Birth control pills are more than 99% effective in preventing pregnancy as long as they are taken as directed. Having said that, birth control pills are a hormonal contraceptive method that must be taken orally every day at roughly the same time. (Progestin-only pills that do not include estrogen must be taken at exactly the same time every day in order to be effective and missing even one can lead to pregnancy; therefore the rules below do not apply to them.)
For many pill users, there will be at least once in your life when you miss taking your pill at the correct time. Don’t beat yourself up about it, but be prepared in advance for what to do in that scenario to continue keeping yourself protected from an unintended pregnancy.
The following are some general rules to follow in regard to combined hormonal contraceptive pills (estrogen and progestin, which are the vast majority of pills prescribed). As a reminder, in these pills the first three weeks are considered “active pills,” meaning that they include the active hormones needed to prevent pregnancy; the fourth week in a pack are considered “placebo pills” which do not include active hormones, and are taken during the menstrual flow portion of your cycle. If you are taking progestin-only pills, every pill in the back is considered active, and you must take them all!
If you miss one of the active pills: take it as soon as you remember and continue as normal with your pack.
If you miss two active pills: take them as soon as you remember but also use a back-up method like a condom (or abstinence) for one week.
If you miss three active pills: abandon the pack and use a different method for protection from pregnancy (like condoms or abstinence) until you have your next period. Begin a new pack the Sunday after your period starts, but continue your back-up method for one week, as you’re not yet protected from pregnancy.
If you mess up on your pills and had intercourse you believe wasn’t protected, you can take emergency contraception up to 72 hours afterward, most effective as soon as possible after the unprotected sex act. Again, if you’re 17 or older you do not need a prescription, but the medication is typically held behind pharmacy counters or at Planned Parenthood. If you’re under 17, you will need a prescription. (By the way, teens get discounted pricing at our affiliate.)
Also, if you find yourself forgetting two or more pills regularly, you might want to consider changing to a contraceptive method that does not require daily use, like the patch (weekly), the ring (monthly), the shot (every 3-4 months), the arm implant (three years), or an IUD (up to 5 years or up to 12 years).
As always, we recommend you use condoms in addition to your birth control method as a way of protecting against sexually transmitted infections, including H.I.V.
Need a text reminder to remember your pills/patch/ring or shot? Check out the free text-reminder service offered through Bedsider!