Mifepristone vs. Plan B. The Language of Reproductive Health Explained.
Mifepristone vs. Plan B. The Language of Reproductive Health Explained.

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Emergency contraception is not the same thing as the abortion pill, but these drugs are often confused. Although both involve reproductive health, emergency contraception—often called Plan B—is intended to stop pregnancy from occurring., and the abortion pill mifepristone terminates an existing pregnancy, medical experts say.

Distinguishing between the two drugs is more important than ever as the Supreme Court on Tuesday heard arguments in a case that could sharply limit access to mifepristone and reduce the independence of the Food and Drug Administration.

An anti-abortion organization is challenging the FDA’s approval of mifepristone, saying the agency bypassed standard protocols to get the drug on the market.

Abortion advocates say the pill should not lose its FDA approval, citing decades of safety and efficacy in patients nationwide.

Currently, mifepristone remains FDA-approved and available to many Americans from reproductive health clinics or telemedicine services, although full access to the pill is limited in 15 states. The Plan B pill is legal in all 50 states with no age restrictions.

The court’s decision in the mifepristone case, expected this summer, could have a long-term impact on the FDA’s ability to make decisions about the safety of all drugs. This means that although the approval of no single pill changes today, there could be implications for all medicines and the future of national reproductive health systems.

“Regardless of the outcome, it won’t have an immediate impact on emergency contraception,” Dana Singiser, co-founder of the Contraceptive Access Initiative, said of Tuesday’s case.

How we got here

Last April, U.S. District Judge Matthew Kaczmarik in Texas effectively voided the FDA’s 23-year-old approval of mifepristone.

The Biden administration appealed, but the New Orleans-based 5th U.S. Circuit Court of Appeals upheld Kacsmaryk’s ruling that the FDA erred in approving changes in 2016 and 2021 that allowed women to take the drug for three weeks longer than pregnancy and allows the drugs to be discontinued. they are distributed by mail without in-person doctor visits.

“In loosening safety restrictions on mifepristone, the FDA failed to address several important concerns about whether the drug would be safe for women who use it,” the court wrote. prescribed and dispensed in person.”

The case marks the first time a court has limited access to an FDA-approved drug by second-guessing the agency’s expert judgment, according to the Biden administration.

A ruling against the FDA could open the “barn doors” for future similar lawsuits against multiple drugs if the court sides with the plaintiff, especially emergency contraception, Singiser and others say.

Current coverage: Supreme Court hears Mifepristone abortion pill case, nation watches with trepidation: Live updates

“If the Supreme Court undermines the FDA’s authority, it could jeopardize every drug that has ever been approved by the FDA,” Singiser said. “This threat is particularly aimed at reproductive health products because there is such an organized advocacy movement against abortion, contraception and IVF.”

What is mifepristone?

Mifepristone is one of two pills commonly used in medical abortion, which accounts for more than half of all abortions in the US. according to the Guttmacher Institute, which researches reproductive health policy. Patients take mifepristone with another drug called misoprostol to terminate a pregnancy that is less than 70 days old. The pills are taken about two days apart.

The abortion drug has been used in the United States since 2000. The drug accounted for 63% of all abortions in the US in 2023, an increase from 53% in 2020.

Some insurers and Medicaid plans cover abortion pills, according to Plan C, which has a state-by-state abortion pill access guide with financial information. The cost of the pill can range from $150 from online clinics that send pills by mail to $500 or more at in-person clinics. Several online providers, such as Hey Jane, offer financial assistance if needed.

Many medical organizations have been quick to defend mifepristone as the “most studied drug” and “extremely” safe, with a better track record than commonly used drugs such as Tylenol and Viagra, according to legal briefs filed in support of the FDA by the American Medical Association, the American College of of Obstetrics and Gynecology, the American Academy of Family Physicians, and several other organizations.

How about Plan B?

Emergency contraception is a type of birth control that must be taken within 72 hours of unprotected sex or failed birth control. A pill sells for about $50 at drugstores like CVS and Walgreens.

It works by delaying ovulation with a hormone called levonorgestrel, according to Planned Parenthood. It is recommended that you take Plan B as soon as possible after unprotected sex, but it can be taken up to five days later.

Emergency contraception is not an abortion. The morning-after pill can be up to 95% effective at preventing pregnancy, but it does not terminate an existing pregnancy. Plan B is designed to prevent ovulation by keeping an egg from being fertilized by sperm and an embryo formed.

Many Americans confuse Plan B with the abortion pill. Some Americans began stockpiling Plan B after Roe v. Wade came down in 2022, causing confusion and panic that emergency contraception was the next best thing or would be the next to be restricted. Even Olivia Rodrigo’s current Guts tour has had to clarify that it’s handing out emergency contraception, not abortion pills, at the pop star’s concerts.

This association between the two drugs is by “design,” said Singiser, who said the anti-abortion movement deliberately framed contraception as a “means of abortion” and worked to codify laws that state life begins at the moment of conception, paving the way paving the way for legal battles over contraception and IVF, such as the recent attack on IVF in Alabama after the state’s highest court ruled that frozen embryos can be considered children.

All of this has led to concerns that the change in federal approval of mifepristone will cause a ripple effect for Plan B. And that confusion is even worse for people in states where abortion care is already limited, the independent Kaiser Family Foundation found in a study from 2023. But Americans’ access to emergency contraception remains unchanged for now.

Contributed by Maureen Groppe

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