Re: Some thoughts on pregnancy.
Mon, 10 Aug 1998 16:04:54 -0500 (EST)

I will try to keep this brief, since Adam alreay bombarded
us with copious quantities of information regarding birth
control and sex ed.

When I e-mailed Adam my response to his query yesterday, I
asked him not to quote me until I could get my hands on
a book and give a precise failure rate for withdrawal
as a method of birth control. Adam did not comply and
went ahead and FoRK'ed my answer. I am now going to
provide the addendum that I had planned to send to
Adam by providing some facts with full citations.

The following facts are taken from pages 300 and 264 of
a book that everyone, both male and female, shoud read.
I am citing from:

"The New Our Bodies, Ourselves: A Book By and For Women"
by The Boston Women's Health Book Collective, 1992.
ISBN: 0-671-79176-1 ($20.00)

"Withdrawal -- also known as Coitus Interruptus, "Taking Care"
or "Pulling Out".

"Worldwide this is the most universally used of all methods,
a folk method passed from one generation to the next ....
Withdrawal is _not_ very effective because the drops of fluid
that come out of the penis right after it becomes erect can
contain enough sperm to cause pregnancy. Also, the man
cannot always get out in time to avoid contact with the vagina
and vaginal lips (sperm can move all the way from the vaginal
lips up into the fallopian tubes)."

"Multiple acts of intercourse in a short period of time increase
the likelihood of failure, because more sperm are mixed in the
lubricating fluid."

"It is not possible to give reliable failure rates for withdrawal
because so few studies have been done. However, researchers estimate
that withdrawal has a typical failure rate of 18%".

So, in my original note to Adam (where I was relying solely on memory of what
I taught several years ago) I stated:

> I believe that the failure rate
> for withdrawal is around the 25% mark (but don't quote me upon this
> until I verify it as it has been a few years since I gave this spiel
> to a classroom full of embarassed pre-pubescent teens).

Hence the reason I asked Adam to wait before forwarding this message
to anyone. I was not too far off, but still I was incorrect when
I stated 25%. As it turns out, it is the Rhythm Method that I was
thinking of when I gave this percentage. The chart on page 264 of
"Our Bodies, Ourselves" gives typical failure rates for Birth Control
Methods in the USA. It lists the percent of women who experience
an accidental pregnancy in any given year by method of birth control.
Here is the breakdown:

Chance 85%
Spermicides 21%
Periodic Abstinence (ie/rhythm) 20% (see note below)
Withdrawal 18%
Sponge 18%
Diaphragm 18%
Condom 12%
IUD 3%
Pill 3% (I was correct on this one)
Depo-Provera 0.3%
Implants 0.2%
Female Sterilization 0.4%
Male Sterilization 0.15%

Note: I also consulted a medical text called "Williams Obstetrics"(1994)
and although it did not contain detailed data as I have given above
it stated that the failure rate for the Rhythm Method was now thought
to be 24% instead of the 20% given in earlier studies.

Okay, that is enough on the clinical side to this question. Between
Adam and I we have probably told you more than you really wanted to

However, I do have a question for the list that I hope will get some
kind of response -- if not to FoRK as a whole, at least to me in

Adam's question set me to thinking about a conversation I had several
years ago with a few girlfriends one drunken night. Several of
my friends had been in relationships (mostly in their teens)
where they had used withdrawal as a means of birth control.
After I gently chastised them all for being so silly and risky
(some of them had no clue of the chance they were taking, so Adam's
friends are not alone in their ignorance) the conversation took a
different turn as they began to discuss how totally unsatisfying it
was for them as a sexual experience.

The jist of the conversation was this: From a female perspective (based
upon the small random sample that night) it would seem that withdrawal
leaves women feeling as if they have been abandoned at the precise point
in the sexual act when they most want to stay connected with their
partner. As well, when using withdrawal they found it hard to relax
as they feared that things would get out of control (ie/their partner
would not withdraw) thus they could not climax. Furthermore, they were
afraid to orgasm in case this sent their partner in to a frenzy that
would mean he would forget about his promise to withdraw. All of these
factors led to very disappointing sex from the female perspective.

My question is this: Is withdrawal equally unsatisfying for men?
Do men not need to feel "connected" when they climax in order to feel
satisfied? It is well-known that men are much more visual than women
when it comes to sex (hence the proliferation of girlie magazines and
such), but is there a deeper difference that allows a man to feel
sexually satisfied even if he is not physically connected to his lover
at the crucial moment? Any thoughts or comments on this will be

As a final aside to this whole discussion, "Our Bodies, Ourselves"
substantiates what my female friends confided in me (and they also
provide a warning about the secondary dangers of using withdrawal
for birth control):

"Withdrawal has a number of drawbacks in addition to its high failure
rate. The man must keep in control and therefore cannot relax. When
used over a long period of time, it may lead to premature ejaculation
by the male. Withdrawal can also be uncomfortable for the woman:
The man may have to withdraw before she reaches orgasm; also a part of
her is wondering whether he is going to withdraw in time, so that she,
too, cannot entirely relax. Finally, withdrawal does not protect
you against STD's, including HIV infection".

Sounds to me like a pretty miserable way to have sex, with both partners
being tense,both afraid to orgasm and the woman feeling abandoned.
Where's the fun in that?