Withdrawal is a method of birth control wherein a husband withdraws from his wife’s vagina before ejaculation, thus avoiding depositing the sperm that can lead to pregnancy. It is not very effective, with a 20% failure rate. However, it can be made better, and it can be combined with other methods of birth control, such as condoms, fertility awareness, diaphrams, and the like.
There is little, if any, research available on why withdrawal fails, but it is suspected that the two main reasons are lack of control and sperm in the urethra.
Younger men in particular may lack the control needed to withdraw each and every time before ejaculation. However, this should improve with age and experience. Be careful to aim well away from your wife’s genitals when you do ejaculate, as even small amounts of ejaculate may have unintended consequences. Consider keeping emergency contraception (aka the morning-after pill) in your medicine cabinet, just in case ejaculate gets in or near the vagina. Emergency contraception can prevent pregnancy for up to five days after unprotected sex. See chapter 10.
The other issue is the potential of a few sperm having been left behind in the urethra from a prior ejaculation. Preejaculate, or “precum”—the drop of lubricant that appears at the tip of the penis early in arousal—does not normally contain sperm, but it may pick up any that were left behind as it travels the urethra. You can reduce the possibility of this occurring by being careful to urinate every time before using withdrawal.
One of the nice things about withdrawal is that it’s always free and always available. Also, it can be combined with any other method of birth control for improved effectiveness. Unfortunately, withdrawal offers no protection against STIs. Still, combined with condoms or other methods of birth control, it can certainly improve your success rate in family planning.