Instructions for Taking the 28-Day Birth Control Pill
This handout will explain how to take the 28-day oral birth control pill. If you have any
questions, please ask your health care provider.
How Does the Pill Work?
When taken as advised, the pill:
ξ Stops the ovary from releasing an egg.
ξ Thickens cervix mucus to stop the sperm
from joining an egg.
ξ Alters the lining of the uterus.
How Effective is the Pill?
The pill is 95-99% effective in preventing
pregnancy if taken within 2 to 3 hours of the
same time every day.
Other Benefits of the Pill
ξ Periods are less heavy, are shorter in
length, and have fewer cramps.
ξ Risk for ovarian and uterine cancer is
ξ Risk of ovary cysts is decreased.
ξ Acne often improves.
ξ Risk of benign breast conditions is
ξ May protect against osteoporosis,
endometriosis, and rheumatoid arthritis.
Instructions for Taking the 28-Day Pill
1. Start taking your pills:
_____ on the Sunday after your period
_____ the first day of your period
2. Take one pill by mouth each day until
you have taken all 28 pills. Take the pill
at the same time every day. Decide on a
time that will work for you and be
consistent. Take the pill within 2 to 3
hours of the same time each day. The
last 7 pills contain no hormones, but help
keep you in the habit of taking a pill
3. For the first month only, if you start
on the first Sunday of your period,
you will not be safe from getting
pregnant until you have taken the pills
for 7 days. During that time be sure
to use a second method of birth
control, such as foam or cream and/or
a condom. If you start the pill on the
first day of your period, you are safe
right away and will not need back up
birth control methods.
4. After finishing a pack, start a new pack
the very next day. There will never be a
day when you do not take a pill.
5. Do not skip pills even if you are spotting
or bleeding between periods.
6. Do not skip pills even if you feel
nauseous. Try switching your pill to a
different time of day, such as bedtime or
with a light meal.
What Should I Do if I Forget to Take a
How late are you in taking your pill?
1. Less than 24 hours
ξ Take the missed pill as soon as you
ξ Take your next pill at the normal
ξ A back-up method of birth control is
2. 24 hours
Take the missed pill and today’s pill at
the same time or you can take them 12
hours apart to avoid nausea.
3. More than 24 hours (You completely
missed one pill and are late for or missed
a second pill, too.)
ξ Take the last pill you missed right
ξ Take the next pill on time. This may
mean taking 2 pills at one time
ξ Take the rest of the pills in the
package right on time.
ξ You may have some spotting or
ξ You will not be protected against
getting pregnant and need to use a
back-up birth control method for
the rest of this pack if this
occurred in the 1st week of pills.
4. If you miss more than 2 pills, call your
health care provider for further
Pills and Your Periods
Your period usually starts on the second or
third day that you start the last row of pills.
Your periods may be lighter and not last as
long when you did not take the pill. If you
were bothered by cramps during your
periods, this should improve while on the
Some women have spotting (bleeding)
between periods, most often during the first
three months of taking the pills. There is no
reason to worry if you have been taking the
pills within 2 to 3 hours of the same time
each day. Keep taking the pills.
Call your health care provider if bleeding
keeps up after the first three months or
if bleeding between periods becomes heavy
or lasts longer than normal.
Sometimes, women will skip a period while
on the pill. This is not a concern as long as
you have not missed any pills or taken any
pills late. If you miss two periods in a row,
call your health care provider.
If you are taking antibiotics while on the
pill, you may have breakthrough
bleeding. It is generally not necessary to use
any form of back-up contraception while on
antibiotics, but call your health care provider
if any concerns.
Report any breakthrough bleeding that
occurs after the first three months, unless the
bleeding occurred because you forgot to take
a pill or have taken one late.
Vomiting and/or diarrhea can also reduce
the absorption of the pill. Discuss with
your health care provider if you need to use
a back-up method of contraception for the
remainder of the pill pack to avoid getting
The pill does not protect you from
sexually transmitted infections, including
Take your pill at about the same time every
day. Try to match taking the pill with a
daily event like brushing your teeth.
When you are on birth control pills, it is best
not to smoke. Research has shown an
increased risk of stroke, heart attacks, and
blood clotting problems if you smoke on the
Talk to your doctor or nurse about how often
you need a physical exam and pap smear.
Tell all of your health care providers that
you are taking birth control pills. Do not
stop your pills without first talking to your
health care provider.
Birth control pills are a safe and effective
method to avoid getting pregnant. However,
there can be rare, serious side effects. You
should contact your health care provider or
Emergency Room right away if you have:
A Abdominal (stomach) pain—severe or
C Chest pain or shortness of breath
H Severe headaches
E Eye problems, like blurred vision,
flashing lights or blindness
S Severe leg pains (calf or thighs)
After hours and weekends, call your clinic. A nurse or the paging operator will assist you in
talking to the clinic doctor on call. Leave your name and phone number with the area code. The
doctor will call you back.
If you live out of the area, please call 1-800-323-8942.
If you have any questions or concerns, please call:
____________________________________________ at ____________________
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©6/2016. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4233