The One Birth Control Method No One Wants to Talk About
"I used to gamble on not getting pregnant... well, pretty much every time I had sex for about a decade," my 30-year-old friend, Kelly*, told me recently over drinks. "I don't think it's necessarily stupid to, if your partner knows his own body and you keep track of your period.
"But I'm not exactly a public advocate for pulling out," she added, "because I can't say I've always been careful. And I definitely know better than I act."
Welcome to the club. According to a recent report from the Centers for Disease Control and Prevention, nearly 60% of sexually active teenagers reported using the withdrawal method as a form of birth control. As one expert explained to the Huffington Post, the stats indicated a need for more condoms handed out at high schools and more education for young people. But teens aren't the only ones pulling out — and they're not likely to stop once they reach adulthood.
According to a recent Mic poll of 90 millennial men and women, plenty of people are still using the pullout method well into adulthood. While many use it as a secondary form of birth control in conjunction with hormonal contraception or condoms, there are those of us who are ashamed to admit to using it — because we did it when we were drunk, or when we couldn't remember our last few periods, or when we were just too damn lazy to go buy condoms.
But by staying silent and shaming ourselves for using the pullout method, we perpetuate stigma around something most of us have done more than once — and we shouldn't feel quite so bad about doing it.
More effective than we think: As a form of contraception, the pullout method isn't simply "better than nothing," as it's so often portrayed. A study by the Guttmacher Institute found that barrier methods were only slightly better at preventing pregnancy than withdrawal, even when considering typical use.
"People call it the 'pull-and-pray' method, but what we found is that if you look at efficacy, or effectiveness, withdrawal is only slightly less effective than condoms," Rachel K. Jones, the study's lead author, told Mic.
"Perfect use for condoms has a 2% failure rate; it's 4% for withdrawal. With typical use for condoms, the failure rate is 17% percent, and with withdrawal it's 18%."
Jones said many young people don't even consider withdrawal a form of contraception, viewing it instead as a last resort or a method to be combined with some other form of birth control. That's why she says estimates for how many couples actually rely on pulling out regularly are likely low. But the CDC estimates that roughly 60% of women have used withdrawal at some point, and about 10% of couples pull out in addition to another form of birth control.
Some of Jones' participants alternated between using condoms and the withdrawal method. Others used the withdrawal method with hormonal birth control. Pulling out without another form of contraception, however, is often perceived as risky.
Several people told Mic that they didn't feel comfortable admitting to pulling out, even when they were doing so with another form of contraception or with a long-term partner.
"When my boyfriend and I first started dating, I tried to put my foot down about the 'condoms every time' thing. But then we forgot the condom once, and then the next time, and then again, and then we dropped the illusion altogether," Alexandra*, 23, told Mic. "If I wasn't on birth control, I'd be worried. Of course, any time my friends bring up pulling out, I enthusiastically chime in with condemnation. Denial, denial, denial."
Shaming ourselves means shaming others. Denying that we've used the pullout method — whether we did it "recklessly" or not — contributes to the widespread myth that only dumb teenagers do it, a sentiment that appeared again and again in the experiences people shared with Mic.
"Among friends I was severely embarrassed to admit my partner and I relied on this method," Elyse*, 24, told Mic. "It seems very adolescent and somehow gross to discuss, but it did not feel that way in practice."
As Ann Friedman noted for the Cut, there's a sizable subset of young women (whom she deems the "pullout generation") who are tired of taking hormones and find withdrawal more appealing. These women are "sick of supposedly egalitarian relationships in which they bear the sole responsibility for staying baby-free," Friedman writes, and so they're choosing an option that requires some male responsibility.
"They know when to make him put on a condom," Friedman writes. "Plus, they can keep a packet of Plan B on hand at all times, ready and waiting should anything go awry. So it makes a certain amount of sense that, for these women, the pullout method is looking more like a legitimate contraception option."
The notion that well-informed adults don't pull out isn't just inaccurate. It also shames us into silence and stupidity. Characterizing withdrawal as inherently bad or useless doesn't stop people from using it to prevent pregnancy. It just makes us feel like crap about our decisions.
But even when people believe pulling out is "stupid," and even when they consider themselves educated about other methods of contraception, they still make of-the-moment decisions they're afraid to confront. Several people self-identified as hypocrites.
"It's a decision I've made in the moment each time, and it's silly," Jessica*, 21, said. "I'm a strong advocate for sex ed and in the past have worked as a peer activist for it. Having used the pullout method is not something I am proud of."
Sometimes, it's OK to lean in to pulling out. That said, it's an undeniable fact that the withdrawal method has potential consequences. Pulling out can lead to pregnancy if the male partner doesn't pull out in time, nor does it provide any protection against STIs like herpes or HIV. Like all birth control methods, pulling out comes with its own risks, and anyone who says otherwise is being disingenuous.
"It was a stupid and completely understandable argument I fell for with my first boyfriend," Scarlett*, 28, told Mic. "Pulling out resulted in a pregnancy and subsequent abortion. I learned my lesson."
But if a woman's cycle is accurately accounted for, a man is in touch with his own body and both partners have been recently tested for STIs, withdrawal isn't as irresponsible as we might think. Sure, using it requires acknowledging the specific risks and accepting them — but that's the case with all forms of contraception.
When we stay silent about our maybe-not-so-wise forays into pregnancy prevention, though, it makes everyone else who has also behaved maybe-not-so-wisely feel as if they're the only idiots in the room. But shame is never conducive to positive mental health, nor does it help foster an understanding of healthy sexuality.
Talking about the ways we try to prevent pregnancy or even STIs, including withdrawal, forces us to talk about risks with our friends and partners. It can also get us to talk more openly about what feels comfortable for us and what doesn't, about our sexual preferences and the politics of coming, or about what would happen if a pregnancy did occur. Most importantly, it makes us confront all the other messy realities of sex — without shame or stigma.
*Some names have been changed to allow subjects to speak freely on private matters.