Can I get pregnant if you missed a pill?

Woman holding birth control pills, mid section.
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Question: Can I get pregnant if you missed a pill?

Answer: If you miss a birth control pill or take one at the wrong time it increases the chances of becoming pregnant. It's not like one missed or late pill takes you to an immediate zero percent effect rate, but it does decrease the protective effects. Part of the risk depends on when you missed the pill, when you took your next pill, how sensitive your body is and what your health is like.

Simply put, each time you take the pill late or forget the pill increases your chance of pregnancy. If this happens more than once in each cycle or pill pack, that risk is even further increased. 

How the Pill Works and Why it Matters

Oral contraceptives or birth control pills work by providing your body with just enough hormones to suppress ovulation. When you take your pills as prescribed, your body has a steady supply of the hormones needed to keep you from ovulating.

Taking it correctly means that you take one pill, at the same time, every day. Even on the weekends. Even in the summer. This is how you keep your hormones in check. When you miss the time by an hour, the risk is less for pregnancy than if you miss the pill by twenty hours, but it is still there. Some people have bodies that are extremely sensitive and that little bit of time is enough for your body to ovulate and you can become pregnant.

Other Reasons That Your Birth Control Pills May Not Work

Remember, nausea, vomiting, diarrhea can also negate the effects of your birth control pill if it occurs too close to when you have taken the pill. This is because your body has gotten rid of the medication before absorbing it. You should use a backup method of birth control.

You may have also heard that taking antibiotics can also affect the effectiveness of your pills. This is true. If you are prescribed antibiotics, you will want to use a backup method of birth control, like condoms, until your begin your next pill pack.

Most of the time you are told to take the missed pill as soon as you remember it. You can usually take up to two doses at a single time. (Check with your prescribing doctor or midwife for specifics.) Remember, each pill should be taken about 24 hours away from each other to maintain the specific level of hormones you require.

What's next?

Here's what you need to do if you've missed a pill:

  1. Take it as soon as you remember it. This may mean doubling a dose the next day if that was the instruction you received when you got your prescription. (If you're not sure, call your doctor, midwife, or pharmacist.)
  2. Use a backup method of birth control to help decrease your risk of pregnancy.

Sources:

Frost JJ, Darroch JE, Remez L. Issues Brief (Alan Guttmacher Inst). 2008;(1):1-8. Improving contraceptive use in the United States.

Molloy GJ, Graham H, McGuinness H. BMC Public Health. 2012 Oct 2;12:838. doi: 10.1186/1471-2458-12-838. Adherence to the oral contraceptive pill: a cross-sectional survey of modifiable behavioural determinants.

Moos MK, Bartholomew NE, Lohr KN. Contraception. 2003 Feb;67(2):115-32. Counseling in the clinical setting to prevent unintended pregnancy: an evidence-based research agenda.

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