Plan B Is Not an Abortion Pill

Understanding emergency contraception.

Dear politicians, health policymakers, reporters, and highly-opinionated social media friends. Plan B is not an abortion pill. Stop calling it that.

Plan B is the brand name of one form of emergency contraception. RU486 (Mifepristone) is a medication used to induce abortion. Plan B and RU486 are not the same medication. Emergency birth control prevents pregnancy. Abortion medication terminates a pregnancy.

Our views on abortion vary. We must understand what we are arguing about. Our country’s public policy and heated Facebook debates should at least be based on facts. Emergency contraception is completely different than a medical abortion. In fact, emergency contraception prevents the need for abortions while preventing unplanned pregnancy.

What is emergency contraception?

Emergency contraception (EC) contains progesterone, a hormone produced naturally by the ovaries. It is often called “the morning after” pill. Common brands, such as Plan B, are available over the counter without a prescription. EC is formulated with a high dose of progesterone. This hormonal blast disrupts, delays, or prevents ovulation. High dose progesterone also thickens the cervical mucus creating a toxic environment for sperm. It will not terminate an already established pregnancy.

It’s not called Plan A

Over-the-counter emergency birth control should be used within 72 hours of unprotected sex. Presciption EllaOne (ulipristal acetate) can be taken up to 5 days after unprotected sex. The earlier it is used, the better it works. EC decreases the risk of pregnancy by 70–80% (ACOG). It is not a great primary form of contraception. Emergency contraception is called Plan B and not Plan A for a reason.

Will it cause an abortion?

Progesterone does not cause abortion. Emergency contraception decreases the risk of pregnancy by inhibiting ovulation. If conception has already, then it is too late for emergency contraception. Once pregnancy occurs, the ovary forms a type of ovary cyst called a corpus luteum. It produces progesterone to support the growing pregnancy. Taking emergency contraception will only add more progesterone to support the developing fetus.

What are the side effects?

Side effects include nausea, vomiting, headache, breast tenderness, abdominal pain, dizziness, and fatigue. Those side effects will subside within 1–2 days after treatment. Because EC disrupts ovulation, irregular bleeding is common. Users may experience menstrual changes, including spotting, heavy bleeding, or altered timing of the next menstrual period.

What works best?

Photo by Reproductive Health Supplies Coalition on Unsplash

A copper intrauterine device (IUD) is the most effective form of emergency contraception. An IUD is a small T-shaped device inserted into the cavity of the uterus. It should be placed within 72 hours of unprotected intercourse. It prevents pregnancy by inhibiting sperm’s ability to swim towards the egg. It reduces the risk of pregnancy by 99% and provides effective birth control for up to ten years.

Short term solution

Emergency contraception is a safe option to prevent pregnancy after having sex without a condom or birth control. Other much more effective forms of contraception are available to help prevent pregnancy over the long term. Emergency contraception also does not protect against HIV or other sexually transmitted infections.

What is the abortion pill?

The abortion pill is a misnomer. Two medications, when combined, can terminate a pregnancy. RU486 (Mifepristone) competes with progesterone at the receptor sites. After taking RU486, a second medication called Misoprostol is given to induce uterine contractions. The combination of these two medications is used in abortion clinics for medical abortions. RU486 is highly regulated and only available under medical supervision at a clinic that offers abortion services.