The Pill is one of the best medical inventions to date. It’s mind-blowing to think that one little tablet has the potential to improve your life in such a huge way, whether it’s by helping you avoid pregnancy or wrangling a beastly period. But in order to reap the Pill’s benefits, taking it properly is non-negotiable.
When taken perfectly—that’s the keyword—the Pill is over 99 percent effective. But when you factor in typical use, that number drops to around 91 percent. Beyond boosting your risk of accidental pregnancy, taking your pill improperly can make your life harder by inducing random spotting. Here, ob/gyns explain the birth control pill mistakes they see most frequently, plus how to avoid them so you can live your best life.
Mistake 1: Not taking your pill every day in the first place.
This is a no-no, whether it happens because you simply forgot or because the pharmacy closed before you could grab a new pill pack. Even if it seems like NBD to miss a pill, each time chips away at your perfect record, making you more likely to get pregnant.
That’s not to say missing one pill definitely means you’ll conceive the next time you have sex. But it’s not a good habit to get into, especially if you’re skipping more than one pill at a time. “Once you go those extra couple of days, you put yourself at a higher risk of failure,” Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynaecology at Yale Medical School, tells SELF.
If you find yourself continuously forgetting to take the Pill or consistently taking it late, talk to your doctor about other options, like the NuvaRing, Nexplanon implant, or an IUD. “There are other products out there that don’t require patients to take a pill every day,” board-certified ob/gyn Antonio Pizarro, M.D., tells SELF.
Mistake 2: Not knowing what to do when you miss a pill.
It depends on how many you’ve skipped. “If you miss one pill, you should basically catch up and take it as soon as you remember,” Pizarro says. For example, if you missed a pill last night, take it in the morning when the realization strikes you out of nowhere (because isn’t that usually how it goes?). Then take the next one at your regularly scheduled time. If you don’t remember until your regularly scheduled time, take both at once. Doing this might cause spotting, but you can still think of yourself as protected from pregnancy, Pizarro explains.
But if you miss two or more pills, Pizarro recommends using a backup method of contraception, like condoms, until you start your next pack and also seeking out emergency contraception if you’ve recently had unprotected sex.
Mistake 3: Taking a progestin-only pill at the wrong time.
“For the most part, patients I see tend to do really well with their birth control,” Pizarro says. But the most common issue he notices is patients taking their pills at the wrong time. If you’re taking progestin-only pills, taking your pill outside of the same three-hour window each day can raise your risk of pregnancy. Combination pills, on the other hand, have much more wiggle room and are effective as long as you take them every day.
But no matter what kind of pill you take, regularly taking your pill at wildly varied times could lead to irregular bleeding, Pizarro explains.
Mistake 4: Ditching placebo weeks for months on end.
Using the Pill to skip your period—whether because you have a big event coming up or just because you’re tired of bleeding from your vagina every month—is perfectly fine. “The only thing that can happen is if you take birth control pills consecutively for over six to eight weeks, you can get breakthrough bleeding,” Minkin says. “There’s nothing evil or dangerous about it, but it can be annoying.” If you’re not a fan of this side effect, she suggests going through with the placebo week every so often to get your uterus off your back.
Mistake 5: Not filling your doctor in on key parts of your medical history before deciding to take the Pill.
Although the Pill is great, it’s not right for everyone. For example, if you have a history of blood clots (either you’ve had them yourself or someone in your family has), it’s necessary to tell your doctor. The Pill’s pregnancy-prevention hormones can boost your risk of blood clots, which can lead to a stroke. (But the risks are still small overall, with 1 in 1,000 women per year taking birth control pills developing a blood clot.) Being over 35 and smoking raises that risk, as does having migraines with aura, Minkin explains.
Also, certain medications might make your BC less effective. Those include St. John’s Wort, which people sometimes take for mood disorders, and some antibiotics. “Don’t hesitate to talk to doctor or nurse practitioner about these issues,” Minkin says. Depending on your situation, you might need a specific type of pill, or you and a medical professional can discuss whether a different contraceptive option might be best for you.
Mistake 6: Not fully understanding what the Pill can and can’t do.
“One misconception about the Pill I hear routinely is that it might harm the pregnancy,” Pizarro says. But if you get pregnant while taking the Pill, it’s extremely unlikely for it to negatively affect the fetus, he explains.
He also sees people thinking of taking birth control pills as instructed can end a pregnancy. False. In a pinch, you can take extra birth control pills as emergency contraception, but regularly taking the Pill every day isn’t the same thing as taking the morning after or abortion pills. “Birth control pills do not end a pregnancy or destroy pregnancy—they prevent pregnancy,” Pizarro says.
