HOW PULLING OUT BECAME THE NEW PILL
IT REQUIRES IRON WILLPOWER, A DEXTEROUS PARTNER AND A VERY RISK-AVERSE MINDSET. JENNIFER GEORGE EXPLAINS WHY SHE, AND EVERY WOMAN SHE KNOWS, IS TURNING TO THE WITHDRAWAL METHOD
One writer reveals why she turned her back on hormonal contraception in favour of the withdrawal method – and she’s not the only one
‘Doesn’t it kill the vibe a bit?’ ‘But where does it, you know, all go?’‘Do you think that, maybe, you’re infertile?’ All common reactions from my friends when I admit that, for the past 1O years, my husband and I have been having sex using the old-fashioned pull-out method instead of any actual contraception. It’s not that we’re trying to have a baby, it’s just that we don’t like any of the other options that prevent the arrival of one. As for my friends’ reactions, the most common one is the rhetorical question: ‘Are you CRAZY?’
Maybe we are. Pulling out (known as the withdrawal method or, more colloquially – brace yourself – ‘spray and pray’) means around 4% of women are likely to fall pregnant. And that’s if
the method is practised perfectly (avoiding highly fertile days and using a spermicide). But nobody’s perfect, of course, especially in the throes of passion. So, in reality, 18-28% of women will conceive using this method in the first year.* Risky business? You bet.
It’s not just us though. In the past four years, around half a million women in the UK have switched from using contraception to pulling out.** Although the Pill and LARCs (long-acting reversible contraceptives, such as intrauterine devices and implants) still reign strong as the top choices, in a straw poll with friends and colleagues, the vast majority admitted – albeit sheepishly – that they, too, have practised, or are currently practising, unprotected sex. And this isn’t just twentysomethings, it’s also midlife mothers who don’t want more children. Given there’s so much at stake, from sexually transmitted infections (STIs) to unplanned pregnancy, what is going on?
”IN THE,PAST FOUR YEARS AROUND half a million WOMEN IN THE UK HAVE SWITCHED FROM USING CONTRACEPTION to pulling out ”
Most women tell the same story: they used to be on the Pill, but they don’t want to take it any more. And I’m no exception. I reached the point where I’d had enough of messing with my body. I’m not a ‘clean living’ person by any means (my diet consists mainly of sugar, meat and caffeine) but in my twenties, after a decadelong on-off relationship with the Pill, I became increasingly aware of the hormone-affecting chemicals I was pumping into my system. Although my weight gain could have been attributed to my aforementioned diet, I found that when I came off the Pill my jeans felt that little bit looser. I also found that my mood swings became less extreme.
My husband – who was keen that I give the medicine one more chance (for his ease of mind, I suspect) – suggested I try a different prescription, but with a history of aggressive female cancers in my bloodline, when I saw that research had discovered the use of the combined Pill is associated with a 5O% increased risk of developing breast cancer (in comparison with the average risk when not taking it),*** that was enough to seal the deal. Time to bin those blister packs forever. I could have turned to the implant or intrauterine device (coil), both over 99% effective against pregnancy, but neither of these alternatives held much appeal. Friends who’ve used the implant complain about spotting, hormonal acne and irregular periods, while a colleague who had complications with her coil described it as ‘feeling like a tiny ball of barbed wire was up my…’, which immediately put me off. Dr Helen Munro, of the Faculty of Sexual and Reproductive Healthcare (FSRH), says women are often confused by, or wary of, contraception. ‘Some might not be aware of all the different methods, while others are afraid of the side-effects. There are many myths and misconceptions, too.’
Dr Munro can understand why many are turning to apps, such as Natural Cycles, that aim to boost the user’s understanding of how their fertility changes throughout the cycle (also known as natural family planning). Natural Cycles claims that, with perfect use, only one in 1OO women will become pregnant over a year. However, Dr Munro warns that these cycle-tracking apps come with many potential problems. ‘They are restrictive when it comes to women’s sexual activity, as they require women to abstain on fertile days. Perfect use is very difficult, as users need high awareness of their bodies and cycles. They might forget to input all of the information required.’ Any slip-ups, such as recording the wrong temperature, and the failure rate can rise dramatically. What’s more, none of the methods mentioned above – pulling out, the Pill, LARCs, the apps – prevent STIs. Only condoms can help with that.
Early on in our relationship, my husband and I both got checked and were each given a clean bill of sexual health, so STIs haven’t been a worry. We’ve had no serious pregnancy scares, either. But are things too good to be true? Could our dramafree decade be due to infertility?
Dr Munro increased my fears by confirming that, yes, ‘pre-cum’ is not an urban myth, but an actual thing. ‘Pre-ejaculate, released during any kind of stimulation, will often contain enough sperm to result in a pregnancy,’ she says. Luckily, a quick and painless fertility check at The Lister Fertility Clinic in London confirms my ovaries are in good nick. Lots of lovely follicles, if we did ever want to start a family. So maybe we are (or, more precisely, my husband is) just really good at pulling out.
That, or we’re just very lucky. Accidents can, and still may, happen. But for us, and a growing number of couples, the withdrawal method – no pills, no chemicals, no hormonal disruption – feels like the best option, so we’ll continue to throw caution to the wind. That is, until the male Pill is finally invented. Then they can have a taste of that medicine.