Academic journal article The Canadian Journal of Human Sexuality

Withdrawal: "A Very Great Deal Better Than Nothing"

Academic journal article The Canadian Journal of Human Sexuality

Withdrawal: "A Very Great Deal Better Than Nothing"

Article excerpt

One day some years ago, at the Sexual Health Clinic where I worked, a woman, recently arrived from Poland, came in asking for the contraceptive sponge. After some discussion about efficacy, and gentle urging on my part to consider combining sponge and condom, or even to consider methods with lower failure rates, she assured me that this one was perfect for her. The main method she and her partner were using was withdrawal and the sponge was, in fact, her backup. My eyes widened (imperceptibly, of course).

Wouldn't she rather consider a method where he could actually ejaculate inside her--such as the pill, for example? "Not at all!" was her reply. "Withdrawal is our method. A man has to know how to pull out. That's part of being a man. The sponge is just in case he doesn't. He won't know I'm using it. When it comes time to make a baby, he can stay inside!"

I learned something that day. And I never forgot it. But really, it was something I already knew. My history lessons had taught me that birthrates declined dramatically in the latter part of the 19th century in Europe. The reasons for this are complex, including the fact that large families were no longer the advantage they once had been in an agricultural society and in the early part of the industrial revolution. With no methods other than abortion, lactation and perhaps condoms, people were interrupting coitus all over the world--and still are.

Dr. John Guillebaud (1999), in his book Contraception: Your Questions Answered, tells us that the use of withdrawal has been associated with some of the lowest birth rates in history, for example in Eastern Europe after the Second World War. He states, "Right up to the second half of the twentieth century withdrawal remained a major and often primary method of contraception" (p. 40). Angus McLaren (1990), in his book A History of Contraception from Antiquity to the Present Day, tells us that in France and Czechoslovakia withdrawal was, until the arrival of the pill in the 1970s, the most widely used method of birth control.

So where does the idea that withdrawal is not a method come from? And why is it portrayed as ineffective and as useless as douching by clinicians and educators? I am amazed at how many young people can recite the dangers of pre-ejaculate, when in fact there is some dispute about whether pre-ejaculate contains any sperm and if it does how it got there. The fluid from the Cowper's gland contains no sperm. The widely cited Contraceptive Technology (Hatcher et al., 1998) tells us that "... in itself, the pre-ejaculate ... contains no sperm. …

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