Q. After the birth of my son, I didn't want to go back on the pill, so now when we have sex, my husband just pulls out when he ejaculates. This method has been working for us just fine, but when I told my ob-gyn about it, she was horrified. Why? It's not as if we're teenagers without any self-control.
A. Your ob-gyn is right: Even if your heroic husband is absolutely diligent about pulling out before he comes, the few drops of fluid emitted by his penis during intercourse prior to ejaculation contain sperm, too.
"Although the number of sperm may be smaller, those present in pre-ejaculate are every bit as strong and smart as the sperm released during orgasm," says Danny J. Schust, MD, an assistant professor of obstetrics and gynecology at Harvard Medical School. In addition, sperm can live for up to 72 hours after ejaculation in a man's urethra, so if your husband ejaculated, say, the day before, additional sperm may be carried in the preseminal fluid.
In other words, you're at a significant risk of getting pregnant if withdrawal is the only birth control method you're using.
If what you're looking for is spontaneity but you think the pill is a pain, there are a couple of good alternatives. Among the newest is the NuvaRing, a small rubber ring that contains low-dose hormones, similar to the pill's. You simply insert the ring into your vagina, and you're set to go for three weeks. The birth control patch works in a similar way.
"If your goal is to absolutely not have another baby right now, then don't use the withdrawal method," says Dr. Schust. "Find contraception that works for you -- then use it!"
Holly Robinson is a Boston-area writer who lives with her husband and their five kids.
Originally published in American Baby magazine, June 2004.