When the Supreme Court ruled on Dobbs vs. Jacksonit took an extra step to overturn the landmark 1973 case Roe vs. Wade, who has championed women’s right to abortion for nearly 50 years. As a result, many states had trigger bans in place that immediately took effect, making abortion illegal within their borders. In other states, new restrictions have been created, such as the ban on telemedicine abortion care – which aims to limit access to abortion pills by mail.
When healthcare providers are denied access to safe abortions, many women will be forced to carry their pregnancies to term and potentially face new health risks. But that’s where access to medical abortion, known as abortion pills or Plan C pills, can help.
What is Plan C?
Plan A is a contraceptive to prevent pregnancy, Plan B is emergency contraception (to prevent pregnancy after sex) and Plan C is an abortion pill.
Also called medical abortion, Plan C is an option for safely and effectively ending a pregnancy. The drug used is a combination of mifepristone and misoprostol (or misoprostol can be used alone, if mifepristone is not available). The whole process can be self-managed at home.
According to ACOG, a medical abortion is most effective if used before 10 weeks of pregnancy, up to 70 days from the first day of your last normal period, but in some cases it can also be used with more advanced pregnancies.
Related: Here’s the Problem: Many Women Don’t Even Know They’re Pregnant at 6 Weeks
Are abortion pills legal?
In short, it’s complicated. Abortion pills are approved by the FDA at the federal level, but access may be restricted at the state level depending on where you live. In a statement on Friday, Attorney General Merrick Garland said access to abortion pills and other reproductive care will be protected by the Justice Department.
“The Department strongly supports congressional efforts to codify Americans’ reproductive rights, which it retains the authority to do. We also support other legislative efforts to ensure access to comprehensive reproductive services. And we stand ready. to work with other branches of the federal government that seek to use their legitimate powers to protect and preserve access to reproductive care,” he says.
Related: Resources for Safe Abortion Access and Reproductive Rights
“In particular, the FDA has approved the use of the drug mifepristone. States cannot ban mifepristone due to disagreement with the FDA’s expert judgment on its safety and efficacy,” Garland says.
The FDA had previously required that one of the drugs used in abortion pills, mifepristone, be dispensed in person. But since December 2021, this requirement has been permanently lifted, paving the way for telehealth platforms to organize safe access to abortion care.
Although the FDA has approved the use of abortion pills, it is important to recognize that at least 19 states have passed regulations that restrict telemedicine abortion care, which means that people living in those states who get the pills could risk legal consequences.
A law that took effect last year in Texas limits access to medical abortion to only the first 7 weeks of pregnancy, narrowing the window for which medical abortion can be performed by a clinician without legal consequence.
The Guttmacher Institute has a list of state regulations, and Plan C has an FAQ on accessing medical abortion resources.
Are abortion pills safe?
Yes. Abortion pills are safe and effective. Abortion pills currently make up the majority of abortion procedures in the United States, accounting for approximately 54% of all procedures.
The protocol of first taking mifepristone (which blocks progesterone, a hormone needed to maintain pregnancy viability), followed by misoprostol 24-48 hours later (which causes cramping and contractions of the uterus , emptying its contents) is approved by the Food and Drug Administration (FDA).
Plan C pills are considered by the American College of Obstetricians and Gynecologists (ACOG) to be a safe and effective regimen for medical abortion or early pregnancy loss.
Related: 10 facts about the state of abortion in America right now
The organization “supports the use and expanded access to mifepristone for these indications and opposes restrictions such as on-site dispensing requirements and mandatory in-person examinations before and after medical abortion.”
The protocol is also recommended by Planned Parenthood.
This medical abortion method is low risk (less than 1% of women who have had medical abortion reported serious adverse side effects such as infection or bleeding), highly effective (95% to 98% of successful abortions) and has the fewest side effects.
Studies show that abortion with Plan C pills tends to take longer and require you to monitor yourself at home, compared to a surgical abortion, known as uterine aspiration, which is usually performed by a clinician in a single office visit. Although no medical procedure is without risk, the risks of a medical abortion are greater if you have an IUD or an ectopic pregnancy.
A small cohort study from 2021 reviewed the safety record of medical abortion care delivered via telehealth and found it “feasible, safe and effective.”
What is the shelf life of abortion pills?
If you are wondering if abortion pills expire, the answer is yes, although they have a long shelf life. According to the International Federation of Gynecology and Obstetrics (FIGO), misoprostol and mifespristone tablets have a shelf life of about two years. Some resources say mifepristone can last up to five years. If used after their expiration date, the pills may still work, but you risk a higher failure rate.
Plan C pills make abortions more accessible
In some European countries, such as Finland, medical abortions account for up to 90% of all abortion procedures. Many health care providers recommend medical abortions to their patients who seek this type of care, as it may be preferable to uterine aspiration in some cases.
Add to that, Plan C pills offer additional benefits: they are more accessible, much more affordable (pills can cost between $40 and $105; uterine aspiration usually costs over $500), and can be self-managed at the home. This self-management factor is extremely important, given that we now live in a post-Roe world, where abortion clinics across the country are forced to close.
Related: Resources for Safe Abortion Access and Reproductive Rights
Resources for Finding Plan C
Resources for finding abortion pills are available through Planned Parenthood, Choix Health (which offers virtual clinician services for California, Illinois, and Colorado), and Plan C, where you can enter your location and determine the best method for access medication, whether clinician-supported or self-managed.
In some states, you can go to a clinic or seek help from a clinician online and then take the pills at home. In other cases, you can order the pills to be delivered to your doorstep without consulting a medical professional. Plan C also offers a list of online resources, such as the M+A hotline, which are available for further assistance.
Abortion care is health care. “Like all patients, women who obtain an abortion are entitled to privacy, dignity, respect and support,” writes the American College of Obstetricians and Gynecologists (ACOG). Plan C offers them exactly that.
A version of this story was published on December 3, 2021. It has been updated.