Twenty-Four Percent Of Women Between 22 To 49 Have Taken Emergency Contraception

·7 min read

On Friday June 24, The Supreme Court voted in a 5-4 decision to overturn Roe v. Wade, the landmark 1973 court case that made abortion legal across the country.

Now, with abortion likely to be banned in many states, people are wondering if that means that access to birth control, IUDs, and emergency contraception will also be affected. In 2021, a study showed that 24 percent of women ages 22 to 49 years old had used emergency contraception in their lifetime, per the CDC.

Rumors have swirled that one form of emergency contraception called Plan B is next on the chopping block. But that hasn't happened yet.

So, what exactly does Plan B do, again? And is it the same thing as the abortion pill? (Spoiler: It's not.)

Women's Health turned to obstetrician-gynecologists Dr. Jennifer Lincoln, MD, and Dr. Jessica Shepherd, MD, to answer all your questions about Plan B and how it's different from the abortion pill.

Meet the experts: Dr. Jennifer Lincoln, MD, is an ob-gyn and author of Let's Talk About Down There. Dr. Jessica Shepherd, MD, is an ob-gyn and director at Minimally Invasive Gynecology at the University of Illinois College of Medicine at Chicago.

What is Plan B?

Plan B One-Step, frequently referred to as the morning after pill, is a type of emergency contraceptive that you can purchase over the counter at a pharmacy for around $50. It's one pill (taken orally) that contains 1.5 milligrams of levonorgestrel, a synthetic form of the hormone progesterone, according to the FDA.

The purpose of Plan B is to stop you from getting pregnant after having unprotected sex or after you think your contraception has failed. It prevents pregnancy by delaying ovulation. It can also prevent a fertilized egg from implanting in the uterus.

But experts warn that it shouldn't be your main way of preventing pregnancy. "Emergency contraception should not be used as a regular method of birth control," says Dr. Jessica Shepherd, an ob-gyn and director of Minimally Invasive Gynecology at the University of Illinois at Chicago.

And for future reference, Plan B can be safely used again after another instance of unprotected sex or birth control failure.

Is Plan B the same thing as an abortion?

No. Plan B is not abortion.

Taking Plan B prevents pregnancy by delaying ovulation. And if fertilization does occur, Plan B may prevent a fertilized egg from attaching to the uterus, per the FDA. However, if a fertilized egg is implanted prior to taking Plan B, the drug will not work and pregnancy proceeds normally.

The Centers for Disease Control and Prevention defines abortion as the termination of an established pregnancy.

What is the abortion pill, and how does it work?

If you opt for a medication abortion, you'll actually take two different pills: mifepristone and misoprostol. On day one, you'll take mifepristone, per Planned Parenthood. Mifepristone blocks the body’s progesterone, a hormone that is needed to continue a pregnancy in its early stages. It causes the pregnancy to stop progressing, says Shepherd.

On day two or three, you will usually take four misoprostol pills. This medication softens the cervix and causes the the uterus to contract, explains Sheperd. This will expel the embryo from the uterus.

Why do people confuse Plan B and the abortion pill?

Lincoln suggests that one of the main reasons why people think that Plan B is the same thing as abortion is because the packaging states it could prevent the implantation of an embryo. However, "this is a hypothetical that has never been proven," she says.

Plus, some people believe that pregnancy begins at fertilization—not at implantation, she adds.

But organizations such as the National Institutes of Health (NIH) Trusted Source and the American College of Obstetricians and Gynecologists (ACOG) says that pregnancy occurs only after a fertilized egg is implanted in the uterus, per Healthline.

"Implantation at the beginning of pregnancy happens about a week after fertilization," explains Shepherd. The blastocyst—a tiny group of cells that will later become the fetus—embeds itself into the wall of the uterus. And that's when experts say you're technically pregnant.

Is Plan B going to be illegal?

As of right now, no states have banned Plan B or made it illegal. However, there have been talks among lawmakers who are considering putting stricter measures in place. It all comes down to how the law is interpreted and whether or not it can be expanded to include the pill or other forms of emergency contraception.

Thirteen states currently have trigger bans that can go into effect now that Roe is overturned. But these bans do not include emergency contraceptives or in vitro fertilization (IVF).

Brent Crane, the House State Affairs Committee Chairman, has said that he would hold hearing about banning emergency contraception due to reports of “complications” causing “health concerns for the mom,” according to the Idaho Statesman.

Meanwhile, Justice Clarence Thomas recently hinted that a woman's right to birth control (protected under Griswold v. Connecticut) could be under threat next. “In future cases, we should reconsider all of this Court’s substantive due process precedents, including Griswold, Lawrence, and Obergefell," he wrote.

When should I take Plan B?

"Plan B should be taken by 3 days or 72 hours of unprotected sex," explains Lincoln. "But it works better the sooner you take it."

How long is Plan B's shelf life?

Plan B has a shelf life of about four years if it's stored properly, per Plan B One Step. Regardless, it's always good practice to check the box for the expiration date before purchase.

What if I can't find Plan B?

If you can't get your hands on a Plan B, consider other options that could buy you more time and might be even more effective.

Ella, another form of emergency contraception, is especially helpful for women with a higher BMI. Ella is effective for people with a BMI of up to 35, instead of Plan B's 26, per Healthline. But it requires a prescription, so it might not be the best option if you're running short on time.

"Ella is better in that you have up to 5 days or 120 hours after unprotected sex to take it," says Lincoln. Ella may prevent pregnancy even before ovulation begins, adds Shepherd.

Shepherd points out that you can also get a copper IUD inserted into your uterus as a form of emergency contraception.

Here are some stats to help you weigh your options:

  • Plan B: 87.5 % effective (per Plan B's website)

  • Ella: 97.9 to 99.1% effective (per Ella's website)

  • Copper IUD: < 99% effective (per Cleveland Clinic)

What are the side effects of Plan B compared to the abortion pill?

Some common but temporary side effects of taking Plan B include nausea, dizziness, fatigue, headaches, breast tenderness, bleeding between periods or heavier menstrual bleeding, and lower abdominal pain or cramps, per Mayo Clinic. But if you vomit within two hours after taking Plan B, consult with your doctor to see if you should take another dose.

The "side effects" are slightly different from the abortion pill. You can expect bleeding and cramping, which is normal to expel the pregnancy, according to Lincoln. You might also experience nausea, chills, and fever for a short period, per Planned Parenthood.

Does emergency contraception affect future fertility?

Emergency contraception does not impact your chances of getting pregnant in the future. "There is no risk to future fertility when using birth control long term or using ECP and data has substantiated this now repeatedly," explains Shepherd. There is also no evidence that taking emergency contraception raises your risk of breast cancer.

Where can I buy Plan B?

Plan B can be purchased over-the-counter at your local drugstore or pharmacy.

But if you're looking to purchase Ella, you'll have to ask your doctor for a prescription. Still, Lincoln notes that both Ella and Plan B can be sent to you from mail-order birth control companies. "It's best to have them on-hand before you need them, so there are no barriers to you taking them ASAP," she suggests.

Should I stockpile Plan B?

Now that Roe v. Wade has been overturned, many women wonder if they should be buying Plan B in bulk just in case they need it in the future.

"It's unnecessary to stock up in bulk like people did with toilet paper back in 2020. This will lead to lack of access when people need it most," cautions Lincoln. "Instead, get yourself one or two so you have them if you or a friend needs them. But don't go overboard."

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