Can We Stop Shaming Women Who Practice Withdrawal Now?

Rachel K. Jones of the Guttmacher Institute has written a piece for the magazine Contraception encouraging health educators to consider talking to people about withdrawal and its effectiveness as a method of birth control.

In fact, it’s not as ineffective at preventing pregnancy as we might think.

The best available estimates indicate that with “perfect use,” 4% of couples relying on withdrawal will become pregnant within a year, compared with 2% of couples relying on the male condom. More realistic estimates suggest that with “typical use,” 18% of couples relying on withdrawal will become pregnant within a year, compared with 17% of those using the male condom. In other words, with either method, more than eight in 10 avoid pregnancy.

So, if it’s just pregnancy we’re concerned with avoiding, it’s actually not the worst choice.

Which is a fact not lost by the majority of women who have used it at one time or another.

A majority of sexually experienced women rely on withdrawal at some point in their life-56%, according to the 2002 National Survey of Family Growth. (By comparison, 82% have ever used the pill, and 90% the male condom.)

Notice, please, that it doesn’t say that the majority of women have used it in monogamous relationships (or that women who rely on hormonal birth control use condoms for that purpose). But there is often a lot of finger-pointing at women who practice withdrawal, as though they’re just playing Russian roulette with their reproductive systems, despite this fact:

A smaller study, the Women’s Well-Being and Sexuality Study, found that 21% of younger and more educated women were using withdrawal.

So you can be smart and educated and practice withdrawal?

In fact, women who practice withdrawal aren’t the only ones taking pregnancy tests — and they’re not even the majority.

However, only 5% of women at risk of unintended pregnancy currently use the method (11% when those who use it in conjunction with another method are included).

Jones thinks it’s time to stop utterly stigmatizing women who practice withdrawal.

Also, we’re hearing anecdotally that because of the current economy, fewer women are able to afford these more effective methods, yet many cannot afford to have another child right now. For these couples, withdrawal may be a good backup option when used in conjunction with condoms. Withdrawal can provide ‘extra insurance’ against pregnancy for all couples, even those using hormonal methods. And withdrawal is far more effective at preventing pregnancy than use of no method at all.

She’s not, however, advocating that everyone use it, or use it instead of more effective methods of birth control (and actually-effective methods of disease-prevention, like condoms). She’s just suggesting that health providers start talking about it in a scientific fashion with their patients, and that they stop telling women who use it that they might as well use nothing at all — which is both inaccurate and unhelpful.