Missed Birth Control Pills: What Are the Risks of Pregnancy?

Missed taking birth control pills?

I would like to ask the doctor, I usually take birth control pills.
I missed two pills two days ago and took two pills yesterday.
I had sexual intercourse with ejaculation early in the morning on the 7th, but I noticed some bleeding that seems like my period might be coming early due to the missed pills.
What is the likelihood of pregnancy in this situation? If I already have some bleeding that resembles my period, do I need to take emergency contraception? Thank you.

Yy, 20~29 year old female. Ask Date: 2017/12/07

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I usually take oral contraceptive pills.
I missed two days of pills a couple of days ago and took two pills yesterday to catch up.
I had intercourse with ejaculation early in the morning on the 7th, but I noticed some bleeding that seems like my period coming early due to the missed pills.
I would like to know what the chances of pregnancy are in this situation.
If I already have some bleeding that resembles my period, do I need to take emergency contraception? Answer: The chances of pregnancy are low, and there is no need to take emergency contraception.

Reply Date: 2017/12/07

More Info

When it comes to missed birth control pills and the associated risks of pregnancy, it's essential to understand how hormonal contraceptives work and the implications of missing doses. Birth control pills contain hormones that prevent ovulation, thicken cervical mucus, and thin the uterine lining, making it less likely for a fertilized egg to implant. When pills are missed, especially in the first week of a new pack, the risk of ovulation increases, which can lead to unintended pregnancy.

In your case, missing two pills and then having unprotected intercourse can indeed raise concerns about the possibility of pregnancy. If you missed two pills in a row, the recommendation is generally to take the missed pills as soon as you remember and continue taking the rest of the pills as scheduled. However, if you missed pills during the first week and had unprotected sex, the risk of pregnancy is higher, as ovulation may have occurred.

The bleeding you experienced could be a breakthrough bleed, which sometimes happens when hormone levels fluctuate due to missed pills. It is not necessarily an indication that your menstrual cycle has started, but it is a sign that your body is responding to the hormonal changes. If you are experiencing bleeding that resembles your period, it is essential to monitor it closely.
As for whether you should take emergency contraception (the "morning-after pill"), it depends on the timing of your missed pills and the unprotected intercourse. If it has been less than 72 hours since the unprotected sex, taking emergency contraception can significantly reduce the risk of pregnancy. However, if you are already experiencing bleeding, it may indicate that your menstrual cycle is starting, which could mean that the window for effective emergency contraception is closing.

In summary, here are the key points to consider:
1. Risk of Pregnancy: Missing two birth control pills, especially in the first week, increases the risk of ovulation and potential pregnancy if unprotected intercourse occurs.

2. Bleeding: The bleeding you are experiencing could be a breakthrough bleed rather than a sign of your period starting. It is essential to monitor this.

3. Emergency Contraception: If the unprotected intercourse occurred within 72 hours and you are concerned about pregnancy, consider taking emergency contraception.
4. Consult a Healthcare Provider: It is always a good idea to consult with a healthcare provider for personalized advice, especially regarding missed pills and the need for emergency contraception.

5. Future Prevention: To avoid similar situations in the future, consider setting reminders for taking your pills or discussing alternative contraceptive methods with your healthcare provider.

In conclusion, while the risk of pregnancy exists after missing birth control pills, taking appropriate steps such as using emergency contraception and consulting with a healthcare provider can help manage that risk effectively.

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