What are the chances of getting pregnant on the pill? 

We hate to break it to you, but even on birth control, you can still get pregnant. 🤭 Now before you get into a frenzy, you need to know that the pill is 99% effective when taken properly. This means if you take it at the same time every day without missing a day, you should be good to go. But, the chances of getting pregnant increases when you start missing days or you take it at a different time every day. Don’t worry, we have your back, so we’ll be spilling all the details you need to know 🥰

The bottom line is birth control is as effective as you make it out to be. While there are some factors out of your control, taking it on time every day will keep the effectiveness of the pill high. If not, the chances of getting pregnant can be as high as 9%.

You should also know that the initial effectiveness of progestin-only pills vs. combined pills is different. On the combined pill, less than one out of 100 users will get pregnant if used correctly. On the progestin only pill, less than 2-3 women out of 100 will get pregnant even while using the pill perfectly. 

Why is this the case? What is the difference between the mini pill (progestin only) and the combined pill (estrogen + progestin)? 

#1: Both pills are intended to suppress ovulation and make the uterine lining unfavourable for implantation of an egg. However, ovulation suppression isn’t the same on both pills. 🥴

Ovulation is the process by which an egg is formed and released. When released, there is a chance of it being fertilized by a sperm. If this occurs, the fertilized egg will implant itself into the uterus and cause a pregnancy. Birth control pills  prevent the release of hormones like luteinizing hormone and follicle stimulating hormone, which in turn prevents ovulation. 

On the mini pill, 40% of users will continue to ovulate. Since the mini pill only contains progestin and a lower amount of it, the chances of ovulation occurring is not consistent among all users. 

With the combined pill, as a result of the estrogen and higher concentration of progestin, it is more effective at consistently preventing ovulation amongst all users. If you miss a day, you can double up on the pill the next day and still be protected from pregnancy. However, with the progestin only pill, taking it even a few hours apart from when you normally would can reduce its effectiveness. 

You might be wondering, why would people still take the mini pill if the combined pill is more effective? 

The mini pill is very much still effective. While the chances of ovulation are higher on the mini pill compared to the combined pill, the mini pill still protects from pregnancy by creating changes in the uterine lining preventing the implantation of a fertilizing egg. 

You should also know that the effectiveness of the combined pill comes at a price. Due to the presence of estrogen, many combined pill users will experience weight gain as a result of fluid retention. They may also experience nausea and headaches as the body adjusts to elevated levels of estrogen. The mini pill, while it may sound less effective at preventing pregnancy, it has its pros. Research shows that the mini pill eliminates the occurrences of estrogen related side effects, lowers the effects on breast milk production (if you are breastfeeding), and also reduces the interaction of the pill with other drugs. 

#2: The interaction between birth control pills and other drugs can reduce the efficacy of the pill. 😬

Antibiotics have been found to reduce the effectiveness of birth control. Specifically, Rifampin, an antibiotic used to treat tuberculosis and other infections, has been shown to interact with hormones in birth control. Well, how does this work? Research shows that Rifampin reduces the levels of the estradiol and progestin in the user. These are the two hormones specifically found in the combined pill, and their purpose is to prevent ovulation. Moreover, Rifampin promotes the production of liver enzymes responsible for breaking down estrogen. In turn, this reduces the level of estrogen in the body once again reducing the effectiveness of the pill. For these reasons, it's important to make your primary care physician aware if you are on any antibiotics, especially Rifampin. Some natural supplements, like St. John’s wort and soy containing foods, antifungal medications, and diabetic medications may also interact with birth control. TL;DR, make sure to make your doctor aware of all other medications you are taking before starting birth control. 

If you’re scared about getting pregnant on the pill, don’t worry. We’ll tell you how to make sure you keep the effectiveness of the pill high. 

Repetition has been proven to improve learning and retention so we’ll say it again. The easiest way to make sure that you’re getting the most out of your pill is to take it at the same time every day and to never miss a day. This is especially important for those taking the mini pill. 

If you miss a day on the combined pill, take two the next day but no more than two. This means if you’ve missed two days, you shouldn’t take three pills on the third day, only two. If you miss more than two days, you’ll want to use extra protection for the next 7 days, as your body needs time to readjust to the missed pills. With the mini pill, take the missed pill as soon as you remember. Don’t wait until the next day to double up. If you choose to have sex around this time, it’s a good idea to use a condom as an extra line of defense. 

Now, let’s say you’ve done all this and taken all the precautionary steps, but you STILL think you might be pregnant. How can you tell? 😳

The first and most obvious sign is a missed period. Other common ones are nausea and spotting in between periods. But, here’s the tea. If you’ve just started birth control, say it’s been a couple of months, all of the above symptoms can be a sign of your body adjusting to the birth control. The sudden introduction of new hormones like estrogen and progestin can cause the uterus to shed some of its lining between periods, resulting in breakthrough bleeding. 

Therefore, if you’ve recently had sex, then you’ll want to look for additional symptoms like backaches, tender breasts, mood swings, and frequent urination. With that being said, you might be pregnant and not experience any of these symptoms, so it’s always a good idea to take a pregnancy test or visit your physician!

Hopefully, this article left you feeling more prepared rather than scared. And to make you feel even more prepared, you should download the Aavia app & check out our smart birth control pill case! The combination of the two will ensure that you always take your pill on time and you can track all your period symptoms along the way. Not to mention you get access to our community, where you can have all your questions answered by other users and doctors! 

Download our FREE APP to help you stay consistent with your pill and track your cycle ✌️