This is topic If the pill is so reliable why do so many women fall pregnant while using it? in forum Ask Scarleteen at Scarleteen Boards: 2000 - 2014 (Archive).

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Posted by Miss_Stress (Member # 97268) on :
I posed this question to my doctor a while back and he said that women who get pregnant on the pill have missed pills, been on conflicting medication or have have vomiting or diarrhea. He said it would be next to impossible to get pregnant if you were a perfect pill user. If that's the case why do so many women claim to have gotten pregnant while on the pill? I know I shouldn't listen to online stories but they're tough to ignore when there's such a huge number or them. This is one example:
Posted by Rei (Member # 49582) on :
Our article about the pill says this:

"The combination birth control pill may fail if it is not taken on time each day (if pills are taken late or missed, especially if more than two pills in a pack are missed or late), if pills are not taken in sequence, if a woman extends the placebo week of the pill too long (past seven days) any given time, if a woman stops taking her pills during the active pill phases, if it is used without a backup method when a user starts the pill for the first time, or if taken in conjunction with other drugs or substances which may interfere with it. While nearly all BCP failures are simply due to not taking the pill every day without fail, there are -- though they are rare -- some women for whom, even when taken perfectly, the pill does not work for.'

So, that will be the reason some people still co-create a pregnancy while on the pill.

The reason there are so many stories like this out there is that, for the most part, we still live in an anti-sex, sexist culture. This means that people are judged and stigmatized for being sexual for reasons other than trying to co-create a pregnancy in the first place (unintended or unwanted pregnancy is often seen a 'consequence' or 'punishment for sexual play) - especially women.

Women are shamed and sometimes threatened for their reproductive choices, such as choosing to have an abortion or choosing to have a child when they are poor, younger, single, not in a flawless relationship, not married, LGBTQ, without support from their families, and many other things. They are then judged if they aren't 100% thrilled about a pregnancy, too. Accidentally pregnant people are seen as innocent and are more likely to be 'forgiven', whereas deliberately trying to co-create a pregnancy under whichever circumstances are deemed unacceptable this week is seen as something unforgivable. User error with the pill is also seen as 'careless' and 'iresponsible' and women are shamed for that, too, so it's unlikely that you'll here many women talking about it, for their own self-protection.

So, with all this pressure, women wind up feeling guilty for the choices they have the right to make, and feel that they owe the world an explaination. Whether that's fabricated or not will of course depend on the woman. They may even feel so guilty that they begin to lie to themselves about it in order to feel less so. Also, if people feel ashamed about the sex they're having, they're less likely to take the pills as directed, as really, they don't feel entitled to the protection they offer.

Sometimes, they don't even want the protection - but instead want a child - but feel they aren't supported in that choice by those around them, but hope that telling the story that 'the pills have just not worked despite my best efforts' will win them the support (and the people who love them are likely to be happy that it wasn't down to deliberately trying to become pregnant or 'carelessness' so they are more likely to support the pregnant person).

At Scarleteen, we always recommend a back-up method of contraception. Condoms are always a great choice, as they also protect against STIs. If you don't feel you can totally relax fully trusting your pills for protection, there are many other forms of contraception with less room for user error, such as IUDs.

For more info on other forms of contraception and on backing up with a second method, check out these links:

Birth Control Bingo and The Buddy System! Backing up your Birth Control with a Second Method

[ 09-11-2012, 09:12 AM: Message edited by: Rei ]
Posted by Miss_Stress (Member # 97268) on :
Thanks for your reply! In all my nine months on the pill I have never missed or been late for a single dose so I'm not worried about user error really. I once took a pill and hour and a quarter early but that's about it in terms of being off my exact time of 8pm. I personally know two people who have conceived while being on the pill, one was on anti-biotics and didn't take hers at the same time each day, the other was significantly over weight and I've heard this can cause pill failure.

From now on though I will be using a condom as a backup method (my pharmacist told me I was being overly cautious when I was discussing it with her). I'm only 22 and abortion is still illegal where I live (ireland) so I suppose one can never be too cautious in that situation!

Could I also ask if antacids can cause pill failure? My pharmacist said that they're highly unlikely to and if I'm worried to space out my dose of my pill and my antacid (I use gaviscon) and it says nothing on my pill info.

Thank you! <3
Posted by Rei (Member # 49582) on :
You're welcome! [Smile]

If it's the combined pill, you can take them anytime within a 12 hour window (3 hour windows for the mini pill, the progesterone-only pill), but as you probably know, it's best to take them around the same time so you don't accidently miss any. (With weight, we just don't know if weighing over 198 pounds affects the pill, as effectiveness testing is generally done on people who are under 200 pounds, and no studies have been done on those who weigh over that).

