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'Pulling Out': Iffy Birth Control Plan Still Popular

A third of women at risk for accidental pregnancy have used the withdrawal method, but most combine it with other forms as a backup for birth control.
Sperm all swimming in one direction.
A new study finds that 30 percent of women have used the withdrawal method of birth control in the past month, but most combine it with other forms of contraception to make sure to avoid having babies.Doug Struthers / Getty Images Stock

A third of women at risk for accidental pregnancy have used the withdrawal method of birth control, a new study finds — but hold off on the coitus interruptus jokes.

It turns out that pulling out during sex is often a strategy for extra protection against pregnancy — not less — used by couples most motivated not to have a baby, according to Rachel K. Jones and other researchers at the Guttmacher Institute.

“Most people using withdrawal are also using another method, or ‘doubling up,’” said Jones, whose study was published Friday in the journal Contraception.

Sperm all swimming in one direction.
A new study finds that 30 percent of women have used the withdrawal method of birth control in the past month, but most combine it with other forms of contraception to make sure to avoid having babies.Doug Struthers / Getty Images Stock

Using an analysis of national survey data from 3,276 women aged 18 to 39 in 2012, Jones and her colleagues found that 33 percent of participants had used the withdrawal method at any time in the past 30 days.

Of those, about 12 percent used only withdrawal to prevent pregnancy. Most women who used withdrawal combined it with other methods, such as birth control pills or condoms, sometimes simultaneously and sometimes in rotation, the study found.

Among younger women in the survey aged 18 to 24, slightly more than 40 percent had used withdrawal to avoid pregnancy in the past month, but only 10 percent relied on it as the sole form of birth control, the researchers found.

“Women in dating relationships and those strongly motivated to avoid pregnancy also had some of the highest levels of combining withdrawal use with condoms or highly effective methods,” Guttmacher officials said.

The new study counters previous national research that found that while nearly 60 percent of women had ever used withdrawal, only 3 percent were currently using it. That might be in part because many people previously surveyed didn’t regard withdrawal as a “real” or effective method of birth control, and so didn’t report it.

Jones and her colleagues constructed the survey differently, making sure to include withdrawal first in a list of birth control options and to allow reporting of mixed methods of pregnancy prevention.

The findings suggest that far more women rely on withdrawal as primary or back-up birth control, indicating that health care providers should discuss its use more thoroughly, Jones said.

Pulling out is about as effective as condoms for preventing pregnancy, with a failure rate of 4 percent compared to 3 percent for condoms, the study reported. Couples should understand that — and that withdrawal doesn’t protect against sexually transmitted infections.

“Increased awareness of the pros and cons of withdrawal has the potential to result in lower contraceptive failure rates,” they wrote.