Table of ContentsView AllTable of ContentsWhat to DoWhat HappensPreventing a Missed PillWhen to Talk to a Healthcare ProviderEmergency Contraception
Table of ContentsView All
View All
Table of Contents
What to Do
What Happens
Preventing a Missed Pill
When to Talk to a Healthcare Provider
Emergency Contraception
It is possible to get pregnant if you missed a pill and had unprotected sex. The risk depends on your medication, how many active (hormone-containing) pills you missed, and how long it has been since your last dose.
If you miss a pill, take it as soon as you remember. Keep taking your pills according to your usual schedule. If it has been more than 48 hours since your last dose, you will need to use backup birth control. If you had unprotected sex in the five days before you resumed taking your pills, it is a good idea to use emergency contraception.
This article discusses the likelihood of pregnancy after forgetting to take birth control pills one or more times in a cycle. It also details how timing and other things can interfere with the pill’s effectiveness.
What to Do If You Miss a Birth Control Pill
Missing one pill may not increase your risk of pregnancy, depending on what type of pill you take.
What to Do If You Missed a Combination Pill
Planned Parenthood has ahandy quizyou can take to figure out what to do in your specific situation, but here’s a review of the general guidelines:
One Late or Missed Combination Pill
If it’s been 24 to 48 hours since your last dose:
Back-up birth control may include condoms, diaphragms, or sponges.
Two or More Missed Combination Pills
If it has been 48 hours or more since your last dose:
What to Do If You Missed a Progestin-Only Pill
One Late Progestin-Only Pill
If it’s been more than three hours since your last pill but less than a day:
One Missed Progestin-Only Pill
If you missed an entire day:
Call your healthcare provider’s office if you are unsure how to proceed or need further assistance. You can also check your birth control package insert for more information.
The pill is 99% effective in people who take their pill on time every day. The percentage drops to 91% in people who do not adhere to a consistent daily schedule.
Does It Matter Which Pill You Missed?
Many birth control pill packs have three weeks of active pills that contain either progestin and estrogen (combination pills) or only progestin. They also have one week of placebos, which are sugar pills that have no hormones.
With these packs, forgetting to take a pill if it’s your first, second, or third week can affect your pregnancy risk. Forgetting to take a placebo pill does not affect your pregnancy risk, as these pills are only there to help you remember to take a pill each day.
If you miss more than one dose per pill pack, the risk of pregnancy jumps.
What Happens When You Miss a Pill
The birth control pill is not 100% effective even when taken perfectly. To achieve the best results, you need to take the pill at the same time every day. Missing or delaying doses allows the therapeutic drug level to drop.
Ultimately, there is a point at which drug levels drop low enough that ovulation can occur. This can happen more quickly in some people than others, and the drop is faster with the progestin-only mini-pill use versus combination pill use.
The two most common side effects of missing a birth control pill are spotting and pregnancy.
Vomiting or diarrhea can also lessen the pill’s effects because too much active drug may be eliminated from the body. The effect can be similar to forgetting to take the pill altogether.
Daylight Saving Time and Your Birth Control Pill
How Do Birth Control Pills Work?Oral contraceptives provide your body with just enough hormones toblock ovulation. Ovulation, when an egg is released from the ovaries, usually occurs between day 11 and day 21 of the menstrual cycle. People are most fertile during the two to three days before ovulation.When you take your birth control pills as prescribed, your body will have a steady supply of medication to keep you from ovulating. This is referred to as “maintaining the therapeutic drug level,” or how much of the drug needs to be in your system to be effective.
How Do Birth Control Pills Work?
Oral contraceptives provide your body with just enough hormones toblock ovulation. Ovulation, when an egg is released from the ovaries, usually occurs between day 11 and day 21 of the menstrual cycle. People are most fertile during the two to three days before ovulation.When you take your birth control pills as prescribed, your body will have a steady supply of medication to keep you from ovulating. This is referred to as “maintaining the therapeutic drug level,” or how much of the drug needs to be in your system to be effective.
Oral contraceptives provide your body with just enough hormones toblock ovulation. Ovulation, when an egg is released from the ovaries, usually occurs between day 11 and day 21 of the menstrual cycle. People are most fertile during the two to three days before ovulation.
