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

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Pre-exposure prophylaxis with external friction through underwear?


I have been taking the oral contraceptive pill for the second month (using a brand not available in my home country).
In the first month, I took the pill consistently at 11 PM, but due to feeling unwell on January 16-17, I accidentally fell asleep and missed 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 January 17, I missed the evening dose at 11 PM, but I took it the next morning (January 18) at 8 AM and then took the evening dose on time at 11 PM.
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 how likely it is.
Thank you.

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

Dr. Cao Guotao reply Obstetrics and Gynecology


Hello, if there was no actual sexual intercourse and you took the emergency contraceptive pill, even if not according to the guidelines, it is unlikely that you would become pregnant.
Wishing you good health.

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, the answer is nuanced and depends on several factors. First, let's clarify what "outer-course" means. Typically, outer-course refers to sexual activities that do not involve vaginal intercourse, such as mutual masturbation, oral sex, or genital rubbing. However, if there is any penetration, even if it's just with fingers, there is a potential risk of pregnancy, especially if sperm is present.

In your case, you mentioned that you have been taking birth control pills but missed doses due to illness. Birth control pills are designed to prevent ovulation, and when taken correctly, they are highly effective at preventing pregnancy. However, missing doses can reduce their effectiveness. The general recommendation is that if you miss a pill, you should take it as soon as you remember. If you miss more than one pill, especially during the first week of a new pack, you may need to use backup contraception, such as condoms, for at least seven days.

Given that you missed doses on January 16 and 17, and considering that you were also taking antibiotics, which can interfere with the effectiveness of birth control pills, your risk of pregnancy may be higher than if you had taken the pills consistently. The interaction between certain antibiotics and hormonal contraceptives can lead to decreased effectiveness, although not all antibiotics have this effect. It's essential to consult with your healthcare provider about any medications you are taking while on birth control.

Regarding your activities on January 20, if there was any possibility of sperm being transferred to the vaginal area, even through fingers, there is a risk of pregnancy. Sperm can survive for a short time outside the body, and if it comes into contact with the vaginal canal, there is a chance, albeit small, of sperm traveling to the egg if ovulation occurs.

To summarize, while the likelihood of getting pregnant from outer-course activities is generally low, the missed birth control pills and the potential interaction with antibiotics increase your risk. If you are concerned about the possibility of pregnancy, consider taking a home pregnancy test if your period is late or consult with your healthcare provider for further guidance. They may also recommend using backup contraception until you can ensure that your birth control is effective again.

In the future, to minimize the risk of unintended pregnancy, it's crucial to take your birth control pills consistently at the same time every day and to have a backup method of contraception available, especially during times of illness or when taking other medications. If you have any further questions or concerns about your birth control method or sexual health, don't hesitate to reach out to a healthcare professional for personalized advice.

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