Can I Get Pregnant After Missing Birth Control Pills?

Will I get pregnant?

Hello doctor, I have been consistently taking the contraceptive pill Qlaira since July 2022, and my menstrual cycle has been normal (28-day cycle, menstruation occurring every 21 days for 7 days).
This month (at the end of January 2023), after my period ended, I was unable to purchase the contraceptive pill, so I did not take the first pill on the fifth day of my period.
I later took it after the fact (my period was from January 23 to January 28).
Today, on February 3, I had sexual intercourse with my boyfriend, but I realized that the condom was put on incorrectly at first, only covering the tip of the penis slightly, so I immediately removed it and put it on correctly.
The condom was worn throughout the intercourse until ejaculation.
However, I am very concerned because I have not taken a full 7 pills this month and I accidentally put the condom on incorrectly.
Is there a risk of pregnancy in this situation, and should I take emergency contraception?

Xiao Ai, 10~19 year old female. Ask Date: 2023/02/03

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the failure rate of condoms as a contraceptive method is over 5%, making it less reliable compared to other methods.
It is best to use emergency contraception as a remedy, but its effectiveness is not 100%, with a failure rate of about 3%.
It is advisable to check for pregnancy if your period is more than a week late.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2023/02/03

More Info

When it comes to the concern of getting pregnant after missing birth control pills, it's important to understand how hormonal contraceptives work and the implications of missed doses. Birth control pills, like the one you mentioned (祈麗安), are designed to prevent ovulation, thicken cervical mucus, and thin the uterine lining, all of which contribute to preventing pregnancy.
In your case, you have been consistently taking your birth control pills since July 2022, and your menstrual cycle has been regular. However, you missed taking the pill at the beginning of your cycle after your period ended on January 28, 2023. Missing a pill can reduce the effectiveness of the contraceptive, especially if it occurs during the first week of a new pack. Since you had unprotected intercourse on February 3, 2023, there is a possibility of pregnancy, particularly because you had not taken the pill for a full week.

The general recommendation for missed pills is as follows:
1. If you miss one pill, take it as soon as you remember, even if it means taking two pills in one day. Continue taking the remaining pills as scheduled.

2. If you miss two or more pills, the instructions can vary based on the specific pill regimen you are using. Typically, you would take the last missed pill as soon as you remember and continue with the rest of the pack. However, you may need to use a backup method of contraception, such as condoms, for at least seven days.

Given that you had a situation where the condom was not used correctly but was worn for the majority of the intercourse, it is understandable to be concerned about the risk of pregnancy. The fact that you did not take the pill consistently leading up to this encounter increases that risk.
Regarding the emergency contraceptive pill (often referred to as the "morning-after pill"), it can be an option if you are worried about the risk of pregnancy. Emergency contraception is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some types can be effective up to 5 days after. It works primarily by delaying ovulation, preventing fertilization, or preventing a fertilized egg from implanting in the uterus.

In summary, while there is a possibility of pregnancy due to the missed pill and the condom mishap, taking emergency contraception could help mitigate that risk if taken promptly. It is also advisable to consult with a healthcare provider for personalized advice and to discuss your options moving forward, including how to manage missed pills in the future and alternative contraceptive methods if needed.
Lastly, if you do not get your period as expected in the following month, consider taking a pregnancy test to confirm your status. Remember, maintaining open communication with your healthcare provider about your contraceptive methods and any concerns you have is crucial for your reproductive health.

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