The pull out (or withdrawal) method is a way to prevent pregnancy by keeping semen away from the vagina at the climax of sexual intercourse (1, 4). You can consider the name at face-value, since pulling out is essentially withdrawing the penis from the vagina before ejaculation occurs. Learn how effective the pull out method really is, and how to practice it safely and properly.
The withdrawal method is about 88% percent effective for pregnancy prevention
According to Planned Parenthood, the effectiveness of the pull out method depends on executing it correctly each time you have sex. If you are able to keep any ejaculate (cum) away from the vagina during and after intercourse, the pull out method will be effective at preventing pregnancy. Only 4% of couples who use the pull out method perfectly every single time will get pregnant.
But in truth, nobody is perfect, and it can be difficult to pull off withdrawal with 100% accuracy every time. So in reality, about 22% of people who rely on the pull out method will get pregnant every year (2).
The pull out method is not effective in preventing STIs
While the withdrawal method can reduce chances of pregnancy, it can’t be counted on to prevent STIs (1). This is because many STIs are spread through skin-to-skin contact. Think: genital warts or herpes. If you want to utilize the pull out method while preventing STIs, use condoms too (5). The pull out method can, however, reduce the risk of HIV as HIV can be transmitted through bodily fluids such as semen, vaginal or anal fluids, breast milk, and blood.
How does the withdrawal method work?
If you have a uterus and semen gets in your vagina, you might get pregnant. Ejaculating away from the vulva or vagina, or pulling out, can reduce the chances of sperm fertilizing an egg (1, 2, 4). If you’re using the withdrawal method, the penis needs to be all the way out of the vagina prior to climax, and any ejaculate needs to be aimed away from the vagina. While it sounds simple enough, it can actually be hard to do it right every single time, and it requires a lot of self-control.
To rely on the pull out method, the partner who has a penis must be willing to stop before cumming. This is usually when inhibitions are the lowest, and arousal has a significant effect on good decision-making (6).
For most people, ejaculation comes hand in hand with orgasm, but this is not the same for everyone (7). In order to use the pull out method properly, you have to know your body’s sexual responses well enough to know exactly when semen will come out of your penis. If you’re concerned about your ability to understand your body, or knowing the signs an orgasm is impending so you have time to pull out, masturbation can be a great way to get to know how your body signals you’re about to ejaculate. You can also practice the withdrawal method using a condom, to reduce margin of error without one.
3 reasons the withdrawal method can fail
Here are three factors to be aware of that may cause the withdrawal method to fail and lead to pregnancy. Remember that while the pull out method may reduce the risk of HIV transmission, it is not effective in preventing STIs.
1. The penis isn’t pulled out at the time of ejaculation. While the withdrawal method can be highly effective, it’s difficult to practice it perfectly every single time. If a person ejaculates viable sperm into the vagina, it can lead to pregnancy (2, 4).
2. There may be viable sperm in precum. Precum, or Cowper’s fluid, is a small amount of ejaculate that is produced from the penis when a person is aroused. People with a penis may not even realize they’re making precum, since no physical sensation signals its release, and there is no control over the production of it. While it’s possible for some people’s precum to have no sperm, in others, precum presents sperm capable of fertilizing an egg. There is no way to tell if you or your partner has sperm in their pre-ejaculate, and because of this, inserting an unprotected penis into a vagina even before proper withdrawal carries the chance of pregnancy (8).
Additionally, STIs like chlamydia, syphilis, and gonorrhea can be spread through precum. Keep this in mind, as the pull out method won’t be effective in preventing these diseases from spreading.
3. Ovulation during intercourse. Finally, the withdrawal method can fail if the partner who has a uterus is ovulating at the time of intercourse. When using the pull out method as your primary form of birth control, it’s smart to use an ovulation calendar to chart your cycle, and be prepared to incorporate another method like condoms or a spermicide when you think you might be ovulating. Even with perfect tracking and a regular cycle, sperm can live inside the uterus for up to five days, so if you’re looking to prevent a pregnancy, stay extra conscious about how you use birth control on the days before and after ovulation too (9).
Consider additional precautions to prevent pregnancy
One advantage of the pull out method is that it can make other forms of birth control more effective. For example, incorporating the pull out method while using condoms will lessen the likelihood that you’ll become pregnant. If you don’t plan on using condoms, it’s a good idea for anyone with a uterus to explore other forms of birth control, to supplement consistent use of the withdrawal method. When you’re planning on withdrawal as your first defense, consider having an emergency contraceptive, like Plan B, on hand in case of any mistakes (10).
Pros and cons of the withdrawal method
Depending on your situation and preferences, the pull out method may be a solid birth control option (2). For others, another method might feel right. Consider the pros and cons of using withdrawal below:
The bottom line
The pull out method is accessible, reliable, and works as a birth control method if you’re on top of tracking your cycle and have perfect execution every time. If you don’t want to count on perfection to prevent a pregnancy, however, you may want to consider boosting the pull out method’s chances by using condoms, or using another type of birth control. Remember, there is no evidence the pull out method prevents the spread of STIs, so be sure you and your partner(s) get regularly tested or also use condoms. To explore other contraceptive options read our guide on birth control.