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Coitus interruptus
Coitus interruptus, also known as withdrawal, pulling out or the pull-out method, is an act of birth control during sexual intercourse, whereby the penis is withdrawn from a vagina prior to ejaculation so that the ejaculate (semen) may be directed away in an effort to avoid insemination.
This method was used by an estimated 38 million couples worldwide in 1991. Coitus interruptus does not protect against sexually transmitted infections (STIs).
Perhaps the oldest description of the use of the withdrawal method to avoid pregnancy is the story of Onan in the Torah and the Bible. This text is believed to have been written over 2,500 years ago. Societies in the ancient civilizations of Greece and Rome preferred small families and are known to have practiced a variety of birth control methods. There are references that have led historians to believe withdrawal was sometimes used as birth control. However, these societies viewed birth control as a woman's responsibility, and the only well-documented contraception methods were female-controlled devices (both possibly effective, such as pessaries, and ineffective, such as amulets).
After the decline of the Roman Empire in the 5th century AD, contraceptive practices fell out of use in Europe; the use of contraceptive pessaries, for example, is not documented again until the 15th century. If withdrawal was used during the Roman Empire, knowledge of the art may have been lost during its decline.
From the 18th century until the development of modern methods, withdrawal was one of the most popular methods of birth-control practised globally.
Like many methods of birth control, reliable effect is achieved only by correct and consistent use. Observed failure rates of withdrawal vary depending on the population being studied: American studies have found actual failure rates of 15–28% per year. One US study, based on self-reported data from the 2006–2010 cycle of the National Survey of Family Growth, found significant differences in failure rate based on parity status. Women with 0 previous births had a 12-month failure rate of only 8.4%, which then increased to 20.4% for those with 1 prior birth and again to 27.7% for those with 2 or more.
An analysis of Demographic and Health Surveys in 43 developing countries between 1990 and 2013 found a median 12-month failure rate across subregions of 13.4%, with a range of 7.8–17.1%. Individual countries within the subregions were even more varied. A large scale study of women in England and Scotland during 1968–1974 to determine the efficacy of various contraceptive methods found a failure rate of 6.7 per 100 woman-years of use. This was a “typical use” failure rate, including user failure to use the method correctly. In comparison, the combined oral contraceptive pill has an actual use failure rate of 2–8%, while intrauterine devices (IUDs) have an actual use failure rate of 0.1–0.8%. Condoms have an actual use failure rate of 10–18%. However, some authors suggest that actual effectiveness of withdrawal could be similar to the effectiveness of condoms; this area needs further research. (See Comparison of birth control methods.)
For couples that use coitus interruptus consistently and correctly at every act of intercourse, the failure rate is 4% per year. This rate is derived from an educated guess based on a modest chance of sperm in the pre-ejaculate. In comparison, the pill has a perfect-use failure rate of 0.3%, IUDs a rate of 0.1–0.6%, and internal condoms a rate of 2%.
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Coitus interruptus
Coitus interruptus, also known as withdrawal, pulling out or the pull-out method, is an act of birth control during sexual intercourse, whereby the penis is withdrawn from a vagina prior to ejaculation so that the ejaculate (semen) may be directed away in an effort to avoid insemination.
This method was used by an estimated 38 million couples worldwide in 1991. Coitus interruptus does not protect against sexually transmitted infections (STIs).
Perhaps the oldest description of the use of the withdrawal method to avoid pregnancy is the story of Onan in the Torah and the Bible. This text is believed to have been written over 2,500 years ago. Societies in the ancient civilizations of Greece and Rome preferred small families and are known to have practiced a variety of birth control methods. There are references that have led historians to believe withdrawal was sometimes used as birth control. However, these societies viewed birth control as a woman's responsibility, and the only well-documented contraception methods were female-controlled devices (both possibly effective, such as pessaries, and ineffective, such as amulets).
After the decline of the Roman Empire in the 5th century AD, contraceptive practices fell out of use in Europe; the use of contraceptive pessaries, for example, is not documented again until the 15th century. If withdrawal was used during the Roman Empire, knowledge of the art may have been lost during its decline.
From the 18th century until the development of modern methods, withdrawal was one of the most popular methods of birth-control practised globally.
Like many methods of birth control, reliable effect is achieved only by correct and consistent use. Observed failure rates of withdrawal vary depending on the population being studied: American studies have found actual failure rates of 15–28% per year. One US study, based on self-reported data from the 2006–2010 cycle of the National Survey of Family Growth, found significant differences in failure rate based on parity status. Women with 0 previous births had a 12-month failure rate of only 8.4%, which then increased to 20.4% for those with 1 prior birth and again to 27.7% for those with 2 or more.
An analysis of Demographic and Health Surveys in 43 developing countries between 1990 and 2013 found a median 12-month failure rate across subregions of 13.4%, with a range of 7.8–17.1%. Individual countries within the subregions were even more varied. A large scale study of women in England and Scotland during 1968–1974 to determine the efficacy of various contraceptive methods found a failure rate of 6.7 per 100 woman-years of use. This was a “typical use” failure rate, including user failure to use the method correctly. In comparison, the combined oral contraceptive pill has an actual use failure rate of 2–8%, while intrauterine devices (IUDs) have an actual use failure rate of 0.1–0.8%. Condoms have an actual use failure rate of 10–18%. However, some authors suggest that actual effectiveness of withdrawal could be similar to the effectiveness of condoms; this area needs further research. (See Comparison of birth control methods.)
For couples that use coitus interruptus consistently and correctly at every act of intercourse, the failure rate is 4% per year. This rate is derived from an educated guess based on a modest chance of sperm in the pre-ejaculate. In comparison, the pill has a perfect-use failure rate of 0.3%, IUDs a rate of 0.1–0.6%, and internal condoms a rate of 2%.