Coitus interruptus (or "pulling out") is probably the oldest contraceptive method in history—and still one of the most commonly used in the world, despite being considered one of the most unreliable methods in medical circles.
Why is this method dangerous?
The principle of the method is simple — the partner withdraws his penis from the vagina before ejaculation, so that sperm does not enter the vagina. The problem lies in two directions: First, pre-ejaculate may contain live sperm, especially if ejaculation has occurred recently in the same session (residual sperm in the urethra). Second, the method relies entirely on precise timing and self-control — the human factor plays a much greater role here than in any other contraceptive method.
Real numbers
The failure rate varies dramatically between ideal and typical use: With ideal use (always timely and complete removal) it is around 4% per year, but with typical use — real-life, human error allowed for — this rate rises to 20%. This means that one in five couples relying on this method will become pregnant unintended within a year.
Why is this method still so popular?
The appeal of the method is understandable — it requires no planning, expense, prescription, or availability. Psychologically, many find it "natural" and "tangible" because of the sense of control. However, this sense of control is also its main weakness — effectiveness depends entirely on the individual, and determining the exact time of peak arousal is objectively difficult for everyone.
It does not protect against infections
Like any non-barrier method, withdrawal does not protect against sexually transmitted infections in any way — direct skin/mucous membrane contact occurs throughout the act.
For whom might it be relatively acceptable?
The effectiveness of the method can be improved if the partner has experience in recognizing their own body's signals, the relationship is stable, it is used as a side method in combination with other contraception (for example, in combination with avoiding fertile days), and in the event of an unplanned pregnancy, the consequences are less critical for a particular couple. However, the medical recommendation is clear: it should not be the only method for those for whom pregnancy prevention is a priority.
Combination with other methods
Many couples use withdrawal as an additional measure, not their only method — for example, in conjunction with fertility awareness methods, as an extra precaution on high-risk days. This approach reduces, but does not eliminate, the risk.
What do gynecologists say?
Most medical sources agree that withdrawal is better than no contraception at all, but it is significantly less reliable than any other modern method. Couples who rely on this method and have made an informed decision are still advised to be aware of emergency contraception in case they fail to keep up with the times.