Good News About Birth Control

The withdrawal method of birth control—otherwise known as “pulling out”—is often seen as a last-ditch, almost comical measure to prevent pregnancy. In terms of both effectiveness and sexual sophistication, it’s seen as just a rung or two above using Coke as some kind of post-coital spermicide (which, seriously—according to every single pregnancy myth website, cola-as-contraception is some kind of epidemic. Does it really happen?). However, the stats don’t support this dismissive attitude to the withdrawal method. “We’ve been recommending it to clients if they don’t have any other access to birth control handy,” says Yvonne Piper, director of San Francisco Sex Information.

The effectiveness rate for pregnancy prevention using the withdrawal method is about 96 percent. Condoms, on the other hand, are about 98 percent. (That’s when both are used perfectly. Otherwise, the success rate for both withdrawal and condoms can drop as low as 76 and 79 percent, respectively). These stats aren’t new; several studies in the early 2000s established the efficacy of withdrawal. But according to a new study from the Guttmacher Institute, otherwise young, smart, sexually savvy Americans still think of it as a shameful and foolish way to prevent pregnancies.

It’s easy to see why this and other myths and misconceptions about birth control abound: the stakes are a lot higher than with other types of health care.  Taking an antibiotic at the wrong time might result in a little nausea, while failing to follow directions when using birth control can result in an actual birth (and a solid 18 to 24 years of hardcore parental responsibility.) While it pays to be cautious, being paranoid can take the fun out of what we’ve heard is a very pleasurable activity. So we uncovered six other birth control facts that will help you stop worrying while still staying safe:

1. You Don’t Need To Double Bag:  Forget the idea that two condoms are better than one. “That surprised me,” says Lawrence Finer, director of domestic research for the Guttmacher Institute. “I thought if one was good, two must be better.” But doubling up on condoms increases friction. “As a result, they’re both likely to tear,” he says. As long as it’s been stored properly (not in a wallet, not in a hot car) and worn correctly (room in the tip, lubricated to prevent tearing or sticking), one condom will do just fine, thank you.  

2. Pre-Ejaculate Isn't A Real Pregnancy Risk
As long as the condom is on when the man ejaculates, you’re safe. A study several years ago found that college men were, more often then not, rolling condoms on backwards before realizing their mistake and flipping them over. This was considered to be a disaster; men were creating sperm-tipped missiles heading straight for the cervix! In fact, if a man hasn’t ejaculated in the past few hours, chances are his pre-seminal fluid is free from sperm (hence the “pre”). This is why the withdrawal method is such a successful one. If a man has ejaculated recently, there can be viable sperm still loitering in the urethra, which can then be secreted with pre-seminal fluid. Urinating should flush things out, says Piper.

3. Sex During Your Period Is Pretty Safe:  The idea that you can get pregnant while menstruating is one of those “scared straight” myths. In fact, menstruation does protect against pregnancy. For the most part. Usually. Like the rest of the items on this list, when it comes to menstruation the consensus seems to be that it’s pretty hard to get pregnant, except for the few unlucky times when it’s not. “Women who have short cycle lengths, between 20 and 22 days, may be in a situation where they are still having a little bit of bleeding at the time of ovulation,” says Vanessa Cullins, MD, vice president for medical affairs at Planned Parenthood. “In general most women do not become pregnant in relationship to a true menstrual period.” Note that she said true menstrual period; pre-menstrual spotting or non-menstrual bleeding (from a cut or external trauma) can occur during more fertile times of a woman’s cycle.   

4. IUDs Are Super Safe
: IUDs, or intrauterine devices, may be the best kept secret since the withdrawal method. Maligned in the 70s, when poorly manufactured IUDs made women sick and sterile, the current incarnation are both safe and incredibly effective when it comes to preventing pregnancy. However, even some doctors are reluctant to recommend them for younger women, since IUDs have traditionally been designated only for those who have had children (the widening of the cervix associated with childbirth was thought to be necessary to keep the IUD in place). In 2005, the FDA approved IUDs for women of all ages, regardless of whether or not they were mothers. It has since become more popular with younger women due to its ease of use (set it and forget it) and efficacy. “It’s pretty much foolproof,” says Piper of the IUD.  (Though they don’t protect from STDs.)

5. Freaking Out About HIV Will Get You Nowhere:
  You shouldn't go around having unprotected sex like gangbusters, but know that for the majority of the population, chances of HIV exposure and subsequent infection are pretty low, says Piper. “People often aren’t worrying enough about STDs like Herpes or Chlamydia, which are much more common.”  To prevent all of these diseases, condoms and regular testing are recommended, but STDs like herpes, which is spread through skin-to-skin contact (as opposed to via bodily fluids) may require extra vigilance.

6. Fail Rates Are Better Than You
Think Yes, the “typical use” failure rate of condoms and pills is lower than the “perfect use” rates—way lower. But the fact that condoms have a 79 percent fail rate when used in real life doesn’t mean that the condom will break two out of every ten times one’s slipped on. “Most of the imperfect use is non-use,” says James Trussell, professor of economics and public affairs and director of the office of population research at Princeton University.  “It’s keeping a condom in the drawer as opposed to on the penis.” When surveys are conducted about sexual heath, researchers ask what method respondents used in the past month, and if those respondants were knocked up by month’s end.  People who use condoms only some of the time, or who use the pill but for a few days before losing their pack, still get credited as getting pregnant on their method of choice—though chances were they weren’t using that method when the baby-making took place. Using your preferred method of birth control as directed, every time you have sex, will give you much higher rates of success.

Use Planned Parenthood's Widget to find the best method of birth control for you here

 

UPDATE: We've heard from a few doctors who feel this post is irresponsible, and their concerns make it clear that we could have done a better job putting this information in context. When it comes to preventing pregnancy, the safest and most proven methods remain oral contraceptives, condoms and abstinence. When it comes to preventing STDs--something about which anyone who is either non-monogamous or sleeping with someone who hasn't been tested should be concerned--condoms are the best bet, and even then you're not 100 percent safe.  So take the information we’ve presented here with those basic facts foremost in your mind.