What is a Medical Abortion and What is a Morning After Pill?
Two categories of medications are used to avoid pregnancy – emergency contraception and another to end an early pregnancy. It is important to know the differences in how and when these medications are used.
What is the difference between emergency contraception and an abortion pill?
Emergency contraception, also known as the ‘morning after pill’, or levonorgestrel is taken within several days after unprotected sexual intercourse to reduce the risk of becoming pregnant. It will not work to end a current pregnancy and will not affect the development of an embryo if you are already pregnant. Emergency contraception should not be used on a regular basis to prevent pregnancy.
The medication used for a medical abortion is mifepristone that is usually given with another medication (misoprostol) to end an early pregnancy. It can be taken up to 70 days (10 weeks) after the first day of the last menstrual period but may not be as effective the closer it gets to 10 weeks. If mifepristone is not available, then some experts recommend that misoprostol may be given alone as an alternative, although it may not be as effective.
How should I use emergency contraception and when can I take it?
The emergency contraceptive product, levonorgestrel (Plan B®, others), is available over the counter without a prescription. There are no age restrictions or need for a prescription to obtain this medication. This medication must be taken within 72 hours of unprotected sex (e.g., sex without any method of birth control or with a birth control method that failed or was not used properly such as a condom that slipped or broke or birth control pills that were not taken as scheduled). The sooner you take this medication after unprotected sex, the better it will work for you.
Another emergency contraceptive product, ulipristal (Ella®), can be used to prevent pregnancy when taken up to 5 days after unprotected sexual intercourse or as a backup in case regular birth control fails or is used incorrectly. However, ulipristal is only available with a prescription. Ulipristal should not be used to prevent pregnancy on a regular basis.
How do emergency contraception medications work?
These medications work by preventing or stopping ovulation when taken as directed in the designated time frame after unprotected sex or a known or suspected birth control failure or misuse.
How do abortion medications work?
Mifepristone works to end a pregnancy by blocking the hormones necessary to maintain a pregnancy. Taking misoprostol after mifepristone causes the uterus to contract and empty within 2 to 24 hours.
How do I get it? Is it legal?
The morning after pill is legal in all states in the U.S. and Federal Law prohibits discrimination against pregnant pharmacy customers, regardless of age. In some pharmacies you may need to ask for the levonorgestrel emergency contraception products if they are stocked behind the counter, but these products are available without a prescription.
However, mifepristone is not available in all states. In those states where it is available, it is available from a clinic, doctor’s office, or hospital and is stocked in retail pharmacies. Talk to your doctor to find a place to receive this product and associated care and monitoring.
A pharmacist’s tips for taking emergency contraceptive products
- Although morning after pills should not be used as regular birth control, it may be helpful to have this product on hand for emergency use. Store according to package directions and use by the expiration date on the package.
- Call your doctor if you vomit within 2 hours of taking the medication.
- Call your doctor if you experience any abdominal pain.
- Read all the instructions carefully before taking these medications.
- Take these medications as instructed. Levonorgestrel products are most effective when taken as soon as possible and up to 72 hours after unprotected sex. Ulipristal should be taken within 5 days after unprotected sex.
- After taking these products, you should get your period at the expected time or within one week. If your period is delayed by more than one week, you should use a pregnancy test or check with your healthcare provider to verify that you are not pregnant.
A pharmacist’s tips for taking Mifepristone-Misoprostol combination
- Tell your doctor and pharmacist what medications you are currently taking or plan to take since some medications may interact with mifepristone and possibly cause side effects.
- After taking mifepristone-misoprostol combination as directed, make sure you know whom to call and what to do, including going to an Emergency Room if you experience complications including prolonged heavy bleeding, severe abdominal pain, or sustained fever.
- Vaginal bleeding, abdominal cramps, and contractions of the uterus can begin within 2 to 24 hours of taking the medications.
- It is important to follow up with your healthcare provider 7 to 14 days after taking this medication to check that the pregnancy has ended.
Summary
Talk to your doctor or pharmacist about the best options available for your situation in which you may need emergency contraception or to end an early pregnancy.