Birth control methods like the pill are known to be very effective ways to delay pregnancy, so it’s only natural for women to believe that they won’t conceive as long as they take the pill consistently. However, did you know that there’s still a chance of you getting pregnant on birth control?

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How can you get pregnant on birth control?

Yes, it is possible to get pregnant on birth control. Today’s Parent notes that while many birth control methods are highly effective, it is also not unheard of for women to conceive even if they use contraceptives. According to Planned Parenthood, an American reproductive health care provider, nine out of 100 pill users get pregnant every year.

“Birth control greatly reduces the chance of having an unplanned pregnancy, but it’s not perfect,” Dustin Costescu, an OB-GYN at McMaster University in Canada, tells Today’s Parent. “This is a common experience and so women should never feel ashamed for missing their pills or for having a pregnancy while using birth control.”

When it comes to getting pregnant on birth control, the main reason is user error, or when you fail to take the pill consistently. With perfect use, you take the pill at the same time every day. If you follow this method, the pill is 99 percent effective. On the other hand, with typical use, you miss a pill once or twice, at least once a month, or fail to take the pill at the same time every day. This brings the effectiveness of the pill down to 91 percent, according to Health.

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Planned Parenthood says that the birth control pill’s effectiveness may also be affected by vomiting or diarrhea for more than 48 hours since this can prevent your system from absorbing the pill before it is expelled.

Another factor that can make the pill less effective and increase your risk of getting pregnant on birth control include taking certain medications, such as the antibiotic Rifampin, the antifungal Griseofulvin, some types of HIV medicines and anti-seizure medicines, and the herb St. John’s Wort.

The type of pill you take can also affect your chances of getting pregnant on birth control, according to Women’s Health. Combination pills, which contain both estrogen and progestin, are more effective than progestin-only pills because the former stops the ovaries from releasing eggs, thickens the cervical mucus, and thins the uterine lining, while the latter only thickens the cervical mucus and thins the uterine lining.

According to Planned Parenthood, combination pills are immediately effective if taken within five days after the first day of your period; if taken at any other time, you’ll need to take them for seven days before they become effective. Meanwhile, you can start taking progestin-only pills any day of the month, and they start protecting from pregnancy after 48 hours.

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What to do if you get pregnant on birth control

If you do think you are pregnant even if you’re using contraceptives, Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, says the first thing to do is to stop taking the pill. She tells Women’s Health that the risk of birth defects could be higher if a woman uses contraceptives during pregnancy.

“We can never really say if [a birth defect] is due to the pill or something else,” says Dr. Minkin. “There’s a very small risk, but it’s not zero.”

After this, she recommends seeing your doctor so they can help figure out what to do next, depending on your personal choices regarding your pregnancy.

Amanda Black, professor of obstetrics and gynecology at the University of Ottawa, also suggests taking a home pregnancy test if you think you might have gotten pregnant on birth control. If the test turns out positive, stop taking the pill immediately, she tells Today’s Parent.

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How to make sure your pill is as effective as possible

Experts say that the best way to make sure the pill is effective is by taking it at the same time every day. Make taking the pill part of your daily routine; for example, Dr. Minkin recommends doing it after you eat your breakfast, which is an ideal time to take any type of medicine.

“That’s [the] recommendation,” Christine Greves, M.D., an OB-GYN, tells Health. “If you do not, that’s when it increases the risk for you of getting pregnant.”

Aside from taking the pill consistently, it can also be helpful to have your partner wear a condom during sex. “Birth control serves multiple purposes, but in the setting of contraception — things can fail even with perfect use,” Dr. Greves explains.

If you really struggle with remembering to take your pill every day, you can always try other contraceptive methods that you might find more effective in reducing your risk of getting pregnant on birth control. For instance, according to Dr. Greves, you can try the intrauterine device (IUD), which has a 0.004 percent failure rate, can last up to a decade, and “takes out the need for you to remember to take it.”

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