Skipped a Pill

Accidentally skipping a pill is a common event among women taking birth control pills. Some researchers have identified as high as a 50% skip rate, each month, among BCP users.

The consequences of skipping just one pill are hard to measure, and I believe the effect is minimal. It is doubtful that the birth control pill would fail because of a single skipped pill. Much more often, when there is a BCP failure (unplanned pregnancy despite the BCPs), it is in the context of someone skipping several pills, several times a month.

If she just skipped one pill, she should take it as soon as she remembers, then continue the rest of the pills at the normal time.

If she didn't remember until the next day, take both the current day's pill and yesterday's pill together. Then continue with the rest of the pills in the usual way.

If she's forgotten two pills or more, some physicians recommend stopping the BCPs, wait a few days for a "withdrawal" menstrual flow, and then restart a fresh package of BCPs 5 days after the onset of flow. Use backup contraception during this time and for the first month after restarting the BCPs.

Other physicians recommend the patient continue taking the pills in sequence, despite having skipped a couple of the pills, keeping in mind that contraceptive effectiveness may be diminished (but not eliminated).

If skipping pills is a recurring issue with the patient, they should consider alternative effective methods, such as IUDs, Patch, Ring, Implant or Shot.