RETHINKING WITHDRAWAL
LESSON PLAN · TEACHING SAFER SEX THIRD EDITION
By Nicole Cushman, MPH and Anna K. Smith, MPH
Objectives
By the end of this lesson, participants will be able to:
1. Identify at least two pros and two cons of withdrawal as a safer sex method.
2. Apply knowledge about withdrawal and other options to real-life scenarios to make the best choice in each sexual situation.
Rationale
Coitus interruptus, more commonly known as “withdrawal,†is often dismissed by educators as an unreliable method of pregnancy prevention. When its efficacy is mentioned, the typical use failure rate (28%) is emphasized or exaggerated. Reasons for its failure are misunderstood and misstated to students. For example, teachers often say that Cowper’s gland fluid (pre-ejaculate or pre-cum) contains sperm, even though research has refuted this. Traces of sperm from a prior ejaculation may remain in the folds of the urethral lining, but experts believe this could be washed out by urinating before the next intercourse.
Teachers may overemphasize failure rates because of a belief that young people may not be able to use the method correctly. Indeed, researchers advise that compliance may be a problem for teens, since they may have less control over ejaculation. They say that condoms, which also protect against sexually transmitted infections, are a better option for teens, but maintain that withdrawal is definitely better than no method at all.
Meanwhile, in terms of pregnancy prevention, withdrawal’s perfect use failure rate of 4% (meaning the percentage of women who become pregnant if the method is used perfectly for one year) is rarely mentioned, even for more experienced adults, and there remains little serious discussion about how one could become a more effective user of withdrawal. Thus, this lesson aims to present accurate information about withdrawal and encourages participants to evaluate the advantages and disadvantages of this method and its potential usage in their own lives.
While discussing the efficacy of withdrawal at preventing pregnancy, it is important that participants are made aware that it is not recommended for STI protection.
