What is the difference between Plan B and the abortion pill?

In the wake of the Supreme Court overturning Roe v. Wade, some women are evaluating their options for reproductive health care. Many are stocking up on morning-after pills, which are used to prevent a pregnancy from occurring within days after unprotected sex; while others are wondering how the ruling will affect their access to abortion pills, which can be used to terminate early pregnancies.

Both medications come in pill form and are often confused for each other. Here’s how they differ.

What is Plan B?

Also called the morning-after pill, Plan B One-Step is a type of emergency contraception that is typically taken within 72 hours of unprotected sex and is meant to prevent a pregnancy from occurring.

It is usually available over the counter at drugstores and pharmacies (though access can vary depending on where you live), and contains levonorgestrel, which mainly works by stopping the release of an egg from the ovaries. It may also prevent sperm from fertilizing an egg; or if fertilization has already occurred, it may prevent the embryo from attaching to the uterus. Other brands of levonorgestrel-based emergency contraceptives include Next Choice One Dose, Aftera and EContra One-Step.

Ella, a different type of emergency contraceptive that contains ulipristal acetate, can prevent pregnancy if taken within five days of unprotected sex. It can be more effective than other types of emergency contraceptives, like Plan B, but it requires a prescription. As with Plan B, it disrupts ovulation in order to prevent pregnancy.

Doctors recommend taking emergency contraceptives as soon as possible after unprotected sex in order for them to be most effective. Because they do not terminate pregnancies, they are not considered abortion methods.

Is Plan B banned?

As of now, emergency contraceptives like Plan B are still legal. However, some states are more restrictive than others about who can access them and under what conditions.

Birth control in general is currently still legal everywhere in the United States, but some legal experts and activists have speculated that the Supreme Court could revisit and reconsider its stance on contraceptives. In a concurring opinion, Justice Clarence Thomas specifically said that one of the landmark cases the justices should reconsider is Griswold v. Connecticut, which ruled a ban on contraceptives unconstitutional.

What is the abortion pill?

About half of people who get legal abortions in the United States use a method called medication abortion, or the abortion pill. Unlike with emergency contraceptives, which prevent pregnancies from occurring, the abortion pill works to terminate an early pregnancy.

This method of ending a pregnancy usually involves taking two pills: first mifepristone, then misoprostol about 24 to 48 hours later. Together, these drugs stop a pregnancy from growing and then cause the uterus to contract and expel it. Medication abortion is approved by the Food and Drug Administration for use within the first 10 weeks of pregnancy, and people can take the pills at home or in any location.

“They’re very, very safe and very effective,” said Dr. Siripanth Nippita, a clinical associate professor of obstetrics and gynecology at N.Y.U. Langone Health.

Abortion is now banned in at least eight states, with trigger bans in additional states set to take effect soon. These restrictions affect all forms of abortion, including medication abortion.