Better than Nothing or Savvy Risk-Reduction Practice? The Importance of Withdrawal

Rachel K. Jones, Guttmacher Institute
Julie Fennell, Central Connecticut State University
Jenny Higgins, Princeton University
Kelly Blanchard, Ibis Reproductive Health

Withdrawal is sometimes referred to as the contraceptive method that is “better than nothing,” and both family planning advocates and lay people often dismiss its potential effectiveness. In spite of skepticism, pregnancy failure rates from withdrawal closely parallel those of male condoms, and the National Survey of Family Growth has documented a substantial increase in withdrawal use since 1982. We review the current limited knowledge about withdrawal, and then draw on multiple qualitative and quantitative data sets to analyze the nature of withdrawal use in the U.S. Based on this work, we suggest that estimates of unprotected sex may be overestimated, but that many “condom users” may be alternating condoms with withdrawal. We conclude that dismissing withdrawal as a legitimate contraceptive method is counterproductive for the prevention of pregnancy and also discourages academic inquiry into this frequently used and reasonably effective method.