Whether because of broken condoms, forgotten pills, or poor choices after too much tequila, there are lots of surprise pregnancies that come through my practice. But, truth be told, some of these “surprise” pregnancies really shouldn’t be a surprise at all – the couples weren’t using reliable contraception. In fact, it’s not unusual for me to see “being careful” listed as the method of contraception on a patient’s intake paperwork (these women are often back in the office for pregnancy appointments soon after). Even though effective contraception is more accessible than ever, there are still a lot couples practicing alternative or inconsistent means of avoiding pregnancy.
If you’re taking a DIY approach to contraception, and you truly do want to avoid pregnancy, it’s important to understand just how effective (or ineffective) your approach really is:
- “Withdrawal” or the “pull out” method. This is when men remove their penis before ejaculation and deposit their semen outside the vagina. This method is ripe with possible errors and has a high failure rate. The first problem is that there can be sperm in the pre-ejaculate (the small amount of lubricating fluid that comes out before or ejaculation), so if you are going to use withdrawal as contraception, the penis should ideally be wiped with an alcohol swab before insertion. The next issue is that, to be effective, the timing would need to be just right. If semen is deposited even at that vaginal opening, then a pregnancy can occur. It should be noted that excessive alcohol intake can impact the effectiveness of this method.
- Anal sex. Many women have very short perineums (skin between rectum and vagina), so if you are practicing anal sex simply to avoid pregnancy that’s not the best idea. If semen ends up on the perineum, a particularly good swimmer could swim up through the vagina and find themselves an egg. While I’m not aware of any studies that have looked at this, it is theoretically possible to get pregnant from anal sex.
- “Outer course.” Basically this means foreplay without any penetration (not even the tip!). As long as the semen is not deposited near the vaginal opening, pregnancy should not occur. Sperm cannot live on other parts if the body, it needs moisture to live. Once semen dries, the sperm die. Keep in mind, as with the “withdrawal” method, too much alcohol can further increase the risk associated with this method.
- Oral Sex. Whether you are on the giving or receiving end, you cannot get pregnant from oral sex. While sperm can live up to 5 days inside a woman’s body, that is only in the vagina not the digestive track. You cannot get pregnant from swallowing semen. Oral sex is not entirely without risk, though – any mouth to genital contact (or genital to genital) can transmit sexually transmitted infections.
If you are serious about avoiding pregnancy, your best bet is to use a medically-proven method of contraception. Your doctor can help you sort out the options and choose the right one for you– and then you can go from “being careful” to being truly protected.