Does Missing a Birth Control Pill Increase Pregnancy Risk?

Does forgetting to take a birth control pill for one day significantly increase the risk of pregnancy?

Hello Dr.
Lin, I take my oral contraceptive pill every night at 11 PM.
However, I have encountered a problem recently.
My last menstrual period was from February 21 to February 27, with a little bleeding still on the 27th.
By February 28, there was no bleeding at all, and that night I had intercourse with my boyfriend, during which he ejaculated inside me.
I continued taking the next cycle of contraceptive pills on March 1, but since there is a break period after each cycle, I had a seven-day break from February 22 to February 28.
The issue is that on the night of March 3, I forgot to take my pill, and when I realized it on March 4, it was already 9:30 PM, so I took two pills at once, including the missed one.
I would like to ask Dr.
Lin how high the chance of pregnancy is in this situation.
Additionally, after March 5, should I change my pill-taking time to 9:30 PM or continue at 11 PM? I would appreciate your guidance.
Thank you.
PS.
I am very anxious, and I would be grateful for your prompt response.
From a very worried young girl.

R.S., 20~29 year old female. Ask Date: 2007/03/07

Dr. Lin Zhaopei reply Obstetrics and Gynecology

1.
If you have been taking birth control pills for a while, missing one day is usually not a major issue.
2.
It is important to take them at the same time each day or to remember to take them consistently.

Reply Date: 2007/03/07

More Info

Missing a birth control pill can indeed increase the risk of pregnancy, especially if it occurs during the first week of a new pill cycle or if you have had unprotected intercourse shortly before or after missing the pill. In your case, since you had unprotected sex on February 28 and then missed a pill on March 3, it is important to consider a few factors regarding your situation.

1. Timing of the Missed Pill: The effectiveness of birth control pills relies on consistent daily intake. If you miss a pill, especially during the first week of a new cycle, the risk of ovulation increases. Since you had unprotected sex shortly before missing the pill, there is a possibility that sperm could still be viable in your reproductive tract when you ovulate, leading to a potential pregnancy.

2. What to Do After Missing a Pill: When you realize you have missed a pill, the general recommendation is to take the missed pill as soon as you remember, even if it means taking two pills in one day (as you did). After that, continue taking the remaining pills at your regular time. In your case, since you took the missed pill on March 4, you should continue taking your pills at the same time you have been taking them (11 PM) rather than changing to 9:30 PM. Consistency is key to maintaining the effectiveness of the pill.

3. Emergency Contraception: If you are concerned about the risk of pregnancy due to the missed pill and unprotected intercourse, you might consider using emergency contraception (EC). EC is most effective when taken as soon as possible after unprotected sex, ideally within 72 hours, but some forms can be effective up to 5 days after. It is important to consult with a healthcare provider to discuss your options.

4. Monitoring for Pregnancy: If your next period is late or if you experience any unusual symptoms, it would be wise to take a pregnancy test. Birth control pills can sometimes cause changes in your menstrual cycle, but a missed period can also be an early sign of pregnancy.

5. Consulting with a Healthcare Provider: Given your anxiety about this situation, it may be beneficial to speak with a healthcare provider. They can provide personalized advice based on your medical history and current situation, and they can help you understand the best steps to take moving forward.

In summary, missing a birth control pill can increase the risk of pregnancy, particularly if it coincides with unprotected intercourse. It is crucial to take the missed pill as soon as you remember and continue with your regular schedule. If you have concerns about potential pregnancy, consider emergency contraception and consult with a healthcare provider for further guidance.

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