Can Missing a Birth Control Pill Lead to Pregnancy Risks?

Is it possible to get pregnant?

I have been taking the birth control pill for the fourth month, consistently at 9 to 10 PM.
I started this month's first pill on December 3.
However, I forgot to take the pill on the night of December 5, and I remembered to take it at 8 AM on December 6.
I took the regular pill again at 10 PM on December 6.
On December 7 and December 9, I had unprotected intercourse, but there was no ejaculation.
Will taking the missed pill affect the contraceptive effectiveness? Is there a possibility of pregnancy?

Miss Chen, 10~19 year old female. Ask Date: 2020/12/28

Dr. Chen Zhiyu reply Obstetrics and Gynecology

In response to your concerns, the correct use of emergency contraceptive pills can achieve over 90% effectiveness.
However, it is still related to whether your menstrual cycle is regular.
If you have a normal 28-day menstrual cycle and take the medication as directed, even if you miss one day and take it the next day, you still have a considerable level of contraceptive efficacy.
The most important thing is to pay attention to whether your menstrual period arrives as expected to determine if you are pregnant.
Thank you for your question, and I wish you health and happiness.

Reply Date: 2020/12/28

More Info

Missing a birth control pill can indeed lead to risks of unintended pregnancy, particularly if the missed pill is not taken within the recommended time frame. In your case, you mentioned that you missed a pill on December 5th and took it the following morning, which is a good practice as it helps to maintain the effectiveness of the contraceptive method. However, the timing and the type of birth control pill you are using can significantly influence the level of protection against pregnancy.

Most combination birth control pills (which contain both estrogen and progestin) are designed to be taken daily at the same time to maintain consistent hormone levels in your body. If you miss a pill and remember to take it within 24 hours, the contraceptive effect is generally maintained. However, if you miss a pill and do not take it within that window, the effectiveness can be compromised, especially if you engage in unprotected intercourse during that time.

In your situation, since you took the missed pill the next morning, you should still have a reasonable level of protection. However, the risk of pregnancy increases if you have unprotected sex after missing a pill, particularly if it occurs during the week when you missed the pill. Since you had unprotected intercourse on December 7th and 9th, it is essential to consider the timing of your missed pill and the subsequent sexual activity.

If you are using a progestin-only pill (often referred to as the "mini-pill"), the rules are slightly different. These pills must be taken at the same time every day, and missing a dose by more than three hours can significantly reduce their effectiveness. In such cases, if you miss a pill, it is recommended to use a backup method of contraception, such as condoms, for at least 48 hours after taking the missed pill.

To further mitigate the risk of unintended pregnancy, consider the following steps:
1. Use Backup Contraception: If you miss a pill, especially if it’s during the first week of a new pack, using a backup method like condoms for at least seven days is advisable.

2. Emergency Contraception: If you are concerned about the possibility of pregnancy after unprotected intercourse, you may consider emergency contraception (like Plan B) if it is within the appropriate time frame (typically within 72 hours after unprotected sex, but some options can be effective up to 5 days).

3. Consult Your Healthcare Provider: If you frequently forget to take your pill or have concerns about your contraceptive method, it may be beneficial to discuss alternative options with your healthcare provider. Long-acting reversible contraceptives (LARCs), such as IUDs or implants, can provide effective contraception without the need for daily attention.

4. Regular Monitoring: Keep track of your menstrual cycle and any changes in your body. If you experience any unusual symptoms or a missed period after having unprotected sex, consider taking a pregnancy test or consulting with your healthcare provider.

In conclusion, while missing a birth control pill can increase the risk of pregnancy, taking the missed pill as soon as you remember can help maintain its effectiveness. However, given the unprotected intercourse that followed, it is wise to remain vigilant and consider additional contraceptive measures or consult with a healthcare professional for personalized advice.

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