Choosing a family planning method
Birth control pills (oral contraceptives or “the pill”)
Birth control pills have all the benefits and problems of hormonal methods listed
on page 306.
When a woman takes a birth control pill at the same time every day, this
method is one of the most effective ways to avoid pregnancy.
There are many brands of birth control pills. Pills should be “low-dose.” That
means they should have 35 micrograms (mcg) or less of estrogen, and 1 milligram
(mg) or less of progestin. Women should never use pills with more than 50 mcg
How to take birth control pills
A woman should take the first pill in a packet on the first day of monthly
bleeding. If that is not possible, she should take the first pill anytime in the
first 7 days after she starts her monthly bleeding.
Pills come in packets of 21 or 28 tablets. If a woman
is using a 28-day packet, she should take one pill every
day. Women will usually have light monthly bleeding
during the last 7 days of a pill packet. As soon as she
finishes one packet, she should begin taking a new one.
28-day pill packet
(The last 7 pills in a 28-day packet are made of sugar. They have no
hormones in them. Women take these pills to remember to take a pill
If a woman prefers not to bleed every month, it is safe to take only the
hormone pills continuously for up to 3 months. When the woman reaches
week 4 of her packet (the sugar pills) she can immediately begin a new
packet of pills instead of taking the sugar pills. Then continue taking the
hormone pills in the usual order.
21-day pill packet
If a woman is using a 21-day packet, she should take
one pill every day for 21 days. She should then wait 7 days
before starting a new packet. Usually, a woman will start
her monthly bleeding after the 21st day. But even if she
does not, she should start a new packet in 7 days.
The pills will not prevent pregnancy
immediately. So during the first 7 days
on pills, the woman should use condoms
or some other backup method to avoid
It is best to take the pill at about the same
time every day. Many women take the pill
with food, especially if they feel some nausea
during the first few months that they take it.
A Book for Midwives (2010)