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Don’t Worry, Plan B Isn’t Actually Banned In Any States Right Now

by News Desk

Recently, a draft opinion that suggested the U.S. Supreme Court might overturn Roe vs. Wade has had plenty of people questioning what that means for the morning-after pill. There’s also some speculation that some states might try to ban emergency contraception, including Plan B, similar morning-after pills, and even IUDs, if Roe v. Wade is overturned.

While no laws banning Plan B or similar morning-after pills have been passed yet, many are concerned about how future laws could affect emergency contraception options in the U.S. With all of the confusion online, it’s only natural to have some (or many) questions.

So, what exactly does Plan B do, again? And, what would a ban on Plan B even look like?

Here’s your guide to everything Plan B, from what’s in it to what it does—and what it means that some state lawmakers are thinking about limiting access to the drug.

What is Plan B?

Plan B One-Step is a type of emergency contraceptive that you can purchase over the counter at a pharmacy for around $50.00. It’s one pill (taken orally) that contains 1.5 milligrams of levonorgestrel, a synthetic form of the hormone progesterone, according to the FDA. The purpose of Plan B is to stop you from getting pregnant after having unprotected sex or after you think your contraception has failed.

How does Plan B work?

“The way it works is very similar to the way that normal birth control pills work,” says Katharine White, MD, MPH, an associate professor of OB-GYN at the Boston University School of Medicine, the vice chair of academics in the department of OB-GYN at Boston Medical Center, and the author of the upcoming book Your Sexual Health. “It prevents or delays ovulation, the release of an egg from the ovary.”

As a result, you might not get pregnant, since an egg has to be fertilized by sperm to cause pregnancy.

And, if fertilization does occur, Plan B may prevent a fertilized egg from attaching to the uterus, per the FDA. However, if a fertilized egg is implanted prior to taking Plan B, the drug will not work and pregnancy proceeds normally.

How is Plan B different from a medical abortion pill?

“All EC works to prevent a pregnancy from ever starting in the first place. Medication abortion only works if there’s an established pregnancy,” White explains. The biggest difference between the two is that if you take Plan B while you’re already pregnant, “it won’t cause a miscarriage or an abortion,” she adds.

Are states considering banning Plan B?

While no states have officially banned Plan B or other morning-after pills yet, some lawmakers are thinking about putting those measures in place.

In Missouri, a “trigger law” (meaning a law that’s set to go into effect immediately after Roe v. Wade is overturned) will likely restrict the use of Plan B and IUDs. The law states that an unborn child will be considered a human being from the moment it is conceived.

Although Plan B won’t terminate an existing pregnancy, legal experts suspect that the terms “abortion” and “abortifacient” (a substance that ends a pregnancy) in the law could be expanded to include the pill. Meaning, using all forms of emergency contraception after having sex might be considered equal to getting an abortion under the law, per the Riverfront Times.

House State Affairs Committee Chairman Brent Crane, a lawmaker from Idaho, also said he would hold hearings on laws banning emergency contraception due to reports of “complications” causing “health concerns for the mom,” according to the Idaho Statesman.

But, while many users on Twitter pointed out a new ban on Plan B in Tennessee, that law only applies to medical abortion pills—not emergency contraception, the Tennessean reported.

How effective is Plan B?

The Plan B website notes that 7 out of 8 women who could have gotten pregnant and who used Plan B as directed didn’t become pregnant after taking the pill.

But how effective Plan B is depends on when you take it: While you can technically take it up to 72 hours (a.k.a. three days) after having sex, both White and the FDA recommend taking the pill as soon as possible.

“Think about EC as preventative medicine,” White says. “You wouldn’t buy Motrin or Band-Aids when you have a headache or you cut yourself—you have Band-Aids in your bathroom for when the need arises. I encourage all my patients to think of EC the same way.”

Plan B shouldn’t be taken as a routine method for birth control, experts add.

Does Plan B have any side effects?

You may experience a few symptoms after taking Plan B. The FDA notes that the pill’s side effects can include:

  • Heavier bleeding during your period
  • Pain in your lower abdomen
  • Nausea
  • Fatigue
  • Headaches
  • Dizziness
  • Tender breasts
  • A late period

    White says most of the immediate side effects usually go away in about a day. She adds that taking Plan B can change the amount you bleed during your next period, too.

    “You could have spotting before your period comes. Your next period could come a bit earlier or later than usual, and it might be heavier or lighter than normal. All of these things are within the scope of what we typically see after EC,” she says. But, she explains that this will only affect your next period. After that, your cycle should be back to normal.

    Note: “The pills are out of your system in a few days, and it has no effect on your ovulation in the future,” says White. Translation? Your fertility or your chances of getting pregnant in the future won’t change.

    Does Plan B have a weight limit?

    “EC is not dangerous to take for anybody at any weight,” White clarifies. But research has shown that the pill may be less effective for women with a higher body mass index (BMI), according to a 2019 study in the Women & Health journal.

    “We know that the Plan B pills are less effective and may not be effective at all, if your BMI is over 26,” confirms White. If you’re wondering what your BMI is, you can use this calculator from the CDC to check. And, if your BMI is higher than 26, you can still access and safely take Plan B—it just might not be as effective.

    Other emergency contraception options might be better for some people.

    Intrauterine devices (IUDs) are another form of emergency contraception. You might think of IUDs as just regular contraception. But an IUD can also be used as a type of emergency contraception, if it is implanted up to five days after you’ve had unprotected sex, according to the World Health Organization (WHO). And they’re more long-acting than a pill, although IUDs are used as EC less often than morning-after pills are, according to a 2019 study published by the National Library of Medicine.

    Besides Plan B (and its generic alternatives), there’s also a prescription pill called Ella. It features a different ingredient called ulipristal acetate, although it works the same way, White says. She adds that Ella has been proven to be more effective than Plan B, but not quite as effective as an IUD.

    Here’s how the numbers stack up, according to White:

    • Plan B is around 89% effective
    • Ella is about 94% effective
    • IUDs are 99% effective

      Plus, Ella is effective for people with a BMI of up to 35, instead of Plan B’s 26.

      Ella can also be taken up to five days after having sex. And, unlike with Plan B, Ella is still just as effective on day five as it is on day one, according to White.

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