So you had a whoopie whoopsy (aka sex without using contraception). No judgment, friends — it happens. Now that the deed is done, it’s time to talk options.
Here’s the lowdown on Plan B and the abortion pill — and why they’re not the same thing.
Fast facts about Plan B
- Plan B is a type of emergency contraception (EC).
- It is not the abortion pill. It will not end an existing pregnancy.
- It contains the same hormone (levonorgestrel) as birth control pills but at a higher dose.
- It shouldn’t be used as an everyday form of birth control.
- You need to take it within 72 hours of sex. It’s more effective if you take it within the first 24 hours.
- It doesn’t protect against sexually transmitted infections (STIs).
- It will not impact your future fertility.
Plan B vs. abortion pill chart
Plan B and the medical abortion pill often get lumped together. This handy-dandy chart will help you spot the differences.
| Plan B | Medication abortion | |
| What is it? | medication that prevents pregnancy after sex | medication that terminates an early pregnancy |
| Can it be used to prevent pregnancy? | yes | yes |
| Can it be used to end a pregnancy? |
no | yes |
| How safe is it? | about as safe as the birth control pill | safer than carrying a pregnancy to term |
| What are possible side effects? | nausea, vomiting, period irregularities, and spotting | nausea, vomiting, cramping, bleeding, and diarrhea |
| How effective is it? | 75–95% | 98–99% |
| How does it work? | slows or prevents the release of an egg from the ovary | stops a pregnancy from growing and removes it from the uterus |
| How long does it take? | several days | 4–5 hours |
What’s the mix-up?
We’re gonna do a deep dive into Plan B versus the abortion pill. But first, here’s a quick recap on the initial stages of pregnancy:
- Ovulation: An egg is released from the ovaries.
- Fertilization: A sperm penetrates the egg.
- Implantation: A fertilized egg (aka zygote) embeds into the uterus.
Trusted medical organizations — like the American College of Obstetricians and Gynecologists (ACOG) and the National Institutes of Health (NIH) — say pregnancy begins with implantation. But some folks think it starts the instant an egg is fertilized.
This “what is pregnancy?” confusion might explain why EC and medical abortions are jumbled together so often.
An easy way to look at it
Plan B won’t end a pregnancy. It prevents pregnancy. Research shows EC won’t work after an egg is implanted. So, it’s not an abortion if you were never pregnant in the first place. Right? Right.
How Plan B works
Plan B prevents pregnancy by delaying ovulation or preventing fertilization. Does it work after an egg is fertilized? Well, the jury is still out.
A 2015 research review suggested that Plan B can work after fertilization. But a 2019 research review said it probably won’t work after fertilization. Oy vey.
Play it safe: It’s uber-important to take the pill ASAP after sex. That way, it can get to work before the egg is fertilized (just in case).
Is bleeding bad?
Vaginal bleeding isn’t a super common side effect of Plan B, but it can happen. In a 2006 study of 232 people, 14.7 percent spotted or bled after taking EC.
Light bleeding is usually harmless. It should go away on its own in a day or two. But in rare cases, bleeding can be a sign of something serious.
When to seek medical attention
Def call a doc if the bleeding:
- is very heavy
- lasts more than a few days
- is joined by other symptoms (like dizziness, nausea, or cramps)
How effective is Plan B?
Again, Plan B prevents pregnancy. That makes it tricky to gauge its accuracy 💯. You’d have to know how many folks would’ve gotten preggo if they hadn’t taken it — and that’s impossible.
So, the actual success rate is an estimate. Plan B’s package insert says it’s 95 percent effective if taken within 24 hours of sex and 61 percent effective if taken between 48 and 72 hours after sex.
Some studies question whether these stats are legit. Experts have argued that progestin-only pills like Plan B are between 52 and 100 percent effective. Once more, it’s hard to know for sure.
Beat the clock
Plan B’s package insert says you should take it within 72 hours of intercourse. Some recent research suggests the pill might work up to 120 hours after sexy time. But you should still take it as quickly as you can.
If you’re already pregnant
Plan B won’t work if you’re already preggers.
There haven’t been many studies on the effects of Plan B on fetal development, but there’s some evidence that it won’t hurt the fetus.
Fertility facts
Plan B won’t F with your fertility. It shouldn’t hurt your chances of getting pregnant in the future, and it won’t increase your risk of miscarriage.
More good news: There’s no limit on how often you can take it.
Who should use it
You should be fine taking Plan B. It’s made with the same chemicals that are in hormonal birth control (but in a higher dose). The perks of Plan B almost always outweigh the risks, according to the Centers for Disease Control and Prevention (CDC).
PSA: Talk to a doc if you have a condition that prevents you from using hormonal birth control. They can offer another solution.
Does weight matter?
Some studies suggest Plan B doesn’t work as well on folks with a body mass index (BMI) over 25. In fact, some research suggests that women with a BMI of 30 or higher are three times more likely to get pregnant than women with a BMI in the “normal” range (even after taking EC).
A 2016 study suggested that a double dose might make it more effective for women with obesity. Just check with a doctor before doubling up.
Are there side effects?
Plan B side effects are usually mild. You should be back to your usual self in a few days.
Common symptoms can include:
- fatigue
- nausea
- vomiting
- dizziness
- headaches
- irregular periods
- unusual bleeding or spotting
- cramps or mild abdominal pain
Abortion pill 101
A medical abortion is made up of two drugs. They work together to terminate a pregnancy.
Mifepristone blocks progesterone, the hormone that’s needed to keep a pregnancy growing.
Misoprostol is usually taken after mifepristone. The combo causes contractions that help your uterus push out the pregnancy.
It has a 98 to 99 percent success rate if taken correctly.
Other 9-1-1 contraceptives
Plan B is just one EC option. You can opt for another EC pill, like ella (ulipristal acetate). Some research has found that ella can even be more effective than Plan B. A 2012 study showed that ella worked up to 120 hours after sex.
BMI bonus: Unlike Plan B, ella is effective regardless of your BMI.
Long-term prevention
An intrauterine device (IUD) is 99 percent effective at preventing pregnancy if it’s inserted within 5 days after having sex without using contraception. IUDs can prevent pregnancy for up to 10 years (depending on the brand). Wowza!
Where to get Plan B
You can skip the script — Plan B is available over the counter. You don’t need to show your ID to buy it, either. You can usually get it from your local pharmacy.
The average cost ranges from $40 to $50, according to Planned Parenthood. You can also opt for a generic brand. They’re just as effective and tend to be easier on the wallet.
Ella will set you back about $50. You’ll need a prescription, but it might be covered by insurance.
You also need an Rx for an IUD, since a doctor has to insert it. Thankfully, the device and procedure are often covered by insurance.
Cut the cost
No insurance? Don’t worry. You still have options. Call your local family planning clinic. They might be able to provide services and medications at little to no cost.
What happens if you get pregnant?
If your EC didn’t work and you aren’t sure what to do, there are tons of resources available. You can call a doctor, local clinic, or counselor. They can give you more info so you can make the best informed decision.
Whether you choose to carry the pregnancy to term or proceed with an abortion, know that you’re not alone. ❤️️
It’s going to be OK
Accidents happen! But EC has you covered. Just remember that Plan B is not the abortion pill. It won’t work if you’re already pregnant. But it can help prevent pregnancy before it occurs.
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