Are Abortion Pills and Plan B the Same Thing?

Many people confuse emergency contraceptives and medical abortion options. Is Plan B the same thing as the abortion pill? How does each one work?

When faced with the possibility of an unintended pregnancy, it’s important to be well-informed on all your options as it directly impacts your health and decisions. It’s worth pausing long enough to get good information and ask any questions you may have.

Clarity empowers you to make informed, responsible choices. Plan B and abortion pills are two different things with very different functions. Let’s take some time in the rest of this article to lay out the differences.

Understanding Abortion Pills

A medical abortion consists of two prescribed medications used to terminate an early pregnancy. Medication abortion uses the drugs mifepristone and misoprostol to terminate an existing pregnancy. Unlike Plan B, which is designed to prevent pregnancy shortly after unprotected intercourse, the abortion pill is a chemical method for ending an existing pregnancy.

What are Abortion Pills?

Medical abortion refers to a combination of mifepristone and misoprostol. Mifepristone blocks the hormone progesterone, which is necessary for a pregnancy to continue. After taking mifepristone, misoprostol is taken to induce uterine contractions and expel the pregnancy from the uterus through the vagina. Heavy bleeding and cramping are to be expected.

Mifepristone blocks progesterone, and misoprostol expels the contents of the uterus.

Abortion pills are FDA-approved to only be used within the first ten weeks of pregnancy as an alternative to surgical abortion options. While abortion pills are now accessible through various online platforms and organizations, there are a few very important things to know regarding your safety.

  1. For your own health and safety, it is never recommended to access abortion pills from an unverified online provider.
  2. Have somebody with you that knows that you are taking the pills. (In case you have a heavy bleed and faint, someone will be able to tell EMS/Doctors that you have just taken the pills.)
  3. It is vitally important that you know exactly how far along you are in your pregnancy before making any abortion decision. This step will protect your health and safety as an ultrasound is the only way to accurately date the pregnancy.  Purchasing abortion pills online, while convenient,  bypasses this important step and can put you at risk if you are further along in your pregnancy than you or the online provider expect. 
  4. Do not take the abortion pill if you do not have access to emergency care, as mifepristone poses risks of serious and sometimes fatal infections or bleeding.
  5. Abortion pills are not effective (and may be contraindicated) in the case of an ectopic pregnancy.

How Do Abortion Pills Work?

The medication abortion process primarily involves the two medications mentioned above, mifepristone and misoprostol.

Mifepristone, taken first, blocks the hormone progesterone. Progesterone has an important role in the female reproductive system, supporting menstruation and helping maintain the early stages of a pregnancy. Progesterone thickens the uterine lining, helping the fertilized egg grow into its next stage as an embryo and then a fetus. Low progesterone levels may lead to difficulty conceiving and/or miscarriage. When mifepristone interrupts progesterone in the body, it begins the pregnancy termination. Following this step, misoprostol induces contractions that expel pregnancy tissue from the uterus, completing the termination process.

This two-step regimen should not be administered without medical guidance due to health and safety risks. If you would like more information or have questions about the abortion process or need to have a dating ultrasound, schedule a consultation with one of our nurses for information on all your options. Appointments are available in-person and via telehealth.

Plan B vs. Abortion Pills

Plan B, often known as the “morning-after pill,” functions primarily as an emergency contraceptive to prevent a pregnancy from being conceived. It works by preventing or delaying ovulation, and must be taken within 72 hours of unprotected intercourse. It is designed to be taken before you ovulate (when your body releases an egg from your ovary).  If you have ovulated and a fertilized egg has implanted in your uterus, Plan B will not terminate the pregnancy.

Pregnancy occurs during ovulation, the phase of the female menstrual cycle when the ovary releases a mature egg which then travels down a fallopian tube toward the uterus. If the egg encounters sperm during the five days leading up to and including ovulation, it can become fertilized. Emergency contraceptives (EC) work primarily by preventing ovulation and therefore the fertilization of the egg. The longer after unprotected sex they’re taken, the less effective they are.

Potential side effects from emergency contraceptives (including options such as Plan B, Ella, and a copper IUD insertion) may include nausea, vomiting, headaches, and subsequent irregular periods.

Morning-after pills will not work if your body has already started ovulating. This is why timing is so important, especially if you’re using Plan B and other levonorgestrel morning-after pills.  If you use an emergency contraceptive, it is important to know that because of the introduction of hormones in the pills, it’s possible that your menstrual cycle and ovulation may be irregular in the days to weeks after you take the medication.  

Differences Between Plan B and Abortion Pills

Abortion pills, specifically mifepristone and misoprostol, are utilized to terminate an existing pregnancy. These medications are not interchangeable with Plan B.

Plan B is designed for use as emergency contraception. It works primarily by preventing or delaying ovulation, ensuring that fertilization does not occur. Conversely, mifepristone and misoprostol, known together as the abortion pill, serve the purpose of terminating an already established pregnancy. Consequently, these medications operate in fundamentally different ways.

Plan B is preventive; the abortion pill is reactive.

Plan B must be taken within a specific time frame – within 72 hours after unprotected sex – for its efficacy in preventing pregnancy. The abortion pill, however, is administered after pregnancy has been confirmed. If you are considering a medical abortion, it’s important to get your pregnancy confirmed via ultrasound before beginning the medication regimen. An ultrasound provides you with essential information, including gestational age and pregnancy viability, as you examine your choices.

A Summary of Plan B vs. Abortion Pills

In summary, Plan B and the abortion pill serve different purposes and function differently.

