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(reply to sexyrika89)

Yes, unfortunately, there is a chance of pregnancy any time you miss pills and have unprotected sex.

The more pills you miss, the higher your chance of pregnancy. It is important to follow your prescription exactly, including how to "make up" for missed pills. Women commonly miss pills, and is the reason there are very detailed instructions on what to do if you miss 1, 2, 3 or more pills in-a-row. What you need to know is, when birth control pills are used consistently (every day) and correctly, they are 99% effective at preventing pregnancy. When pills are not used perfectly (called "typical use"), the effectiveness rate drops down to 92% or much lower.

Also, it is important to "double-up" on pills once you've missed them (let me know if you would like me to explain how, as it is confusing the first few times). When you miss 3 or more pills in-a-row, most prescriptions say to throw that pack away and start a new one on specified day. ANYTIME you miss ANY pills, it is crucial to use back-up method (condom) for the next 7 days.

There is a chance of pregnancy when you miss pills, as women do not actually ovulate while using hormonal contraception. When you have your "period", it is actually "withdrawal bleeding" from the inactive pills (your body is "withdrawing" from not taking hormone-containing pills for the 7 days). This is probably confusing, and I'm not sure why doctors don't tell women these things! :-)
The pills works in a few ways:
1. Preventing ovulation (release of an egg)
2. Thickening cervical mucus (in case of an egg being released, this makes it difficult for sperm to get inside the cervix)
3. Altering uterine lining (so that in case an egg is released and there is a very motivated sperm, the uterine lining does not make a good habitat for a fertilized egg, thus preventing implantation).

So, if this makes sense...you don't actually ovulate when you are on the pill. When you are off the pill, say when you miss 3 pills in-a-row and do not double-up, then your body thinks you are off the pill...there are not more synthetic hormones from the pill entering your body. So, your body starts its natural process of producing and releasing hormones to begin your cycle, including signaling the maturation and release of an egg from your ovary (ovulation). This is why back-up protection is so crucial, as you do not know when you ovulate after abruptly stopping birth control, and sperm can live inside a woman's body for up to 5 days "waiting" for an egg...it allows enough time for a possible pregnancy to occur.

Lastly, there is also a fourth line of defense if you are ever in this situation again of missing pills, not making up the missed pills, then having unprotected sex without a backup method...and that is using emergency contraception (Plan B). But, if you do miss pills again, please use a condom or choose not to have intercourse and be creative with sexual intimacy in other ways!

September 20, 2009 - 1:29pm

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