Why the withdrawal method is back

Published Oct 25, 2013

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London - Charliegh Avent never has to remember to take the Pill. She and husband Paul don’t have a supply of male contraceptives in their bedside cabinets either.

In fact the couple, who’ve been together for seven years, don’t make any sort of special preparations before they make love.

Because they’ve chosen to rely on the oldest contraceptive system there is: the withdrawal method, in which the man withdraws from the woman’s body just before climax occurs.

In an age when there have never been more options to prevent pregnancy, it would be easy to assume that Charliegh’s approach is rare.

But it seems she’s one of a growing number of women who are rejecting conventional contraceptives and going back to basics.

Recent research in the US revealed that a third of young women there had used withdrawal at least once to prevent pregnancy, far more than had previously been thought.

As it’s not a medically approved form of contraception, it’s not known exactly how many women in the UK rely on the withdrawal method, but nevertheless forums on popular mothering websites are littered with conversational threads from women in their late 20s or 30s admitting that they do it - successfully or otherwise - or quizzing those who have tried it for advice.

While it’s thought, realistically, that eight out of 100 women get pregnant using the Pill, with withdrawal the rate is closer to 20 percent.

As GP Dr Anne Connolly, Chair of the Primary Care Women’s Health Forum, says, this risky method not only fails to protect against sexually transmitted infections but it’s playing “Russian roulette with unplanned pregnancy”.

So why are women taking such risks when it comes to contraception?

Is it because so many men are reluctant to have babies and this is a way to increase the chances of getting pregnant while leaving your partner thinking he’s in control?

Or is it simply because women today are increasingly cavalier?

For many, like Charliegh, it’s simply a reaction against the Pill and other hormone-based contraceptives, and the effect that they can have on women’s bodies.

Invented in 1960, the Pill is now taken by nearly four million women in the UK, but over the years many women have reported side-effects of varying severity - from changes in weight and skin, to depression and lowered libido and in very rare cases blood clots.

Recent research, for example, suggests at least one in six British women on the Pill will suffer from lowered sexual desire, while another study suggested women on a certain type of pill were three times more likely to have a mental illness than those who were not on any medication.

Charliegh, 33, explains that in the past she has tried several types of Pill - from the combined pill (which uses oestrogen and progesterone hormones to stop ovulation), which gave her migraines, to the progesterone-only mini pill, which, she says, not only gave her extensive acne on her face and back, but failed to prevent her falling pregnant.

Charliegh, who runs her own jewellery business, went on to have a miscarriage and - deciding the mini pill was too unreliable - next tried the copper coil, which prevents pregnancy by stopping a fertilised egg implanting in the womb.

“But this gave me excruciating stomach pains so I had to stop,” she says. “My nurse then suggested the progesterone-only contraceptive injection but this made me bleed every day for six months.”

Not long after, Charliegh found herself single so contraception wasn’t an issue, but when she met her husband Paul, 43, an engineer, in late 2006, she couldn’t face trying any more.

For the first month the pair used condoms, but like many couples they felt these lessened the intimacy between them and they didn’t view them as a long-term option.

Charliegh, from Newbury, Berkshire, adds: “We knew very early on that we were going to be together for the long term - I think you know when you meet ‘The One’ - so we talked and decided to try the pulling-out method and found that this is the one that works for us.

“There are no unpleasant side effects for me either.”

She says that while their sex life has tailed off a little since having their two daughters, the technique doesn’t diminish the intimacy between a couple, or make love-making any less pleasurable.

“I think you still have the closeness doing it this way,” she says. “There’s making love and having sex. Sex is just for pleasure. Making love is because you want to be together. How intercourse ends doesn’t have an impact on that.”

For others, using withdrawal is part of a broader desire to keep their bodies free of chemicals and artificial hormones.

Lara Bincham, who works with horses, has been relying on her partner Wayne, 32, to “pull out” for six years, ever since they got together. “We started using condoms, then after about six months discussed what we were going to do long term,” she says.

Twenty-eight-year-old Lara, from South London, admits she’s never tried the Pill, and previously relied on condoms, but says: “Once I was in a serious relationship, I preferred the idea of keeping things natural.

“I’ve got a lot of friends who’ve been on the Pill and found it changed their whole hormonal balance.

“One of my friends got quite depressed, another gained a lot of weight and when she came off the Pill found it very hard to lose the weight. It all put me off the idea.

“I started to research what else I might be able to do and started plotting my cycle to avoid my fertile time and using withdrawal as well.’

After her first son was born and she was unable to work out her cycle because breastfeeding had stopped her periods, Lara relied on withdrawal alone. Like Charliegh, she too says that doing this hasn’t made love-making less enjoyable for her or Wayne.

“We’ve never been five-times-a-night people, but we’ve always had a healthy sex life and that’s something that’s continued since having children,” she says.

Jane Knight, a fertility nurse specialist who is also director of Fertility UK (the body that promotes “natural family planning”, also known as the NFP method) says demand for practitioners is currently high because of a vogue - encouraged by mobile phone apps that claim to help work out when a woman’s likely to get pregnant - for wanting to return to more natural methods.

