The pull out method is a form of birth control where the penis is fully removed from the vagina, and away from the vulva, before ejaculation. When done perfectly every time, 4 out of 100 people using it will become pregnant in a year. In real life, that number jumps to about 22 out of 100, or roughly 1 in 5. The gap between those two numbers tells you most of what you need to know: the method works in theory but is hard to execute consistently.
How It Works
The idea is straightforward. During vaginal sex, the partner with the penis withdraws completely before ejaculating, directing ejaculation away from the vagina and the surrounding skin. This prevents sperm from entering the vagina and reaching an egg. There’s no device, no prescription, and no cost, which is a big part of its appeal.
CDC data shows the method is remarkably common. About two in three women of reproductive age (65.7%) reported having used withdrawal at some point between 2015 and 2019, up from roughly 60% a decade earlier. Usage rates are fairly consistent across racial groups, education levels, and urban versus rural areas.
Why It Fails
The most obvious reason the pull out method fails is timing. Withdrawal requires the person to recognize when ejaculation is imminent and act quickly enough to pull out completely. Alcohol, intense arousal, inexperience, or simply losing focus can all lead to late withdrawal or incomplete withdrawal. That human error is what drives the real-world failure rate to 22%.
Then there’s the question of pre-ejaculate, the small amount of fluid released from the penis before orgasm. You may have heard that pre-ejaculate contains sperm, and the honest answer is that the science isn’t settled. A review of six studies examining sperm in pre-ejaculate found mixed results: three detected no sperm, while others did find some. However, all of these studies had significant limitations, including tiny sample sizes, inability to assess whether any sperm found were actually motile (capable of swimming toward an egg), and poor controls to ensure samples weren’t contaminated with leftover semen from a previous ejaculation. The bottom line is that pre-ejaculate may carry some risk, but researchers still can’t say exactly how much.
If you’re having sex more than once in a session, the risk goes up. Sperm can remain in the urethra after a previous ejaculation, and the next round of pre-ejaculate can pick them up. Urinating between rounds may help flush residual sperm, though this hasn’t been rigorously studied either.
How It Compares to Other Methods
To put the pull out method’s effectiveness in perspective, consider the range of birth control options. Long-acting methods like IUDs and hormonal implants have a pregnancy rate of less than 1 per 100 users per year. Male condoms, with typical use, have a failure rate of about 13 out of 100. Withdrawal, at 22 out of 100 with typical use, sits at the less reliable end of the spectrum.
The 4% perfect-use rate for withdrawal is actually closer to the perfect-use rate for condoms (about 2%). The problem is that “perfect use” of withdrawal is harder to achieve consistently than perfect use of a condom, because it depends entirely on self-control in the moment with no physical barrier as a backup.
It Doesn’t Protect Against STIs
Even when withdrawal is performed perfectly, it offers no meaningful protection against sexually transmitted infections. Many STIs, including herpes, HPV, syphilis, and chlamydia, can be transmitted through skin-to-skin contact or through pre-ejaculate and vaginal fluids exchanged during intercourse, well before ejaculation occurs. If STI prevention matters to you, condoms are the only non-prescription option that provides a barrier.
What to Do If It Fails
If withdrawal doesn’t go as planned, emergency contraception can help prevent pregnancy if used promptly. You have a few options depending on timing, access, and your body weight.
- Levonorgestrel pills (Plan B): Available over the counter at any age, no prescription needed. Most effective when taken as soon as possible, and can be used up to 72 hours (3 days) after unprotected sex. Research suggests it becomes less effective for people who weigh more than 165 pounds or have a BMI above 25.
- Ella: A prescription pill that works up to 5 days (120 hours) after unprotected sex. It’s a better option for people with a higher body weight, though its effectiveness may decrease at a BMI of 35 or above.
- IUD insertion: Both copper and hormonal IUDs can serve as emergency contraception if inserted within 5 days. They’re the most effective emergency option available and are not affected by body weight. They also provide ongoing contraception afterward.
With all emergency contraception, sooner is better. The effectiveness of every option decreases as hours pass.
Making It More Reliable
If you plan to rely on withdrawal, a few practical steps can reduce (though not eliminate) the risk. The withdrawing partner should have a strong awareness of their own arousal cycle and confidence in their ability to pull out in time, every time. Urinating between rounds of sex helps clear any leftover sperm from the urethra. And pairing withdrawal with another method, like fertility awareness tracking or a spermicide, reduces the odds of pregnancy more than using withdrawal alone.
For many couples, withdrawal serves as a backup or a bridge between other methods rather than a primary strategy. It’s the method people turn to when they don’t have a condom, have stopped hormonal birth control, or are in a long-term relationship where an unplanned pregnancy wouldn’t be catastrophic. Understanding its real failure rate helps you decide whether that trade-off makes sense for your situation.