Emergency contraceptive pills vs. abortion pills: Is Plan B the same as the abortion pill?

In the world of reproductive health, there’s a lot of confusion and misinformation — especially since the Supreme Court Dobbs decision, when the landmark case Roe v. Wade was overturned. A common misconception is that Plan B, a form of emergency contraception, is the same exact thing as abortion pills. The truth is that these medications differ quite a bit in everything from when and why they’re used to how they work.

So, what exactly is the difference between Plan B and abortion pills? And how do they both work? Keep reading to find out!

First up: All about Plan B

What is Plan B?

Plan B One-Step is the brand name of a specific kind of emergency contraceptive pill (ECP) containing the synthetic hormone levonorgestrel (a type of progestin that’s also found in birth control pills). It’s commonly referred to as the “morning-after pill.”

While Plan B is probably the most well-known form of emergency contraception, it’s not the only one. Other forms include pills containing ulipristal acetate (brand name: ella) and the non-hormonal as well as the hormonal intrauterine device (IUD). 

How does Plan B work?

Taking Plan B pills, or ECPs containing levonorgestrel, works as a barrier to the release of an egg from the ovary (the part of the menstrual cycle called ovulation). Preventing ovulation means blocking a released egg from becoming a fertilized egg — leading to implantation and then resulting in a pregnancy.

ECPs with levonorgestrel are 75-89% effective at preventing pregnancy if they’re taken within three days of having unprotected sex for people who weigh less than 165 lbs. The only emergency contraceptive that doesn’t become less effective at higher weights is the IUD. The downside, however, is that IUDs aren’t available over the counter like Plan B is. 

What are common side effects of Plan B?

Experiencing side effects from Plan B isn’t common. That said, there’s a chance people may experience: 

  • Differences in their next period (timing and flow)
  • Stomach issues
  • Lightheadedness
  • Dizziness
  • Breast/chest tenderness

All about abortion pills

What are abortion pills?

Abortion pills refer to two different types of pills: mifepristone and misoprostol. The pills can be taken in combination, which is the FDA-approved protocol for up to 10 weeks, or misoprostol can be taken on its own to safely and effectively end a pregnancy. The combination is up to 98% effective through 11 weeks of pregnancy. The World Health Organization (WHO) has guidelines for safe use through 12 weeks. One way to get abortion pills is to consult with a telemedicine healthcare provider like Juniper Midwifery.

Unlike with Plan B, there’s no reason to believe that weight has any impact on the effectiveness of abortion pills.

How do abortion pills work?

The two pills used in medication abortion both play a distinct role in ending a pregnancy:

  • Mifepristone blocks the body’s production of progesterone — a necessary hormone for sustaining a pregnancy.
  • Misoprostol causes the uterus to cramp and empty out the lining of the uterus and its contents.

What are common side effects of abortion pills?

A few hours after taking misoprostol, the uterine cramping and vaginal bleeding may begin. Aside from those two symptoms of abortion pills, which are a good sign the medication is working, these other symptoms are common:

  • Fevers
  • Chills
  • Headache
  • Nausea
  • Vomiting
  • Diarrhea

Taking over-the-counter ibuprofen (Tylenol if you’re allergic to ibuprofen) and using a heating pad can help with cramping. Alternating ibuprofen with Tylenol every 3-4 hours (without going past daily limits) may be even more effective than just ibuprofen alone. Some people may also take anti-nausea medication or Benadryl (which some may find also helps with nausea).

What are the main differences between Plan B and abortion pills? Let’s break them down

Here are the main differences between Plan B and abortion pills:

  • Plan B prevents a pregnancy while abortion pills end an existing pregnancy.
  • Plan B is one medication that contains a hormone called levonorgestrel, while abortion pills are two different medications called mifepristone and misoprostol.
  • Plan B is about 75-89% effective if taken within 72 hours of unprotected sex while abortion pills are up to 98% effective through 11 weeks of pregnancy.
  • Plan B is less effective for people who weigh more while abortion pills don’t lose effectiveness across different weights.

How can you get Plan B or abortion pills?

Plan B and other ECPs containing levonorgestrel are the only form of emergency contraception that’s available over the counter. You should be able to get any type of emergency contraception, including Ella and the copper IUD, from your healthcare provider.

Abortion pills can be prescribed by providers at in-person or telemedicine clinics in states without abortion bans or telemedicine abortion restrictions. Telemedicine medication abortion, although shown to be extremely safe and effective, is not currently allowed in 19 states. Some people may also access medication from online pharmacies or community care providers.

Need abortion care? Juniper Midwifery can help

If you’re currently less than 10 weeks pregnant and need to access abortion care in New York, New Jersey, Connecticut, California, or New Mexico, Juniper Midwifery can help. After completing an intake assessment, our clinicians will review your information to make sure medication abortion is right for you. Once your prescription is confirmed, it’ll take about 2-4 business days for your medication to arrive. (You can also expedite shipping for $25 when checking out for guaranteed 1-2 business day shipment). 

Juniper Midwifery patients who would also like a consultation and prescription for contraceptives can get them for free in addition to abortion care.

For any of our patients who need additional support or medical advice, our clinicians are here for you. Please reach out whenever you need to. Organizations like the Reprocare Healthline, All-Options, Exhale Pro-Voice, and Connect & Breathe also provide free, anonymous, and nonjudgmental emotional support for people accessing abortion care.