The other week, I was talking to a family member about the threats to contraception access in this country, “thanks” to our new president and his fanatical administration. He thought it was ridiculous that abortion opponents also fight tooth and nail to put obstacles in front of birth control — after all, reliable contraception prevents unintended pregnancies, which itself prevents untold abortions. It seems like a win-win for everyone, regardless of where their opinion on abortion falls.
The morning-after pill prevents pregnancy. The abortion pill ends pregnancy.
Then he said, “Of course, I understand them not wanting tax dollars going toward the morning-after pill, since that causes abortion.”
I had to stop him right there: “Nope.” A bit self-conscious of appearing to be a persnickety know-it-all, I summarized the vast differences between the morning-after pill and the abortion pill — differences that many people, even full supporters of reproductive rights, don’t understand. Opponents of abortion and contraception exploit this misunderstanding, pretending these two pills are one and the same, hoping to elicit “compromise” from “reasonable” people. Compromises that harm real people with real lives and real families. Just as women’s health opponents have been so successful at chipping away at abortion access, so too do they hope to erode access to contraception.
The morning-after pill and the abortion pill are completely different medications, used for different purposes and made up of different ingredients. Let’s look at a quick rundown of the two.
The Morning-After Pill
Also known as:
- emergency contraception
- day-after pill
- levonorgestrel
- ulipristal acetate
- Plan B, Plan B One-Step, Next Choice, Take Action, My Way, AfterPill, ella, ellaOne
Morning-after pills delay or inhibit ovulation. Sperm can live in the reproductive tract for six days, and if an egg pops out of an ovary, it can pull a lingering sperm into it, combining DNA to become a zygote — a fertilized egg. But, if you take the morning-after pill after unprotected vaginal sex, you can decrease your chances of ovulating. If you don’t ovulate, there is no egg to meet any lingering sperm — nothing to get fertilized, and no pregnancy.
The morning-after pill doesn’t cause abortion, just as birth-control pills don’t cause abortion. In fact, before the morning-after pill was available, birth control pills could be given at adjusted dosages to achieve the same effect (it’s called the Yuzpe regimen).
During the Obama administration, a type of morning-after pill called Plan B became available over the counter — meaning you could buy it at a drugstore without a prescription. You can also get the morning-after pill at places like Planned Parenthood or student health centers, from your regular doctor, at emergency departments, and even through the mail. You can keep it on-hand in case of emergency, or you can obtain it on an as-needed basis, though after unprotected sex, time is of the essence as the effectiveness of most morning-after pills wanes as the hours pass by.
Levonorgestrel pills like Plan B should be taken within three days of unprotected vaginal sex, and are between 75 to 89 percent effective. That means that, for every 100 people who would have become pregnant had they not taken the morning-after pill, 75 to 89 pregnancies will be avoided. Ulipristal acetate pills like ella can be taken within five days of unprotected vaginal sex, and are 85 percent effective. Another type of emergency contraceptive, the copper IUD (a device inserted into the uterus — not a pill), is 99 percent effective, and can be used within five days of unprotected vaginal sex.
Here’s a summary of the different types of emergency contraception:
Image: Planned Parenthood
The Abortion Pill
Also known as:
- medical abortion, medication abortion
- mifepristone
- Mifeprex
- RU-486
The abortion pill stops an existing pregnancy from developing. It can be taken up to 70 days (10 weeks) after the first day of your last menstrual period. The abortion pill itself is made of an ingredient called mifepristone, which blocks hormones that are necessary to maintain a pregnancy. A second pill, called misoprostol, causes the uterus to contract, helping to end the pregnancy. While mifepristone alone can cause abortion, 30 to 50 percent of people who take only this first pill experience an incomplete abortion. Mifepristone and misoprostol in combination are highly effective, with only a 3 to 4 percent failure rate. In the rare case the abortion pills fail, you can end the pregnancy with a second round of pills or with a surgical procedure.
You can’t walk into a drugstore and buy the abortion pill — you need a prescription and some medical supervision. First, you will visit an abortion provider to discuss your options and your decision, and will receive an exam, testing, and possibly an ultrasound depending on state law. If you decide to end your pregnancy, you’ll receive mifepristone in the clinic, along with an antibiotic to prevent infection. Within 24 to 48 hours, usually at home, you will take the second pill, misoprostol, which will initiate cramping and bleeding. The process will be similar to a miscarriage, and takes 4 to 5 hours for most people. In addition to your initial consultation(s), you might also return for a follow-up visit to confirm you’re no longer pregnant.
Many Planned Parenthood health centers, as well as other abortion providers, offer the abortion pill. Those that do not can refer you to locations that do. If you are uninsured or if your insurance does not cover abortion, Planned Parenthood may be able to help, or you can seek financial assistance from the National Network of Abortion Funds.
Both the morning-after pill and the abortion pill are incredibly safe, but they’re not the same: The morning-after pill prevents pregnancy while the abortion pill ends pregnancy.
For more information about the differences between the morning-after pill and the abortion pill, check out this informative fact sheet. You can also get more information on emergency contraception from Planned Parenthood or Princeton University. To obtain emergency contraception or receive information on the abortion pill, talk to health care providers at your nearest Planned Parenthood.
