Emergency contraception is often confused with abortion pills – here’s how Plan B and other generic versions work to prevent pregnancy

Since the overturning of Roe v. Wade in June 2022 and the end of constitutional protection for abortion, emergency contraception has become more difficult to obtain and – more than ever – shrouded in misinformation.

Attempting to control inventory, Amazon, Rite Aid and Walmart have imposed purchase limits on the emergency contraception known as Plan B since the Supreme Court’s ruling. Panicked buyers have been trying to stock up on the drug in case it becomes unavailable.

Several legislators and proposed bills have conflated emergency contraception with abortion and are trying to limit access to it. The recent court ruling blocking access to mifepristone – which has been approved by the FDA since 2000 – is an ominous sign to many that emergency contraception could be the next target.

Regardless of one’s stance on abortion, it is important to understand why emergency contraception should be a basic component of women’s reproductive health care and family planning services. As a researcher of women’s sexual and reproductive health and decision-making, I have extensively researched access to emergency contraception.

Emergency contraception is the only way to prevent pregnancy after sex has already occurred. It can be used when no contraception was used or it was used incorrectly, such as with missed birth control pills or broken condoms. Emergency contraception is also used to prevent pregnancy after sexual assault or rape.

Emergency contraception can take the form of pills – sometimes called the morning-after pill – or an intrauterine device, or IUD that delays ovulation.

There are two types of emergency contraception pills. The most widely known is levonorgestrel, which is sold in the U.S. under the brand name Plan B, along with numerous generic versions.

Levonorgestrel was first approved for over-the-counter sale to women 18 and older in 2006, and in 2013 age restrictions were removed.

The second type of emergency contraception pill is ulipristal acetate, which is sold under the brand name ella. Both Plan B and ella work by delaying ovulation. In addition, ella also thins the uterus lining so that even if an egg were fertilized, it is harder for it to implant in the uterus to start a pregnancy.

Both types of pills are effective at preventing pregnancy. Plan B is most effective if taken within three days of sex, with some declining effectiveness on days four and five. Ella is effective if taken within five days of sex and, unlike Plan B, is equally effective all five days.

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