When to Use Emergency Contraception

Do I need emergency contraception if I missed one or more of my regular birth control pills?

Whether you should use emergency
contraception or take other steps to prevent pregnancy after missing
one or more of your regular birth control pills depends on how many pills have been missed, and when in your cycle the pills were missed. Please note: if you need EC because of missed pills, use levonorgestrel EC (like Plan B One-Step or My Way) – do not use ulipristal acetate EC (ella) because the active ingredient in ella may counteract your ongoing pills.

The latest guidelines (which have been simplified for easier use) are as follows:

If you have missed 1 pill (more than 24 hours and up to 48 hours late):

• Take your missed pill as soon as you remember (even if that means taking two pills in one day)
• Continue your the rest of the pill pack as usual
• Do you need EC? EC is not usually needed in this case, but consider it if you missed pills earlier in the pack, or in the last week of the previous pack

If you have missed 2 or more pills (more than 48 hours late):

• Take the last pill you missed right away (even if that means taking two pills in one day)
• Leave any earlier missed pills
• Continue taking the rest of the pack as usual, and use a backup method for the next 7 days
• Do you need EC? If you have had unprotected sex in the previous 5 days and have missed two or more pills in the first week of your pack, EC will reduce your risk of becoming pregnant.

Don’t worry if you miss inactive pills (these are the ones without
any hormones, which are included in your pill pack to help you remember
to take a pill every day). You can just throw away any missed “reminder”
pills and continue taking the rest of the pills in your pack as usual.
Since there are no hormones in the reminder pills, you are not at
risk of pregnancy if you don’t take them.

You should know that not using pills correctly or consistently is
a major reason that so many women get pregnant when they aren’t
trying to have a baby (a situation researchers refer to as an unintended
pregnancy). If you find yourself missing pills often, talk to your
health care provider about other kinds of regular
birth control that might fit your health and lifestyle needs better.

This information is adapted from the Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit at the UK Royal College of Obstetricians and Gynecologists May 2011 guidelines, available online here.