it’s good to get this information out there for people who, for financial, cultural, or religious reasons, don’t find condoms feasible.
Also, since some men find this sexy (did porn actually do something good for us?) it can be easier for women to negotiate than condom use, and it does reduce (not prevent)STD transmission at the population level.
I think the key is doing it correctly, just like with the Pill and condoms.
I think more information can never be a bad thing and I think it’s great to discuss different methods of contraception with sexual partners and work out which is right for you. But DISCUSS is the key word for me here. If PhDork’s suspicions are correct and withdrawal is being used in lieu of other forms of birth control out of embarrassment then that is a dismaying thought. I’m of the opinion that if you can talk comfortably about safe sex then you shouldn’t be doing it regardless of you contraceptive choices.
La sooz – It’s not called the pull and pray method for nothing!
I’ve used it, it’s worked, but I chalk that up more to dumb luck and statistics than anything scientific.
This is a surprising and interesting study. Personally, I’m a big fan of withdrawl used in conjunction with other BC methods (condoms, pill, ring, etc.).
Actually, I was getting this information in my sex-ed classes 10 years ago. And I was appalled they would even suggest it. (Guess I was wrong.)
kyley – this is a bit of a personal question so do tell me to bugger off if you want, but why do you use withdrawal if you’re also using other birth control? I feel very naive asking!
Right, I mean, it’s Type A people who are best at withdrawal it’s Type B people like me who use it because we are too lazy and disorganized to keep up with pills and condoms and too lacking in discipline to let a little thing like that stop us from having sex. I haven’t been pregnant either but I don’t kid myself that it’s not dumb luck.
I’m with Rodriguez that the whole sexual disease thing should be a focus.
Other than that – I always used condoms (i’ve never gone on the pill due to the whole migraine/strokes issue) but I will say that I have largely used withdrawal with my husband and we had no pregnancy scares at all during the time we were using it (in that my children while not exactly planned meticulously were sort of the result of a laissez faire lets stop practising this and see what happens approach). On the other hand I’m with JD Regent, those non pregnancy scares, they were probably dumb luck.
Oh, the joys of menopause!
First – thanks, Becky for alerting the world to this research! I think it’s fascinating, of course.
Second, one of my favorite parts of the article is this:
“Still, Ms. Kempner said: “It has made some classroom teachers nervous to give out the truth in this instance, but we do have to tell the truth. People, kids in particular, they’re using it. It is better than nothing, and it is always available. You can’t say, ‘Oh, I didn’t have one.’ ”
Whereas I’d like to stuff condoms into every teenager’s pockets and beat them with the knowledge that they really ARE better than nothing (especially for preventing disease!), I also have high respect for kids’ bullshit meters. So I agree that we do have to tell kids the truth. If it can work, even imperfectly, it is an option. Not a smart one if you don’t know your partner really, really well and aren’t willing to risk pregnancy. But lying to kids never works out in the long run.
@mischiefmanager: hey, no gloating!
afteriris: I am only speaking for myself–I’m on BC but sometimes when we’re going somewhere, i dont feel like leaking thru a whole movie or whatever, or maybe I havent had my “turn” yet and he’ll take care of me after he’s done– That is the practical side. The other side is that’s it’s fun to see. Just my opinion however!!
@la sooz: totally agree. Clean-up is way easier and it’s hot to watch! Plus dudes seem to enjoy showing off!