I also freak out about this a lot! After a few years on birth control and some anxious (but negative) pregnancy tests, I decided to switch to an IUD which has been better so far.

I have though about getting the arm implant just because it constantly being there & no chance for missed pill might help with the anxiety

I often dealt with this when I first started having sex. Firstly, if you're on birth control, AND you're using condoms, you're safe. Yes there's a one percent chance you could get pregnant, but that's less than the odds of a tornado striking where you are right now. Back when I was worrying about this, I wasn't on birth control, didn't use condoms, and we only had the pullout method. In two years I never got pregnant. Even if you did exactly what I did, you probably wouldn't get pregnant. Precum contains no sperm. If you ever don't have a condom, have your partner pee beforehand to flush out any remaining sperm. But you're not even doing that- you are doubly protected. Imagine you're wearing a rain jacket, shower cap, and carrying an umbrella, but you're worried about getting rain in your hair because it's supposed to rain three cities away in a week. That's how silly this is. (I say silly not in a derogatory way, I'm giving you the same talk that was given to me to help me realize how I was being! Perhaps the better word is unnecessary) Let's say your protection breaks. You're on birth control. After I was using no protection and no birth control for a while, I went on birth control. I didn't use condoms at all, and never got pregnant. Not once. I did still have OCD of course! So I took tests whenever panic attacks hit me. Always negative, of course. But if you're still using condoms? You are DOUBLE protected against pregnancy. And if your condoms break, get a plan B pill within a few days. You don't need it, but if the anxiety and obsession just won't let up, it'll help. Imagine you're TRYING to get pregnant. Recently, I went off birth control, and it took me over a year of having sex every other day with no protection to get pregnant. You are loved, needed, respected, and you're more likely to win the lottery than you are to get pregnant the way you're going. I hope this helps!

I’m not sure about your thoughts on this… but just putting it out there that you can get Plan B over the counter. Maybe have one just in case you think you need it. (I’m not getting into any moral/religious arguments with anyone. Just a thought.)

Come up with a game plan for what to do if you manage to fall pregnant, whether that's finding an abortion clinic or coming up with baby names. If you know what's gonna happen next if you DO end up being that 1%, it's a lot easier to stop worrying so much about it

To add to Dire_Wolf's comment, depending on your insurance, you might qualify for free ones every so often at a clinic like Planned Parenthood! Just as a disclaimer, it was information that I was told secondhand, so definitely check before you would theoretically go through insurance for it. Best of luck, and I hope that you find something that helps put your mind at ease!