Missed Birth Control: What to Do After Unprotected Intercourse? - Obstetrics and Gynecology

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When it comes to missed birth control and unprotected intercourse, it’s essential to understand how hormonal contraceptives work and what steps to take if a dose is missed. In your situation, your girlfriend has been taking birth control pills for about two months but had a break of one week. After resuming the pills, she missed a dose and then had unprotected intercourse shortly after.

Firstly, it's important to note that birth control pills are most effective when taken consistently at the same time every day. Missing a dose can reduce their effectiveness, especially if it happens during the first week of a new pack. In your case, since your girlfriend missed a pill on July 18 and had unprotected intercourse on July 19, there is a potential risk of pregnancy because the missed pill could lead to ovulation.

When a pill is missed, the general recommendation is to take the missed pill as soon as remembered, even if it means taking two pills in one day. Since your girlfriend took two pills on July 19 (one missed and one for that day), she has taken steps to mitigate the risk of pregnancy. However, the effectiveness of this action depends on the timing of the missed pill and the timing of intercourse.

In the case of missed pills, especially if more than 24 hours have passed since the last scheduled dose, it is often recommended to use a backup method of contraception, such as condoms, for at least seven days after resuming the pill. Since your girlfriend had unprotected intercourse within this timeframe, it is advisable to consider emergency contraception (EC) if there is a concern about potential pregnancy. EC is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some forms can be effective up to five days later.

Emergency contraception options include:
1. Levonorgestrel (Plan B): This is available over-the-counter and is most effective when taken within 72 hours after unprotected intercourse. It works primarily by preventing ovulation.

2. Ulipristal Acetate (Ella): This is a prescription medication that can be taken up to 120 hours (five days) after unprotected intercourse and is effective regardless of where you are in your menstrual cycle.

3. Copper Intrauterine Device (IUD): This can be used as emergency contraception if inserted by a healthcare provider within five days after unprotected intercourse. It is the most effective form of emergency contraception.

In summary, while your girlfriend has taken steps to resume her birth control regimen, the missed pill and subsequent unprotected intercourse do pose a risk for pregnancy. It is advisable to consider emergency contraception if there is concern about potential pregnancy. Additionally, moving forward, it’s crucial to maintain a consistent schedule with birth control pills to maximize their effectiveness and reduce the risk of unintended pregnancy. If there are any uncertainties or further questions, consulting with a healthcare provider is always a good step to ensure both partners are informed and comfortable with their contraceptive choices.