Inconsistent use of oral contraceptives (OCs) exposes women to risks of unintended pregnancy. This study explored women's self-described reasons for missed OC pills. Data from diary cards completed by 141 women were studied to see how reasons for missing pills were related to patterns of pill use. The findings suggest that practitioners might improve OC use by focusing on the reasons that women miss pills, thus providing a more tailored approach that addresses individual risks based on women's personal experiences.