The pull-out method is one method people use to prevent pregnancy, but does it work?
The pull-out method involves a male sexual partner removing their penis from the vagina before ejaculating. This aims to prevent pregnancy by not allowing sperm to the vagina and reaching an egg.
According to Planned Parenthood, this method is less effective than other types of birth control but is better than not using anything at all. When a person uses it perfectly every time, it can be relatively effective.
This article looks at how effective the pull-out method is for preventing pregnancy and the reasons why. It also compares this method with other birth control methods.
According to the Office on Women’s Health (OWH), around 22% of some (approximately 1 in 5) will get pregnant each year using the pull-out method. This is similar to a pregnancy rate of about 18% with the common use of condoms.
However, when used perfectly every time, the World Health Organization (WHO) estimate that 4% of people using the pull-out method will become pregnant. This is similar to condoms, which have a 2% chance of pregnancy when used perfectly.
Some people prefer to use the pull-out method because it allows full sensation; it is free and non-permanent, unlike some other forms of contraception that are expensive and require prescriptions or medical procedures.
In reality, it is difficult to use withdrawal perfectly. As with many other types of birth control, human error makes it less reliable.
For the pull-out method to be effective, the male must know precisely when they will ejaculate, and be able to withdraw before. This can take practice. Practicing when masturbating or using condoms during sex can help.
It can also be tricky because the pull-out method may reduce physical pleasure or make it more difficult for one or more of the sexual partners to reach climax. That means that some people may be reluctant to pull out before ejaculating or feel tempted to cut it close with their timing.
To be effective, all sexual partners must make sure that no semen comes into contact with the vagina or vulva. This includes when cleaning up after ejaculation, and people must make sure to clean their hands and penis before any further sexual activity.
Substances such as alcohol or drugs can also reduce a person’s reaction time, making it harder to judge the timing.
Many people wonder whether the pull-out method works, even when performed properly because pre-ejaculate or pre-cum still enters the vagina. This refers to the fluid that leaves the penis before ejaculation.
This is a very common question. In fact, one study reports that around half of the email questions an emergency contraception website received in one year asked whether pre-cum could cause pregnancy.
According to the OWH, some sperm may still leave the penis before withdrawal. They say that pre-cum may contain sperm. If it does, the female could become pregnant.
However, there is some scientific debate over whether pre-cum contains viable sperm. Only a few studies have looked into it, and the results tend to be inconsistent. This is likely due to the differing collection methods, sample populations, and small numbers of participants.
According to an article in Human Fertility, the function of pre-cum is to lubricate the genitals and help create safe pH conditions for semen to travel through later. The Cowper’s glands and the Glands of Littre produce it, not the testes, so technically, it should not contain sperm.
An earlier 2003 study that examined pre-cum samples from 12 males and reported that no samples contained active sperm.
However, a 2010 study found that pre-cum samples from 11 out of 27 healthy male subjects contained sperm, 10 of which contained mobile or viable sperm.
A 2016 study also found active sperm in 16.7% of pre-cum samples from 42 healthy males. However, the authors note that samples may have become contaminated during collection.
In summary, some experts believe that pre-cum should not contain sperm, but that it may contain a small, viable amount under some circumstances. Unfortunately, there is currently no easy way to test the sperm content of pre-cum.
The risk of pregnancy from intercourse depends on several factors aside from birth control.
According to an article in Best Practice & Research Clinical Obstetrics & Gynaecology, having sex more often is the most significant factor that increases the chances of pregnancy in people using birth control correctly and consistently.
Pregnancy risk also heavily depends on whether the female is ovulating. Female fertility changes throughout the menstrual cycle, and they are most likely to get pregnant around ovulation, known as the fertile window.
It is a good idea to keep emergency contraceptives, also called the morning-after pill, on hand in case the primary method of contraception fails. They are most effective within 3 –5 days of having sex without using contraception.
The pull-out method does not prevent sexually transmitted infections (STIs). Using barrier protection, such as condoms, is a good way to protect against STIs.
According to research in the journal Contraception, most Americans will use the pullout method once in their lifetime. According to some estimates, 60% of American women aged 15–44 have used the pull-out method at some point.
In a 2014 study, most people who occasionally used the pull-out method also used other forms of birth control.
Another 2014 study that surveyed more than 4,600 American women found that only 12% of women who used the pull-out method did not use any other method of birth control.
These findings suggest that people may use the pull-out method as a back-up birth control method or in conjunction with other methods to further reduce their risk of pregnancy.
When looking at statistics and other information about the withdrawal or pull-out method, it is important to remember that there is very little research on the topic.
According to the article in Best Practice & Research Clinical Obstetrics & Gynaecology, this gap in contraceptive research likely exists because, unlike many other forms of contraception, the method carries no clear financial rewards. Most research investigating contraception methods are carried out by companies working to develop products or receive approval for them.
The effectiveness of different birth control methods varies between types and whether people use them correctly and consistently.
According to the WHO and other sources, the following table provides the effectiveness of different birth control types based on perfect use and common use.
|Method||Effectiveness with perfect use||Effectiveness with common use|
|Combined oral contraceptives, or “the pill”||> 99%||92%|
|Progesterone only pills, or “the minipill”||99%||90–97%|
|Hormonal implants||> 99%||> 99%|
|Progesterone-only injectables||> 99%||97%|
|Monthly injectables or combined injectables (CIC)||> 99%||97%|
|Copper intrauterine device (IUD)||> 99%||> 99%|
|Hormonal IUD with levonorgestrel||> 99%||> 99%|
|Diaphragm or cervical cap||77–83%||88%|
|Male sterilization (vasectomy)||> 99% after 3 months semen evaluation||97–99% without semen evaluation|
|Female sterilization (tubal ligation)||99%||99.5%|
|The pull-out method||96%||73%|
|Tracking fertility cycles (the standard days method, or SDM)||95%||88%|
|Body temperature tracking||99%||75%|
According to Planned Parenthood, the pull-out method is less effective than some other types of birth control but is better than not using anything at all.
When used perfectly, it can be relatively effective. However, it is difficult to use perfectly. An estimated 1 in 5 people using this method will get pregnant in a year.
While many people use the pull-out method, most also use other back-up contraception methods.
When choosing which method of contraception to use, people can speak to their healthcare provider the benefits, risks, and costs of each.