We have never seen any data even suggesting that antacids interfere with the pill, so I don't see a cause for concern there.

You can absolutely never been too cautious when it comes to things as huge as pregnancy, I agree, and especially in Ireland where abortion is not an option without loads of money to travel for one. So, honestly, I think that was pretty bad practice of your pharmacist to suggest you were being over-cautious with adding a back up - they're a fantasic idea, for people of any country, as they bump up the protection percentage of the pill from around 92-96% to 97-99% (depending on which method we're taking about here, if it's condoms it's 98-99%). So, as close to 100% as you can be. Also, a benefit of condoms is that we can tell if they haven't worked, as they tend to look very obvious when they break - like a burst balloon - so, if that ever does happen (which is extremely unlikely if you follow out How-To guide here: Condom Basics) you can get Emergency Contraception from a clinic right away as a back-up to you pill, taking you back up to your 98-99% if taken as soon as possible.

Condoms also protect again STIs, if you and your partner aren't all up to date with a clear full panal of STI test results and 6 months of sexual exclusivity - which, obviously, can be lifesaving in some cases.

[ 09-12-2012, 08:05 AM: Message edited by: Rei ]
Posted by Miss_Stress (Member # 97268) on :
Thanks again for your insight! We're both up to date on STD testing so all is good there. [Smile]
Posted by Rei (Member # 49582) on :
No worries - and that's great news. [Smile]
Posted by Miss_Stress (Member # 97268) on :
Hi again Rei, I just have one more small question in relation to the topic above! I've been reading a lot of literature around the BCP, trying to become as educated as I can about it. I've noticed that many sources (here included) talk about 'typical use' and 'perfect use'. I've also read that perfect use is almost next to impossible to achieve and that most fall into the typical category.

My question is that if I am a textbook pill user: always take them 8pm each day, never miss one, never take a late one, always use a backup if on conflicting medications, never start a pack late or finish a pack early, being extra careful by using a backup if I even have an anxious or nervous tummy (in case that could potentially cause diarrhea) and so on does that make me perfect user and is my protection really at 99%?

I'm asking this because I'm feeling a little anxious at the moment. Last month I had spotting on day 21 of my active pill which then turned into my bleed on day 4 of my off-week. It felt like a period and lasted as long as a period (six days excluding initial spotting) does but because I've read so much I naturally was freaking about pregnancy and how while on the pill it can cause spotting. I took a pregnancy test 3 weeks after the last time I has sex without a condom and on day six of my withdrawal bleed and it was negative and since I've joined the forums here my mind has been put more at rest but I'm still feeling a little antsy even though I know it's highly unlikely that I would be pregnant if I had my bleed and had a negative test.

The even more unsettling thing is that the spotting happened on the third month of a new pill (I switched from Yasmin to Yasminelle, a lighter dose). Therefore I know breakthrough bleeding is expected and have also read the topic about breakthrough bleeding here. Yet I am still paranoid. Is there anything for me to be paranoid about? Particularly if I fit into the category of a perfect user which I hope I do.

I have no idea why I am always so paranoid, my mother is a midwife and talks about unplanned pregnancies all the time and I'm thinking maybe that's why. I'm 22 I should get over this.

Thank you in advance and thank you for always giving such insightful advice!
Posted by Heather (Member # 3) on :
I'd say that you are indeed as close to perfect pill use as it gets. And yes, that means in one year of using it that way, you have approximately 99% protection. (I say approximate, because those rates are measured by whole groups of people and are averages, meaning you might have a little more or a little less, depending.)

But actually, if you are using a backup method -- dual contraception, the way of using contraceptive methods those of us who work in the field (your Mom can probably speak to this too) know is the very best way to prevent pregnancy -- then your level of protection is going to be as close to 100% as it gets.

I don't see any cause for concern from experiencing a common and benign side effect of a medication you are taking.
Posted by Miss_Stress (Member # 97268) on :
Thank you! I feel better now.

Also, should point out that I grew up in a Catholic Irish house and am in a relationship with a Catholic Polish boyfriend. Most likely the greatest reason for my paranoia! Oh the guilt! Haha. [Wink]

Thank you to you both. Such a wonderful resource for crazies like me! <3 x
Posted by Heather (Member # 3) on :
Ah, say no more: that's half my (incredibly large, because, of course) family, so I completely understand.

That said, you also then know that if you, too, have a giant Irish catholic family, the central reason for that is because very few of them likely used any birth control. [Smile]

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