Plan B: Is It Abortion?

Thinking you might be pregnant when you aren’t ready for a baby may have you considering Plan B, or the Morning After Pill, as an emergency contraceptive. If you’re wondering about the ethical complications of Plan B, wondering if it is abortion, or want to know more about how it works, you’ve come to the right place.

A study from Princeton University says this about emergency contraceptives, like Plan B:

To make an informed choice, women must know that [emergency contraceptives] … prevent pregnancy primarily by delaying or inhibiting ovulation and inhibiting fertilization, but it is not scientifically possible to definitively rule out that any of these methods, including breastfeeding, may inhibit implantation of a fertilized egg in the endometrium. At the same time, however, all women should be informed that the best available evidence is that the ability of levonorgestrel and ulipristal acetate ECPs to prevent pregnancy can be fully accounted for by mechanisms that do not involve interference with post-fertilization events.

If you’re unsure what that means, that’s okay! This article will break it down for you. We want to explain what Plan B is and how it works, so you can make an informed decision about your possible pregnancy. Let’s get started!

What is Plan B?

Plan B is one type of emergency contraceptive. Women typically use Plan B after unprotected sex or after the failed attempts of another birth control method: a condom breaks, a dosage of birth control gets missed, etc.

Plan B is available over-the-counter in most drugstores. A prescription is not required, and anyone of any age can buy it in-store or online. It typically costs $15 to $50, depending on the brand and where you buy it from.

How Does Plan B work?

How Plan B works is dependent on when a woman takes it. Therefore, before explaining how Plan B works, it’s important to understand a few key terms within a woman’s monthly cycle: ovulation, fertilization, and implantation.

• Ovulation occurs during the midpoint of a woman’s cycle when an egg gets released from her ovaries.
• Fertilization occurs after intercourse when a sperm enters a woman’s released egg. This is also called “conception.”
• Implantation occurs when a fertilized egg attaches to the uterine wall.

Research suggests that Plan B primarily interferes with the ovulation stage of pregnancy. Plan B does this by containing a high dosage of levonorgestrel, a hormone that essentially mimics progesterone. Progesterone is naturally produced in a woman’s body and gets released after ovulation to thicken the wall of the uterine lining to prepare for a fertilized egg and also maintain a pregnancy. If there is no fertilized egg, progesterone levels drop and your period begins.

Progesterone is found in both Plan B and birth control pills. However, Plan B is less effective when used routinely, and it should not be relied upon as a primary form of birth control. Plan B also contains a high concentration of levonorgestrel, which can lead to negative or acute side effects.

What About Ella? Is It The Same as Plan B?

Not exactly. Ella is another brand of emergency contraception that contains ulipristal acetate. Ella is only available by prescription, and it is recommended to take only once during a menstrual cycle. There have not been adequate studies to know if ulipristal acetate is safe or effective to take several times during a cycle. Taking Ella alongside Plan B can cancel the effectiveness of both.

Research says that the primary function of Plan B (levonorgestrel) is to interfere with ovulation, which can prevent fertilization. If a woman has unprotected sex after ovulation and takes Plan B, studies show that taking Plan B doesn’t lower a woman’s chance of getting pregnant.

Similarly, Ella (ulipristal acetate) interferes with ovulation, and studies have indicated that it can alter the endometrium, or the uterine lining. It’s inconclusive if this could prevent implantation of a fertilized egg. However, studies agree that neither emergency contraceptive will terminate an established, active pregnancy.

Here’s a quick comparison chart to show you the differences between Plan B and Ella.

	Plan B / Levonorgestrel	Ella / Ulipristal Acetate
Offered Over-the-Counter	Yes	No
Prescription Required	No	Yes
Delays Ovulation	No	Possibly
Prevents Ovulation	Yes	Yes
Impairs Sperm Function	Possibly, at higher dosages	No
Compromises Uterine Lining	Possibly	Possibly
Inhibits Fertilization	Possibly	Possibly
Affects Implantation	No	Possibly
Interferes with Post-Fertilization	No	No
Terminates Active Pregnancy	No	No

(Source: Study from Princeton University in 2019)

How Effective Is Plan B?

If taken within the recommended 72 hours (three days) of unprotected sex, Plan B has a 56% to 89% chance of preventing pregnancy. Again, this is dependent on when a woman takes the pill during her cycle, and at what point after unprotected sex she takes the pill. If she takes Plan B after ovulation or after the recommended time frame, she will likely experience a similar pregnancy rate than if she didn’t take emergency contraception in the first place. Some studies also indicate that Plan B may not work as effectively in women who are overweight.

Experts say that Plan B does not stop an active pregnancy, and the side effects it may have on an unborn baby are not well researched. For these reasons, a woman should not take Plan B if she suspects she is already pregnant.

What are Side Effects of Plan B / Levonorgestrel?

If a woman decides to take Plan B, here is a list of side effects she should be aware of. Common side effects of taking Plan B include:

• Nausea and Vomiting
• Dizziness
• Tiredness
• Headache
• Depression
• Abdominal Pain
• Breast Tenderness
• Spotting
• Cycle Changes (including heavy bleeding or timing irregularities)

These side effects usually last a few days. When it comes to cycle changes, her period may come sooner, later, last longer than expected, or she may bleed heavier than usual. If a woman’s period is a week or more late, she should take a pregnancy test.

Because the hormonal dosage in Plan B is much higher than what most women experience, some who have taken it experience severe side effects. Rare side effects can include:

• Vision changes
• Migraines
• Stroke
• Breast cancer
• Ectopic pregnancy

If a woman experiences severe effects from taking Plan B, she should seek professional medical assistance immediately.

Need Help Making the Right Decision?

If you would like support in making a decision about your unplanned pregnancy, we have friendly and trained staff who would love to speak with you about your options, judgement free. Feel free to call or text us at (612) 712-6113. You can also schedule a visit at one of our pregnancy centers in Minneapolis, Richfield, Rochester, or Saint Paul for a free consultation.

Like a non-judgemental friend, we are here for you! We will always have your best interest in mind as we help you sort through the pros and cons of your options. All our services are free and confidential for your benefit.