Can You Get Pregnant from Outer-Course While on Birth Control?

Using pre-exposure prophylaxis (PrEP) and external friction with underwear?

I have been taking the emergency contraceptive pill for the second month (since I am abroad and not using the domestic brand).
I took the first month's pills on time, usually at 11 PM.
However, on January 16-17, I felt unwell and accidentally fell asleep early, missing my dose.
On the first day of the second month (January 16), I did not take the pill at 11 PM, but I took it the next morning (January 17) at 8 AM.
On the evening of January 17, I again missed the dose at 11 PM, but I took it the next morning (January 18) at 8 AM and then took the scheduled dose at 11 PM that night.
On January 19, I took the pill on time at 11 PM (I had taken antibiotics on January 18 due to being ill).
Today (January 20), I had genital rubbing with my boyfriend (without a condom) and there was also finger penetration.
I would like to know if there is a chance of pregnancy or if the risk is high.
Thank you.

Yan, 20~29 year old female. Ask Date: 2022/01/20

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
Each type of combined oral contraceptive pill comes in different formulations.
It is important to take the contraceptive 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 the next seven days.
If you miss a dose for more than 24 hours, you should stop taking the current pack of pills and refrain from taking them for seven days (including the days you missed), then continue with the next cycle.

Combined oral contraceptives (COCs) must be taken at the same time every day, and proper adherence can achieve a 99% effectiveness rate in preventing pregnancy.
If you miss a pill and do not experience the expected withdrawal bleeding during the subsequent pill-free interval, you should consider the possibility of pregnancy.

Thank you! Wishing you safety and health.

Dr.
Zhang

Reply Date: 2022/01/20

More Info

When it comes to the question of whether you can get pregnant from outer-course while on birth control, it's important to understand how birth control pills work and the implications of missed doses. Birth control pills are designed to prevent ovulation, thicken cervical mucus, and thin the uterine lining, making it less likely for a pregnancy to occur. However, their effectiveness can be compromised if doses are missed or taken irregularly.

In your case, you mentioned that you have been on birth control for two months and that you missed a dose on January 16th and took it the following morning. You also mentioned that you were taking antibiotics, which can sometimes reduce the effectiveness of birth control pills. The general recommendation is that if you miss a pill, you should take it as soon as you remember, and if you miss more than one, you may need to use backup contraception for a short period.

Regarding your specific situation, engaging in outer-course (which includes activities like genital rubbing or fingering) without a condom does carry some risk of pregnancy, especially if there was any pre-ejaculate fluid involved. Pre-ejaculate can contain sperm, and if it comes into contact with the vaginal area, there is a potential risk of pregnancy, albeit lower than with penetrative intercourse.

Given that you missed a dose and took antibiotics, your birth control may not be as effective as it should be. The timing of your missed doses and the fact that you engaged in outer-course shortly after these missed doses raises some concerns. While the likelihood of pregnancy is generally lower with consistent birth control use, the irregularities you've described could increase that risk.

To summarize, while the chances of getting pregnant from outer-course while on birth control are generally low, your missed doses and the use of antibiotics could potentially increase that risk. If you are concerned about the possibility of pregnancy, consider taking a home pregnancy test if your period is late or consult with a healthcare provider for further guidance. Additionally, using backup contraception, such as condoms, during times when you are unsure about the effectiveness of your birth control can help reduce the risk of unintended pregnancy.

In the future, it's crucial to take your birth control pills consistently at the same time each day and to have a backup plan in case of missed doses. If you have any further questions or concerns about your birth control or reproductive health, don't hesitate to reach out to a healthcare professional for personalized advice.

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