North American Registry of Midwives (NARM) Practice Exam

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What should a woman do if she misses two of her OC pills?

Use a back-up method for 14 days
Take one pill each day until she catches up
Use a back-up method of contraception for seven days
Continue taking pills as normal

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

When a woman misses two oral contraceptive pills, the recommended action is to use a back-up method of contraception for seven days. This is because missing two pills increases the risk of ovulation, and using a back-up method during this time helps to prevent unintended pregnancy. The guidelines typically suggest that if two consecutive pills are missed, the woman should take the most recently missed pill as soon as she remembers, discard any other missed pills, and then continue with the remaining pills as scheduled. However, due to the higher risk of ovulation during this time, using a back-up method for at least seven days is crucial to ensure effective contraceptive protection. Options that suggest taking a pill each day without an additional back-up method may not adequately address the increased risk of ovulation, and suggesting to continue as normal ignores the potential lapse in contraceptive effectiveness. Therefore, using a back-up method for seven days is the most appropriate course of action after missing two pills.