Tuesday, June 23, 2009

The Withdrawal Method

An egg and sperm just before conception

Withdrawal: There has been a lot of publicity recently about some ‘research’ done on the ‘withdrawal’ method of birth control. Below is one of the more balances articles. Buried in the article is the comment that how well it works depends a lot on the woman’s fertility which is key to any success it might have. For a woman practicing Natural Family Planning where she abstains from sex when she is fertile I can see withdrawal being highly effective. However, I’m betting that used during the 8 or so days a woman is fertile each cycle withdrawal is not at all effective as birth control. I agree with a comment in the article that the studies cited were poorly conducted.

Simple method turns out to be a popular form of birth control:
Healthy Cleveland Tuesday June 23, 2009, 8:00 AM

“The last time I checked, nobody was actively touting the withdrawal method (also known as coitus interruptus or "pulling out") as an effective form of birth control.

So when a colleague suggested that I check out the article in the June 2009 issue of the journal Contraception titled "Better than nothing or savvy risk-reduction practice? The importance of withdrawal," I rolled my eyes.

Then I decided to give it a glance.
Written by Rachel K. Jones and three of her colleagues, the commentary analyzed previous studies and unpublished research on the withdrawal method as a means of birth control.

Based on what they analyzed, they came up with the conclusion that the method of withdrawing prior to ejaculation not only was pretty common -- especially by younger women and their partners -- but that it also was used as a back-up to condoms or oral contraception and was "almost as effective as the male condom."

The commentary cited some interesting statistics. The withdrawal method has a 4 percent perfect-use failure rate, and an 18 percent typical-use failure rate over a one-year period.

In comparison, condoms have a 2 percent perfect-use and 17 percent typical-use failure rate.

Jones, a Tulane University-trained sociologist who joined the Guttmacher Institute 10 years ago, told me during a telephone interview that she and her colleagues aren't in the business of endorsing one method of birth control over another.

But the topic of withdrawal -- how many people do it, how often it works -- is something that deserves further research. More isn't known about its effectiveness because the research community hasn't been interested in the topic, Jones said.

"Whether you like it or not, people are using it," she said. "The majority of women have used it at some point in their lives." It makes sense then, she said, that people be armed with better information about coitus interruptus.

Predictably, reaction has been swift, not only in academic circles and in the blogosphere, but by those who make a living in the study and marketing of birth control.

I asked a couple of condom makers to weigh in on the debate, especially since Jones' writing suggests that pulling out is nearly as effective as their products.

Here's an excerpt from a statement from Jim Daniels, vice president for Trojan Brand Condoms:

"When used consistently and correctly, condoms have been shown to be 98 percent effective in preventing pregnancy. In contrast to withdrawal or hormonal methods, condoms provide visual confirmation, to both partners, that contraception is being used during sexual activity."

Visual confirmation. Got that?

Both Daniels and Carol Carrozza, vice president of marketing for Ansell Healthcare, which makes LifeStyles Condoms, mentioned the added protection that condoms have against sexually transmitted diseases, including HIV and AIDS.

Given the times in which we live, that's not an insignificant point.

Carrozza questioned the "perfect-use" rate of withdrawal. "The scary thing about withdrawal is that it really requires that the male be in control, that he properly know how to use the method," she said.

While he agreed that it would be nice to know how effective the withdrawal method is, Planned Parenthood Northeast Ohio chief medical officer Dr. Lazlo Sogor said that would be difficult to research.

"It probably does some good, but we don't know how well," he said of the method. "Some days you pull out quick enough, and some days you don't. A lot of it depends on a woman's fertility."

The studies that were referenced in Contraception are "poor science" from which no solid conclusions can be drawn, Sogor said.

Then he raised two important issues:

First, where would you find people willing to be observed in a clinical trial?

The only way to do it right, Sogor said, would be to randomize research subjects into two groups -- one using only the withdrawal method, the other using only condoms -- and study them for at least six months.

And, secondly, he said:

"Let's face it -- who's going to fund this?" he asked, sounding a bit incredulous. "Pharmaceutical companies certainly aren't interested in this. There's no money to be made." “

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I'm a classically trained dancer and SAB grad. A Dance Captain and go-to girl overseeing high-roller entertainment for a major casino/resort