  • Plan B (Emergency Contraception): Used within 72 hours of unprotected intercourse. Prevents pregnancy by preventing ovulation.
  • Abortion Pill (Mifepristone and Misoprostol): Used to terminate an existing pregnancy. Ends pregnancy by blocking progesterone and inducing uterine contractions to expel the pregnancy.

Abortion pills should not be taken if no intrauterine pregnancy has been confirmed and gestational age is uncertain. This information can be determined via ultrasound. At Clearway Clinic, we offer free ultrasounds to confirm pregnancy and determine gestational age.

Side Effects & Risks of Plan B

The “morning-after pill” is used to prevent pregnancy after unprotected sex. It is not 100% effective, nor is it recommended for routine use. It also offers no protection against STIs. If you’ve had unprotected sex, get tested for STIs as soon as possible in order to receive treatment if necessary. (At Clearway, we offer free STI testing and treatment for chlamydia and gonorrhea, two of the most common bacterial STIs.)

Side effects of the morning-after pill include nausea (with or without vomiting), dizziness, fatigue, breast tenderness, irregular periods or heavier menstrual bleeding, and lower abdominal pain or cramps. It’s also important to understand that emergency contraception is not recommended or effective for everyone. It is important to discuss any concerns you may have regarding these medications with a doctor who knows your health history.  Do not take any medication if you are allergic to any components of the pill.

If you have bleeding or spotting that lasts longer than a week or have severe lower abdominal pain three to five weeks after, contact your doctor. This can indicate either a miscarriage or an ectopic pregnancy, the second of which requires emergency care (1). 

Potential Risks and Side Effects

The abortion pills cause some side effects.

Common side effects include nausea, vomiting, and diarrhea. The most significant side effects tend to involve intense cramping and heavier-than-normal bleeding. Women should expect bleeding for 9-16 days with heavy bleeding for an average of 2 days. Some women experience bleeding for over 30 days. It’s also important to note that after 8 weeks gestation, the fetus may be visible when passed, which can cause unexpected emotional trauma.

Other commonly reported adverse reactions to medical abortion include nausea, weakness, fever/chills, vomiting, headache, diarrhea, and dizziness. Anxiety, fainting, and heart palpitations have also been reported. Abdominal pain and cramping are to be expected.

More severe complications include infections (severe infections and sepsis can be fatal), incomplete abortion, heavy prolonged bleeding that may require a transfusion or surgery, ruptured ectopic pregnancy, ruptured uterus, and an allergic reaction to the medication (anaphylaxis). Such instances necessitate immediate medical attention to safeguard one’s health.

It is vital to have access to professional medical guidance throughout the process to swiftly address any complications. Emotional support and follow-up care are also crucial. Understanding and preparing for potential risks allows you to make confident, informed choices for your reproductive health.

Aftercare and Support

Aftercare following an abortion includes aspects that are both physical and emotional. Physically, individuals should monitor their symptoms and seek medical advice if experiencing severe pain, heavy bleeding, or signs of infection.

Emotional recovery may take longer. Support networks and professional counseling can offer great support. Whatever your story, you are not alone. Many women and men report adverse emotional effects to an abortion decision.

After-Abortion Care

After undergoing an abortion, prioritize rest and avoid strenuous activities for at least one week. Drink lots of clear fluids and eat healthy foods. Take any antibiotics prescribed to you for the recommended time, and avoid inserting anything vaginally for at least two weeks (this includes penetrative sex and tampons). 

Pay attention to any signs of complications such as heavy bleeding, high fever, severe abdominal pain, sudden abdominal swelling, rapid heart rate, increased and/or foul-smelling vaginal discharge, or severe vomiting, and contact their healthcare provider if these occur.

Emotional and Psychological Support

Feelings of pain, grief, and loss after an abortion are commonly experienced. Because women often lack sufficient information and counseling before an abortion, many don’t realize how common this response is. They are then left surprised by their reaction and wondering, “Why am I feeling this way?”

Any experience of an unexpected stressful event or a sudden loss can be traumatic. It can shake up your  sense of stability. The world isn’t the way you expected it to be, which can complicate the grieving process. Know that you are not alone.

Clearway offers healing groups to help you process abortion-related grief and pain with support and guidance. We offer this program in groups to provide an opportunity for you to speak with others who share similar experiences. You may feel like your feelings are different from those around you and that’s okay. Try not to compare your grief to someone else’s or judge yourself for your feelings. Your feelings are valid, and trying to convince yourself that you shouldn’t feel this way won’t change those feelings. Instead, allow yourself space to process and work through them.

Unprocessed grief can lead to long-term depression. In our healing groups, participants are guided through the process of mourning the loss and accepting the hope. These feelings can change, but they may not go away. People who have received grief support decades after their abortion(s) have overwhelmingly said that they wish they had gone through a healing group sooner. At Clearway, we offer healing group classes and 4-day healing retreats. We can also refer you to a therapist with an understanding of your type of grief.

Clearway Clinic is Here For You

If you think you might be pregnant, schedule your free pregnancy test appointment.

If you recently found out you’re pregnant but have not had it medically confirmed, schedule your free confirmation ultrasound.

If you’re considering abortion, schedule a telehealth appointment with one of our nurses to learn about the different abortion procedures and ask any questions you have.

If you’re struggling with a past abortion decision, meet with one of our ClearPast team members for support.

Wherever you’re at, Clearway is here to offer a listening ear, provide resource referrals, and support without judgment! You are not alone.      

Reviewed by Kate O., BSN RN 

(Please note: We do not provide, prescribe, or refer for abortions. This article is for informational purposes only and is not intended to replace the advice of a professional medical provider.)


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