This Is What Happens When You Forget To Take Your Birth Control

Like, on a scale of 1-pregnant, how screwed are you?

Every person on the pill knows the moment of terror that comes from missing a dose.

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Are you screwed? Are you desperately searching for condoms? ARE YOU LITERALLY ALREADY PREGNANT?

Even though the pill is over 99% effective with perfect use, it has a 9% failure rate with typical use, according to research from The Guttmacher Institute. And typical use includes people who use it imperfectly or incorrectly — like missing pills every once in a while.

It turns out, missing *one* pill usually isn't a big deal.

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If you're taking combined oral contraceptives (birth control pills that contain both estrogen and progestin), one late or missed dose isn't a reason to panic, Dr. Mary Jane Minkin, board-certified OB-GYN, tells BuzzFeed Health.

Just take it as soon as you remember and get on with your life — even if that means taking two pills in one day. There's no need for a backup method of birth control like condoms, according to Minkin and CDC recommendations.

But there are two pills you really don't want to miss: the first one in the pack or the last one before your placebo week.

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These are the ones that really matter, Dr. Nerys Benfield, assistant professor and director of family planning at the Albert Einstein College of Medicine, tells BuzzFeed Health. Especially if you're on a method with 21 active pills and 7 inactive pills.

Here's why: One of the ways birth control suppresses ovulation is by suppressing the production of FSH (follicle-stimulating hormone) by the pituitary gland, explains Minkin. Research tells us that FSH production remains suppressed even during those seven days of inactive pills, but if you lengthen that hormone-free interval — even by a day — your body may start prepping for the process of ovulation again, says Benfield.

That's why you really don't want to miss the one pill before or after the placebo week. If you do, take it as soon as you remember, and then use backup birth control (like condoms) for the next week. It's unlikely you'd get pregnant, says Minkin, but it could happen if you have sex without a condom around that time.

If you're on a progestin-only pill (also known as the minipill), you need to be more cautious about late or missed pills at ANY point in your cycle.

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The progestin-only pill is much less common, but it's recommended for people who can't take combined pills, since it's safe to use even if you have high blood pressure or a history of blood clots.

The downside: There's less leeway when it comes to missing a dose. If you're more than three hours late taking the progestin-only pill, it's recommended that you use a backup method of birth control (or abstain from sex) until you've taken the pills correctly for at least two consecutive days. You should also take the late/missed pill as soon as you remember it, even if that means taking two pills in one day.

OMG YOU FLUSHED A PILL DOWN THE TOILET.

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How can you take it as soon as you remember when IT'S GONE? OK, you have a few options. Ideally, you should keep around an extra pack of pills for this very occasion, suggests Minkin. And if you don't have one handy, you can ask your doctor to call one in for you.

But, again, it's not a huge deal to miss *one* pill, so as long as you haven't missed any others, you don't need to worry. Your other option would be to take the next pill in the pack, and then just be one day ahead for the rest of your cycle, says Minkin. (For instance, if you flushed a pill on Wednesday, you could take Thursday's and just continue that way.) If you do this, remember to start your next pack a day early, so that your inactive week isn't more than seven days.

And as long as you only had one pill go rogue, you don't need to use a backup method of birth control.

OK well now that we're being honest, you actually missed two pills in a row... Now what?

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This is why we can't have nice things. If you miss two (or more) pills in a row, you should take the most recent missed pill as soon as you remember, even if that means taking two pills in one day.

Now, remember that big packet with tiny writing that always comes in your pill pack each month? Grab that if you can find it. Somewhere in there it should explain exactly how to take (or toss) the rest of your pill pack if you screwed up. If you can't find it, call up your doctor or pharmacist to ask for recommendations specifically tailored to your situation and prescription, since it varies based on the type of pill you're taking.

As far as condoms go, yeah, you're going to need those. When you miss two (or more) pills in a row, it's recommended that you use a backup birth control (like condoms) until you've taken active pills correctly for seven consecutive days. And if these missed pills happened in the first week of your pack, you might want to ask your doctor or pharmacist about emergency contraception if you had sex without a condom in the past five days and you're worried about becoming pregnant.

What if *hypothetically* you miss a pill one week, and then another the next week... and then another the next week.

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OK *hypothetically* that person should probably be on different method of birth control, suggests Minkin, because remembering to take a pill every day is just not one of their skills.

That said, missing a few random pills throughout the month isn't the same as missing a few consecutive pills, says Minkin, so it shouldn't screw with the effectiveness. Still, you might want to consider another method if this is happening. "Talk to your provider," Minkin says. "We can do better for you."

If you're not worried about getting pregnant, missing a pill now and then isn't a big deal, but it may result in breakthrough bleeding.

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This is when you have some light bleeding or spotting between periods, and it's totally normal, says Minkin.

So if you're taking birth control for one of the many other reasons aside from pregnancy prevention, this may be the only real concern with missing pills. You may also experience some nausea if you have to take two pills in one day, but that's less common, says Minkin.

The bottom line: It's best to be on a method that's easy for you to adhere to, so talk to your doctor if you're screwing up on a regular basis.

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They can help you find a method you don't have to think about as much, which should keep your "oh shit" moments to a minimum.