Missed Birth Control Pill(s)

[NCFELLA]

Hi,
I’ll start off by saying that I am someone who worries more than I probably should sometimes.  Therefore I like to educate myself as to the real risks so that I don’t obsess or worry myself sick about something considered low risk or not a high enough risk to lose sleep over.  My girlfriend and I have sex on a daily basis.  She’s 22 and presently takes Yaz (has been on it for years).  I realize that no birth control is 100% effective, therefore to further reduce the risk of pregnancy I choose NOT to ejaculate inside of her.  I do realize that there is semen in pre-seminal fluid therefore I know there is still a risk of pregnancy, though I like to think of that risk as pretty low (please correct me if I'm wrong).  

Here is my question:

My girlfriend and I have had intercourse daily for the past ten straight days.  She takes birth control daily, including the day of last time we had sex which was this past Sunday (7/5/09).  Unfortunately, the following day, Monday (7/5/09), she realized that she lost her birth control pills.  She immediately contacted her doctor who called in a prescription for the following day (Tuesday). Late Tuesday evening she doubled up and took two pills per her physician's recommendation.  So, given the timing she essentially missed two days worth of pills (Monday and most of the day Tuesday since she took it so late on Tuesday and almost 48 hours had passed). We have NOT had intercourse for the past two days (Monday and Tuesday) because of this.  My ultimate question is this:  Is there a realistic risk that conception occurred on Monday or Tuesday from any residual pre-seminal fluid left inside of her from the sex we had on Sunday?  I know sperm can live for several days and if she didn't take birth control for 48 hours (two days), is there a credible risk of her getting pregnant?  As I mentioned she doubled up on pills late last night and will take one today, tomorrow and so on.  

[Elaine Brown, MD]

Hi!
Usually if only one pill is missed, and it is then made up on the following day, they continue to effectively prevent pregnancy. It depends somewhat on the time of the cycle.  If your girlfriend was in the first week of her pill pack your risk is a little higher. Missing a pill and making it up in the first week of a new pack can actually trigger ovulation in some cases. If she was in the second or third week, you should be fine, as ovulation has already been prevented.
As you say, no birth control is 100% effective--even if taken 100% correctly. So you are taking a gamble by having sex.  Most couples are willing to take the risk. :)
Good luck!
Dr B

[manderz85]

From what my gyno has told me... the risk is pretty damn low.  Most birth control pills work by both building up excess mucus to block the cervix and preventing an egg from being released.  Definitely nice to err on the side of caution but unless she misses doses regularly you have nothing to worry about, even if you did ejaculate inside her on a regular basis.