Can Missing a Birth Control Pill Increase Pregnancy Risk?

Can I get pregnant?

Hello, doctor.
I would like to ask about the issue of missing a dose of oral contraceptives.
My girlfriend has been taking the oral contraceptive pill "Wenbu Nü 28" for three months, and she has not missed any doses before.
She usually takes the pill at 9 PM.
This month, she took the first pill on April 4th, but on April 8th, she forgot to bring the pill and did not take it.
The next day, April 9th, she took one pill at 3 PM to make up for it, and then took another pill that evening (so she took two pills that day).
After that, she continued to take the pills at the usual time.
I would like to know if this method is correct.
We had intercourse on April 7th, and I used a condom, but I took it off for a short time (about 3 minutes) without it.
However, there was no ejaculation.
Will this missed dose increase the risk of pregnancy? If she has not missed any pills from April 17th onward and has taken them on time, will the missed pill on April 8th cause the ovarian ovulation mechanism to resume? If we have intercourse on April 21st, will there still be contraceptive effectiveness?

Jahn, 10~19 year old female. Ask Date: 2018/04/17

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Your girlfriend has been taking the oral contraceptive pill for three months now, specifically the Wenbu Ninfang 28 film-coated tablets, and she has not missed any doses until now.
She usually takes the pill at 9 PM.
This month, she took the first pill on April 4th, but on April 8th, she forgot to bring her pill and did not take it.
The next day, April 9th, she took one pill at 3 PM to make up for it and then took another pill that evening (which means she took two pills that day).
After that, she continued to take her pills at the regular time.

1.
Is this method correct?
Answer: Yes, this method is correct.
2.
We had intercourse on April 7th, and I used a condom, but I removed it for a brief moment (about 3 minutes) without ejaculation.
Does this missed pill increase the chance of pregnancy?
Answer: No, the chance of pregnancy does not increase.
3.
If she has not missed any pills between April 8th and today, April 17th, and has taken them on time, will the missed pill on April 8th cause the ovarian ovulation mechanism to resume?
Answer: No, it will not.
4.
If we have intercourse on April 21st, will there still be contraceptive effectiveness?
Answer: Yes, there will still be contraceptive effectiveness.

Reply Date: 2018/04/17

More Info

Missing a birth control pill can indeed increase the risk of pregnancy, particularly if the missed pill occurs during the first week of a new pack or if it coincides with unprotected intercourse. In your case, your girlfriend missed a pill on April 8 but took it the next day, which is a good response to mitigate the risk. However, there are a few important points to consider regarding the effectiveness of oral contraceptives and the potential for ovulation.

First, it's essential to understand how oral contraceptives work. They primarily prevent ovulation, which means that if taken consistently and correctly, they inhibit the ovaries from releasing eggs. When a pill is missed, especially during the first week of the pack, there is a risk that ovulation could occur. Since you mentioned that the missed pill was on April 8 and you had intercourse on April 7, this could be a concern. However, since you used a condom, that adds a layer of protection, even though you mentioned that the condom was briefly removed.

When a pill is missed, the general recommendation is to take the missed pill as soon as you remember, even if it means taking two pills in one day. This is what your girlfriend did by taking the missed pill on April 9 and continuing with her regular schedule. The effectiveness of the pill can be maintained as long as the missed pill is addressed promptly. However, if more than 24 hours have passed since the scheduled time for the pill, the risk of ovulation increases.

Regarding your concern about whether the missed pill could cause the ovarian function to resume, it is possible but depends on several factors, including how many pills were missed and when. Since your girlfriend resumed taking her pills correctly after the missed dose, the likelihood of ovulation occurring is reduced, but it is not eliminated entirely.
If you continue to have unprotected intercourse after a missed pill, especially if it is during the first week of the pack, the risk of pregnancy does increase. In your case, since you had intercourse on April 7 before the missed pill, there is a slight risk, but the condom use mitigates that risk significantly.

To ensure continued protection, it is advisable to use backup contraception, such as condoms, for at least seven days after a missed pill, especially if the missed pill was in the first week of the pack. Since your girlfriend has been taking her pills regularly since April 9, by April 21, she should be back to full contraceptive effectiveness.

In summary, while missing a birth control pill can increase the risk of pregnancy, your girlfriend's prompt action in taking the missed pill and resuming her regular schedule helps maintain contraceptive effectiveness. However, considering the circumstances surrounding the missed pill and the brief removal of the condom, it would be wise to consult with a healthcare provider for personalized advice and possibly consider emergency contraception if there are significant concerns about potential pregnancy. Always remember that consistent and correct use of birth control is key to preventing unintended pregnancies.

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