Yes, you can get pregnant if you forget one pill. However, the chances of this happening depend on the type of pill you take, how many active tablets you’ve missed, and how long it has been since you last took a pill.
Forgetting an active combination contraceptive pill increases the risk of pregnancy slightly but not significantly. Even if you forget an active tablet or take it at the wrong time, some of the drug will remain in your body.
If you take the mini pill, which contains progestin but no estrogen, your chances of getting pregnant after you forget to take an active tablet are increased, although it remains unlikely.
What are the chances of getting pregnant after you forget one pill?
When taken correctly, contraceptive pills are quite effective at preventing pregnancy. However, if you skip a pill (or several doses), your chances of getting pregnant increase significantly.
When you forget a tablet on your pack can affect your chances of getting pregnant. Forgetting one pill during the first week of your combination pills further increases your chances of pregnancy more than forgetting one pill in the middle of your pack. This is because your system is already depleted of hormones after a seven-day absence.
If you forget several pills and have unprotected sex, your chances of getting pregnant increase, especially in the last half of your pack or at the start of a new pack. It’s advisable to use emergency contraception or contact your health-care provider at this time.
If you have forgotten a pill and are anxious, using condoms as backup protection is always a good option. Remember that it’s the missing combined hormone tablet that counts, not the reminder pill.
Did you forget to take the pill? What to do for each type
As mentioned, what you should do if you forget one or several tablets depends on the type of contraceptive pill you use. Let’s look at each type separately:
Take the missing hormonal pill as soon as possible (which means you may have to take two hormone pills on the same day). Continue to take the rest of the pack as usual.
If your last pill was taken more than 48 hours ago, you must use a nonhormonal backup method for seven days (for example, condoms).
If you have had sex during the time you forgot to take your pill, you can use emergency contraception. Consider using emergency contraception if you forgot to take your pill earlier in the pack or during the last week of the previous pack.
Take the last missing tablet immediately (you may need to take two tablets on the same day). Remove the other missing tablets and continue to take the rest of the pack as usual.
If you forget two or more tablets during the third week (tablets 15-21 in a 28-day pack), finish the current pack and start a new one the next day.
If you cannot start a new pack immediately, use a nonhormonal backup method of contraception (such as condoms) or abstain from sex until you have taken the hormonal tablets in a new pack for seven consecutive days.
Progestin-only pills (mini pill)
Progestin-only tablets are often recommended for breastfeeding mothers and for women who cannot use the combination oral contraceptive pill for medical reasons.
Because the progestin tablet must be taken at the same time every day, it is a little more difficult to use than the combination hormonal contraceptive pills. If you skip your progestin tablet for more than three hours, you can get pregnant.
- As soon as you remember, take one tablet.
- Take the next pill at your usual time (which means you can take two pills on the same day).
- Talk to your health provider about emergency contraception if you have had sex in the last three to five days.
Extended-cycle contraceptive pills
To avoid the inconvenience of monthly periods, a significant number of women turn to the extended-cycle pill. Extended-cycle packs consist of 84 active and seven inactive (or low-dose estrogen) tablets which works out to four packs per year.
The intake of low-dose estrogens in the last seven tablets reduces the negative effects of a hormone-free interval, such as bleeding and bloating.
If you forget one or several pills from an extended-cycle pack, follow the steps below.
- Take an active pill right away.
- Take the next active pill as usual (which means you can take two pills in one day).
- Continue to take one pill per day until the end of the pack.
Two active pills in a row:
- Take two active pills immediately, then take two active pills the next day.
- Continue to take one pill every day until you finish the pack.
Three or more active pills in a row:
- Don’t take missed pills.
- Continue to take one tablet every day until the pack is finished.
- If you skip three doses in a row, you may experience bleeding or spotting.
At least one inactive pill:
- Throw away all forgotten medication.
- Continue to take the rest of the pills in your pack as indicated.
If you forget to take a contraceptive pill, take it as soon as possible. Take two pills at once if you don’t remember before the next dose. If you have sex and forget to take a pill on the same day, as long as you take it within 24 hours, it is unlikely you will get pregnant.
If you plan to have sex after forgetting a dose of contraceptive, you should first determine whether you are taking a combination pill that contains both estrogen and progestin or a progestin-only pill because the type of contraceptive you use will determine whether or not you need extra protection.
- “Getting pregnant with the pill: symptoms, risks.” Les Journal Des Femmes, 2019, sante.journaldesfemmes.fr/fiches-sexo-gyneco/2547396-tomber-enceinte-avec-la-pilule/. Accessed May 2023.
- “Forgetting the pill. What are the risks of getting pregnant?” Femmes D’Aujourd’hui, 2020, www.femmesdaujourdhui.be/bien-etre/sante/oubli-de-pilule-quels-sont-les-risques-de-tomber-enceinte/. Accessed May 2023.
- “Birth control pill: what to do if you forget.” Futura Sciences, www.futura-sciences.com/sante/questions-reponses/sexualite-pilule-contraceptive-faire-cas-oubli-7/. Accessed May 2023.