Risk of Pregnancy After Missing Birth Control Pill: What You Need to Know

The likelihood of pregnancy after missing a dose of emergency contraception?

Hello, doctor.
My last menstrual period was from June 1 to June 5.
I started taking the Diane contraceptive pill on June 5, consistently taking it every night at 9 PM.
On the night of June 17, I forgot to take the pill, and that night I had unprotected intercourse but there was no ejaculation.
The next morning around 9 AM, I remembered and took the pill.
After that, I had unprotected intercourse for the next three consecutive days, but there was no ejaculation.
Is there a chance I could be pregnant?

Xin, 10~19 year old female. Ask Date: 2020/06/27

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
Wishing you good health.

Reply Date: 2020/06/27

More Info

When it comes to the risk of pregnancy after missing a birth control pill, it is essential to understand how hormonal contraceptives work and the implications of missing a dose. Birth control pills, like the one you are taking (Diane), are designed to prevent ovulation, thicken cervical mucus, and thin the uterine lining to reduce the chances of pregnancy. However, their effectiveness can be compromised if pills are missed.

In your case, you missed a pill on June 17 and had unprotected intercourse on the same day. The general guideline for missed pills is as follows: if you miss one pill, you should take it as soon as you remember, even if that means taking two pills in one day. Since you took the missed pill the next morning, you mitigated some risk. However, the effectiveness of the pill may be reduced for that cycle, especially if you missed the pill during the first week of your pack.

The risk of pregnancy is higher if you miss a pill during the first week of your cycle, particularly if you have unprotected intercourse. Since you mentioned that you had unprotected sex on the day you missed the pill and the following three days, there is a possibility of pregnancy, albeit the risk is lower since you took the missed pill the next morning.

To further reduce the risk of pregnancy, it is advisable to use a backup method of contraception, such as condoms, for at least seven days after missing a pill. This is because it takes time for the hormone levels to stabilize and for the pill to regain its full effectiveness.

If you are concerned about the possibility of pregnancy, you may consider taking a home pregnancy test if your period is late. Most tests are reliable about a week after a missed period. Additionally, if you find yourself frequently forgetting to take your pill, you might want to discuss alternative contraceptive methods with your healthcare provider, such as an intrauterine device (IUD), implant, or other long-acting reversible contraceptives (LARCs) that do not require daily attention.

In summary, while there is a risk of pregnancy due to missing a pill and having unprotected intercourse, taking the missed pill promptly reduces that risk. If you have any further concerns or experience any unusual symptoms, it is always best to consult with your healthcare provider for personalized advice and guidance.

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