The pill, and condoms, and a sponge...oh my!

I am normally on the Pill, but due to sickness, stopped taking it and began waiting for my next period to begin it again. It has been over a month since I had my last period. Anyway, my bf and I had sex for the first time recently. I wore a Today Sponge and he wore a new condom both times. He also pulled out both times, just in case (we were very careful in lubing, using condom, and sponge, etc). What are my chances of being pregnant? Today I had a rush of watery pink discharge (what is this??) and now I believe I have my period. I am bleeding, but not heavily and it doesn't look normal (not as thick). I took the Pill today since I think I have my period. It has been about a day since the last time we had sex, but I am worried still. Should I take Emergency Contraception just in case? Even if the condom didn't break, should I take it to ease my worried mind? We were so careful, but what constitutes the small percentage of failure in condoms? I don't think I am pregnant, but I am worried. Especially wondering if I should take the EC just because I am within the 5 day period...
Sarah replies:

Stopping and starting the pill (especially if you stopped in the middle of a cycle) can really do a number on your body. Remember that when you're on the pill (or any form of hormonal birth control for that matter) adds extra hormones into your system and essentially changes the way it is functioning. So when you stop taking the pill, your body no longer gets those extra hormones that it is expecting and it can take a while for things to even out and get back to "normal" (the way it was prior to being on the pill). All of that can definitely lead to some weirdness with your periods until they get worked back out.

As long as you used condoms for all genital contact and did not have breakage or slippage, you should not have anything to worry about in terms of pregnancy (and even less so since you backed those up with a sponge). We do not generally recommend the sponge, especially as a sole form of birth control, because it is not as effective as other methods (failure rates are 9% for perfect use and 14% for typical use), because of the possible toxic shock and yeast infection risks, and because spermicides simply aren't the best thing to be putting in your body (they can be very irritating for many people). (Also, just as a note, spermicides can increase risks of STI transmission, which is why most of the major health organizations now recommend avoiding them completely.) But since you were only using that as a backup and you do not report a problem with your condoms, you do not seem to have a risk that would require emergency contraception. When condoms fail, it is typically very obvious, so you would have noticed had a problem occurred.

I would not advise using EC in this case. You did not have a failure of your other contraceptive(s). And beyond that, since you've just started the pill again now, throwing a big, whomping dose of hormones into your system (which is what EC is) will likely just cause your body more confusion. You would probably be more likely to experience weirdness with your cycles and be more likely to have side effects. It is just not necessary in this case and the side effects outweigh the benefits.

Since you are just starting the pill again, remember that you should wait an entire cycle before relying on the pill alone to protect you. So if you were to have a condom failure in the next cycle and the pill is your only backup, you might want to consider getting EC in that case. You may also find that you have some cycle wonkiness as your body readjusts to the hormones. For future reference, unless you are gravely ill or your health care provider advises you to stop the pill, it is generally best to continue taking it even when you are sick (and even if you throw up one or two, your effectiveness may be effected, but you're still better off continuing than just stopping it completely). Messing with your hormones like that can add an extra wrench into things, so you don't really want to be stopping and starting the pill if it can be at all avoided.

The failure rates on condoms are particularly from two factors. First off, with the "typical use" failure rate, you have the times when condoms are not used correctly for all genital contact (this includes only using them for parts of the activity, not applying them correctly, not using enough lube, not holding the base while pulling out, using two condoms at once, using expired condoms, not storing condoms correctly before use, etc.). Basically all of the wrong usages for condoms that cause them to fail fall into the "typical use" category failures. The small failure rates for "perfect use" come from those failures that still occur even though they were applied and used correctly. Condoms are tested and regulated (the testing data can be found online), but even with testing, nothing is going to be absolutely perfect 100% of the time. However, when these failures occur (and with "perfect use" that is going to be very rare), you know about it. Condom failures tend to be quite spectacular in nature. Because of all of the friction involved, if your condom tears or develops a hole, it's going to be a big/easily noticeable one. If a condom slips off, you are going to notice it (maybe not right away, but it will eventually become apparent because it's not going to magically slip back on). So if you have a condom failure, you are going to know about it and will then be able to seek EC if you are not already backing up your condoms with another method.

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