03/30/2012 04:39 EDT | Updated 03/31/2012 09:38 EDT

'Pulling Out' Birth Control The Option Most Preferred By Moms


By Nadia Bruno for

I did some stupid things in my teens and 20s, but having unprotected sex was not one of them. In fact, I was all about doubling up on the protection (pill and condom; condom and foam -- remember foam?). Sure, I had my share of drunken sex and one-night stands. Then, at one point, there was a serious boyfriend whom I thought I’d marry, maybe pop out a couple of babies with one day in the future. Throughout it all, my little purple packet of birth-control pills (Diane-35) lay on the bathroom counter alongside the staples (tweezers, toothbrush, hair straightener). In my mind, birth control was a given. It didn’t matter if you were banging some random frat boy in a dirty bathroom stall – so long as you used protection, you were golden.

Fast-forward two decades and, well, I use the “withdrawal” method (a.k.a. “pull out method” – when a man pulls out before he ejaculates). I say this sheepishly because, back in the early 90s, I would have judged anyone who actually considered “pulling out” to be a form of birth control. I would have called them stupid and naive. Because, really, you’re going to trust a 20-something guy not to come inside of you each and every time you have sex? What if he’s drunk? Or lazy? What if he miscalculates? (One woman I know got pregnant after her no-strings-attached ‘f*ck buddy’ pulled out a bit too late; she had an abortion.) In other words, it’s risky. And it’s been a long controversial of method of birth control even among the medical community for as long as I can remember.

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Now that I’m married with kids, birth control is the last thing on my mind. It shouldn’t be, but it is. My story is similar to so many moms I know. It goes a little something like this:

  • Get boyfriend, go on pill.
  • Think about starting a family, go off pill.
  • Get pregnant!
  • Have baby, use condoms, realize condoms suck.
  • Figure pull-out method is fine (if you have a little “oops,” oh well).
  • Get pregnant!
  • Have baby #2, stop having sex altogether.
  • Get tipsy one night, realize halfway through intercourse that you’re not using any birth control, whisper to partner to “please pull out.”
  • Continue with this method for years and years. Add IUD and/or vasectomy to your giant to-do list.

This sums up my life and pretty much the lives of all 30- and 40-something moms I spoke with for this piece. In fact, the pull-out method is quickly becoming mom’s preferred method of birth control. These are women who have no desire ever to use a condom again – “Condoms are for kids,” is what they say – but who don’t like the permanency of a vasectomy, or the invasive nature of an IUD. In some cases, they’re not opposed to either but simply haven’t found the time (as in, they’re not making it a priority).

Most women I know – and many doctors, too – don’t consider the withdrawal method to be all that effective. That’s why so many were reluctant to admit it’s their form of birth control (one went so far as to say she’s “ashamed” and declined to be interviewed for this story). In 2009, a team of researchers published a report – based on several studies and data from the Guttmacher Institute – suggesting that the withdrawal method of birth control is nearly as effective as condoms in preventing pregnancy. They got a lot of criticism at the time, but lead researcher Rachel K. Jones stands by her claims. She found that in perfect use (meaning the man pulls out every time), withdrawal has a 4% failure rate as compared to condoms, which have a 2% failure rate.

"Although withdrawal may not be as effective as some contraceptive methods, it is substantially more effective than nothing," Jones said the report. "It is also convenient, requires no prior planning and there is no cost involved."

When I went to my own six-week doctor’s appointment post-baby – you know, the one where they examine you and then give you the green light for sex – she asked what I planned on using for protection. “Huh?” I asked her. “What form of birth control will you be using?” she asked again. “Abstinence,” I said deadpan (I really meant it at the time!). She laughed and sent me on my way, shouting down the hallway, “Remember, you can get pregnant while breastfeeding!”

Interestingly, at least a handful of women I interviewed lie to their doctors when asked about birth control (they know they’ll get lectured if they admit withdrawal). One 34-year-old mother of two, Laura, cut her doctor off mid-sentence when he inquired about birth control. “We use condoms!” she lied as he went on about IUDs. He even encouraged her to go on the pill, but she’d have none of it.

“I didn’t want to gain any weight on the pill and besides, I had been on it twice before and never liked how I felt on it or what it did to my body,” she said. “And, the truth is, we rarely have sex. When we do, withdrawal works.”

Laura knows in her gut that if she “accidentally” got pregnant again, she’d be fine with it. She’s happy with two kids and doesn’t plan to have any more, but she says she wouldn’t freak out if she found herself pregnant with baby number three. Which helps explain why she’s so lax about a method that she doesn’t fully trust. (Like me, she was on the pill for most of her 20s – and she never, not once, had sex without a condom. Now she could care less.)

But some women trust it wholeheartedly. Like Amy, a 40-year-old mother of three who, despite being “done,” puts her faith in the pull out method. It’s somewhat ironic, given that she had an unwanted pregnancy in her 20s thanks to a guy who didn’t pull out in time. But Amy trusts her husband like no other and, besides, she says a man in his 40s has the self-control to do it right (unlike those in their 20s). “It’s a no brainer for them,” she insists. “Plus, he [my husband] is a good puller-outer.”

“I trust that it works and I don’t even think about it anymore,” Amy says, then proceeds to tell me about her closest girlfriend who, at age 44, had a major “oops” and got pregnant when her youngest (of four) was already 10 years old. “I’m an idiot because I know that could happen to us,” she says upon further reflection. Still, she says she’ll continue with withdrawal until her husband gets a vasectomy (which may be never, she explains, since he claims to be too busy; she knows it’s because he’s nervous).

Sasha, 38 years old and a mom of two school-aged children, is also “not okay” with having another child. And while she knows that the withdrawal method isn’t full-proof, she’s using it anyway.

“I’m just decidedly ignorant,” she tells me. “Though I’m no more willing to have a baby now than I was 20 years ago. It would be incredibly tragic if I got pregnant – I’d probably have an abortion – yet I still use this method of birth control because it’s always served me well.”

When Sasha told this to her GP, she’d get lectured. She finally started lying “just to get her off my back.” Her doctor was not impressed. “Well, I hope you’re on folic acid,” she’d tell Sasha sternly. Deep down, Sasha knows it’s not full-proof and she’d like her husband to get a vasectomy one day (but like Amy’s husband, he’s anxious about the procedure and keeps putting it off). Until then, it’s a risk she’s willing to take.

“It’s like breastfeeding: you don’t have to buy anything, spend money, lug anything around or prepare in any way,” she says of withdrawal.

“And, besides, we all pick and choose what conveniently works with our egos.”

UPDATE: The wording in this article has been changed. It previously contained words deemed counter to our editorial policy.