Emergency Contraception vs. Abortion Pills: What to Know Right Now

While much is up in the air about reproductive rights at the moment, the constitutional right to access contraceptives remains in tact.

This means people across the country still have access to emergency contraception like Plan B. However, medication abortions—or abortion pills—will not be as accessible.

“I want people to know that it is not illegal in any state to utilize emergency contraception. There are no laws that I know of to this point that intend to make it illegal,” Laura Purdy, MD, MBA, a board-certified family medicine physician, told Verywell. 

Here are a few things to know about emergency contraception and abortion pills in light of the the reversal of Roe v. Wade, which leaves it up to individual states to determine if abortion is legal within their borders.

When Can You Use Emergency Contraception? 

If a person has unprotected sex or contraception like birth control and condoms fail to work, emergency contraception like Plan B is still an option.

For someone who takes a pregnancy test and receives a positive result or is already pregnant, emergency contraception will not work, Meera Shah, MD, MPH, Chief Medical Officer of Planned Parenthood Hudson Peconic in New York, told Verywell. 

"Emergency contraception is not the same thing as medication abortion, which is also called the abortion pill," Shah said.

Emergency contraception can be available over the counter and should be taken within three to five days of having sex. The abortion bill requires a prescription, and can be taken up to 10 weeks gestation.

What Are Your Emergency Contraception Options?

There are three types of emergency contraceptives that are currently available in the U.S., Jennifer Lincoln, MD, IBCLC, a board-certified OB-GYN in Portland, Oregon, and TikTok educator, told Verywell via email. These include two oral options and one that isn’t a pill at all. 

1. Pills containing the medication levonorgestrel are sold under brand names like Plan B One-Step, Take Action, My Way, AfterPill, and several others. Levonorgestrel is a drug used to prevent pregnancy after unprotected sexual intercourse, sex without any method of birth control, or failed uses of contraception like a condom that slipped or broke during sex. These pills are also called “morning after” pills and can be used up to three days after unprotected sex. The pill works by delaying or preventing ovulation. 
2. Medication (tablets or pills) that contain ulipristal acetate, which is sold under the brand name ella, works to prevent or delay ovulation and can be used up to five days after unprotected intercourse. 
3. Intrauterine devices (IUDs) like Paragard, Liletta, and Mirena are acceptable options for emergency contraception in the U.S. Dr. Lincoln said IUDs can be inserted up to five days after unprotected sex and are “the most effective form of emergency contraception.”

How to Get Emergency Contraception

Plan B and other brand-name morning-after pills are available over-the-counter without any age or sex restrictions at most pharmacy convenience stores such as Walgreens and CVS, Purdy said. 

However, ella requires a prescription, whether from your doctor or an online telehealth company. According to Shah, you can get a prescription for ella before you actually need it.

“You can keep it in your medicine cabinet or bedside table and it will be there for you, just in case," she said.

Both Plan B and ella can be purchased online and mailed to you from mail-order pharmacies, Lincoln added. 

“It is a great idea to get a personal prescription of ella (ideally, as it works better) or have Plan B on hand, but there is no need to buy a bunch and go overboard,” Lincoln said. 

An IUD requires an in-office visit with a trained provider since it needs to be inserted. Purdy said if your doctor is not available as quickly as the need arises, there are community resources available through your local Planned Parenthood or other local health clinics. 

What Are Your Abortion Pill Options?

For people who are already pregnant and wish to terminate a pregnancy, there are two different pills that should be used together for a medication abortion. The pill regimen is approved by the U.S. Food and Drug Administration (FDA) for use up until week 10 of pregnancy or 70 days or less since the first day of a woman’s last menstrual period. 

1. Mifeprex (mifepristone) is a medication that is taken first to block progesterone and prevent the fetus from growing.
2. Misoprostol is taken either immediately after mifepristone or up to 48 hours after, depending on your healthcare provider's direction. It works by emptying the uterus, causing cramping and bleeding. This medication is also used to prevent and treat stomach ulcers.

How to Get Abortion Pills

Abortion pills typically require a prescription from a doctor, nurse, health clinic, or Planned Parenthood health center. However, depending on where you live, there may be restrictions, especially if you’re 17 years or younger. Some states have banned abortion, including medication abortions that involve abortion pills. 

A report by CNBC states abortion bans went into effect in Arkansas, Kentucky, Louisiana, Missouri, Oklahoma, South Dakota, Utah and Alabama on Friday. Other states including Mississippi, North Dakota and Wyoming are expected to have abortion bans after a “certification process.” Idaho, Tennessee and Texas will implement bans in 30 days. 

“Nearly all of these 14 states specifically outlaw the prescription or administration of any drug to terminate a pregnancy, while in other states the bans are written so broadly that they include the pill as well,” the CNBC report said. 

With this restriction in place, people who are wanting an abortion or abortion pills will have to cross state lines or order pills online.