Can Emergency Contraception Be Used for an Abortion? MDs Unpack the Latest Research

Get the Full StoryAccess to reproductive care has been under fire in America since June 2022, when the Supreme Court overturned Roe v. Wade, the landmark decision that guaranteed the federal right to an abortion. Since then, abortion access has plummeted for American women, with 12 states enacting total abortion bans. Mifepristone, a drug commonly used in medications including medication abortion , is also under attack, with abortion opponents trying to restrict its use even more.

If you're a woman, or honestly just a decent human being living in America, you're probably well aware of all of this. But new research suggests that a pill used for emergency contraception may help women have an abortion, broadening access for women across the country. While this sounds good in theory, emergency contraception has also been targeted by abortion opponents - and these findings could make things even messier, potentially restricting even more reproductive care for women down the road. Let's unpack the murkiness.

Experts Featured in This Article:

Lauren Streicher, MD, is a clinical professor of obstetrics and gynecology.

Jennifer Wider, MD, is a women's health expert and author.

The Research

The study, which was published in NEJM Evidence, reports on an early phase study of 133 women who were up to nine weeks in their pregnancy and took ulipristal acetate, a medication that's used for emergency contraception and sold under the brand name Ella.

The researchers found that when a 60 milligram dose of ulipristal acetate which is double the usual dose was taken with a single dose of misoprostol, it was 97 percent effective at causing an abortion up to 63 days of the pregnancy. Misoprostol is a medication that's often used in a medicated abortion, usually in combination with mifepristone. However, it's also used to prevent ulcers in people who take certain medications, per the US National Library of Medicine.

"Although the study is small and lacks a concurrent comparison group, the findings suggest that this regimen may be effective for medication abortion, and more research is warranted," the researchers concluded.

The Caveat

It's very important to point out that the study did not find that taking emergency contraception alone will cause an abortion. "It doesn't work. It will not disrupt an established pregnancy," says Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine.

HRA Pharma America, the company that makes Ella, also clearly states on its website that the medication won't terminate an existing pregnancy. However, it can be taken up to five days after having unprotected sex to prevent pregnancy.

Ella works to delay ovulation so that there is no egg to meet the sperm after having unprotected sex, the company explains online. Sperm can live in the fallopian tubes for up to five days after sex, and this delay helps prevent pregnancy by keeping the sperm and egg from meeting.

There has been a lot of confusion with the general public about how emergency contraception works in general, with some claiming that the medication will terminate an early pregnancy. With the latest findings, there is concern that they could be misconstrued to suggest that emergency contraception alone can be used to have an abortion.

The truth is, misoprostol alone is "very effective" in causing an abortion, says Kelly Cleland, executive director of the American Society for Emergency Contraception ASEC . Meaning, the addition of ulipristal acetate aka the medication used for emergency contraception isn't needed. Cleland says the recent findings may confuse people into thinking that emergency contraception alone will cause abortions, and potentially limit access in the future.

"In the US, we're at a moment where access to reproductive healthcare is under constant fire. So it's more important than ever to make sure that access to emergency contraception is fully protected," she says.

As for the future, Cleland says it's "not really clear" what this means for abortion and emergency contraception access going forward. "This study did not include a comparison group, so it's not possible to say whether adding ulipristal acetate to misoprostol is better than using just misoprostol on its own for medication abortion," she says. "As an organization, ASEC embraces new options for reproductive healthcare, including contraception and abortion. But this particular study just isn't enough to change medical practice or recommendations about abortion."

Streicher, on the other hand, calls the study findings "dangerous." Her main concern: "Those who are anti-reproductive rights will try to now limit access to emergency contraceptives, which is going to mean that we'll need more abortions. They'll say this is an abortifacient when it's not."

The Upside

The study's findings are still "very encouraging" for people with limited access to abortion care, says Jennifer Wider, MD. "Even though the study is small and lacks a comparison group, it has promising potential for an additional regimen for medical abortion."

That said, the study "does not change anything we know about emergency contraception," Cleland stresses. "Ella is the most effective emergency contraception pill available in the US, and people need access to it without barriers - especially in places where abortion is banned."

Fortunately, you can still find emergency contraception at most major pharmacies - and access to that has not changed. But if you're particularly concerned about future access, it doesn't hurt to pick up a pack or two the next time you're at the store for the just-in-case.

Korin Miller is a writer specializing in general wellness, health, and lifestyle trends. Her work has appeared in Women's Health, Self, Health, Forbes, and more.

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