If you aren't hankering for a baby any time soon, you may have tried different birth control options on for size. Although no technique is 100 percent infallible, modern medicine has ensured that you have plenty of choices, from the IUD to the Pill to the female condom. But maybe you're considering going au naturel and trying the pull-out method—also known as the withdrawal method—instead. The technique hinges on a guy pulling out of the vagina before he orgasms. No hormones, no latex, no problem, right? Wrong. Here, ob/gyns explain why the pull-out method might as well be called "baby roulette."
"[The pull-out method] has risks that are greater than a woman who really doesn’t want to get pregnant should take," Hilda Hutcherson, M.D., professor of obstetrics and gynecology at Columbia University Medical Center, tells SELF. It's just not reliable—22 out of every 100 women will experience an unintended pregnancy in the first year of typical use of the pull-out method, according to the Centers for Disease Control and Prevention. For comparison's sake, 18 women will get pregnant within the first year of typical use of male condoms, nine will on the Pill, and less than one woman will while using an IUD. Why the difference? Because the pull-out method is so damn easy to screw up.
Hutcherson has seen women in her practice get pregnant after relying on pulling out, sometimes because "during the throes of orgasm and ejaculation, men pull out too late," she explains. "Other women have told me they lost control and pulled the guy in, not realizing he was about to come." Even if the guy pulls out, if he ejaculates in the immediate vaginal vicinity, there's still a risk of some getting inside the vagina and causing pregnancy, explains Idries Abdur-Rahman, M.D., a board-certified ob/gyn.
And there’s the question of pre-cum. Although controversy surrounds whether there's technically sperm in pre-ejaculatory fluid, many ob/gyns agree that sperm sometimes ends up in it, at the very least because it may be in a guy's urethra after earlier ejaculation. "The majority of sperm is released during ejaculation, but while the number of sperm is less in pre-ejaculatory fluid, they can definitely be there," Abdur-Rahman tells SELF. So even if you do everything else right, the little guys could make their way up there anyway.
Some people swear by pulling out when used in conjunction with fertility-awareness based methods, meaning a person who menstruates tracks their cycle and only has sex when they're least likely to be fertile. But there's a major issue here: "It's always possible to ovulate when you're not expecting it, especially when you're young," says Hutcherson. "It's not 100 percent, so you're still taking a chance."
Combined with the fact that sperm can live for up to five days in a woman's body, you can technically get pregnant at any time—including during your period. (And FYI, on their own, fertility-awareness based methods are even less effective than the pull-out method, with 24 out of every 100 women getting pregnant within a year of typical use, says the CDC.)
Its less-than-perfect pregnancy prevention is one thing, but the pull-out method is worthless when it comes to sexually transmitted infections. "Some STIs just require skin-to-skin contact [for transmission]—obviously pulling out does nothing for that," says Abdur-Rahman. "And even for STIs that do require bodily fluids, all of those pre-ejaculatory fluids can still have bacteria and viruses as well," as can vaginal fluids, says Abdur-Rahman.
"If a woman is having sex, it should be without anxiety about pregnancy or a sexually transmitted infection," says Hutcherson. "Many women practicing this method aren't able to enjoy it because they're surveying the man's response to make sure he pulls out in time—they can't focus on their own pleasure. Unless there’s some really good reason why someone is doing this rather than using other methods of contraception that are better at [pregnancy prevention], I just don’t think it’s something people should do."
