Pregnancy and the Pill

When you decide to try for a baby, there can be many decisions to make. When should you stop taking the pill? How long should you wait to try after you've stopped? How soon can you expect to be pregnant? Could the pill have affected your fertility?

While every woman is unique and each will have a different experience, there is some general advice and information that can help you answer these questions.

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When should you stop taking the contraceptive pill?

It's safe to stop whenever you choose – whether you finish your month's course or stop mid pack. But it can often be beneficial to wait until the end of the pack so you experience a withdrawal bleed. This can make the transition back into your normal menstrual cycle a little more regular and your next bleed will be your normal menstrual period. If you stop mid-pack, you may find your bleeding a little erratic for the first 4-6 weeks.

It is usually recommended that you then wait until you have had one normal period after the pill before trying to conceive, as it makes it easier to calculate the date of ovulation and due date of the baby. In the past people were concerned that if pregnancy occurred straight after stopping the pill, you could have a higher chance of miscarriage. But, research has found that these concerns are largely unfounded and the hormones quickly leave your system after stopping contraception.

What happens after the pill is stopped?

Once you stop taking the contraceptive pill, you may experience some bleeding and the cycle of your menstruations may alter. It may only take two weeks after you stop the pill before you start ovulating again. Your period should start within four-six weeks of your last pill. If you ovulate in your first cycle off the pill and become pregnant, you may not have a period at all.

Some women, however, find it can take a few months before their regular monthly menstrual cycles resume. And, if you had infrequent periods before you started taking the pill, you may find it is the same when you stop. Other factors such as your age when you stop taking the pill, how long you were taking the pill and your general health, can also impact on how quickly your normal periods resume.

In rare cases, women's period may not return for several months, which could be a condition known as post-pill amenorrhea. This condition is thought to affect between 0.2% and 3% of women and is when the body takes a long time to start making progesterone and oestrogen again itself after taking the pill. If you haven't gotten your period for 3 months or longer you should take a pregnancy test, and if you're not pregnant, you should consult your doctor

How long before pregnancy is possible?

Each woman is unique. Pregnancy is possible as soon as you ovulate, which can start happening as soon as you stop taking the pill. The pill is 99.5% effective, so while taking it only 0.5% of women will fall pregnant.

Research has shown that neither long or short term use of the pill has any lasting impact on fertility. It has found that once women stop taking the pill, up to 90% can fall pregnant within 12 months. In fact, a study carried out by researchers at BUSPH and the University of Aarhus in Denmark recently found evidence to suggest that longer-term use of contraceptives actually improved chances of pregnancy. They found that women who'd been taking contraception for four or five years were more fertile when they stopped than those taking it for under two years.

Other frequently asked questions

Finally, there are the other questions. What happens if you think you're pregnant while still taking the pill – is it safe? How can you check? And, aside from stopping the contraceptive pill – what other steps should you be taking?

Will a pregnancy test be accurate while you're taking the pill?

Yes, you can get accurate pregnancy test results while you're taking the pill. There is a myth that the hormones in the pill will lead to inaccurate results, but pregnancy tests work by measuring a specific pregnancy-related hormone called human chorionic gonadotropin (HCG). The oestrogen and progesterone contained in contraceptive pills don't impact on a tests measurement of HCG in your blood or urine.

Is it dangerous if I become pregnant while taking birth control pills?

Once you realise you're pregnant you should stop taking birth control, but many people have accidentally continued taking them in the early stages before realising they were pregnant and it isn't a cause for alarm. There is little evidence to suggest any strong links between this and any birth defects.

However, if you become pregnant while still taking the progesterone only pill, also known as the mini-pill, there is a slightly higher chance that it could be an ectopic pregnancy. This is where the fertilised egg becomes implanted outside the uterus, usually in the fallopian tubes.

What other steps should I take after I stop the pill?

If you are stopping the pill and trying to conceive, you should also look at the other steps you can take to prepare for pregnancy. You should begin taking folic acid supplements, which can reduce the effects of neural tube defects. You should also stop smoking, reduce alcohol intake and try to follow a healthy diet. If you do plan to wait until your normal monthly cycles resume before attempting to conceive, you should use an alternative method of contraception in the meantime.