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THE DIFFERENCE BETWEEN THE
MORNING-AFTER PILL AND THE ABORTION PILL
There has been considerable public confusion about the difference between the morning-after pill
and the abortion pill because of misinformation disseminated by groups that oppose safe and legal
abortion. The morning-after pil , also known as emergency contraception, helps prevent pregnancy;
the abortion pil , also known as medication abortion, terminates pregnancy. According to the general
medical definitions of pregnancy that have been endorsed by many organizations — including the
American Col ege of Obstetricians and Gynecologists and the United States Department of Health
and Human Services — pregnancy begins when a pre-embryo completes implantation into the lining
of the uterus (ACOG, 1998; DHHS, 1978; Hughes, 1972; “Make the Distinction …, “ 2001). Hormonal
methods of contraception, including the morning-after pil , prevent pregnancy by inhibiting ovulation
and fertilization (ACOG, 1998). The abortion pill terminates a pregnancy without using instruments.
By helping women terminate unwanted pregnancies up to 63 days after their last menstruation, the
abortion pill is a safe and effective option.
THE MORNING-AFTER PILL
THE ABORTION PILL
What is the morning after pil ?
What is the abortion pil ?
Also known as emergency contraception, the Also known as medication abortion, the abortion pill morning-after pill contains medication that reduces contains medication cal ed mifepristone to induce the risk of pregnancy if started within 120 hours (five abortion. Mifepristone (Mifeprex®) can be taken days) of unprotected intercourse. Plan B One-Step® under supervision up to 63 days after the first day of contains the hormone progestin and are currently the last menstrual period. It is used in conjunction available over the counter in the family planning with misoprostol, which is taken later to complete the aisle of drug stores with no age requirement. Other abortion (Creinin & Aubény, 1999; Middleton et al., 2005; Schaff et al., 2000; Schaff et al., 2001).
EC such as Next Choice® remain behind the counter with pharmacists for purchase by anyone 17 or older without a prescription, or anyone younger than 17 with a prescription. el a®, which contains ulipristal acetate (UPA), and certain brands of oral contraception taken in increased doses for use as emergency contraception require a prescription at any age (Barr Pharmaceuticals, 2006; Glasier, 2010; RHTP, 2009; Rodrigues et al., 2001; Van Look & THE MORNING-AFTER PILL
THE ABORTION PILL
How does the morning-after pill work?
How does the abortion pill work?
In its approval of the morning-after pil , the U.S. Food Mifepristone ends pregnancy by blocking the and Drug Administration (FDA) declared, “Emergency hormones necessary for maintaining a pregnancy. contraceptives act by delaying or inhibiting ovulation Misoprostol causes the uterus to contract and empty and/or altering tubal transport of sperm and/or ova (thereby inhibiting implantation)” (FDA, 1997). More recently, studies suggested that progestin-only morning-after pil s work only by preventing ovulation or fertilization, and have no effect on implantation (Croxatto et al., 2003; Novikova et al., 2007). In 2008, a consortium of authorities declared that progestin-only emergency contraception does not interfere with implantation (ICEC-FIGO, 2008). UPA works only by preventing ovulation (Glasier, 2010).
How effective is the morning-after pil ?
How effective is the abortion pil ?
The morning-after pill is very effective at reducing The abortion pill is highly effective at ending very the risk of pregnancy. Studies have shown that it early pregnancies. Complete abortion will occur in reduces the risk of pregnancy when taken up to 96–97 percent of women who choose mifepristone. 120 hours after unprotected intercourse. With the In the small percentage of cases that medication exception of UPA, the sooner the dosing begins, the abortion fails, other abortion procedures are required more effective the treatment. When taken within 72 to end the pregnancies (ACOG, 2001; Schaff et al., hours of unprotected intercourse, morning-after pil s 2000).
that contain both estrogen and progestin reduce the risk of pregnancy by 75 percent. Within that same time, progestin-only regimens, such as Plan B One-Step and Next Choice, reduce the risk of pregnancy by 89 percent. When initiated within 24 hours of unprotected intercourse, progestin-only morning-after pill reduced the risk of pregnancy by 95 percent (El ertson et al., 2003; Rodrigues et al., 2001; TFPMFR, 1998; Van Look & Stewart, 1998). The effectiveness of UPA, however, does not diminish over the course of the five days fol owing unprotected intercourse (Fine et al., 2010; Glasier et al., 2010).
THE MORNING-AFTER PILL
THE ABORTION PILL
How safe is the morning-after pil ?
How safe is the abortion pil ?
The morning-after pill is safe for nearly all women The abortion pill is safe for most women — mil ions of — mil ions of women around the world have used it women around the world have used it safely. There safely (Guil ebaud, 1998; Van Look & Stewart, 1998).
are risks associated with all medical procedures, including abortion. And, in extremely rare cases, death is possible from serious complications of the abortion pil , but it remains safer than carrying a Does the morning-after pill cause an abortion?
