Withdrawal method

Coitus interruptus
Background
Type	Behavioral
First use	Ancient
Failure rates (first year)
Perfect use	4%
Typical use	22%
Usage
Reversibility	Yes
User reminders	Dependent upon self-control. Urinating between acts of sexual intercourse helps clear sperm from urethra.
Advantages and disadvantages
STI protection	No

Coitus interruptus, also known as the rejected sexual intercourse, withdrawal or pull-out method, is a method of birth control in which a man, during sexual intercourse, withdraws his penis from a woman's vagina prior to orgasm (and ejaculation), and then directs his ejaculate (semen) away from the vagina in an effort to avoid insemination.

This method of contraception, widely used for at least two millennia, is still in use today. This method was used by an estimated 38 million couples worldwide in 1991. Coitus interruptus does not protect against sexually transmitted infections (STIs/STDs).

Perhaps the oldest documentation of the use of the withdrawal method to avoid pregnancy is the story of Onan in the Torah. This text is believed to have been written down over 2,500 years ago. Societies in the ancient civilizations of Greece and Rome preferred small families and are known to have practiced a variety of birth control methods. There are references that have led historians to believe withdrawal was sometimes used as birth control. However, these societies viewed birth control as a woman's responsibility, and the only well-documented contraception methods were female-controlled devices (both possibly effective, such as pessaries, and ineffective, such as amulets).

After the decline of the Roman Empire in the 5th century AD, contraceptive practices fell out of use in Europe; the use of contraceptive pessaries, for example, is not documented again until the 15th century. If withdrawal was used during the Roman Empire, knowledge of the practice may have been lost during its decline.

From the 18th century until the development of modern methods, withdrawal was one of the most popular methods of birth-control in Europe, North America, and elsewhere.

Like many methods of birth control, reliable effect is achieved only by correct and consistent use. Observed failure rates of withdrawal vary depending on the population being studied: studies have found actual failure rates of 15–28% per year. In comparison, the pill has an actual use failure rate of 2–8%, while the intrauterine device (IUD) has an actual use failure rate of 0.8%. The condom has an actual use failure rate of 10–18%. However, some authors suggest that actual effectiveness of withdrawal could be similar to effectiveness of condoms, and this area needs further research. (See Comparison of birth control methods.)

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