Pulling Out: Not Your Mom's Birth Control

More Gen Y women are forgoing hormonal birth control in favor of the "pull-out method." Should we worry?

Amanda Marcotte thinks so. In a post on Slate's XX Factor blog, she asks women using this method to "please reconsider." She believes the upswing in pill- to pulling-out converts reflects "pregnancy ambivalence" — a state of not quite trying to get pregnant, and not quite not trying to, either.

"Not everyone is decisive when it comes to knowing when to start having kids — or, if you want more than one kid, when the time is right to try for another. For some, it becomes easier to just be inconsistent with contraception or switch to less effective methods and let fate make the decisions for you."

The problem, Marcotte says, is that men express a lot more pregnancy ambivalence than women do. In "the throes of coital bliss," they might be a lot more likely to take a chance by not actually pulling out.

That does sound like a problem — but not one inherent in the pull-out method. If your partner decides to just "roll the nice" and cum inside you without your consent, you have bigger relationship issues to address.

So let's take that critique off the table for now. Why else should we reconsider pulling out? Marcotte doesn't say. Other critics tend to focus on the efficacy of the withdrawal method — surely this long-mocked method of birth control is irresponsible. But while you're certainly less likely to get pregnant on the pill, research from the Guttmacher Institute shows pulling out is only slightly less effective than average condom use.

Ann Friedman explored all of this in a recent article for The Cut. Calling Gen Y "the Pullout Generation," Friedman cites "women who are sick of taking hormones, are in a long-term relationship with a man they trust, and rely on a period-tracker app so they know to use condoms when they're ovulating." On non-ovulating days, they rely on their partners pulling out.

If these were teens Friedman were describing, or people who had no idea about how pregnancy and birth control work, I can understand the mass concern. But in Friedman's article and similar pieces, the women we're talking about all seem to be informed 20- and 30-something women who have assessed their personal situations, weighed their options and decided this is the best choice. It seems patronizing to insist they just don't understand why the pill is better or can't fully comprehend the implications of their actions.

I'm glad writers like Friedman and Marcotte are talking about this, because it is more common than we tend to acknowledge and it's good to try and understand why, as well as make sure everyone understands the risks. But the pull-out method is a legitimate contraceptive option that can work, especially when combined with period-tracking and the safety net of emergency contraception. Not all women or couples who rely on pulling out do so thoughtlessly, ignorantly or as part of some larger worldview including "organic kale and all-natural cleaning products."