Can birth control fail if taken correctly?

Yes. Although birth control pills have a high success rate, they can fail and you can get pregnant while on the pill. Certain factors increase your risk of getting pregnant, even if you’re on birth control. Keep these factors in mind if you’re sexually active and want to prevent an unplanned pregnancy.

Success and failure rates of birth control pills

Birth control pills are 99 percent effective with “perfect use,” which means taking the pill at the same time every day without missing a dose. “Typical use” is how most women take the pill, and then it’s about 91 percent effective. Both combined oral contraceptives and progestin-only pills (also known as the mini pill) have a typical failure rate of 9 percent.

Many women accidentally miss a dose or forget to start a new pack of pills. When that happens, the chances for an accidental pregnancy go up.

The Pregnancy Quiz: Am I Pregnant? »

What causes birth control to fail

Certain conditions or behaviors can increase the likelihood that your birth control won’t be as effective at preventing pregnancy.

If you can’t remember to take your pill at the same time every day, you increase your risk of pregnancy. Birth control pills are designed to maintain a constant level of hormones in your body. If you skip or miss a dose, you hormone levels can drop quickly. Depending on where you are in your cycle, this may cause you to ovulate. Ovulation can increase your chances of becoming pregnant.

Reckless alcohol consumption can also cause birth control failure. While under the influence, some women may forget to take their pill at the correct time. If you vomit too soon after taking your pill, your body may not be able to absorb any of the hormones. This can result in a drop in your hormone levels, which could trigger ovulation.

Taking another medication or supplement at the same time as your birth control pill can also affect the pill’s effectiveness.

How to prevent birth control failure

Keep these tips in mind if you’re on birth control and want to prevent pregnancy.

Time it right

Make sure you take your birth control pill at the same time every day. Set a reminder on your phone or watch if you need to. You may also consider taking the pill with a specific daily activity, such as during lunch or dinner.

If you take progestin-only pills, you should be especially careful about taking the pill at the same time every day. If you’re late with a dose or skip one altogether, your hormone levels can drop very quickly. This could cause you to ovulate and that greatly increases your chances for getting pregnant.

If you miss a dose, use a backup method or avoid sex for the next week. To be extra cautious, use a backup method, such as a condom, or avoid sex for the next month.

Take the placebo pills

Combination pill packs typically contain three weeks of active pills that contain hormones and one week of inactive, or placebo, pills. Although it isn’t medically necessary to take the placebo pills, doing so can help you stay in your routine.

If you choose to skip the placebo pills, there’s a chance that you may be late in starting your next pill pack. This can interrupt your body’s expected level of hormones and cause you to ovulate. Ovulation increases your chances of being pregnant.

Don’t mix medications

Some prescription and over-the-counter medications may interfere with your birth control’s effectiveness. Before you begin taking a new medicine, ask your doctor or pharmacist if you should use a backup method of protection while taking this new medication.

Although some antibiotics have been anecdotally connected to unplanned pregnancies, research has largely debunked this connection. A possible connection with reduced birth control effectiveness is only recognized with one type of uncommon antibiotic called rifampin.

Don’t use St. John’s wort

St. John’s wort is a popular over-the-counter herbal supplement that can affect liver metabolism. This supplement can interfere with birth control’s effectiveness. You could experience breakthrough bleeding and possibly an unplanned pregnancy if you take the two medicines together. Talk with your doctor about any additional measures you should take, including a backup protection method while you’re taking St. John’s wort.

Knowing what can make your birth control ineffective and how you can increase your chances of successfully avoiding pregnancy will help you make the best decisions for you and your lifestyle.

Different methods of birth control can be highly effective at preventing pregnancy, but birth control failure is more common than most people realize. Here is a chart displaying birth control failure rate percentages, as well as common risks and side effects.

Birth Control Failure Chart

Note that the failure rates are for the average use of the method. Consistent and correct use may further decrease your chances. For specific hormonal birth control methods, the risk of pregnancy for correct use should be listed in the instructions/details.

When speaking of hormonal birth control, it is important to consider both the high success rate and the ethical concerns of the third act of the birth control:  changing/thinning the lining of the uterus to prevent implantation.

Since this can stop an already begun pregnancy from continuing, it is said to have abortifacient qualities. This will be an action of any of the hormonal birth control methods listed.

Below are brief explanations of how each birth control method works along with risks and side effects associated with each:

