Is it safe to take a birth control pill that has risks of blood clots when you have varicose veins?

Depends : Most such pills do increase your risk of deep venous thrombosis. Depending on how bad the vein problem is, varicose veins can also clot but usually its the larger varicosities, not just spider veins. If you want to fix the veins to allow pill use, vein ablation is often possible, less painful and easier to get over than stripping. Check with your local vascular surgeon or vein center.

Yes. : Yes, it's okay to be on oral contraceptives (ocps) with varicose veins. The ocps will increase your risk of DVT but the presence of varicose veins does not.

Increased risk: Oral bcp's due increase the risk of developing dvt. And , can potentially increase women's risks of clots elsewhere (hyper coagulable). The presence of varicose veins also pose a potential for the varicose veins to clot. So, although bcp's may not have a direct effect on causing vv's to clot, certainly the risk is increased. You should see a vein specialist and have the vv's evaluated.