NuvaRing and Pregnancy: What to Do If You Missed Your Pill

Question
During the Thanksgiving Holidays I was busy and forgot to take my ring out.  I actually started my period and realized that I had not taken my ring out.  To add an insult to injury...I was three days late putting the ring back in (7 days of period...three days extra) I put the ring in as soon as I realized my mistake but now I'm worried that I could be pregnant.  My husband and I have had unprotected sex.  My main concern is that the ring I have in now could affect the baby.  I have taken a test that resulted in negative, although, I feel it is too soon to tell.  What are the chances that I could be pregnant and if so could the ring harm the baby?

Thank you!

Answer
Dear Christie,

OK, so you were late taking Nuvaring out, but you did when you started your period. Do you know whether that was at the 3 week point or 4 week or longer? But you did go through with your 7 day ring-free period. Then you had a delay of three days before inserting another Nuvaring. (Just to make sure I understand completely.)

Anytime you go longer than 3 hours during the 3 week time of scheduled Nuvaring wear, you really are at risk for pregnancy and should use a back-up method of birth control until you have had the ring in for a continuous 7 days. If your unprotected sex was during that period right after your period, that wasn't your most fertile time. BUT you can't rule out pregnancy completely. If you put the Nuvaring in on Day 10 of your cycle, you really weren't completely protected again until Day 17. Days 11-21 you are most fertile. So, there's quite a window there, depending upon when your sexual encounters took place.

You are correct in assuming that a HPT would more than likely be too early to pick up the pregnancy hormone at this point. You would need to wait until you actually missed a full period and use 1st morning urine to get a concentrated sample.

As far as continuing use of Nuvaring, there really is no difference between using the ring and taking BCPs - both release hormones. The recommendation typically is that when you miss a period, you should rule out pregnancy before continuing use. But although use is not recommended, studies have not indicated that there is an increased incidence of birth defects in babies when contraceptives are inadvertently taken in early pregnancy.

I hope this information has helped you and answered your questions. I wish you well and a happy Christmas season.

Brenda