North American Registry of Midwives (NARM) Practice Exam

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If a woman misses one of her oral contraceptive (OC) pills, what is the recommended action?

Take two pills the next day
Use a back-up method of contraception for seven days
Immediately stop taking the OC pills
Only take the missed pill without any precautions

The correct answer is: Use a back-up method of contraception for seven days

The recommended action for a woman who misses one of her oral contraceptive pills is to use a back-up method of contraception for seven days. This precaution is important because missing a pill can reduce the effectiveness of the contraceptive method and increase the risk of unintended pregnancy. When a pill is missed, the body may not have the consistent hormone levels that the oral contraceptive is designed to maintain. Using a backup method, such as condoms, helps to ensure protection while the hormonal balance is being restored. The accuracy of this recommendation is influenced by the type of oral contraceptive being used and how many pills have been missed. For example, if only one active pill is missed and is taken within 24 hours of the scheduled time, the effectiveness may remain intact; however, for general guidelines, using backup is a safer approach, especially if the woman has missed more than one pill or it's been longer than 24 hours since the missed dose. By taking this precautionary measure, women can significantly mitigate the risk of unplanned pregnancy while maintaining the integrity of their contraceptive regimen.