Which birth-control method is more effective: condoms or withdrawal?

For sex educators and others, the answer is glaringly obvious. Withdrawal before ejaculation, the so-called pullout method, is a last resort, they say  something to be used only if there are no other options. The effectiveness of condoms, on the other hand, is well known.

So reproductive experts were taken aback by a paper in the June issue of Contraception magazine. Based on an analysis of studies, the paper pronounced withdrawal “almost as effective as the male condom  at least when it comes to pregnancy prevention.”

“If the male partner withdraws before ejaculation every time a couple has vaginal intercourse, about 4 percent of couples will become pregnant over the course of a year,” the authors write.

For condoms, used optimally, the rate is about 2 percent. But more significant, the authors say, are the rates for “typical use,” because people can’t be expected to use any contraception method perfectly every time. Typical use of withdrawal leads to pregnancy 18 percent of the time, they write; for typical use of condoms 17 percent of the time.