All the natural methods of avoiding pregnancy involve some sort of abstinence, or avoidance, of penis-in-vagina intercourse.

Total abstinence is theoretically 100% effective at preventing pregnancy; and for people who are not ready to have sex, it is a great contraceptive choice. In reality, however, many people who intend to remain abstinent wind up having sex, and typically when they do, the sex they have is unprotected.

Natural family planning, also called fertility awareness or the rhythm method, means that a couple abstains from sexual intercourse during a woman’s fertile time. This means avoiding intercourse three days before, the day of, and the day after the woman ovulates.

This method requires careful tracking of a woman’s ovulation and menstrual cycles usually with a calendar and a daily record of her basal body temperature. Because of individual variability, even the most rigorous tracking may only be an estimate; therefore, the theoretical effectiveness of this method is over 90% while the actual effectiveness is only 70%.

Coitus interruptus (KOH eh tuhs | in teh RUP tuhs), or withdrawal, has been used for centuries as a natural way to avoid pregnancy. In this method, the male removes his penis from his partner’s vagina just before he ejaculates. This method requires careful timing and a tremendous amount of self-control to be effective. But its actual effectiveness is 78%.