Birth control is an effective way for women to prevent pregnancy. But is it foolproof? Can you still get pregnant if you’re on the pill, have an IUD, use condoms or other contraception methods?

The short answer is yes, it is possible to get pregnant on birth control. However, with consistent and correct use, the risk of pregnancy is very low for most forms of contraception.

In this comprehensive guide, we’ll break down your odds of getting pregnant while on different types of birth control. We’ll also discuss the main reasons contraception fails and tips to maximize effectiveness.

Key Takeaways: Can You Get Pregnant on Birth Control?

• No birth control method other than abstinence is 100% effective at preventing pregnancy. However, with consistent and correct use, modern contraceptives are very reliable.
• Hormonal methods like the pill, patch, ring, shot and IUD are over 99% effective with perfect use. With typical use, the pill is 91% effective and IUDs over 99%.
• Barrier methods like condoms and diaphragms have higher failure rates around 15-28% with typical use. But using them perfectly every time reduces the risk significantly.
• Natural family planning methods can be up to 95% effective when learned properly. But the risk is higher with imperfect use.
• Your odds go up if you don’t use birth control correctly, forget to take pills, have medication interactions or use condoms improperly.
• Symptoms like nausea, sore breasts or spotting are not reliable indicators of pregnancy on birth control. Take a pregnancy test if unsure.

How Effective Are Different Birth Control Methods?

The effectiveness of birth control varies based on the method you use. Here’s an overview of typical-use and perfect-use failure rates for common contraceptives:

Hormonal Birth Control Methods

The pill, patch, ring: With typical use, around 9% get pregnant in a year. With perfect use, the failure rate is less than 1%.

Hormonal IUD: Less than 1% failure rate with typical use. Near 100% effective with perfect use.

The shot: 6% failure rate with typical use. Less than 1% failure rate with perfect use.

Implant: Less than 1% failure rate with both typical and perfect use.

Barrier Methods

Male condoms: 15% failure rate on average. With perfect use, only 2% failure rate.

Diaphragms: 16% failure rate with typical use. 6% failure rate with perfect use.

Cervical caps: 16-23% failure rate with typical use. 9-26% failure rate with perfect use

Sponges: 16-32% failure rate with typical use. 9-20% failure rate with perfect use.

Natural Family Planning Methods

Fertility awareness method: 24% failure rate with typical use. Up to 5% failure rate with perfect use.

Withdrawal method: About 20-22% failure rate on average. 4% failure rate with perfect use.

Lactational amenorrhea method: 2% failure rate with perfect use. Higher rates with typical use.

Top Reasons Birth Control Can Fail

There are several common reasons birth control methods are sometimes ineffective at preventing pregnancy:

Inconsistent or Incorrect Use

• Forgetting to take hormonal birth control pills or use other methods (like condoms, diaphragms etc) regularly as directed.
• Putting in diaphragms, contraceptive rings or sponges incorrectly.
• Not using condoms properly or having them break, slip or leak.
• Missing fertility awareness method instructions on avoiding sex or using backup protection on fertile days.
• Continuing to have unprotected sex after stopping a method (like the pill, shot etc).

Medication Interactions

• Taking antibiotics, antifungals, anti-seizure drugs, St. John’s Wort and other medications that interact with hormonal birth control.
• Vomiting/diarrhea episodes that prevent proper absorption of birth control pills.

Device Problems

• Dislodged, punctured, slipped or broken condoms.
• IUD expulsion or perforation.
• Broken contraceptive patches or rings.
• Diaphragm holes, tears or dislodgment.

Medical Conditions

• Obesity, which can lower effectiveness of hormonal birth control methods.
• Breastfeeding, which impacts fertility awareness and lactational amenorrhea method effectiveness.
• Family history of blood clots or other contraindications ruling out estrogen birth control use.

Timing/Fertility Factors

• Having sex very close to starting or stopping hormonal contraceptives before they become effective.
• Inaccurate predictions of “safe” fertile days when using fertility awareness methods.
• Pre-ejaculate fluid leaking sperm prior to condom application.
• Increased fertility due to factors like age, medications, health conditions etc.

Are There Signs You Can Get Pregnant on Birth Control?

Many women wonder if symptoms like nausea, fatigue and breast tenderness are early signs of pregnancy while on birth control. However, these are unreliable indicators and often just normal side effects of hormonal methods.

Likewise, having no period while on the pill or missing your usual bleeding days with an IUD does not necessarily mean you are pregnant. This is a common birth control side effect.

