Answers to Frequently Asked Questions About...
When to Use Emergency Contraception
Do I need emergency contraception if I missed one or more of my regular birth control pills?
Whether you should use emergency
contraception or take other steps to prevent pregnancy after missing
one or more of your regular birth control pills depends on:
- the type of pills you are using
- how many you missed taking, and
- which week of pills you are on.
As a general rule, your chances of getting pregnant are the highest if you miss pills that contain hormones (often called “active” pills) just as you are starting or ending that part of your pill pack. Any time you miss an active (hormone) pill, take the missed one as soon as you remember it. And if you ever miss 3 or more active pills, be sure to take additional steps to prevent pregnancy – like using emergency contraceptive pills and/or using condoms or not having sex for seven days in a row (that’s the number of days you need to have taken active pills to be sure you aren’t going to ovulate).
Don’t worry if you miss inactive pills (these are the ones without
any hormones, which are included in your pill pack to help you remember
to take a pill every day). You can just throw away any missed “reminder”
pills and continue taking the rest of the pills in your pack as usual.
Since there are no hormones in the reminder pills, you are not at
risk of pregnancy if you don’t take them.
For 30–35 µg ethinylestradiol pills:
Missed 1 or 2 active (hormone) pills in
a row or started your new pill pack 1 or 2 days late?
- Take the missed active (hormonal) pill as soon as possible and then continue taking your remaining pills at the regular time each day after that. (If you missed 2 active pills, you have several options: take one of the missed pills 2 days in a row, take both missed pills on the same day, or – if you really want to stay on schedule – take the first missed pill right away and throw the second one away.)
- You do not need to use any additional protection (like condoms or emergency contraception).
Missed 3 or more active (hormone) pills
in a row or started your new pill pack 3 or more days late?
- Take an active (hormone) pill as soon as possible and then continue taking your pill at the regular time every day after that. (You have the option of taking one of the missed pills 3 days in a row, taking two missed pills on the same day and the third the next, or – if you really want to stay on schedule – taking the first missed pill and throwing the other missed pills away.)
- Any time you miss 3 or more active pills in a row, use condoms or don’t have sex until you have taken active (hormone) pills for 7 days in a row.
- If you missed pills in the third week of your pack, finish the active (hormone) pills and then immediately start a new pack. Do not take the 7 inactive pills.
- If you missed pills in the first week of your pack, you might want to consider using emergency contraception.
For 20 µg or less ethinylestradiol pills:
- If you missed 1 active (hormone) pill or started your new pill pack 1 day late, follow the instructions above for “Missed 1 or 2.”
- If you missed 2 or more active (hormone) pills in a row or started your pack 2 or more days late, follow the guidance above for “Missed 3 or more.”
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The risk of pregnancy may be higher when missing these active
pills, so the recommendations call for a more cautious approach.
You should know that not using pills correctly or consistently is a major reason that so many women get pregnant when they aren’t trying to have a baby (a situation researchers refer to as an unintended pregnancy). If you find yourself missing pills often, talk to your health care provider about other kinds of regular birth control that might fit your health and lifestyle needs better.
This information is based on the World Health Organization (WHO) report
entitled "Selected practice recommendations for contraceptive
use," 2nd edition, Geneva, World Health Organization, 2004. The
WHO report can be accessed online at: http://www.who.int/reproductive-health/publications/spr/spr.pdf
(information
on missed oral contraceptive pills is found on page 94).