The Confused Choice: Morning-after Pill or Abortion Pill?

by Monty L. Patterson on December 2, 2011

"Confused Woman"What is the difference between the Morning-after Pill and the Abortion Pill? 

The emergency contraceptive “Morning-after Pill” can prevent an unplanned pregnancy while the "Abortion Pill" can terminate an established early pregnancy.

The Morning-after Pill to Prevent Pregnancy

Emergency contraception pills (ECPs), also known as the “Morning-after Pill”, are used to help prevent a woman from getting pregnant after she has had sex without using birth control or if the birth control method failed. (1)

The term "Morning-after Pill," can be misleading because ECPs don't have to be taken the morning after. (1)

ECPs can reduce the chance of pregnancy when taken as directed up to 72 hours (3 days) after unprotected sex. Some kinds of ECPs can work up to 120 hours (5 days) later. (1)

In the United States, there are several kinds of FDA-approved emergency contraception pills (ECPs). The trade names of the ECPs or morning-after pills are Plan B One-Step, Next Choice and ella. (2) (3) (4)

Plan B One-Step and Next Choice contain levonorgestrel, a hormone used in birth control pills and are available at drugstores and stores with a licensed pharmacist. The FDA approved Plan B One-Step and Next Choice for sale without a prescription to those 17 and older. Women and men must show proof of age to buy Plan B One-Step or Next Choice. If you are younger than 17 and need emergency contraception, you will need a prescription. (2) (3)

Emergency contraception pills, such as Plan B One-Step® and Next Choice, when taken as directed, are not effective in ending an existing pregnancy. (2) (3)

The emergency contraceptive pill, ella (U.S. trade name), is a progesterone agonist/antagonist whose likely main effect is to inhibit or delay ovulation. (5) The prescription-only product prevents pregnancy when taken orally within 120 hours (five days) after a contraceptive failure or unprotected intercourse. (4)

ella is not for use in the case of known or suspected pregnancy. The risks to a fetus when ella is administered to a pregnant woman are unknown. (4)

The Abortion Pill to Terminate Early Pregnancy

The Abortion Pill, otherwise known as Mifepristone (U.S. trade name: Mifeprex) or RU-486, is a medical or drug induced alternative to surgical or vacuum aspiration abortion for women who elect to terminate an early pregnancy. (6) (7)

On September 28, 2000, the United States Food and Drug Administration (FDA) approved a combined medical abortion regimen of mifepristone (Mifeprex) with another drug called misoprostol (Cytotec) for termination of pregnancy up to 49 days or less since a woman’s last menstrual period began. (8) (9)

In the United States, mifepristone is not available to the public through licensed pharmacies. The medical abortion regimen of mifepristone and misoprostol must be provided by or under the supervision of a qualified physician who has met specific qualifications to administer the drugs. (10)

How does the abortion pill regimen work?

Mifepristone blocks a hormone, progesterone, which is needed for a woman’s pregnancy to continue. The mifepristone abortion pill is an anti-progestin that blocks the action of progesterone which is necessary to establish and maintain placental and embryo attachment. (11) (12)

Mifepristone is used in conjunction with another drug called misoprostol (Cytotec) which stimulates uterine contractions that expel the embryo and placental tissue to complete the medical abortion procedure. (11)

Should patients be concerned about the risks of the abortion pill?

Medical abortion with mifepristone and misoprostol has increasingly become an integral part of abortion provision in the United States and likely has contributed to a trend toward very early abortions. (13)

The continuing increase in the number of medical abortions performed each year and the risk of major health complications is of great interest to patients and health care providers. (14)

Patients may experience adverse events and health risks that can range in severity from complications that are serious and life-threatening to those that can lead to hospitalization or death. (15)

For more information about the Abortion Pill and its risks please visit


1. U.S. Department of Health & Human Services Office on Women's Health. Publications, Emergency contraception (emergency birth control) fact sheet., Empowering women to live healthier lives! [Online] November 21, 2011. [Cited: December 2, 2011.]

2. Teva Women's Health, Inc. Plan B One-Step, Levonorgestrel, One Pill. One Step. Plan B One-Step. [Online] 2011. [Cited: December 2, 2011.]

3. Watson Pharma, Inc. Next Choice, Levonorgestrel, Emergency Contraceptive. My Next Choice. [Online] 2011. [Cited: December 2, 2011.]

4. U.S. Department of Health & Human Services. FDA, Full Prescribing Information, ella Initial U.S. Approval: 2010. FDA, U.S. Food and Drug Administration. [Online] August 2010. [Cited: December 25, 2011.]

5. U.S. Department of Health & Human Services. FDA, News & Events, FDA approves ella tablets for prescription emergency contraception. FDA, U.S. Food and Drug Administration. [Online] August 13, 2010. [Cited: December 2, 2011.]

6. Danco Laboratories, LLC. What is Mifeprex. Mifeprex (mifepristone tablets, 200 mg) the early option pill to end pregnancy. [Online] [Cited: June 15, 2011.]

7. Johnson, Judith. CRS Reports, Abortion Termination of Early Pregnancy with RU-486 (Mifepristone). University of Maryland School of Law, Thurgood Marshall Law Library, CRS Reports:Abortion. [Online] February 23, 2001. [Cited: September 3, 2010.]

8. Shannon, Caitlin S, et al., et al. Multicenter Trial of a Simplified Mifepristone Medical Abortion Regimen, Volume 105, Issue 2. Obstetrics & Gynecology, The American College of Obstetricians and Gynecologists . [Online] February 2005. [Cited: September 7, 2011.]

9. U.S. Department of Health & Human Services. Drugs, Mifeprex (mifepristone) Information. FDA, U.S. Food and Drug Administration. [Online] July 19, 2011. [Cited: July 19, 2011.]

10. U.S. Department of Health & Human Services. FDA, U.S. Food and Drug Administration, 9/28/2000 Approval Letter to Population Council. [Online] September 28, 2000. [Cited: July 14, 2011.]

11. UCSF Center for Reproductive Health Research & Policy: San Francisco. Early Medical Abortion: Issues for Practice. Bixby Center for Global Reproductive Health. [Online] July 2001. [Cited: June 15, 2011.]

12. Ulmann, Andre, Teutsch, Georges and Philibert, Daniel. RU 486. [Online] June 1990. [Cited: July 25, 2011.]

13. Jordan, Beth and Shields, Wayne C. Happy anniversary mifepristone: a decade of promise and challenges. Contraception Journal. September, 2010, Vol. 82, 3, Pages 219-220 .

14. Niinimäki, Maarit, et al., et al. Immediate Complications After Medical Compared With Surgical Termination of Pregnancy, Obstetrics & Gynecology, 114(4):795-804. NCBI, PubMed. [Online] October 2009. [Cited: September 20, 2011.] PMID: 19888037.

15. PBS. Frontline, Dangerous Prescription,The FDA: Hazardous to Your Health?, Interview: Paul Seligman, M.D.,M.P.H., WGBH educational foundation. [Online] November 13, 2003. [Cited: August 16, 2011.]

Page Last Updated: 12/02/2011

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