Norms, Trust, and Backup Plans: U.S. College Women's Use of Withdrawal with Casual and Committed Romantic Partners.

This study integrates research on contraceptive prevalence with research on contraceptive dynamics in hookup culture to examine college women's use of withdrawal with sexual partners. Drawing on in-depth interviews with 57 women at a midwestern U.S. university, we analyzed women's explanations for using withdrawal for pregnancy prevention and framed our study within the research on gender norms, sexual scripts, and power dynamics. Findings showed withdrawal was normalized within collegiate hookup culture, and that women frequently relied on withdrawal as a secondary or backup method or when switching between methods. Women often followed up with emergency contraceptives if using withdrawal alone. With casual partners, women advocated for their own preferences, including for partners to withdraw. In committed relationships, women prioritized their partner's desires for condomless sex, but also linked withdrawal with trust and love. Thus, women in relationships may be disadvantaged by hookup culture norms suggesting sex is freely available, putting pressure on them to acquiesce to withdrawal. Many women used withdrawal despite acknowledging it was not the most desirable or effective method, emphasizing the need for a sexual health approach that acknowledges these tensions and strives to help women and their partners safely meet their sexual and contraceptive preferences.