Can you still get pregnant on the pill?

But you may have heard that it isn’t 100% effective. So, can you still get pregnant on the pill?

If you’re thinking about what type of birth control is going to work best for you, or just concerned about the level of protection you get, let us explain this situation.

What are the chances of getting pregnant on the pill?

No form of contraception is 100% effective. That's right. Even when used perfectly, the combined oral contraceptive pill (that is, one that contains both an estrogen and a progesterone) is still only 99% effective.

This rate assumes that everyone taking birth control does so exactly as directed, but of course, people aren't perfect. 

This means that typically, the pill tends to be around 91% effective. That means nearly one in ten women who take the pill will get pregnant.

Remember that 91-99% efficacy is pretty amazing, though. So, how do you take the pill correctly to protect yourself from getting pregnant? 

How to use the pill correctly

The key to taking the pill is taking it every day you are supposed to take one. If you’re on a 28 day package that means taking the pill every single day. Those on a 21 day package will have seven pill-free days. ‍

The Combined Oral Contraceptive Pill (which is the most popular type of pill and contains two hormones: estrogen and a progestin). 

The advice is that you need to take the pill at the same time every day. So, to be on the safe side — make it part of your routine.

Suppose you wear a specific moisturizer every morning. Why not keep them together so that when you put your moisturizer on, you take your pill too? ‍

The Progesterone Only Pill (does not contain any estrogen, just a progestin). The POP must be taken at the same time daily to be effective. 

The safest thing to do is set a specific time of day to take your pill and engrain it into your daily routine. If you struggle to remember to take it, then set the alarm on your phone, or download a pill tracking app to help you remember. 

What can cause the birth control pill to be ineffective?

Even if you remember to take your pill at the same time every day, there are still factors that can decrease efficacy

Your pill can become less effective if:

• You take certain medications, including:

• Antibiotics such as rifampin and rifabutin
• Specific anticonvulsants or anti-seizure medications (usually used to treat epilepsy)
• Antifungal drugs like griseofulvin
• HIV medications such as ritonavir
• St. John's wort (an herbal remedy)

• You are unwell with diarrhea or vomiting 
• You have missed taking your pill (Side note: if you do miss a pill, be sure to read this)
• You take laxative pills
• You are on the progestin-only pill and don't take it at the same time every day‍
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If you are prescribed a new medication or want to start a herbal remedy, speak to your doctor about whether it will affect your pill.

With a range of drugs reducing the pill's efficacy, it is always better to double-check than find out it has stopped it working when it is too late. 

When to use extra birth control precautions

If you are concerned your pill may not work correctly due to illness or medication, it is always safest to use an additional birth control method like condoms. You should always use extra contraception precautions if:

• You have missed taking more than one pill
• You have been unwell with sickness or diarrhea
• A doctor has prescribed you a medication that will interfere with the pill
• You have started taking a laxative, diet pill, or herbal remedy and have not consulted your doctor for advice

If you have missed more than one pill or have been unwell with sickness or diarrhea, you will need to use extra contraception. Use condoms for the next seven days to protect yourself from pregnancy. Your healthcare practitioner can also help determine what precautions to take.

Early signs of pregnancy to look out for

If you are on the pill but concerned you may be pregnant, there are some things you can look out for.

Being on the pill can sometimes mean your periods are different from usual, and for some people, it means they don't have a period at all. This can make it a little harder to spot the early signs of pregnancy.

However, on the whole, early signs of pregnancy may include:

• Missing a period — or a lighter, shorter period or irregular spotting
• Mood swings or feeling over-emotional
• Feeling faint or lightheaded
• Peeing more often
• Feeling much more tired than usual
• Constipation, gas, or bloating of the stomach
• Darkening of the skin directly surrounding the nipples (called the areola)
• Tender, sensitive, or swollen breasts
• Nausea and/or vomiting (or aversions to specific foods or smells)

The pill is an extremely effective birth control method as long as it is taken correctly and you know when it might stop working.

Stay vigilant in taking it at the same time of day, every day, and you significantly reduce your chances of getting pregnant while on the pill. However, if you have any concerns that it might not be effective, then use a condom to be on the safe side. 

If you suspect you might be pregnant, the best way to get confirmation is to take a home pregnancy test or visit your healthcare practitioner.