Can You Get Pregnant on Birth Control? Know Your Risks

Intro 

The birth control pill has been a game changer for contraception, but the only foolproof way to prevent pregnancy is to abstain completely. Although the pill is effective, your chances of getting pregnant on birth control are never zero. Can you get pregnant on birth control? Read on to find out why it happens and what you need to know so you can reduce the risk.   

Can you get pregnant on birth control? 

In a word, yes!  Even when used perfectly, no form of contraception is 100% effective.  The birth control pill is only 99% effective with perfect use but no one is perfect and there are common mistakes that increase your risk.   

What are the chances of getting pregnant on birth control

Different types of birth control have different success rates. Under perfect use, the birth control pill is 99% effective meaning only one out of every 100 users will become pregnant. Under typical conditions though that rate falls to 91% and about nine out of every 100 users will become pregnant every year. These rates are similar to those of the birth control ring and the patch, two other common forms of hormonal contraception. Other forms of birth control like the birth control shot (Depo-Provera) are also 99% effective with perfect use but only 94% effective in typical real world conditions.

When fitted properly, the IUD is one of the most effective forms of birth control for preventing pregnancy since it mostly lacks user involvement. It is more than 99% effective meaning fewer than one out of 100 people will get pregnant each year. It can also be used as emergency contraception and is more than 99% effective if put in within 120 hours or 5 days of having unprotected sex. Much like IUDs, the birth control implant requires no human involvement after it has been fitted into your arm. It boasts a more than 99% effective rate and can last for up to 3 years. 

The reality is, the more a method of birth control relies on you to use it perfectly, the higher the likelihood that it can fail. Most require perfect use and no deviation from that plan to be effective at preventing pregnancy. But humans are humans and certain behaviors or conditions (like other medications) can increase your risk of failure and possible pregnancy.           

How you can get pregnant while on birth control

The key to taking birth control is to follow the directions precisely to maximize effectiveness. But even then, there are certain instances where effectiveness may be reduced. When one or more of these situations occur, your pill is not as effective and your chances of getting pregnant on birth control increase. How to get pregnant on birth control is as simple as not following the instructions or paying attention to factors that reduce effectiveness.

Missing one or more pills

Missing one or more pills means that your system is not getting the right hormones in your bloodstream to prevent pregnancy. You need consistent levels for the pill to work properly and even missing one pill means the amount in your bloodstream will drop and make the pill less effective.  

Taking medication that affects the pill’s effectiveness

Birth control pills are absorbed in your gastrointestinal tract and then metabolized in the liver by certain enzymes. Other medications may be affected by the same enzymes thereby lowering the absorption rate of your birth control pill. Even some health supplements may lower absorption and make your pill less effective.   

Having diarrhea or vomiting 

Your digestive tract comes into play again when it comes to pill effectiveness and having diarrhea or vomiting. Both of these situations mean that your body may not properly absorb the hormones in the pill and you could be at risk for getting pregnant.  

Taking the pill at the wrong time of day 

Just like you can’t miss any pills, it’s important to take the pill at the same time every day. It relies on consistency to keep your bloodstream supplied with the right hormones at the right levels. If you take your pill at a different time your hormone supply won’t be consistent and you will increase your risk for birth control failure. 

How to reduce risk of pregnancy while on birth control

Maintaining a strict protocol of how and when you take your pill is key to reducing the risk of pregnancy while on birth control. Follow the instructions closely and use backup methods if there is any deviation from the protocol. The following tips can help you reduce your risk of pregnancy while on birth control. 

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Take your pill at the same time daily

To keep your hormone levels consistent, take your pill at the same time every single day. There are plenty of reminder apps to help you remember or you can set an alarm or pair it with an activity that you do every day at a certain time. This is especially important for progestin-only pills since hormone levels can drop quickly and you may ovulate which increases your chance of getting pregnant.

Consider taking your placebo pills

Many people skip the placebo pills as a bit of a break from having to take one, but consider taking them to keep your routine intact. Even though it may not be medically necessary, it helps to keep your behavior consistent and can help you stick to the routine.

Wait for birth control to be effective before having sex

It can take several days or weeks for your birth control to be effective, so if you’re having sex before that you are at a higher risk of pregnancy. You can either avoid sex or use a backup method for protection.

If you miss a pill, follow instructions for your birth control brand

Every manufacturer is different, but if you miss a pill, check the instructions to see what your brand recommends. Often you’ll be advised to take the missed pill right away, but even so, the effectiveness will be decreased since your schedule of hormone release has been altered.  

Consider other effective birth control like IUD or implants

If you struggle to take your pill at the same time every day or your lifestyle simply doesn’t allow it, consider other effective birth control methods. IUDs, implants, and the shot all require less interaction than pills and can keep you protected and reduce your risk of pregnancy. 

Check that other medications won’t affect birth control

Certain medications may reduce the effectiveness of your birth control, especially if they are absorbed through your digestive tract. If you’re on any other medications, check that they won’t affect your birth control or consider switching methods. Always speak to your healthcare provider to check for medication interaction or look at alternatives that may work better for you.

Don’t use St. John’s wort

St. John’s wort is a popular herbal supplement available in teas, tablets, liquids, and as a cream.  It’s often used to treat depression or menopausal symptoms but it also interacts with other medications and can also cause serious side effects. Among the interactions, the effectiveness of birth control is greatly reduced when taking this supplement. It’s been well known to disrupt oral contraceptives but may also make other hormonal contraceptives ineffective as well.  

If you made a mistake, use emergency contraceptive

If you’re concerned that you’ve made a mistake with taking your birth control, use an emergency contraceptive to keep yourself protected. You’ll need to act fast but both the morning after pill (known as Plan B) and IUDs are effective methods of emergency contraception. 

What happens if you get pregnant on birth control

The earliest symptoms of pregnancy may be easy to miss while on birth control and you may be wondering what happens if you get pregnant on birth control. Although birth control is mostly safe in early pregnancy, it does increase your risk of ectopic pregnancy. This is an early pregnancy outside of the uterus and is not only serious but life threatening. Sometimes called a tubal pregnancy, ectopic pregnancies are not viable and should be treated immediately due to its life threatening consequences. But you’ll be pleased to know that there are no links to problems with the baby even if you continued to take the pill while pregnant. Once you find out you’re pregnant, stop taking the pill immediately.      

Early signs of pregnancy while on birth control

As mentioned, it can be easy to miss the early signs of pregnancy even if you’re not on birth control, but since many of the side effects of birth control are similar to the early symptoms of pregnancy, it can complicate matters. Early signs of pregnancy while on birth control include a missed period, nausea, breast tenderness, and fatigue and headaches. Since your hormone levels are altered in both pregnancy and while on birth control, you may experience similar side effects and miss the early signs.  

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Getting pregnant on birth control FAQ

We’ve got the answers to some common questions about getting pregnant on birth control.