When you take your birth control pills as prescribed, your body will have a steady supply of medication to keep you from ovulating. This is referred to as “maintaining the therapeutic drug level,” or how much of the drug needs to be in your system to be effective.
Try to identify why you missed your dose:
If you frequently miss pills, you might consider a long-acting reversible contraception (LARC) such as an intrauterine device (IUD) or hormonal implant.Copper IUDs do not contain hormones and can stay in place for up to 10 years. Hormone-releasing IUDs can be left in place for up to five years. Implants, such as Implanon and Nexplanon, use hormones and are placed in the upper arm. They are effective for three years.
If you frequently miss pills, you might consider a long-acting reversible contraception (LARC) such as an intrauterine device (IUD) or hormonal implant.
Copper IUDs do not contain hormones and can stay in place for up to 10 years. Hormone-releasing IUDs can be left in place for up to five years. Implants, such as Implanon and Nexplanon, use hormones and are placed in the upper arm. They are effective for three years.
By pinpointing the cause, you can take steps to avoid missing a pill in the future. For example:
Neuroscientists who study habit formation recommend tying habits together—such as taking your birth control pill right after you brush your teeth.
This technique, known as habit stacking or habit chaining, has been shown to increase the likelihood that a new habit will stick.
If you miss your birth control pill often, talk to your healthcare provider about an alternate contraception that does not need to be taken daily. For example, you may want to consider using a birth control patch or IUD.
You should also see your healthcare provider if you have had a positive pregnancy test, or if you have any early signs of pregnancy such as:
If you missed a pill and had unprotected sex before realizing you missed a pill, you might consider using emergency contraception. The most common forms of emergency contraception are the copper IUD or the morning-after pill.
Many people wonder whether emergency contraception can cause an abortion if pregnancy has already occurred. Emergency contraceptive pills will not be effective if implantation of a fertilized egg has occurred. They can not cause abortion.Copper IUDs are only implanted if a high-sensitivity pregnancy test is negative.
Copper IUD
The most effective emergency contraception is insertion of acopper intrauterine device (IUD). It is effective up to five days after unprotected sex.It involves a healthcare provider inserting a T-shaped copper device into the uterus.
The IUD will prevent pregnancy with more than 99% effectiveness. It can be inserted up to five days after unprotected sex, although some studies suggest it can be inserted even later, as long as high-sensitivity pregnancy tests are negative.
The Morning After Pill
Emergency contraception pills are another option. They are commonly called the morning after pill. There are two main types of morning after pills.
What to Do When You Forget Your Pill
Summary
Taking birth control every day, at the same time each day, is the best way to prevent pregnancy. A steady supply of hormones will keep you from ovulating. However, don’t panic if you forget. You may still have some level of protection.
Be sure to resume your birth control according to the specific instructions for your medication.
If you had unprotected sex and want to prevent pregnancy, you may want to consider using emergency contraception.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Recommended actions after late or missed combined oral contraceptives.American Academy of Family Physicians.Progestin-only birth control pills.Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM.Combined oral contraceptive adherence and pregnancy rates.Obstet Gynecol. 2023;141(5):989-994. doi:10.1097/AOG.0000000000005155Chabbert-Buffet N, Jamin C, Lete I, et al.Missed pills: Frequency, reasons, consequences and solutions.Eur J Contracept Reprod Health Care. 2017;22(3):165-169. doi:10.1080/13625187.2017.1295437Planned Parenthood.Can I change my birth control timing after I finish a pack?Smith KS, Graybiel AM.Habit formation.Dialogues Clin Neurosci. 2016;18(1):33-43. doi:10.31887/DCNS.2016.18.1/ksmithPavičić Baldani D, Škrgatić L, Goldštajn MŠ, Goluža T, Flisar I, Pagon S.Questionnaire on the midwives’ knowledge about oral emergency contraception.Acta Clin Croat. 2018;57(1):134-140. doi:10.20471/acc.2018.57.01.17Goldstuck ND, Cheung TS.The efficacy of intrauterine devices for emergency contraception and beyond: a systematic review update.Int J Womens Health. 2019;11:471-479. doi:10.2147/IJWH.S213815Planned Parenthood.What kind of emergency contraception is best for me?