Natural family planning, which is NHS approved, involves teaching a woman to understand her body’s cycle through changes in body temperature, and learning how to calculate - and avoid having sex during - the fertile window when conception can occur.

While NFP does not advocate withdrawal as part of the practice, some couples choose to use it for added protection.

Jane agrees a significant number of women turn to more natural solutions because they dislike the effect hormones in the Pill, and other long-lasting contraceptives such as the injection and implant, have on their bodies and moods.

“These women just say they feel better without hormones,” she says. “In particular, the main thing women notice when they come off the Pill is that their libido is stronger, and that they hadn’t realised how much it had been dulled when they were on the Pill.”

Wanting to feel more in tune with her body was a key reason Maisie Hill, 33, turned to natural family planning methods. But instead of avoiding her fertile time, this is when Maisie, a doula from East London, relies on withdrawal.

She stopped taking the Pill ten years ago after having a bad experience, too. “During that time I suffered from depression and much lower libido,” she says. “I didn’t see the point in using a form of contraception that makes you unhappy and stops you wanting to have sex.

“Condoms aren’t a long-term solution, neither men nor women like using them, and I didn’t relish the thought of having something inside me like a coil. For all they say there are options when it comes to contraception, it didn’t feel that there were.”

She adds: “There were also so many benefits to not being on any hormonal contraceptives and being totally in touch with my own body and cycle. I now plan my calendar around the times of the month I know I’ll have a lot of energy and those days I know I’ll want to curl up and not see anyone.”

She has used the method without experiencing any “accidents” through three long-term relationships, and says that through her work and social circle she meets a lot of women who use it too, though they don’t admit it publicly “because they fear they are going to be judged as irresponsible or stupid.”

And on the contrary, Maisie argues that using withdrawal actually requires a high level of trust and honesty between a couple.

She’s been using the withdrawal method with her boyfriend, 29, who works in development and planning, for six months.

“Deciding to use withdrawal makes you think about the relationship.

“You have to address all outcomes, such as: what would we do if I got pregnant? Any conversation that doesn’t get past this suggests your relationship is not at the right stage or you’re not with the right man.”

And it seems that discussing all possible outcomes may be vital.

Jane Knight suspects that many of the women who use withdrawal as their sole means of contraception are secretly hoping for another baby, and this is a way of making reluctant husbands think they are in control.

While Charliegh - who already has daughters Lily, five, and Eevie, two; and Lara - who is mom to Cayden, three, and Malik, ten months - are adamant that their children were planned, there’s no doubt withdrawal comes with a higher chance of an unplanned pregnancy.

When used perfectly, it’s said to be 96 percent effective, but medics estimate that more realistically it fails in no fewer than one in five cases.

As discussions on parenting websites reveal, there are many examples of women who tried withdrawal only to find themselves presented with an unexpected baby nine months later.

Kerry Gwilliam, 38, from Weymouth, Dorset, knows this all too well.

The part-time bookkeeper - who has tried many types of Pill but says each turned her into a “hormonal witch” and is also allergic to condoms - started using withdrawal with her partner Derek Billings, a 34-year-old countryside ranger, after they met four years ago.

Then three years ago Kerry got a surprise - she found she was pregnant. Their daughter Tia is now two.

“Obviously now we have our little girl we couldn’t be more delighted about how it turned out, but at the time it was a huge shock,” she says.

“As well as using withdrawal, I thought it was highly unlikely I could get pregnant as I have endometriosis, which doctors said could make having children difficult.”

Kerry admits that before she got pregnant Derek wasn’t always scrupulous about withdrawing when they thought she was out of her fertile period. After Tia was born they returned to pulling out, but this time he was much more careful.

However, five months ago they got another surprise - once again the withdrawal method had failed and Kerry was pregnant. Their second child is due in March.

“I was surprised it happened again as we’d been so careful,” she says. “While we always wanted two children, so it’s far from a disaster for us, I certainly wouldn’t recommend this method to any woman who was young and not in a secure relationship.”

Part of the problem, explains Dr Anne Connolly, is the fluid that men often secrete before ejaculation.

This can contain many thousands of sperm, and there are no warnings when it happens.

A man may withdraw before ejaculation, but by then, it may be already too late.

While she concedes that many women do report problems - of varying severity - from the Pill, because of the many different types available, each containing varying proportions of hormones, she says a good GP will spend time helping a woman find the right one for her.

“Unfortunately, with all the pressures that GPs and nurses are under, contraception is not given the priority it should have and women are often not given the time or up-to-date advice they should be able to have,” she says.

She adds that while some women do suffer side effects from the Pill, many others treat it as a convenient scapegoat for putting on weight or other problems in their lives that might make them feel depressed.

In any case, she says for those who are medically unable to take oestrogen, long-term contraceptives such as the coil, implant and injection are good options.

But Lara, Maisie and Charliegh both insist withdrawal is still their preferred method. “For me, it’s been more reliable than the Pill,” says Charliegh.

As for Kerry? What will she do after baby number two?

“We’re not planning on any more children,” she says.

“So we’re discussing whether a vasectomy might be our best option after the baby is born.” - Daily Mail

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