The problem, according to the health ministry and Silesia, was not the pills, but the packaging. Like many other oral birth control pills, packets of Anulette CD include 21 active pills, which are yellow, and seven blue placebo pills, which are intended to be taken during the time the user is menstruating.

An undetermined number of packets included placebo pills in the active slots and vice versa, according to the alert. A week after the initial recall, the health ministry issued a second one withdrawing an additional 137,730 Anulette CD packets. The second alert said some of the packets had missing or crushed pills.

The recalls, issued amid a severe coronavirus outbreak and on a government website that the public generally does not consult, generated relatively little news coverage. The government did not hold a news conference or develop a plan to directly warn the women who got the recalled contraceptives.

Marlisett Guisel Rain Rain, 37, a mother of three, was taking the pills when she learned she was pregnant. The news came at a challenging time: She was splitting up with her husband and starting the third year of a college degree in public administration.

“It was very hard to come to terms with the pregnancy,” Ms. Rain Rain said. “I was studying and didn’t have a stable place to live.”


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