Plan B vs. the Abortion Pill

People often confuse the morning-after pill (often called Plan B) with the abortion pill. They are different medicines, used at different times, and they are regulated differently. The summaries below come from the U.S. Food and Drug Administration (FDA) and the American College of Obstetricians and Gynecologists (ACOG). This is not a substitute for medical advice from a qualified health care provider.

The morning-after pill (Plan B and similar)

According to the FDA’s information on Plan B One-Step, Plan B One-Step is an emergency contraceptive: one 1.5 mg levonorgestrel tablet taken by mouth after unprotected sex or contraceptive failure. The FDA says it should be taken as soon as possible within 72 hours, and that it is not for routine contraceptive use. The FDA also states that Plan B One-Step will not work if a person is already pregnant and “does not terminate a pregnancy.” The agency describes it as usually stopping or delaying release of an egg from the ovary.

ACOG’s emergency contraception FAQ likewise says emergency contraception reduces the chance of pregnancy after unprotected sex, does not cause an abortion, and does not work if pregnancy has already occurred. ACOG notes that progestin-only emergency contraceptive pills (the Plan B type) are available over the counter, and that ulipristal (often sold as ella) is a prescription pill that can be taken up to five days after unprotected sex.

Ramah’s page on the morning-after pill offers additional ministry context on this topic.

The abortion pill (mifepristone / RU-486)

According to the FDA’s information on mifepristone, Mifeprex (mifepristone) and its generic are approved, in a regimen with misoprostol, “to end an intrauterine pregnancy through ten weeks gestation” (70 days or less since the first day of the last menstrual period). The FDA first approved Mifeprex in 2000. These medicines are available under a Risk Evaluation and Mitigation Strategy (the Mifepristone REMS Program). The FDA does not recommend buying mifepristone outside that program (for example, from an unverified online source).

ACOG’s Abortion Care FAQ describes a first-trimester medication abortion as two steps: mifepristone, then misoprostol about one to two days later, which causes cramping and bleeding as the uterus empties. ACOG notes that bleeding may be much heavier than a period and that follow-up is needed to confirm the abortion is complete.

For Ramah’s discussion of risks and aftercare, see The Abortion Pill (RU-486) and Abortion Risks.

A simple way to tell them apart

• Timing: Plan B / emergency contraception is used after sex, before a pregnancy is established, according to the FDA and ACOG. The abortion pill regimen is used to end an existing intrauterine pregnancy, through 10 weeks as approved by the FDA.
• How you obtain them: Plan B One-Step is available over the counter, per the FDA. Mifepristone is a prescription medicine under the FDA’s REMS program.
• What they are not: They are not interchangeable. If you are unsure which medicine you have, or whether you may already be pregnant, talk with a qualified health care provider before taking anything.

If you need local, confidential help with a pregnancy decision, you can search Local Pregnancy Support or contact Ramah.