What is a Medical Abortion and What is a Morning After Pill?

Published: November 08, 2022
Revised: May 03, 2023
Barbara Young
By Barbara Young, PharmD

You may have heard the words “medical abortion” and wondered what this is or whether this option is for you. Two categories of medications can be used to avoid pregnancy – emergency contraception and an abortion pill.

What is the difference between emergency contraception and an abortion pill?
Emergency contraception, also known as the ‘morning after pill’, is taken within days after unprotected sexual intercourse to reduce the risk of becoming pregnant. It will not work to end a pregnancy and will not affect the development of an embryo if you are already pregnant. Emergency contraception should not be used on a regular basis to prevent pregnancy.

Misoprostol can be given alone or in combination with mifepristone to end early pregnancy. It can be taken up to 70 days (10 weeks) after the first day of the last menstrual period but may not be as effective the closer it gets to 10 weeks.

How should I use emergency contraception and when can I take it?
The emergency contraceptive product, levonorgestrel, is available over the counter without a prescription. You do not need to be a certain age or have a prescription to obtain this medication. This medication must be taken within 72 hours of unprotected sex (e.g., sex without any method of birth control or with a birth control method that failed or was not used properly such as a condom that slipped or broke or birth control pills that were not taken as scheduled). The sooner you take this medication after unprotected sex, the better it will work for you.

Another emergency contraceptive product, Ulipristal (Ella), can be used to prevent pregnancy when taken up to 5 days after unprotected sexual intercourse or as a backup in case regular birth control fails or is used incorrectly. However, ulipristal is only available with a prescription. Ulipristal should not be used to prevent pregnancy on a regular basis.

How do emergency contraception medications work?
These medications work by preventing or stopping ovulation and they may not work as well in preventing pregnancy in women weighing more than 165 pounds.

How do abortion medications work?
Mifepristone works to end a pregnancy by blocking the hormones necessary to maintain a pregnancy. Taking misoprostol after mifepristone causes the uterus to contract and empty within 2 to 24 hours.

How do I get it? Is it legal?
Both morning after pills and the abortion pills are legal in all states in the U.S. and Federal Law prohibits discrimination against pregnant pharmacy customers, regardless of age. In some pharmacies you may need to ask for the levonorgestrel emergency contraception products if they are stocked behind the counter, but these products are available without a prescription.

Mifepristone is only available from a clinic, doctor’s office, or hospital and is stocked in retail pharmacies. Talk to your doctor to find a place to receive this product and associated care and monitoring.

A pharmacist’s tips for taking emergency contraceptive products

  • Although morning after pills should not be used as regular birth control, it may be helpful to have this product on hand for emergency use. Store according to package directions and use by the expiration date on the package.
  • Call your doctor if you vomit within 2 hours of taking the medications.
  • Call your doctor if you experience any abdominal pain.
  • Read all the instructions carefully before taking these medications.
  • Take these medications as instructed. Levonorgestrel products are most effective when taken as soon as possible and up to 72 hours after unprotected sex. Ulipristal should be taken within 5 days after unprotected sex.
  • After taking these products, you should get your period at the expected time or within one week. If your period is delayed by more than one week, you should use a pregnancy test or check with your healthcare provider to verify that you are not pregnant.

A pharmacist’s tips for taking Mifepristone-Misoprostol combination or Misoprostol alone

  • After taking these medications, make sure you know whom to call and what to do, including going to an Emergency Room if you experience complications including prolonged heavy bleeding, severe abdominal pain, or sustained fever.
  • Vaginal bleeding, abdominal cramps, and contractions of the uterus can begin within 2 to 24 hours of taking the medications.
  • It is important to follow up with your healthcare provider 7 to 14 days after taking this medication to check that the pregnancy has ended.

Talk to your doctor or pharmacist about the best options available for your situation in which you may need emergency contraception or to end an early pregnancy.

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