Can the medicines used in the abortion pill also
be used for emergency contraception?
The morning-after pill will not induce an abortion in a woman who is already pregnant, nor will it affect the Although some studies show that mifepristone could be developing pre-embryo or embryo (Van Look & Stewart, used in very low doses to reduce the risk of pregnancy 1998). Emergency contraception prevents pregnancy as a method of emergency contraception within five and helps a woman prevent the need for abortion. days of unprotected intercourse, it is not approved for use as emergency contraception in the United States at this time (Ho et al., 2002: TFPMFR, 1999).
Why might a woman choose the morning-after pil ? Why might a woman choose the abortion pil ?
Women may choose emergency contraception
Women might choose the abortion pill as a way to as a way to prevent pregnancy after unprotected end pregnancy because it is a noninvasive procedure intercourse — in cases of unanticipated sexual and does not require anesthesia. It is free from the activity, contraceptive failure, or sexual assault. risk of injury to the cervix or uterus and the possible Nearly half of America’s 6.7 mil ion annual complications caused by the use of anesthesia used pregnancies are unintended (Finer & Zolna, 2011).
for other abortion procedures (Aguil aume & Tyrer, 1995). Women who chose medication abortion also reported that they felt it was a more “natural” way to Does the morning-after pill have side effects?
Does the abortion pill have side effects?
Side effects are far less common using progestin- The most common side effects fol owing medication only and UPA pil s than using combined hormone abortion are similar to those of a miscarriage pil s. The most common side effects include nausea — abdominal pain, bleeding, changes in body and vomiting. Abdominal pain, breast tenderness, temperature, dizziness, fatigue, and gastrointestinal dizziness, fatigue, headaches, and irregular bleeding distress (ACOG, 2005; Creinin & Aubény, 1999; may also occur (Van Look & Stewart, 1998; OPR, 2011; TFPMFR, 1998; Trussell & Schwarz, 2011).
THE MORNING-AFTER PILL
THE ABORTION PILL
How long does the process of using the
How long does the process of the
morning-after pill take?
abortion pill take?
Combined hormone pil s are taken in two doses, 12 It begins immediately after taking the mifepristone. hours apart. Progestin-only pil s can be taken in Some women may begin spotting before taking the one dose. UPA is taken in one dose. Side effects misoprostol, the second medication. For most, the associated with emergency contraception pil s bleeding and cramping associated with medication general y subside within 48 hours. They affect the abortion begin after taking it. More than 50 percent of timing of the menstrual cycle in 10–15 percent of women who use mifepristone abort within four or five women. Changes in the menstrual cycle are seen hours after taking the misoprostol. Heavy bleeding with combined hormone, progestin-only, and UPA may continue for about 13 days. Spotting can last pil s. If the next menstrual cycle is more than one for a few weeks. About 92 percent of mifepristone week late, a woman should visit her clinician for a abortions are completed within a week (ACOG, 2001; pregnancy test (Fine et al., 2010; Van Look & Stewart, el-Refaey et al., 1995; Newhall & Winikoff, 2000; Peyron et al., 1993; Wiebe et al., 2002).
Are women who have used the morning-after pill Are women who have used the abortion pill
satisfied with it?
satisfied with the method?
An overwhelming majority of morning-after pill An overwhelming majority of women who choose users are satisfied with it. One study found that 97 medication abortion were satisfied with it. A recent percent of users would recommend it to friends and study found that 97 percent of women who had a family (Harvey et al., 1999). Another study found medication abortion would recommend it to a friend. that 92 percent of women who had used emergency Additional y, 91 percent of the women reported that contraception would use it again in the case of a they would choose medication abortion again if they contraceptive emergency (Breitbart et al., 1998).
had to have another abortion (Hol ander, 2000).
Where can I get the morning-after pil ?
Where can I get the abortion pil ?
Plan B-One Step is now available over the counter in Contact your nearest Planned Parenthood the family planning aisle of drug stores with no age health center at 1-800-230-PLAN or www.
requirement. Other brands of levonorgestrel plannedparenthood.org, another women’s health care EC remain behind the counter with pharmacists center, or your private clinician. Planned Parenthood for purchase by anyone 17 or older without a health centers that do not provide medication prescription, or anyone younger than 17 with a abortion can refer you to a provider who does.
prescription. el a requires a prescription at any age. If you need a prescription for emergency contraception, you can contact your nearest Planned Parenthood health center at 1-800-230-PLAN or How much does the morning-after pill cost?
How much does the abortion pill cost?
Nationwide, the price of EC ranges from $30–$65 Nationwide, the price of medication abortion ranges (PPFA, 2013b). Costs vary from community to between $300 and $800. This includes two or three community, based on regional and local expenses. office visits, testing, and exams (PPFA, 2013a). Costs vary from community to community, based on health center at 1-800-230-PLAN or www.
plannedparenthood.org, another women’s health CITED REFERENCES
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