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In a post-Roe America, women are looking for alternatives, so much so, that there was a run on the Morning-After Pill and the Abortion Pill in the days immediately following the announcement of the Supreme Court’s ruling. This led several major pharmacies to place a limit on the number of these products people can purchase.

What also has become clear in post Roe America is that there is a lot of confusion between the pills, with many people thinking they are one and the same. They are not. They are two different medications with two totally different roles in the reproductive process. Much of the confusion about the difference between the pills comes from misinformation disseminated by groups that oppose abortions.

The Major Difference

The morning-after pill, also known as emergency contraception, helps prevent pregnancy; the abortion pill, also known as a medication abortion, ends pregnancy.

According to the general medical definitions of pregnancy that have been endorsed by many organizations — including the American College of Obstetricians and Gynecologists and the United States Department of Health and Human Services — pregnancy begins when a pre-embryo completes implantation into the lining of the uterus.

Hormonal methods of contraception, including the morning-after pill, prevent pregnancy by inhibiting ovulation and fertilization.

The Morning-After Pill

The morning-after pill contains medication that reduces the risk of pregnancy if started within 120 hours (five days) of unprotected intercourse. The pills are produced by several manufacturers but they all contain the same basic ingredient, levonorgestrel, a synthetic progestin that is similar to the hormone, progesterone, the body makes to regulate the menstrual cycles.

Brand names include: Plan B One-Step, Take Action, My Way, Option 2, Preventeza, AfterPill, My Choice, Aftera, and EContra. They are available over the counter at drugstores and can cost from between $20 to $50 dollars with generics costing less. The brand of emergency contraceptives’ you buy or how much you pay for it doesn’t matter — all brand-name and generic levonorgestrel morning-after pills work just as well.

There are certain brands of oral contraception taken in increased doses for use as emergency contraception that require a prescription at any age.

MAP – How Does It Work?

Morning-After Pills (MAP) work by delaying or inhibiting ovulation and/or altering tubal transport of sperm with the goal of preventing ovulation or fertilization of the egg. Part of the confusion by those who are against MAP and abortion is that they believe these pills work to remove fertilized and implemented eggs from the woman’s body.

All research supports the fact that MAP only stops fertilization of an egg. Plan B pills are no longer effective once an egg is fertilized. It doesn’t prevent a fertilized egg from implanting in the uterus or interfere with a zygote that has already been implanted.

The morning-after pill is very effective at reducing pregnancy if taken within 120 hours after unprotected intercourse. The sooner the dose begins, the more effective the treatment.

When taken within 24 hours of unprotected intercourse, the progestin-only pills are 95% effective at reducing the risk of pregnancy.

The Abortion Pill

The abortion pill ends a pregnancy without using instruments. In the United States, the pills are approved for use by the Federal Drug Administration up to 10 weeks after the person’s last menstruation, however, it’s authorized for 12 weeks and sometimes longer in some other countries.

Also known as medication abortion, the abortion pill is actually two medications that must be prescribed by a doctor: Mifepristone which ends a pregnancy by blocking the hormones necessary for maintaining a pregnancy and Misoprostol which causes the uterus to contract and empty.

Unlike a surgical abortion, medical abortion doesn’t involve getting surgery or anesthesia (medicine that makes you unconscious during an operation). Instead, you take the abortive medications in a health care setting (like a doctor’s office) or at home. You need to follow the doctor’s directions on how and when to take the drugs exactly, with the second pill taken 24 to 48 hours after the first.

The abortion pill is highly effective at ending very early pregnancies. Complete abortion will occur in 96–97% percent of women who choose mifepristone. In the small percentage of cases where medication abortion fails, other abortion procedures are required to end the pregnancies.

Telemedicine Abortions

Medical Abortion was approved for use in the United States in 2000 and by 2020, more than half of all abortions in the U.S. were medication abortions, according to the Guttmacher Institute, a research group that supports abortion rights. A growing number of those abortions were telemedicine abortions. Also called telehealth abortion, it is essentially a  medical abortion in which medical consultations occur over video chat, phone call or text message, and the medications are sent through the mail.

With some telemedicine services, the entire process happens through telehealth, meaning the patient never meets their provider in person; they may be asked about a positive pregnancy test, but aren’t generally required to provide one, and there are no mandatory ultrasounds. In other settings, clinics or hospitals may use telehealth for just a part of the process, like the initial consultation.

How Safe is It?

The second pill Misoprostol induces heavy bleeding and cramping 1 to 4 hours after taking it. This is a normal response with the purpose of emptying the uterus of pregnancy tissue. Users may experience a variety of side effects including: tiredness, dizziness, cramping, heavy bleeding, diarrhea, and a mild fever. To alleviate the pain, ibuprofen can be taken; however, aspirin should be avoided as it might increase bleeding.

Like with any medication, there are potential risks associated with a medical abortion. The likelihood of experiencing these risks is very low. The rare but serious complications include: unsuccessful abortion, infection, prolonged bleeding, long-lasting fever, and blood clots in the uterus.

The abortion pill regimen can cost from $200 to $800, depending on your insurance and the provider.

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Bonita Gooch

Since 1996, Bonita has served as as Editor-in-Chief of The Community Voice newspaper. As the owner, she has guided the Wichita-based publication’s growth in reach across the state of Kansas and into...