MethodHow it is UsedFailure Rate (average use)Risks & Side EffectsAbstinenceNo sexual intercourse and no type of contact between the male and female sexual organs where bodily fluids could be exchanged0%No Side EffectsCervical CapA soft rubber barrier that covers the cervix in order to
prevent sperm from entering the uterus12% (higher after childbirth)No Side Effects (unless allergic)Condom – FemaleA sheath, often made of latex rubber, inserted into the
vaginal canal to block the passage of sperm21%No Side Effects (unless allergic)Condom – MaleA sheath, often made of latex rubber, covering the erect penis to block the passage of sperm18%No Side Effects (unless allergic)Depo-Provera InjectionInjection of Progestin that is given every 3 months to prevent ovulation, changes the cervical mucus to block sperm, and change the lining of the uterus to prevent implantation of a fertilized egg6%Irregular, missed, or heavier than normal menstrual cycle, weight gain, breast tenderness, depression, bloating, abdominal pain, headaches, allergic reactionDiaphragmA soft rubber dome that covers the cervix to block the passage of sperm.12%No Side Effects (unless allergic)Fertility AwarenessUsing the menstrual cycle and other tools to predict
ovulation and abstaining from intercourse during these expected fertile times25%No Side EffectsImplant – HormonalA small, matchstick-sized implant inserted in the upper arm and lasts for 3 years, releasing a hormone supply. Works in a similar way to Depo-Provera.0.05%No period, spotting, light or heavy and prolonged bleeding; painful menstruation, acne, weight gain, depressed mood; blood clots, movement of the implant, ectopic pregnancy, ovarian cystsIntrauterine Device (IUD) – CopperA device is inserted into a woman’s uterus (by a doctor) to block sperm and change the uterus lining to prevent implantation of a fertilized egg0.8%Ectopic pregnancies increased bleeding during menstrual
cycle, severe menstruation cramps, perforation of the uterus, Pelvic Inflammatory Disease (PID)Intrauterine Device (IUD) – Progestin0.2%Nothing/ChanceNo birth control method85%No Side Effects; highest chance of unintended pregnancyOral Contraceptive
(estrogen/progestin)Taken daily by women to suppress ovulation, change cervical mucus, and change the lining of the uterus to prevent implantation of a fertilized egg9%Nausea, headaches, weight gain, depression, irregular bleeding, acne, blood clots
*Women who smoke are advised not to take oral contraceptivesOral Contraceptive (progestin
only)Taken daily by women to change the cervical mucus to block sperm and also changes the uterus lining to prevent implantation of a fertilized egg9%Breast tenderness, weight gain, menstrual cycle changes
*Women who smoke are advised not to take oral contraceptivesOrtho-Evra PatchA patch containing synthetic hormones placed on your skin; works the same as oral contraceptives9% (greater if over 198 lbs)Similar to oral contraceptivesSpermicide (only)A jelly, foam, or cream containing chemicals that kill sperm28%No Side Effects (unless allergic)SpongeA soft saucer-shaped polyurethane sponge that blocks the cervix and absorbs semen20% (40% after childbirth)No Side Effects (unless allergic)Sterilization – FemaleA permanent surgical procedure to prevent pregnancy: the fallopian tube is damaged (cut, tied, burnt) to prevent the passage of eggs and sperm0.5%If a woman conceives after a sterilization procedure there is a risk of ectopic pregnancies. The earlier the age of the woman at the time of the procedure, the greater risk of pregnancy after 10 years (up to ~5%).Sterilization – MaleA permanent surgical procedure to prevent pregnancy:  vas deferens tube is damaged (cut, tied, burnt) to prevent the passage of sperm into ejaculate fluid0.15%No Side EffectsVaginal Ring – HormonalA flexible ring placed inside the vagina near the cervix. Active for 3 weeks. Has actions similar to oral contraceptives.9%Blood clots, liver or gallbladder problems, TSS, depressed mood, acne, headache, weight gain, nausea/vomiting, movement of the ringWithdrawalWithdrawal of the penis before ejaculation22%No Side Effects

1. Centers for Disease Control:  Reproductive Health.

https://www.cdc.gov/reproductivehealth/contraception/index.htm

2. Centers for Disease Control:  Reproductive Health “Implants.”

https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/implants.html

3. Mayo Clinic: Depo-Provera (contraceptive injection).

https://www.mayoclinic.org/tests-procedures/depo-provera/about/pac-20392204

4. Nexplanon: Side Effects.

https://www.nexplanon.com/side-effects/

5. Nuva Ring: Risks and Side Effects.

https://www.nuvaring.com/risks-side-effects/

6. University of Pittsburgh Medical Center (UPMC): Tubal Ligation (Tubes Tied).

https://www.upmc.com/patients-visitors/education/contraception/Pages/tubal-ligation.aspx

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Can birth control fail if taken perfectly?

When used perfectly, the birth control pill is 99% effective at preventing pregnancy. Even the typical success rate, factoring in women who don't always use it flawlessly, is 91%. That's an average of only 9 in 100 women who get pregnant each year while using the pill.

Can you get pregnant if you take birth control perfectly?

Birth control pills are considered effective, but not foolproof. They're about 99% effective when you take them correctly. But that's if you take them perfectly, meaning at the same time each and every day. If you don't, your odds of becoming pregnant go up to 9%.

What can cause your birth control to fail?

Read on for some examples..
Taking certain medications. ... .
Taking some antibiotics. ... .
Taking some herbal remedies. ... .
Forgetting to take the pill or taking it late. ... .
Not getting injections on time. ... .
Not changing patches or rings on time. ... .
Not using condoms, diaphragms, or other barriers properly. ... .
Not abstaining when you're fertile..

How do I know if my birth control isn't working?

Hormonal contraceptives such as pills, the patch, the ring are known to cause mood changes because they alter normal hormonal levels in your body..
Your acne breakouts are out of this world. ... .
You have bid farewell to your sex drive. ... .
Migraines and headaches are your daily companions. ... .
Irregular spotting and periods..