Pull Out Method

What is the pull-out method (withdrawal)?

With the pull-out method, your partner pulls their penis out of your vagina and away from your genitals (vulva) before ejaculating. During ejaculation, sperm gets released from the penis in a fluid called semen. The pull-out method is also called coitus interruptus or the withdrawal method.

Pulling out is less effective than other types of contraception (IUDs, birth control pills, condoms, etc.). It doesn’t offer protection from sexually transmitted infections (STIs) as condoms do.

Still, the pull-out method is better than no birth control if you want to have sex, but you want to reduce your chance of pregnancy.

How does the pull-out method work?

Your partner’s sperm has to travel from your vagina (where your partner ejaculates semen) to your fallopian tubes for you to become pregnant. Fertilization happens in the fallopian tubes.

With the pull-out method, your partner’s penis is in your vagina until before ejaculation. Your partner withdrawals their penis so that the semen remains outside your body. The goal is to prevent sperm from reaching your vaginal canal so sperm can’t make the journey to your fallopian tubes.

How effective is the pull-out method?

The pull-out method is about 80% effective. About one in five people who rely on the pull-out method for birth control become pregnant.

What is the likelihood of pregnancy if my partner pulls out?

In the best-case scenario, where your partner pulls out on time, the pull-out method still doesn’t prevent pregnancy 100% of the time.

The reality is that many things have to go perfectly for best-case scenarios. Even if you’ve used the pull-out method for years and have avoided pregnancy so far, there’s no guarantee that the next time won’t lead to pregnancy. All it takes is one slight miscalculation on your partner’s part.

How does the pull-out method fail?

There’s a lot of room for error with the pull-out method.

Getting the timing wrong

It can be difficult to pinpoint the exact moment when ejaculation will happen. Usually — but not always — ejaculation happens right before orgasm, at the height of sexual pleasure. It can be challenging to switch on the logical part of the brain that says, now’s the time to pull out, when the pleasure is most intense.

If your partner isn’t sexually experienced, they may not be familiar enough with their bodies to know when they’ll likely ejaculate. Even with experienced partners who can usually predict when they’ll ejaculate, distractions like stress or the influence of alcohol can lead to mistakes.

Getting the timing just right is always a gamble with the pull-out method.

Pre-ejaculate fluid containing sperm

Sperm can still enter your body even if your partner pulls out on time. Before ejaculation, your partner releases a pre-ejaculate fluid that may contain sperm. This fluid doesn’t have as much sperm as semen, but it may still contain sperm. Pre-ejaculate that contains sperm can get you pregnant if the fluid enters your body.

Semen on or near your vulva

Semen on your upper thighs and genitals can potentially cause pregnancy, too. Your partner may pull out in time to keep sperm from entering your vagina. In the process, the fluid can land on your genitals (vulva) or upper thighs. Sperm are excellent swimmers. If there’s a fluid passageway leading from your genitals or thighs to your vagina, sperm can make the journey.

What are the disadvantages of the pull-out method?

The pull-out method isn’t a reliable form of birth control. In addition to the biological reasons that cause pulling out to go wrong, the pull-out method:

• Places the responsibility of birth control onto the partner with zero pregnancy risk. With the pull-out method, you have no control over your likelihood of becoming pregnant. If your partner gets the timing wrong or decides not to pull because the sex feels too good, you’re the one who could become pregnant.
• May make sex more stressful. Even if your partner does their best to pull out in time, things can always go wrong. The pressure to pull out can make sex a more stressful, high-risk situation than if you were using more reliable birth control methods.
• Doesn’t remove the need for reliable contraception. If you suspect that semen entered your vagina, you’ll need to locate emergency contraception. Using an effective form of birth control upfront may be less stressful than finding emergency contraception because something went wrong.
• Doesn’t provide STI protection. Unlike condoms, the pull-out method offers zero protection against STIs transmitted through body fluids, like trichomoniasis, chlamydia and gonorrhea.

Why do people use the pull-out method?

Despite the risks involved, many couples still rely on the pull-out method for various reasons:

• It eliminates the need to research and choose more effective contraceptives.
• Couples may be unaware of more effective birth control options (like LARCs or birth control pills).
• Couples may object to birth control that involves devices, pills, injections or patches.
• The pull-out method preserves the spontaneity of sex. You don’t have to locate protection right when things are starting to heat up.
• There’s no risk of non-pregnancy-related side effects, as with some birth control options.
• You can have sex even if you forget birth control.

Some people use the pull-out method with other forms of birth control as an added safeguard to prevent pregnancy.

How should you use the pull-out method?

If you decide to use the pull-out method, try the following to improve its effectiveness.

• Use an additional form of birth control. Using the pull-out method with another form of birth control is the best way to reduce your chance of pregnancy. Long-acting reversible contraception (IUDs and implants) is 99% effective at preventing pregnancy. Birth control pills are about 96% effective. When factoring in user error, condoms prevent pregnancy about 85% of the time. Using spermicides and contraceptive gels in addition to the pull-out method also decreases your likelihood of becoming pregnant.
• Don’t attempt the pull-out method around ovulation. You’re most likely to become pregnant in the days leading up to and during ovulation (when your body releases an egg). For reference, most people ovulate about halfway through their menstrual cycle (2 weeks before your period). Use an ovulation calendar to track your most fertile days. Definitely don’t attempt the pull-out method around this time.
• Have your partner pee before sex. Peeing before sex can help your partner get rid of pre-ejaculate fluid that may contain sperm. It doesn’t guarantee that sperm won’t enter your body through pre-ejaculate fluid, but it reduces the risk.
• Keep emergency contraception on hand. Plan for worst-case scenarios if you’re using the pull-out method. Emergency contraception, like the morning-after pill, can prevent pregnancy if taken within five days of intercourse. It’s a good idea to have some available if you’re relying on the pull-out method.

A note from Cleveland Clinic

The pull out method is better than no birth control at all if you’re trying to prevent pregnancy. Still, it’s important to know the risks. There’s a one in five chance you’ll become pregnant if you’re not pairing the pull-out method with a more effective form of contraception. You’ll still need to protect yourself against STIs. Weigh the pros and cons of using the pull out method against other birth control methods with a healthcare provider.