The recent Supreme Court ruling overturned Roe v. Wadethe nearly 50-year-old legal precedent that guaranteed a constitutional right to an abortion has people scrambling for access to medication that could end a pregnancy or prevent one.
But there is already confusion about the difference between medication for abortion, which is prescribed to terminate a pregnancy, and emergency contraception (including Plan B), which is taken shortly after sex and prevent pregnancy.
Medication abortion in the US usually consists of a combination of two drugs, both taken orally after consultation with a medical provider. Approved by the Food and Drug Administration, this protocol includes the drugs mifepristone and misoprostol. They work together by causing something like a heavy menstruation.
Mifepristone (Mifeprex), also known as RU-486, is taken within 10 weeks of a pregnant person’s last period. It blocks receptors for the hormone progesterone, which causes the embryo to detach from the uterine wall and break down the uterine lining, terminating the pregnancy. Misoprostol (Cytotec), a synthetic form of a prostaglandin, a group of compounds with hormone-like effects, is taken after mifepristone within a day or two. This causes the uterus to contract and soften the cervix, allowing the uterus to empty. Misoprostol can be taken on its own to cause an abortion, but is more effective when taken with mifepristone.
In contrast, emergency contraception – sometimes called the “morning-after-pill” – can be taken up to three to five days after unprotected sex or failed birth control. These types of drugs work primarily by preventing or delaying ovulation, or releasing an egg from an ovary. If ovulation has already occurred, the hypothesis is assumed that the morning-after pill may prevent the ovum from being fertilized or implanted in the uterus, although some studies suggest that it does not affect these processes. What is important is that emergency contraception cannot terminate a pregnancy, which defines the medical community as a fertilized egg implanted in the uterus.
“The main difference between emergency contraception and medication abortion is that emergency contraception prevents a pregnancy from happening, while medication abortion terminates a pregnancy,” says Jen Villavicencio, head of equity transformation at the American College of Obstetricians and Gynecologists.
There are several types of morning-after pills: Plan B, perhaps the best known, consists of the synthetic hormone levonorgestrel and works by preventing or delaying ovulation. It is available without a prescription and can be taken within 72 hours after sex (the sooner Plan B is taken, the more effective it is). However, it may not be effective for people who weigh more than about 155 to 165 pounds. “Plan B is unable to cause an abortion,” a spokesman for Foundation Consumer Healthcare, the company that owns Plan B, wrote in an email. Scientific American.
Another emergency contraceptive called Ella is effective in people weighing up to about 195 pounds. It contains a substance called ulipristal acetate, and like Plan B, it works by preventing or delaying ovulation. Ella needs a prescription and can be taken within five days of unprotected sex, but it works better the sooner it is taken.
Despite the fact that the morning-after pills do not terminate an existing pregnancy, clinics in some states may misinterpret abortion restrictions as a ban on emergency contraception. Saint Luke’s Health System in Kansas City, Mo., initially stopped providing Plan B at its locations in the state, which banned most abortions, including those resulting from rape or incest. “To ensure that we comply with all state and federal laws – and until the law in this area is better defined – Saint Luke’s will not provide emergency contraception at our Missouri – based locations,” said Saint Luke’s Health System spokeswoman Laurel Gifford said in a statement. June 28, issued by the Kansas City Star and other outlets. But the next day, the health system said it would provide emergency contraception again.
Emergency contraception “should never be subject to laws prohibiting abortion,” Villavicencio says. “Any impact of abortion ban on emergency contraception is a misapplication of the law and a misunderstanding of medical science.”
Contraception — including emergency contraception — remains legal in Missouri and throughout the country. But situations like the one in Kansas City suggest that laws restricting abortion could have a cooling effect on access to contraception like Plan B. And it’s not a little to think that the Supreme Court could ultimately provide protection for contraception in general does not turn back: in his assent opinion in the Court’s recent ruling in Dobbs vs. Jackson Women’s Health Organizationwhat turned up Roe v. WadeJudge Clarence Thomas wrote that the court should also reconsider other cases, including Griswold vs. Connecticut—A 1965 decision confirming married couples’ freedom to buy and use contraceptives.
For now, it is important for patients and policymakers to know the difference between medication abortions, which are now illegal to prescribe in some states, and emergency contraception, which is legal across the country.
“Refusing people emergency contraception will only make more people face the realities of unintended pregnancy without having legal abortion care as a solution,” Villavicencio says.