Wise choices, all. Until the point where my partner and I had been mutually monogamous for many years and were fairly ready to have a baby, the thought of relying on withdrawal or any other single method with an efficacy rate of <99% never even crossed my mind. I absolutely want every life my partner and I bring into the world to be planned, wanted, and loved from the moment of conception. We use primarily the sympto-thermal method of fertility awareness but back it up with withdrawal or very occasionally condoms during my fertile week. Consider then, DtC, that we’ve used withdrawal as our primary method of birth control specifically during the week where I’m absolutely going to conceive for just about three years running now. At an average of three times a week during my active ovulatory phase, for three years.
I appreciate that your experiences tell you withdrawal doesn’t work. Mine tell me that it does, for long-term, mutually monogamous partners unconcerned about disease transmission, with a high degree of trust, and where a 4% risk of pregnancy is acceptable. I trust that my partner knows when he is about to ejaculate, that he wants to avoid pregnancy as much as I do, and most fortunately we’ve yet to experience a sneaky, spontaneous ejaculation.
I’ve yet to meet any teenagers who fit the profile of couples likely to be good candidates for “perfect use” of withdrawal, for a sparkily, rainbowy myriad of reasons which anybody who’s ever been a teenager can imagine. I hope I have been clear that a sensible discussion of contraceptive options involves a thorough review of criteria upon which a woman or a couple might base their decision. Some of these criteria include (but are not limited to) cost, ease of accessibility, potential or actual side effects, discretion of use, convenience, portability, partner’s willingness to comply, and certainly not the least, efficacy. Everyone has different priorities and what seems the only criterion to you may not even rank top five on someone else’s list. For society in general and mostly for the teenagers themselves, efficacy is paramount, combined hormonal methods are the first stop, and withdrawal is nothing but a parenthetical note in the “not really advisable” category, along with spermicides and progestin-only pills. All three are potentially great, when used with a high degree of compliance, but most people are quite aware that they’re not likely to do so. When presented with better, more effective options, few consciously choose withdrawal as their primary method.
Sometimes, for whatever personal reason of their own, they will not use other methods. You might not understand their reasoning, I might not understand it, and I might want them very badly to make other choices, but the fact of the matter remains: the only effective method of birth control is the one which you will use, every single time you encounter a sexual situation. I can encourage teenagers to use condoms every single time they have sex, I can give them all the free condoms they want, I can show them the potential results of choosing not to use condoms, I can give them all the statistics the CDC can throw at them… but in the end, if for whatever reason they don’t want to use a condom, they won’t. Maybe they feel like carrying one around makes them a slut. Maybe her boyfriend refuses to use one and she doesn’t have the self-confidence to insist. Maybe she or her partner is allergic to latex and can’t afford non-latex condoms. Maybe they don’t like the way it feels, and think sex isn’t as fun. For whatever reason, they don’t want to use them, and I can’t be standing there to force them to.
I will do my best all day long to help them achieve >99% efficacy in contraception, through whatever method or combination of methods they feel they can and will use every single time they have sex. Saying “withdrawal doesn’t work” is a lie that DtC wants me to tell. What I do say is this: “withdrawal isn’t as effective as other methods, and is really not a good idea to rely on, for the following reasons: …” I can educate them and help them make the best choices possible, but I cannot force them to do it, and in the event that they choose not to use other methods, withdrawal will reduce their risk. As an added backup method, a tool in the proverbial contraceptive arsenal, I think every person everywhere who wants to avoid pregnancy should always withdraw, as a matter of policy. The statistics sure as fuck demonstrate that it helps.
