Many people don’t know the difference between “the pill,” “the morning after pill,” and “the abortion pill.” It makes a lot of sense: the names we use to talk about them are incredibly similar and confusing. But they each refer to different medications that impact the body in distinct ways. And depending on your current pregnancy status, they may or may not be appropriate choices.
One myth that’s important to dispel right away is that emergency contraception and abortion are not the same thing. If you’re already pregnant, emergency contraception won’t terminate the pregnancy. The only pill that will end a pregnancy that’s already started is the abortion pill.
Emergency contraception is legal in all 50 states, while access to the abortion pill — also known as medical abortion — is more limited. Read on to learn more of the key differences between these three important kinds of medications.
Birth Control Pills, Aka “The Pill”
The terms birth control pills, oral contraceptives, hormonal contraceptives, and “the pill” all refer to hormone medications taken daily. These pills prevent pregnancy, but cannot terminate one. In the United States, you need a prescription for hormonal contraceptives, but most health insurance plans pay for many types.
Some folks take hormonal birth control pills because they’re sexually active and want to avoid getting pregnant. Other people take them because the hormones in certain pills, like Junel Fe, can help control acne and regulate menstruation. These pills can give users shorter, lighter periods and fewer PMS symptoms. Specific effects depend a lot on the user, the dosage, and the brand.
The most commonly prescribed birth control pills are called combination pills, because they contain two hormones, estrogen and progestin. Another type of birth control pills contain only progestin, and these are often referred to as POPs or mini pills. Combination pills are generally taken once a day at roughly the same time. The mini pill must be taken every single day at almost exactly the same time, with no missed doses.
If you use birth control pills consistently and correctly, they are up to 99% effective. But, due to human error, the actual effectiveness is closer to 90%, with combination pills slightly more effective than minipills. If you miss a dose of either pill, check your package instructions and use a backup birth control method. You might also need emergency contraception if you’ve been sexually active and missed a dose.
Emergency Contraception, Aka “The Morning After Pill”
Also known as “the morning after pill,” emergency contraception also cannot terminate a pregnancy. It’s called emergency contraception because it’s a high-dose medication you can take if your normal birth control method fails. You can also use it in other unanticipated situations where there’s a possibility you might become pregnant.
You can use emergency contraception if your partner doesn’t withdraw in time or a condom breaks during intercourse. You can also take these pills if you miss too many doses of your regular birth control pills. If you’ve been sexually assaulted and aren’t on birth control, you may want to take emergency contraception right away.
There are two main types of morning after pills available in the United States. The most effective one, called ella, contains the active ingredient ulipristal acetate. This medication requires a prescription, and is effective in people up to 195 lbs, up to five days after unprotected sex. Other morning after pills contain the hormone levonorgestrel, and you can get them over-the-counter. They’re effective for people up to 165 lbs for at least three days after unprotected sex.
The morning after pill is available online, and you can get some types no matter what age you are. But you may still have barriers — like location, cost, or a partner or parent — preventing you from getting emergency contraception. If this is the case, you may be able to use a higher dose of regular birth control to prevent pregnancy. If you’re over 195 lbs, you may also need to consider other options, like having an IUD inserted.
Medical Abortion, Aka “The Abortion Pill”
The methods discussed above work by preventing ovulation and making the uterus and cervix inhospitable to sperm. This means they can keep a pregnancy from starting in the first place. But birth control pills and emergency contraception cannot stop a pregnancy after you have already conceived. If you are already pregnant and don’t want to be, an abortion would terminate the pregnancy.
The abortion pill is a good alternative for patients who don’t want to or can’t have an in-clinic (surgical) abortion. The abortion pill is the only pill that can terminate a pregnancy after you have already conceived. It is considered safe, and has been prescribed legally in most U.S. states for over two decades. It’s a good idea, though, to have a doctor or clinic you can call in case of complications.
The abortion pill, also called a medical abortion, consists of one dose each of two different medications, mifepristone and misoprostol. Mifepristone blocks the hormone progesterone, which your body needs to continue a pregnancy. Misoprostol, taken afterwards, causes the uterus to contract and expel the pregnancy from the body.
Medical abortion has a lower risk of side effects when mifepristone and misoprostol are used together. But in some states, the use of mifepristone has been banned, restricted, or called into question. If you can’t get access to mifepristone, an misoprostol-only abortion may also be an option. This regimen is still considered safe and effective and is frequently prescribed in other countries. It may, however, cause more cramping, bleeding, diarrhea, and other side effects.
A Word Of Caution
Some politicians and other bad faith actors may intentionally conflate these three distinct types of pills. This is generally to dissuade people from getting care or to limit legal access to pregnancy prevention and other healthcare. In extreme cases, “pregnancy crisis centers” posing as abortion providers may try to dissuade you from getting contraception or abortion.
When seeking any kind of prescription or treatment, always carefully research all facilities and providers. Choose a trusted provider whose methods are backed by science, to get unbiased access to all of your options.