Let's Talk About Sex: Emergency contraception vs. medication abortion


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Plan B, emergency contraception, Ella, medication abortion, Mifepristone and Misoprostol. 

Chances are, you only know a few of these terms. That’s OK if you’re not confronting an unplanned pregnancy. But in the moments of shock following a broken condom, a missed period or even a sexual assault, knowing these terms can empower you to determine the best course of action.

Unfortunately, these terms are often shrouded in stigma and misrepresented by perverse political rhetoric. Let’s categorize and define them. 

Plan B and Ella are forms of emergency contraception. Mifepristone and Misoprostol are pills used in medication abortion. So what’s the difference?

Emergency contraception prevents pregnancy. It will not end an existing pregnancy. Let me repeat that. If you are already pregnant — meaning a fertilized egg has implanted into your uterine lining — emergency contraception will not terminate that pregnancy.

Most people misunderstand this because they do not understand how pregnancy occurs. Many people believe pregnancy occurs moments after ejaculation. This is rarely the case. In most cases, sperm will stay alive inside the uterus and fallopian tubes, waiting for an egg. Sperm can last for up to five days, but average three. If an egg is ovulated during this time, fertilized and implanted into the uterine lining, pregnancy occurs.

Emergency contraception works by preventing ovulation during this time frame. Since no egg is released, it cannot be fertilized, and pregnancy will not occur. However, if an egg is released before the emergency contraception is taken, it will be ineffective. That’s why it is important to take emergency contraception as soon as possible after contraception failure or intercourse without contraception. If you need emergency contraception, Plan B is available over the counter in most drugstores and pharmacies. A $10 coupon is available on Plan B's website if cost is a concern.

Medication abortion is a completely separate practice. Instead of preventing pregnancy, it ends pregnancy. This abortion method can be used until the 10th week of a pregnancy. 

However, many physicians recommend it for pregnancies nine weeks or under. After that, the options are aspiration abortion or dilation and evacuation abortion. Many people choose medication abortion because it “feels more natural” and can be completed at home.

Medication abortion uses two pills, Mifepristone and Misoprostol. The first pill, Mifepristone, is usually taken at a clinic in the presence of a doctor. The Mifepristone causes the placenta to separate from the lining of the uterus, the cervix to soften and may start soft contractions. 

The second pill, Misoprostol, can be taken orally or inserted into the vagina within 48 hours of taking the Mifepristone. This will cause stronger contractions and the uterus will shed its contents. Many doctors allow patients to do this at home. The abortion is experienced much like a miscarriage and would be indistinguishable to a doctor who did not know Mifepristone and Misprostol were used. The pain level can range from mild period-like cramps to quite painful. 

Whether or not to seek an abortion is an extremely difficult choice to make, and every woman reserves the right to approach that decision in her own way. 

Understanding the difference between emergency contraception and abortion medications, and knowing which method you actually need, will allow you to deal with a potential unplanned pregnancy with more confidence.

Ashlea Phenicie is a senior at Central Michigan University and the president of Voices for Planned Parenthood. She has been trained in sexual health education and reproductive rights by Planned Parenthood and Advocates for Youth.

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