What to Do If You Missed One or More of Your Birth Control Pills

There are several courses of action, and they all depend on what form of birth control pill you’re using, as well as how many pills you may have missed.

If you aren’t sure what you should do, ask yourself the following.

When did you miss your pill?

Did you miss your pill today, yesterday, or earlier in the pack? When you missed the pill may affect what you should do in response.

What type of pill do you take?

If you take a combination birth control pill, the response to a missed pill is slightly different from someone who takes a progestin-only pill.

When do you take your last 2 pills?

Did you take your last two pills in the past 2 to 3 days? Or has it been longer? A longer break between taking your pills may mean that emergency contraception and backup contraception are required.

When did you start this pill pack?

Did you start this pill pack in the past week or so? Or has it been longer? If you’re in the first or last week of the pill pack, emergency contraception may be useful.

What do you take the pill for?

Not everyone takes the pill for contraception, which means your response to a missed pill might be different.

If you take the pill for contraception, depending on the number of pills you missed and when you missed them, you might need to take emergency contraception or use a backup form of contraception to prevent pregnancy.

If you take the pill for condition management, use the steps below for more information on how to return to your regular schedule.

Hormonal contraceptive pills are also known as combined birth control pills.

This form of contraception typically involves taking one hormonal (active) pill every single day for 21 days, followed by either a 7-day break or 7 days of nonactive placebo pills.

If you take the progestin-only pill, however, the response to a single missed pill is slightly different since you need to take the pill for 2 consecutive days to ensure protection.

For combination pills

• When should you take your next pill(s)? As soon as possible. You should also return to your normal schedule, meaning you might need to take two pills in 1 day.
• How likely is pregnancy? Very low.
• Is emergency contraception necessary? No, unless you missed the pill early in your pack or late in the previous pack.
• Is backup contraception needed? No.
• Are side effects possible? Yes. You may experience some breakthrough bleeding.

For progestin-only pills

• When should you take your next pill(s)? As soon as possible. You should also return to your normal schedule, taking the next pill at your usual time.
• How likely is pregnancy? Somewhat likely.
• Is emergency contraception necessary? If you had unprotected sex within the past 5 days, consider using emergency contraception.
• Is backup contraception needed? Use backup contraception, such as condoms, or abstain from penis-in-vagina sex until you’ve taken pills for 2 consecutive days.
• Are side effects possible? Yes. Increased pregnancy risk is possible until you’ve taken the pill for 2 consecutive days.

If you’ve missed two or more hormonal (active) pills, you may need to take additional action to prevent pregnancy, especially if you’re sexually active.

For combination pills

• When should you take your next pill(s)? As soon as possible. You should also return to your normal schedule, meaning you might need to take two pills in 1 day.
  • If you missed pills in the third week, take the active pills in the pack daily until you run out, then start a new pack the next day. Don’t take the seven inactive pills or take a 7-day break.
  • If you’ve reached the end of your pack and you’ve missed two or more pills, count the number of pills remaining in the pack.
  • If there are seven or more pills, finish the pack normally or take your 7-day break from pills before starting the next pack.
  • If there are less than seven pills in the pack, finish the active pills in the pack then discard the pack.
  • Don’t take the seven inactive pills or a 7-day break, and begin a new pack the next day.
• How likely is pregnancy? Somewhat likely.
• Is emergency contraception necessary? If you missed your pills during the first week of your cycle and had unprotected sex, consider using emergency contraception.
• Is backup contraception needed? Yes. Use backup, such as condoms, or abstain from penis-in-vagina sex until you’ve taken active pills for 7 consecutive days.
• Are side effects possible? Yes. You may experience some breakthrough bleeding, as well as increased risk of pregnancy until you return to your normal pill schedule.

For progestin-only pills

• When should you take your next pill(s)? As soon as possible. You should also return to your normal schedule, taking the next pill at your usual time.
• How likely is pregnancy? Very likely.
• Is emergency contraception necessary? If you had unprotected sex within the past 5 days, use emergency contraception.
• Is backup contraception needed? Use backup contraception, such as condoms, or abstain from penis-in-vagina sex until you’ve taken pills for 2 consecutive days.
• Are side effects possible? Yes. Increased pregnancy risk is possible until you’ve taken the pill for 2 consecutive days.

If you’ve missed one or more nonhormonal or placebo pills, simply discard the missed pill(s) and resume your normal schedule.

You should never leave more than 7 consecutive days between taking active pills.

• When should you take your next pill(s)? Discard the missed inactive pill(s), and continue on your normal schedule.
• How likely is pregnancy? Very unlikely.
• Is emergency contraception necessary? No.
• Is backup contraception needed? No.
• Are side effects possible? No.

If you aren’t sure which type of birth control you’re using or how many pills you missed, consider speaking with a healthcare provider.

If you’ve been sexually active, you may want to consider using emergency contraceptive or backup contraception until you’re back on a regular schedule.

• When should you take your next pill(s)? As soon as possible.
• How likely is pregnancy? It depends. Birth control must be taken at the same time, every day, to be considered 99 percent effective.
• Is emergency contraception necessary? It depends. If you’ve been sexually active, consider using emergency contraception.
• Is backup contraception needed? Yes. Until you’ve taken combination pills for 7 days in a row, or progestin-only pills for 2 days in a row, backup contraception is necessary.
• Are side effects possible? Yes. You may experience some breakthrough bleeding, as well as increased risk of pregnancy until you return to your normal pill schedule.

You should speak to a healthcare professional if you:

• have questions about your birth control schedule
• aren’t sure how many pills you’ve missed
• are struggling to stick to your birth control schedule

Birth control pills must be taken consistently to be effective, so it might be worth speaking to your provider about finding a birth control method that best suits your lifestyle.

Jandra Sutton is an author, freelance journalist, and entrepreneur who is passionate about helping people live full, happy, and creative lives. In her spare time, she enjoys nerding out, krav maga, and anything related to ice cream. You can follow her on Twitter and Instagram.