Plan B vs. the Abortion Pill: What’s the Difference?

If you’ve ever searched “Plan B vs. the abortion pill,” you’re definitely not alone. In fact, about 73% of adults think they’re the same thing, which honestly tells you a lot about  just how confusing reproductive health information can be online.

At first glance, the mix-up makes sense. Both are pills, both relate to pregnancy, and they’re often talked about in the same conversations. But medically, they do two very different things.

• Emergency contraception (like Plan B) prevents pregnancy from happening

• Abortion pills end a pregnancy that has already started

Both are safe and widely used. They just work at completely different points in the process. Understanding that difference can make it much easier to figure out what you need and when you need it.

Here’s the simplest way to think about it:

Emergency contraception prevents a pregnancy. Abortion pills end an early pregnancy.

Tell me more about emergency contraception

Emergency contraception is used after unprotected sex to help prevent pregnancy.

It works mainly by delaying ovulation, which means your ovary does not release an egg. If no egg is released, sperm cannot fertilize it, and pregnancy cannot begin.

Timing matters! The sooner emergency contraception is taken after sex, the better it works.

It’s important to note that emergency contraception does not cause an abortion and will not affect an existing pregnancy.

There are three different types of emergency contraception:

1: Plan B and generic versions (levonorgestrel)

Levonorgestrel emergency contraception includes Plan B and generic options that are equally effective and may be less expensive. They work best when taken as soon as possible after sex, ideally within 3 days (72 hours).

They are safe to use while breastfeeding.

How to get it

Levonorgestrel emergency contraception is available over the counter, so you can buy it at many pharmacies and stores without a prescription. You can also get generic Plan B at many reproductive health clinics like carafem, often at a greatly reduced cost.

2: ella (ulipristal acetate)

ella is another type of emergency contraception pill that uses a different medication than Plan B.

Body weight can affect how well emergency contraception like Plan B works. Levonorgestrel pills may be less effective for people with higher body weight. In those cases, ella may work better.

One advantage of ella is timing. ella can be used for up to 5 days after sex and stays effective throughout that time.

If you are breastfeeding, small amounts of this medication may pass into breast milk. Some people choose to pump and discard breast milk for 24 hours after taking ella, but updated FDA guidance no longer considers this necessary. 

How to get it

ella requires a prescription.

Many clinics and healthcare providers can prescribe ella, which you can pick up at a local pharmacy. At carafem, a clinician can send a prescription to your pharmacy of choice for the cost of a short clinical consultation. Many pharmacies carry ella, and it may be covered by insurance.

3: IUDs as emergency contraception

An IUD can also be used as a very effective emergency contraception. It must be inserted within 5 days after unprotected sex to work best.

The copper IUD is one of the most common and effective kinds of emergency contraception available; however there are two forms of hormonal IUD, mirena and lilletta that can also be used based on recent studies.

Bonus: An IUD can also work as long-term birth control, providing highly effective protection for 8–12 years. It can be removed at any time if your needs change or if you decide you want to get pregnant. It won’t affect your ability to get pregnant in the future — even if you only use it for emergency contraception and have it removed after a few weeks.

If you are interested in using an IUD for emergency contraception and live near one of our clinics, you can learn more about your options here.

What are abortion pills?

Abortion pills are medications used to end an early pregnancy.

Even though people often say “the abortion pill,” the process actually uses two different medications..

• The first medicine, mifepristone, blocks progesterone. Progesterone is a hormone the body needs to continue a pregnancy.

• The second medication, misoprostol, causes cramping and bleeding as the uterus empties.

Abortion pills are approved for use early in pregnancy in the first 12 weeks at carafem.

Many people choose this option because it is safe, effective, and private. It’s often described as feeling like a heavy period or worse, with cramping and bleeding that can often be heavy for a few hours but can stop and start bleeding for several days or more.

carafem offers abortion pill care both through abortion pills by mail or in one of our private clinics, depending on where you live.

carafem can help

carafem health centers offer a range of reproductive healthcare services, including:

• emergency contraception

• abortion pills

• birth control options

• in-clinic visits and telehealth care

Our care teams provide private, judgment-free support so you can get clear answers and the care you need.

Common questions

Does Plan B cause an abortion?

No. Emergency contraception helps prevent pregnancy by delaying ovulation so an egg is not released. It works before pregnancy begins, not after.

Is there a maximum number of times I can take Plan B?

There is no limit on how many times you can take a levonorgestrel emergency contraceptive like Plan B or a generic. It is safe to use more than once if you need it. 

Using ella more than once in the same menstrual cycle isn’t recommended, since we don’t yet have enough information about repeated use within one cycle. If you need emergency contraception again after taking ella, a pharmacist or healthcare provider can help you figure out the best next step.

What if I took Plan B and I’m still pregnant?

Emergency contraception can lower the chance of pregnancy, but it does not work every time. If you do become pregnant after taking Plan B, the medication will not harm an ongoing pregnancy.

If you have a positive pregnancy test and want to talk through your options, a clinician can help you understand what choices are available to you and answer any questions you might have.

Will Plan B affect my period?

Yes, it can. Plan B works by temporarily affecting hormones, so your next period may come a little earlier or later than usual. Some people also notice spotting or light bleeding after taking it. This is common and usually not a cause for concern.

If your period is more than a week late, it’s a good idea to take a pregnancy test or talk with a clinician.

Can I get emergency contraception at carafem?

Yes. carafem health centers offer generic emergency contraception similar to Plan B. You can call us to check cost, location, and the best time to pick it up.

If ella may be a better option for you, a clinician can help through a short consultation, either in a health center or through telehealth, and send a prescription to a local pharmacy.

You’ve got options. We’ve got you.

Trying to figure out what to do after unprotected sex or a positive pregnancy test can feel stressful.

The most important thing to know is this: you have options.

Emergency contraception can help prevent pregnancy even after sex. The abortion pill can be used to safely end an early pregnancy with medication if you decide not to continue it.

carafem is here to provide clear information, compassionate care, and support without judgment. We support your needs.

You can learn more, find a clinic, get care online, or schedule an appointment at carafem.org.