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What happens if I throw up my birth control pill?

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Jane asks:

I started a pack of combination birth control pills for the first time on the first day of my period as instructed and took it perfectly until the third week. In the third week, I was sick and that Wednesday about 20 minutes after taking my pill, I threw up. The following day, Thursday, I fell asleep very early (being sick) and missed the pill that night. (I usually take it at 8pm). I woke up at 11am on Friday and took the pill I missed and then took my usual pill at 8pm that night. I finished the pack and got my period. So I know I'm not pregnant right now and I was using condoms anyway.

Now my question: When I start my next pack of pills, am I protected? Was the danger period from missing pills just until my period? The pill pack says I should have thrown out the pack after the second pill missed and started another pack but I didn't do that. So again, when I start up my new pack of pills will I be protected or am I in danger of still ovulating? And how long does it take for the pill to digest in your system? Because the pack says if I only missed one pill I am fine. But I don't know if the pill I took before I threw up counts.

Sarah replies:

Your pills should be fully effective beginning at the start of your new pack. Typically, problems with pills only affect that particular cycle (unless the problem itself carries over into the next pack). So as long as you don't have any problems during your next cycle, you should be well protected.

Generally, if you throw up less than 2-3 hours after taking a pill, you should assume that the pill may not have made it into your system. So if you threw up 20 minutes after taking your pill, then you would count that as a missed pill on Wednesday. Thursday's pill would probably be called "late" rather than missed. If you had been relying on your pill to protect you (which you probably would not have been doing anyway since this was your first pack and you usually want to wait one full pack before relying on it), then it would have been wise to consider your protection compromised. But in this case, since you used a condom without problems, you were still protected by that method.

Especially if pregnancy is absolutely not an option for you, a good rule of thumb is to backup or abstain for the rest of any cycle where you have had illness that caused you to vomit or to have missed (or late) pills. It's better to backup anytime you have any doubt or question than to have worries later.

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