The only way to know for sure if you are pregnant while using contraception is to take a pregnancy test. Home urine tests can detect the hCG hormone as early as one week after conception. A blood test at the doctor’s office can confirm even sooner.

Get a pregnancy test if you have:

• Unusual spotting/bleeding not during your regular off-week or placebo pill phase
• Severe abdominal pain
• No period for more than one month if not typical for your birth control method
• Pregnancy symptoms like breast soreness, fatigue despite birth control method
• Signs of ectopic pregnancy like one-sided pelvic pain and abnormal vaginal bleeding

If the test is positive, make an appointment with your healthcare provider right away to discuss your options and prenatal care.

Tips for Preventing Pregnancy on Birth Control

You can maximize birth control effectiveness with these best practices:

Be Consistent

Take pills at the same time daily, use patches/rings as directed, get Depo shots on schedule, and carefully chart fertility with natural methods.

Use Backup Protection

Use condoms along with hormonal or natural methods for added pregnancy prevention.

Check Strings

Make sure IUD strings are present monthly to confirm placement.

Avoid Risky Situations

Don’t use spermicides, sponges, caps or fertility awareness methods alone if pregnancy could be dangerous.

Get a Prescription Fit

Discuss medical history and needs to find the right birth control pill or method for your body.

Use Emergency Contraception if Needed

Take emergency contraceptive pills (or get a copper IUD) if birth control fails or you have unprotected sex. This can prevent pregnancy when used quickly after intercourse.

Let Partners Know

Inform any sexual partners you are using birth control, but it’s not 100% effective. Use condoms as well.

See Your Doctor if Unsure

Get medical advice if you think your birth control may have failed or you have pregnancy risk factors.

Frequently Asked Questions About Pregnancy on Birth Control

Confused about your odds of getting pregnant while using contraception? Here are answers to some commonly asked questions.

Can you get pregnant on birth control pills?

Yes, it is possible but unlikely. With perfect use, less than 1 out 100 women get pregnant in a year on the pill. But with typical real-world use, around 9 out of 100 get pregnant because pills are missed or forgotten. Using a backup method like condoms reduces the risk.

Can you get pregnant with an IUD?

IUDs (both hormonal and copper) are over 99% effective at preventing pregnancy. Less than 1 out of 100 women get pregnant in a year with an IUD. The main risk occurs if the IUD shifts out of place, which is uncommon but leads to decreased effectiveness.

Can you get pregnant after stopping the pill?

Yes, you can ovulate and get pregnant as soon as 3 weeks after stopping birth control pills. Use condoms for at least one month to reduce this risk. Plan B can also be used for emergencies.

Can you get pregnant on the shot?

The birth control shot is very effective (less than 1% failure rate) when administered on time every 3 months. But if youʼre late getting your next shot, ovulation and pregnancy risk increases. Use a backup method if your next shot is delayed.

Can you get pregnant on your period while on birth control?

In very rare cases, it is possible to get pregnant during your period or withdrawal bleed while on the pill, patch, ring etc. This could occur if you ovulate very early in your cycle. But the odds are extremely low, and it’s more likely that bleeding is just breakthrough spotting which is common with hormonal birth control use.

Can you get pregnant right after stopping the pill?

Yes, you can ovulate as soon as two weeks after stopping birth control pills and implants. Use condoms for at least one month after discontinuing the pill or other hormonal contraceptives. Emergency contraception can also lower risk if you have unprotected sex.

When to See a Doctor About Pregnancy on Birth Control

Make an appointment with your healthcare provider right away if:

• You get a positive pregnancy test while using any birth control method. Timely prenatal care is important for your health and the health of the fetus.
• You have signs of ectopic pregnancy like severe one-sided abdominal pain and abnormal vaginal bleeding while on an IUD or hormonal birth control. This is a rare but serious complication.
• You think your IUD may have shifted out of place based on not feeling the strings or unusual cramping/pain. Your doctor can check placement.
• You miss multiple birth control pills, use a condom improperly, or notice other potential contraceptive failures that increase pregnancy risk. Your doctor can advise on emergency contraception options.
• You want to switch birth control methods due to side effects, safety concerns, changing needs or pregnancy desire in the future. Your provider can help find the optimal contraceptive choice for your situation.

The Takeaway

No birth control method is foolproof except abstinence. But modern contraceptives are highly effective when used consistently and correctly. Being responsible with your birth control method of choice, using backup protection like condoms when possible, and speaking with your doctor if you have any concerns can minimize chances of an unintended pregnancy. But if birth control does happen to fail, timely medical care is key.