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6 reasons why pulling out alone is like Russian roulette, not contraception

And what to do instead.

A young woman in the street with closed eyes and tightly-crossed fingers

Photo by Dayne Topkin on Unsplash

This article was published by Medium in June 2024


Pulling out is not contraception – that is a myth – I think it’s like playing Russian roulette with your sperm. All adults and young people globally need 'pulling out' removed from their sex education curriculum and it needs removing from the internet as a method of contraception at large. In a survey of over 4,500 American women pulling out alone was used by around 12% of couples (Jones et al 2015).

Russian roulette is used as a form of torture where just one bullet is loaded into a gun, then spun, while pointing the gun at someone’s head. There’s a 1/6 chance of death.

Why such an intense comparison? Doesn’t that thrill of risk make the sex even better? I was shocked to find out from the Centres for Disease Control that almost half of all pregnancies in America were unintended (42%). There is a lack of access to birth control and healthcare; and nearly 40% of women were not satisfied with the contraception they were using, according to the Guttmacher Institute.

The Kaiser Family Foundation reported that at least one-third of men feel left out when it comes to contraception. More than half the men said they knew either not a lot, or next to nothing, about contraceptive options.

The options for men’s contraception have always been extremely limited:

  1. Condoms

  2. 'pull out' or

  3. a semi-reversible vasectomy.

We were once taken on a journey about the viability of the men’s contraceptive pill in the American sitcom Workin' Moms. The joke is on the men who suffer side-effects such as nausea, mood swings, headaches and loss of libido, as many women do on the pill.

If men’s knowledge and control of contraception is low, the responsibility unnecessarily lies with women to be aware of all the possibilities and to discuss them with their partner.

What if I argued that for the 12% of us who use pulling out alone as a method of contraception, it is contributing to the breakdown of family and society? It’s unreliable at best, and in 20% of couples it will lead to pregnancy in 12 months as it’s only 70–80% effective. Like Russian roulette, it should be avoided - for 6 reasons:

  1. It relies on strong willpower and self-control,

  2. ... the accurate judgment of when to pull out,

  3. ... and precise reaction times

  4. Can contain pre-ejaculate sperm

  5. Risks sexually transmitted diseases (STDs) and infections (STIs)

  6. Causes anxiety, stress and relationship strain due to fear of possible pregnancy

I hear you ask: how can Russian roulette and death be linked to birth? In America, there’s also a 42% chance of couples deciding to terminate an unwanted pregnancy.

The abortion debate will always divide people, and I’m not here to judge your decisions around that. We can all agree prevention is better than termination. In some parts of the world abortion is illegal. New laws have come into effect in some US states with the Fetal Hearbeat Bill, making abortions over 6 weeks illegal, further limiting people’s options.

Other methods you can discuss with your partner are as follows. You could ideally consider using two methods together: one barrier like a condom to prevent STIs and STDs, plus an additional method to prevent pregnancy:

  1. Male condoms

  2. Female condoms

  3. Pills (progesterone-only or combination pill)

  4. Patches

  5. Hormonal coils

  6. Implants

  7. Diaphragm

Oftentimes women talk about how little men 'suffer' in the process of conception, pregnancy and giving birth. After all, following moments of ecstasy, there’s nothing directly 'physical' that Dads do with the baby, until they’re born.

I actually disagree that men don’t suffer. Were we living in societies where there was no sex before marriage, the boundaries would be much clearer. However, yes, men do also suffer tremendously from unwanted pregnancies. Couples are also most likely to separate within the first year after a child is born.

As a society we wonder why so many fathers aren’t present, when the child isn’t something they 'signed up for'. In this new world culture of dating apps and not declaring a relationship status, pleasure doesn’t necessarily mean either the man or woman wish to become lifelong partners or parents.

Then when relationships don’t work out there are often court proceedings to get child maintenance, or decide upon childcare arrangements. Your lives and the child’s are altered completely.

Obviously there are millions of examples where the pregnancy was a pleasant surprise! Congratulations!

However, after some research into what has been a common phenomenon in community and society at large, I did think this message around pulling out was a mess.

It started with a lack of education and sharing of knowledge at school, which continued into lack of access to healthcare, understanding, communication and suitability of birth control into adulthood. So with 'pull out and pray', you may as well be putting a gun to someone’s head.


Jones, Lindberg & Higgins (2015). Pull and pray or extra protection? Contraceptive strategies involving withdrawal among US adult women. Retrieved 26 June 2024 from:

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