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Recommended actions after late or missed combined oral contraceptives.American Academy of Family Physicians.Progestin-only birth control pills.Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM.Combined oral contraceptive adherence and pregnancy rates.Obstet Gynecol. 2023;141(5):989-994. doi:10.1097/AOG.0000000000005155Chabbert-Buffet N, Jamin C, Lete I, et al.Missed pills: Frequency, reasons, consequences and solutions.Eur J Contracept Reprod Health Care. 2017;22(3):165-169. doi:10.1080/13625187.2017.1295437Planned Parenthood.Can I change my birth control timing after I finish a pack?Smith KS, Graybiel AM.Habit formation.Dialogues Clin Neurosci. 2016;18(1):33-43. doi:10.31887/DCNS.2016.18.1/ksmithPavičić Baldani D, Škrgatić L, Goldštajn MŠ, Goluža T, Flisar I, Pagon S.Questionnaire on the midwives’ knowledge about oral emergency contraception.Acta Clin Croat. 2018;57(1):134-140. doi:10.20471/acc.2018.57.01.17Goldstuck ND, Cheung TS.The efficacy of intrauterine devices for emergency contraception and beyond: a systematic review update.Int J Womens Health. 2019;11:471-479. doi:10.2147/IJWH.S213815Planned Parenthood.What kind of emergency contraception is best for me?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Recommended actions after late or missed combined oral contraceptives.American Academy of Family Physicians.Progestin-only birth control pills.Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM.Combined oral contraceptive adherence and pregnancy rates.Obstet Gynecol. 2023;141(5):989-994. doi:10.1097/AOG.0000000000005155Chabbert-Buffet N, Jamin C, Lete I, et al.Missed pills: Frequency, reasons, consequences and solutions.Eur J Contracept Reprod Health Care. 2017;22(3):165-169. doi:10.1080/13625187.2017.1295437Planned Parenthood.Can I change my birth control timing after I finish a pack?Smith KS, Graybiel AM.Habit formation.Dialogues Clin Neurosci. 2016;18(1):33-43. doi:10.31887/DCNS.2016.18.1/ksmithPavičić Baldani D, Škrgatić L, Goldštajn MŠ, Goluža T, Flisar I, Pagon S.Questionnaire on the midwives’ knowledge about oral emergency contraception.Acta Clin Croat. 2018;57(1):134-140. doi:10.20471/acc.2018.57.01.17Goldstuck ND, Cheung TS.The efficacy of intrauterine devices for emergency contraception and beyond: a systematic review update.Int J Womens Health. 2019;11:471-479. doi:10.2147/IJWH.S213815Planned Parenthood.What kind of emergency contraception is best for me?
Centers for Disease Control and Prevention.Recommended actions after late or missed combined oral contraceptives.
American Academy of Family Physicians.Progestin-only birth control pills.
Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM.Combined oral contraceptive adherence and pregnancy rates.Obstet Gynecol. 2023;141(5):989-994. doi:10.1097/AOG.0000000000005155
Chabbert-Buffet N, Jamin C, Lete I, et al.Missed pills: Frequency, reasons, consequences and solutions.Eur J Contracept Reprod Health Care. 2017;22(3):165-169. doi:10.1080/13625187.2017.1295437
Planned Parenthood.Can I change my birth control timing after I finish a pack?
Smith KS, Graybiel AM.Habit formation.Dialogues Clin Neurosci. 2016;18(1):33-43. doi:10.31887/DCNS.2016.18.1/ksmith
Pavičić Baldani D, Škrgatić L, Goldštajn MŠ, Goluža T, Flisar I, Pagon S.Questionnaire on the midwives’ knowledge about oral emergency contraception.Acta Clin Croat. 2018;57(1):134-140. doi:10.20471/acc.2018.57.01.17
Goldstuck ND, Cheung TS.The efficacy of intrauterine devices for emergency contraception and beyond: a systematic review update.Int J Womens Health. 2019;11:471-479. doi:10.2147/IJWH.S213815
Planned Parenthood.What kind of emergency contraception is best for me?
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