Impact of Missing Birth Control Pills on Pregnancy Risk: Your Questions Answered

Missed a dose of emergency contraception?

Hello Doctor, I have been taking the contraceptive pill for three months now, starting on July 13.
I forgot to take the pill on either July 24 or 25, but I resumed taking it as usual on July 26.
On July 27, I had unprotected intercourse, and in the evening, when it was time to take the pill, I realized I had missed a dose and immediately took two pills.

1.
Will this affect the contraceptive effectiveness?
2.
Is there a chance of pregnancy in this situation? Thank you.
🙏

Guo, 20~29 year old female. Ask Date: 2021/07/28

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the number of pills in each type of combination oral contraceptive varies, and it is important to take the pills as directed.
If you forget to take a pill, you should take it as soon as you remember, and continue taking the next pill at the usual time.
If you miss a dose of an active 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 miss a dose for more than 24 hours, you should stop taking the current pack of contraceptives, refrain from taking any pills for seven days (including the days you missed), and then continue with the next cycle.
If you miss a pill and do not experience the expected withdrawal bleeding during the placebo period, you should consider the possibility of pregnancy.
Thank you! Wishing you safety and health, Dr.
Zhang.

Reply Date: 2021/07/28

More Info

When it comes to the impact of missing birth control pills on pregnancy risk, it's essential to understand how hormonal contraceptives work and the implications of missing a dose. Birth control pills, such as the one you mentioned (likely a combination pill), are designed to prevent ovulation, thicken cervical mucus, and thin the uterine lining, thereby reducing the chances of pregnancy.

1. Effectiveness of Birth Control Pills: Birth control pills are most effective when taken consistently at the same time every day. Missing a pill can decrease their effectiveness, particularly if the missed pill is not taken within the recommended time frame. In your case, since you missed a pill on either July 24 or 25 but took your next pill on July 26 and doubled up on July 27, you have taken steps to mitigate the risk. However, the effectiveness of the pill may be compromised, especially if you missed the pill during the first week of your cycle, which is when the risk of ovulation is highest.

2. Risk of Pregnancy: The risk of pregnancy after missing a pill depends on several factors, including when in your cycle the pill was missed and whether you had unprotected intercourse. Since you mentioned that you had unprotected intercourse on July 27 after missing a pill, there is a potential risk of pregnancy. If the missed pill was during the first week of your cycle and you had unprotected sex, the risk of ovulation and thus pregnancy is higher.
To summarize, while you took corrective action by taking the missed pill as soon as you remembered, the risk of pregnancy cannot be entirely ruled out, especially given the timing of your missed pill and subsequent unprotected intercourse.
Recommendations:
- Emergency Contraception: If you are concerned about the possibility of pregnancy, you may consider using emergency contraception (like Plan B) within 72 hours of unprotected intercourse. This can significantly reduce the risk of pregnancy if taken promptly.

- Follow-Up: If your next period is late or you experience unusual symptoms, consider taking a pregnancy test or consulting with your healthcare provider for further evaluation.

- Consistency is Key: To prevent similar situations in the future, try to establish a routine for taking your pills, such as setting a daily alarm or using a pill organizer.

In conclusion, while the missed pill does pose a risk to the effectiveness of your birth control, taking the missed pill as soon as you remembered helps. However, given the circumstances, it is wise to be cautious and consider emergency contraception if you are worried about pregnancy. Always consult with your healthcare provider for personalized advice and to discuss any concerns regarding your birth control method.

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