What Happens If You Miss A Day Of Birth Control?

Photographed by Ashley Armitage.
You carry your pills in your bag at all times. You set an alarm. You even set a follow-up alarm in case you snooze your first alarm. But alas, you are a human being who makes mistakes, and sometimes you forget to take your daily birth control pill. Realizing you forgot for even one day can make rational people panic. Realistically, though, what could happens if you forget to take a birth control pill?
"You can get pregnant," says Taraneh Shirazian, MD, assistant professor in the Department of Obstetrics and Gynecology at NYU Langone Medical Center. That sounds a little extreme, and possibly scary if you're not trying to get pregnant (which you presumably aren't, if you're taking the pill) — and it's certainly not guaranteed. It's not like the stork will come and make you pregnant just because you missed a pill, but technically you could get pregnant. Hormonal birth control pills are supposed to suppress ovulation, so that you won't release an egg to be fertilized. So if you miss a pill, "you could ovulate, and that's the problem," Dr. Shirazian says.
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In most cases, if you just forgot one pill, you should take the pill that you missed ASAP to get back on track and ultimately prevent pregnancy, Dr. Shirazian says. It's safe to take two pills in a day if you need to, but the pill is definitely designed to be taken daily, so don't get in the habit of doing it. Doubling up generally makes up for a missed day whether you're on a combination birth control pill or a progesterone only pill, according to the Mayo Clinic. But it's also a good idea to keep in mind where you are in your cycle before you pop that extra pill — especially if you've missed more than one.
Obviously, if you're on a pill that has a row of inactive pills during the week that you get your period, nothing is going to happen if you forget to take one of them, according to the Mayo Clinic. Those pills are often called "sugar pills" or "placebo pills," because they don't contain any hormones or active ingredients, according to the American Congress of Obstetrics and Gynecology. You just have to make sure you know which day to start your next new pack of pills, but otherwise, you can skip them. If you're on a progesterone-only pill, though, then you won't have a week of inactive pills, so it's crucial to take each pill every single day, for your whole cycle.
Now, let's say you miss two pills in a row during the first or second week of your cycle. You should take two pills on the day you remember, and two more the day after, to get up to speed, according to the Mayo Clinic. Dr. Shirazian also says there's a chance you'll bleed heavily if you miss two pills, so watch out for that.
But if you happen to miss two pills in a row on the third week, or three pills in a row at any point of your cycle, then it's slightly more complicated. If you have a "Day-1 start" pill, meaning you started the pack of pills on any day of the week, then you should just toss the whole pack and start a new one. On the other hand, if you use a "Sunday-start" pill, you should keep taking the pills one at a time (don't double up) until Sunday comes. Then, start a new pack on that Sunday. If that happens, your cycle might be slightly out of whack, so don't be surprised if you don't get your period that month.
In general, if you forget to take a pill at any point in your cycle, it's a really good idea to use a backup birth control method, like condoms, for the rest of your cycle, Dr. Shirazian says. Even though using condoms might be inconvenient, consider it your penance for missing a pill. And although it can be confusing to get back on schedule with your pills, most birth control pill packs will come with instructions that explain what to do if you forget a pill. If you're still confused, which is possible, just ask your doctor what to do. They won't scold you for missing a pill, because after all, you're only human.
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