How risky is the withdrawal method of contraception?

Q: I recently had sex with my boyfriend using only the withdrawal method. It’s time for me to get my period and it hasn’t come yet. I am often irregular, so I’m taking a homeopathic preparation to make it come faster. Do these remedies really work? Should I worry about pregnancy?

A: Unfortunately, you do need to worry about pregnancy. At this point, there is not much you can do about a pregnancy now – that is, about two weeks after the egg would have been fertilized. No medication that we have will undo a pregnancy, and there are no safe herbal preparations that will help.

A medication called RU 486 is available in Europe. It lowers the level of a hormone called progesterone, which is needed to maintain a pregnancy. If progesterone levels fall, the pregnancy will miscarry. Although the drug has received approval to be manufactured in the United States, no drug company is currently making it here.

All women should be aware of morning after contraception. If you have unprotected intercourse (for example, if a condom breaks), you can take a dose of several birth control pills, which prevents pregnancy 99% of the time. You can ask your doctor (or call your local chapter of Planned Parenthood) to prescribe Preven, now available in this country. You can also take four tablets of a low-dose birth control pill, such as LoOvral, and follow that up by another dose of 4 tablets 12 hours later. You need to take the first dose within 72 hours of unprotected intercourse for it to be effective.

Most importantly, you need to remember that withdrawal, the rhythm method, and natural family planning methods are at best 85% effective, which means that if 100 couples rely on this method for a year, 15 of them will be pregnant by the end of the year. If that high a failure rate is okay with you, fine. But I find that most couples relying on withdrawal will be devastated by a pregnancy. So why not switch to condoms and foam, which, besides giving you 98% effectiveness, will also substantially help to reduce the spread of STDs?

What you have in your mind?