Plan C Vs. Plan B: What's The Difference?

On June 24, 2022, the Supreme Court overturned Roe v. Wade, which immediately allowed each state to decide how to move forward with their laws regarding abortion. With the reversal of Roe, half the country was put at risk for losing access to abortion care. With this landmark ruling reversed, it’s become increasingly important to equip yourself with information available — including your options when it comes to your reproductive health.

The reversal of Roe v. Wade has been overwhelming, but it’s helpful to keep in mind that there are resources available to you other than going to an in-person clinic for care. Plan C, a website run by the National Women’s Health Network, allows you to locate abortion pills that you can take from the comfort and privacy of your own home. The organization researches and compiles information for getting abortion pills across the country, both online and in person.

Different from Plan B pill, aka the morning-after pill that’s an emergency contraception to prevent pregnancy, “Plan C” commonly refers to mifepristone and misoprostol — aka abortion medication. According to both Dr. Mary Jacobson, M.D., a board-certified OB-GYN and chief medical officer of Alpha Medical, and Dr. Sheila Attaie, D.O. a family medicine physician and fellow with Physicians for Reproductive Health, medical abortions are safe and effective. (Attaie says they’re even safer than taking Tylenol.)

To learn more, here’s everything you need to know about how abortion pills differ from emergency contraception.

Where To Get Abortion Pills Vs. Plan B

If you need access to abortion medication, there are a few options open to you. To get started, it’s important to know what requirements your state has regarding a doctor’s ability to prescribe you abortion medication. “Many states have specific requirements affecting abortion, which are not evidence-based and create barriers to clinician and patient access to medication abortion,” Jacobson tells Bustle. “Most of these laws apply both to medication and [procedure abortion]. Providers must comply with mandatory waiting periods, parental notification, gestational age limits, and department of health reporting, as required.”

To find out the requirements specific to your state, you can visit Ineedana, a comprehensive website where you can find local options for both medication and procedure abortion, as well as information on the exact restrictions in your state. The site only uses your age, zip code, and the length of time since your last period, so no personally identifying information is needed.

Although these requirements do exist in some states, there are ways to legally get abortion pills in every state. “A person can get abortion pills from their doctor or advanced practice clinician, through telemedicine, or other trusted online platforms and pharmacies depending on the state you live in,” Attaie says. “To find abortion pills at in-person clinics, people can visit Ineedana. To find abortion pills online, people can visit Plan C. To find information or advice on self-managing a miscarriage or abortion, people can call the Miscarriage and Abortion Hotline.”

Unlike Plan C, Plan B pills can be purchased over the counter at pharmacies nationwide, as well as family planning clinics like Planned Parenthood. There are also online pharmacies, like wisp and Nurx, that ship Plan B pills to your home. Planned Parenthood and most online pharmacies accept insurance, as well, making them a lower cost option than buying it over the counter at a drugstore. It’s important to note that there’s another type of emergency contraception available called ella, but that must be prescribed by a doctor.

When To Use Abortion Pills Vs. Plan B

If you need an abortion and are considering a self-managed one, you’ll want to understand how to safely and properly use the pills. According to Jacobson, mifepristone and misoprostol can be taken by patients who are up to 11 weeks pregnant, first starting with the oral mifepristone tablet. The patient will finish the process either by putting two of the misoprostol tablets between the gum and cheek, or inserting four tablets vaginally, between six and 72 hours later. If the pregnancy is between 63 and 77 days, it’s recommended to take a second dose of the misoprostol four hours after the first dose, to increase effectiveness.

Attaie shares that it is possible to take the series of abortion pills later, if the pregnancy is not detected before 11 weeks, adding that the World Health Organization (WHO) approves the use of abortion medication up to 12 weeks, while the FDA currently approves use up to 10 weeks. As long as you take the pills with proper medical guidance or supervision, medication abortion is 95% to 99% effective.

As opposed to the longer timelines for medication abortion, the single Plan B pill is most effective (75% to 89% effective, according to Planned Parenthood) when taken within 72 hours of having unprotected sex. It can be taken up to five days afterward, but the effectiveness decreases significantly.

How Abortion Pills Work Vs. How Plan B Works

The process of passing a pregnancy through medication abortion is relatively simple. “The first pill, mifepristone, works by blocking the pregnancy hormone and stopping the pregnancy from continuing,” says Attaie. “The second set of [four] pills, called misoprostol, cause the uterus to cramp, the cervix to open, and the uterus to safely empty.” The process is complete once all five pills are taken in the correct order and time frame, and Jacobson reports that less than 1% of patients need any medical care for excessive bleeding.

As for what to expect once you’ve started taking the pills, Jacobson says that some cramping and bleeding will begin one to four hours after taking the four pills of misoprostol, and most patients pass the pregnancy tissue in four to five hours. You may also experience cramping for one to two days after the uterus is emptied. Jacobson recommends having pain medication, like ibuprofen or naproxen, on hand to mitigate the pain from cramping. It’s also important to note that medication abortion doesn’t impact your ability to get pregnant again, and you’ll be fertile again with your next menstrual cycle. If you choose to have sex after the process (which is safe after 72 hours), be sure to use protection.

Plan B pills work quite differently than Plan C. The Plan B pill is taken in one single dose, and serves as emergency contraception — meaning it prevents pregnancy before it occurs. Plan B contains a hormone called levonorgestrel, and sometimes causes side effects like light cramping, an upset stomach, or a slight change in your next period. Plan B may not work for anyone who weighs over 165 pounds, and ella may not work for anyone over 195 pounds, so alternative methods may need to be considered.

How Plan C Is Affected By The Overturning of Roe v. Wade

Ever since Roe v. Wade was overturned, the process of accessing abortion pills has changed. Because of the ruling, states have the ability to form their own laws regarding abortion care — meaning that some states have utilized the power to ban abortion altogether, including access to Plan C. Although abortion pills have become illegal in some states, patients in those states may be able to travel to other states that allow access to Plan C or get access to them online.

Studies referenced:

Gatter, M. (2015). Efficacy and safety of medical abortion using mifepristone and buccal misoprostol through 63 days. Contraception. doi: 10.1016/j.contraception.2015.01.005. Epub 2015 Jan 13. PMID: 25592080; PMCID: PMC4373977.

Experts:

Dr. Mary Jacobson, M.D., board-certified OB-GYN and chief medical officer of Alpha Medical

Dr. Sheila Attaie, D.O. family medicine physician and fellow with Physicians for Reproductive Health

Correction: A previous version of this story misstated Dr. Mary Jacobson’s title and the name of the second set of pills a patient should take during a medication abortion. It has been updated.