President Biden Just Signed An Executive Order To Protect Plan B
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For the first time in almost 50 years, women’s reproductive rights are facing an existential threat after the Supreme Court overturned its landmark 1973 case, Roe v. Wade on June 24th.
Roe v. Wade protected the right to abortion at the federal level. But now that it's been overturned, individual states will decide whether abortion is legal within their state boundaries.
With the drastic decrease in abortion access, people are wondering what that means for the future of the future holds for emergency contraception. Legal experts say that emergency contraception like Plan B could become the next target of restrictive court rulings.
Some states, such as Idaho and Louisiana, have already discussed possible future restrictions on morning-after pills and even IUDs. In Idaho, Senior State Lawmaker Brent Crane expressed his desire to hold hearings regarding a potential emergency contraception ban.
While no laws banning Plan B or similar morning-after pills have been passed yet, recent events have left many Americans concerned about how future laws could affect women's 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.
Meet the expert: Dr. Katharine White, MD, MPH, is an associate professor of ob-gyn at the Boston University School of Medicine.
What is Plan B?
Plan B One-Step is a type of emergency contraceptive that you can purchase without an ID 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 Dr. 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.
There is no limit to the number of times Plan B can be taken, and there are no significant health risks that come with the emergency contraception’s use. Medical professionals do not recommend Plan B as a regular form of birth control because it has a lower success rate compared to other options, reports medicalnewstoday.com.
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 stricter measures in place.
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, 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.
While Missouri's "trigger law" (meaning a law that's set to go into effect immediately after Roe v. Wade is overturned) would attack abortion access in the state, the clause does not directly address pregnancy prevention. Therefore, emergency contraception, like Plan B, would not be immediately affected, The Kansas City Star reports.
On Twitter, some users spread false information about a supposed ban on Plan B in Tennessee, which was inaccurate. A new law puts restrictions on the method in which medical abortion pills are prescribed, and doesn't impact emergency contraception, the Tennessean reported.
Some of this fear stems from the fact that 13 states have trigger bans that can easily go into effect now that Roe has been overturned; however, these bans do not pertain to emergency contraceptives, such as Plan B, or in vitro fertilization (IVF).
The recent Roe v. Wade opinion, however, does question cases like Griswold v. Connecticut which legalized the right to obtain birth control.
“In future cases, we should reconsider all of this Court’s substantive due process precedents, including Griswold, Lawrence, and Obergefell," Justice Clarence Thomas wrote in a concurring opinion.
President Joe Biden signed an executive order to expand access to emergency contraception on July 8.
President Joe Biden signed an executive order aimed at protecting access to reproductive health services in the wake of the Supreme Court overturning Roe v. Wade and eliminating the constitutional right to an abortion.
The order directs the Secretary of Health and Human Services (HHS) to "take additional actions to expand access to the full range of reproductive health services, including family planning services and providers, such as access to emergency contraception and long-acting reversible contraception like intrauterine devices (IUDs)."
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.
How do you know if Plan B worked?
The only real proof of Plan B’s success is your next period or a negative pregnancy test, nurx.com reports. However, after taking the pill, it is common for your next period to be slightly irregular, arriving earlier or later than expected or seeming heavier, lighter, or more spotty than usual. This response is an expected side effect of Plan B and not evidence of its effect.
Plan B is not an abortion pill. Therefore, it will not end a pregnancy that has already started. Taking this medication as soon as possible after having unprotected sex is crucial to its success.
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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