Pregnancy Risks After Missed Birth Control Pills

Possible pregnancy

I would like to ask the doctor: My girlfriend has been taking the oral contraceptive pill, starting a new cycle on February 3rd.
She forgot to take the pill on February 4th but took two pills the next day and has been taking them regularly since then.
We had unprotected intercourse with ejaculation on February 11th during the night, and we used lubricant.
When withdrawing, there was a thick, sticky discharge, which coincided with her ovulation period.
I would like to inquire about this situation.
Is there a chance of pregnancy?

Niming, 20~29 year old female. Ask Date: 2020/02/13

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
Combination oral contraceptives (COCs) must be taken at the same time every day to achieve a 99% effectiveness rate.
If you forget to take a pill one day, it is best to take it as soon as possible within twelve hours.
You should continue to take the regular pill for that day (taking two pills that day).
If you miss an effective pill for more than 12 hours, in addition to taking the missed pill, it is advisable to use an additional barrier method of contraception for seven days.

If you forget to take the pill for two consecutive days, you should take two pills each day for the next two days, and then continue taking one pill daily until the entire pack is finished.
If you miss three or more pills, the contraceptive effectiveness for that month is compromised, and you should stop taking the remaining pills.
You will need to wait a few days for your period to start, and then begin a new pack of contraceptives on the first day (or the fifth day) of your menstrual cycle.

Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2020/02/13

More Info

When it comes to understanding the risks of pregnancy after missing birth control pills, it's essential to consider several factors, including the timing of the missed pill, the type of birth control being used, and the timing of sexual intercourse in relation to the menstrual cycle.

In your case, your girlfriend was taking a combined oral contraceptive pill (often referred to as "the pill") and missed a dose on February 4th. The general recommendation for missed pills is to take the missed pill as soon as you remember, even if it means taking two pills in one day. Since she did this and continued to take her pills regularly afterward, she has mitigated some of the risks associated with missing a dose.

However, the timing of sexual intercourse is crucial. You mentioned that the intercourse occurred on February 11th, which is around the time of ovulation for many women with a typical 28-day cycle. If your girlfriend has a longer cycle, ovulation could occur later, but if she has a shorter cycle, it could be right around that time. The likelihood of pregnancy is highest during the ovulation window, which typically occurs about 12 to 16 days before the start of her next period.

Given that she missed a pill but took it as soon as she remembered, and continued to take her pills regularly, the risk of pregnancy is reduced but not eliminated. The effectiveness of the pill can decrease if pills are missed, especially if unprotected intercourse occurs during the ovulation period. The presence of a thick, clear discharge (often referred to as cervical mucus) can indicate that she is in her fertile window, which further increases the chances of conception if unprotected intercourse occurs.

If there is concern about the possibility of pregnancy, it would be advisable for her to take a home pregnancy test if her period is late. Most home pregnancy tests are reliable and can detect pregnancy about a week after a missed period. Additionally, if she experiences any unusual symptoms or has concerns about her menstrual cycle, she should consult a healthcare provider for further evaluation and guidance.

In summary, while the risk of pregnancy exists due to the timing of the missed pill and the sexual activity during the ovulation period, the immediate action taken by your girlfriend to catch up on her pills helps reduce that risk. Monitoring her menstrual cycle and being aware of any changes in her body will be important in the coming weeks. If there are any doubts or if she experiences any unusual symptoms, seeking medical advice is always a prudent step.

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