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Can You Still Get Pregnant on the Pill?

Yes, there is a small chance you can get pregnant while taking the pill. The birth control pill is an oral contraceptive women take daily to avoid getting pregnant. If you don’t take it as directed, however, or another factor such as a medication you’re taking at the same time affects its efficacy, you might still get pregnant.

How Does the Pill Work?

The birth control pill contains hormones that affect your cervix, uterus, and ovaries in ways that prevent sperm from fertilizing an egg when you have sex. The main two types of pills are:

  • Combined, which includes both the hormones estrogen and progestin. They prevent your ovaries from releasing eggs. They also cause the mucous lining your cervix to thicken and your uterine lining to thin, making it difficult for sperm to come in contact with an egg if your ovaries do release one.
  • Progestin-only pills, which are also known as mini-pills, and do not contain estrogen. They also change your cervical mucus and uterine lining to block sperm. Sometimes they also prevent the ovaries from releasing eggs.

Combined pills typically include 21 days of active, hormone-containing pills and seven days of inactive, placebo pills. Mini-pills are all active. Regardless, you must take each type at the same time every day for them to work.

How Effective Is the Pill?

If you take the pill every day around the same time, it should be 91-95% effective. If you use it perfectly, meaning you’ve followed the exact directions and always take it consistently and correctly, the pill is 99.7% effective. Your chances of becoming pregnant go up when you miss a pill or take it late.

Reasons You Might Become Pregnant

Certain factors and behaviors can affect the pill’s efficacy, making it more likely you’ll still get pregnant while taking it. These include:

  • Forgetting to take the pill. Birth control pills work by keeping the estrogen and progesterone in your body at certain levels constantly. When you miss a pill, these hormone levels can drop, potentially allowing the ovaries to ovulate and making it easier for sperm to reach the egg.
  • Taking the pill at different times of the day. Forgetting to take the pill around the same time every day can also affect the consistency of the hormone levels in your body.
  • Throwing up. If you vomit soon (typically within two hours) after taking the pill, your body won’t have enough time to absorb the hormones.
  • Taking certain medications. Some drugs can affect the birth control pill’s efficacy. These include the antibiotic rifampin, some anti-seizure or epilepsy medications, HIV medications such as ritonavir, and some antifungals.
  • Taking certain supplements. Herbal supplements such as St. John’s wort, which alters liver metabolism, can also affect the way your body breaks down the hormones in the pill.

Steps to Prevent Pregnancy

If you’re on the pill, these steps can help you further reduce your chances of getting pregnant.

  • Take the pill around the same time every day. To help you remember, set a daily alarm on your phone, download a tracking app, or time taking the pill with a daily activity such as eating lunch. If you accidentally forget to take the pill, use a backup method of protection, such as condoms, when you have sex for the next week.
  • Take missed pills as soon as possible. If you realize you’ve forgotten to take your combination pill, take it right away. If you’re a day behind, this might mean taking two pills in one day. If you’ve forgotten to take your mini-pill, take it right away but also use backup protection for the next two days.
  • Start your next pack right away. If you don’t have your next month’s worth of pills yet, you might be forced to miss a day or more of birth control.
  • Be smart about mixing medications. Ask your healthcare provider whether any supplements or medications you’re currently taking or get prescribed might affect your birth control. If so, use backup contraception during sex for as long as you’re on that medication.
  • Store pills properly. To make sure the pill doesn’t lose its potency, keep it in its packaging, and store it at room temperature in a cool, dry place. Excessive heat, in particular, can affect how medications work.
  • Use barrier birth control. Using additional methods of birth control, such as condoms, diaphragms, or cervical caps, can help prevent pregnancy, as well. You should also use backup contraception for the first week after starting on the pill, until the hormones take full effect.

If you’re ever in doubt about the pill’s efficacy, talk to your Nurx™ medical team and use condoms during sex just to be safe.

How Do You Know if You’re Pregnant?

The early signs of pregnancy can be subtle and easy to miss. Watch for these symptoms, even if you’re on the pill, that might mean you’re pregnant:

  • Swollen, tender breasts.
  • Cravings for unusual foods.
  • A sudden distaste for certain foods or smells.
  • Nausea and vomiting, also known as morning sickness even though it can happen any time of day.
  • Fatigue or getting tired easily.
  • A missed period.
  • Spotting or irregular bleeding, known as implantation bleeding.

If you experience one or more of these symptoms, you can take an over-the-counter, at-home pregnancy test to confirm whether you are, indeed, pregnant. If you are, talk to your healthcare provider right away. He or she can do a blood test to confirm whether you’re pregnant and help you determine your next steps.

While no form of birth control is 100% effective, when taken correctly the pill is a highly effective way to prevent pregnancy.

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