The FDA Just Changed the Wording on Plan B Packaging — Here's Why That's Huge
Editor's Note: We at POPSUGAR recognize that people of many genders and identities have vaginas and uteruses, not just those who are women. For this particular story, we interviewed experts who generally referred to people with vaginas and uteruses as women.
When the Supreme Court ruled to overturn Roe v. Wade on June 24, people started wondering whether it was wise to stock up on the morning-after pill in case their access to abortion became limited — or in case access to birth control or emergency contraception was the next to come under fire. (In fact, in the days after the SCOTUS decision, some pharmacies began limiting customers' emergency contraception purchases to three pills per person because demand skyrocketed, per Bloomberg.)
And it's been a valid concern. Following the overturn of Roe, many states passed laws dramatically restricting abortion. And depending on the exact laws and definitions, this new legislation had the potential to restrict emergency contraception if "pregnancy" was defined as beginning at fertilization.
Thankfully, on Dec. 23, the Food and Drug Administration made a move to protect emergency contraception from anti-abortion laws. The FDA revised the consumer pamphlet information in boxes of Plan B One-Step emergency contraception, making it clear that the medication cannot be described as abortion pills.
The change establishes the fact that levonorgestrel, the drug in Plan B One-Step and other emergency contraception or "morning-after" pills, works by impacting ovulation — not by preventing a fertilized egg from implanting in the womb — thus protecting it from any abortion legislation that could apply to an already fertilized egg. The packaging of Plan B One-Step had previously said that the medication might block fertilized eggs from implanting in the womb, according to The New York Times; however, newer evidence suggests that the drug does not act in that way.
"Plan B One-Step prevents pregnancy by acting on ovulation, which occurs well before implantation," the FDA writes in the updated information about Plan B on their website. "Evidence does not support that the drug affects implantation or maintenance of a pregnancy after implantation, therefore it does not terminate a pregnancy."
The FDA very clearly maintains that the drug cannot be considered an abortifacient (a drug that causes abortion). "Plan B One-Step will not work if a person is already pregnant, meaning it will not affect an existing pregnancy," the FDA says.
While this change is first being executed with Plan B One-Step, all 11 generics of the drug are expected to update their labeling as well, and as soon as possible, according to the FDA. (To note: This label change will not impact the emergency contraception sold as the brand name, Ella (ulipristal acetate), as it's already described as working "by preventing or delaying ovulation.")
But what does this all mean for your access to emergency contraception? And is it wise to stock up on emergency contraception given the overturn of Roe? Here's what you need to know.
Why the Overturn of Roe v. Wade Could Have Affected Emergency Contraception
The Supreme Court decision cleared the way for a number of states to pass laws that banned abortion outright, "and some of those laws have medically inaccurate definitions about when pregnancy begins," Rachel Fey, vice president of policy and strategic partnerships at Power to Decide, an organization dedicated to preventing unplanned pregnancy, told POPSUGAR in June. For example, some Republican-led states, including Arkansas, Kentucky, Missouri, and Oklahoma, passed laws stating that life begins at fertilization, according to NPR. (This is contrary to the medical definition, which says pregnancy begins at implantation when the fertilized egg implants itself onto the uterine wall, Fey says.) For that reason, state abortion laws could encompass restrictions on emergency contraception — that is, when these pills were described as working to prevent implantation after an egg is fertilized. However, thanks to the FDA's changes to the Plan B One-Step Drug Facts label, levonorgestrel-based emergency contraception is now safe from that sort of legislation.
Should You Stock Up on Emergency Contraception?
Even before the FDA's protective change, experts did not recommend stocking up on emergency contraception. And now that these medications should be safe from anti-abortion legislation, there's even less of a need to do so.
That said, because all morning-after pills are more effective the sooner you take them, it's not a bad idea to keep some on hand if you're worried about unwanted pregnancy. "One way to take control of your health decisions can be stocking up on essentials so you can act quickly and move forward with confidence," says Jamie Norwood, cofounder of Stix, a direct-to-consumer brand of fertility and vaginal health products, including emergency contraception. Taking emergency contraception can help offer peace of mind in case your contraceptive method fails (for example, if a condom breaks) or if you're worried about pregnancy despite using another form of birth control. After all, birth control pills, for example, are still only 91 percent effective at preventing pregnancy (with typical use), according to the American College of Obstetrics and Gynecology.
But there's no need to hoard a ton of doses or rush to do it right this second. In fact, activists are also pointing out that panic buying emergency contraceptives in bulk to keep on hand just in case could keep people from accessing it who need it right now. "It's a great thing to have on hand, but stockpiling large amounts only makes it harder for somebody to get it in an emergency," says Fey.
Does the Morning-After Pill Expire?
Emergency contraception can be good for up to five years, according to Planned Parenthood. But the expiration date is based on the manufacturer date, not the date the pill was purchased, per Nurx — so make sure to check the expiration date, or ask a pharmacist or physician if you're concerned that the pill may be expired. If the morning-after pill is expired, it will be less effective and may not successfully prevent pregnancy, says Heather Irobunda, MD, a board-certified ob-gyn in New York City.
"When such an important issue as a conception is involved, I would recommend strictly following the expiration-date advisories," says Felice Gersh, MD, ob-gyn, author and founder of the Integrative Medical Group of Irvine. Because of this, she suggests keeping only three or four packs of the pill at a time — you don't want to buy so many that you're unlikely to use them before they expire. (And remember: the morning-after pill should only be taken in case of emergency, anyway.)
Where to Get Emergency Contraception
While it isn't the only form of emergency contraception, Plan B is one of the most accessible. It and other progestin-only morning-after pills are available over the counter without a prescription. Anyone at any age can buy these pills, without a parent's consent, according to Planned Parenthood, and you can even purchase them online through telehealth apps (such as Nurx or Wisp) or on sites like After Pill or even Amazon. It can be taken up to five days after having sex that could result in pregnancy.
The other emergency contraception option, Ella (ulipristal acetate), requires a prescription; however, you can also get it online and shipped to you with a quick medical consultation from Nurx or Prjkt Ruby. Like Plan B, it's also possible to purchase Ella ahead of time and hold onto it just in case, according to Planned Parenthood.
Nonprescription emergency contraception is available at many local pharmacies and generally costs $40 to $50, depending on where you buy it, Planned Parenthood reports. And if you can't get the morning-after pill close to home, there are other options.
"[Mail-order] services make it easier for women from all over the US, especially in areas where it may be more difficult to get [the morning-after pill], to have access to it," Dr. Irobunda says. She personally recommends Bedsider (an online birth-control support resource that can help you weigh your options and find a provider or mail-order service) and Nurx (a mail-order pharmacy that provides birth control, Plan B, and other reproductive health services).
Stix has also created the Restart Donation Bank to help address inequities in accessing emergency contraception. "Anyone can donate now to get Restart [Stix's morning-after pill] into the hands of as many people as possible for free, and anyone — no matter your gender, age, or what state you live in — can request a free dose to be shipped to them discreetly, no questions asked," says Norwood.
If you're past the window where emergency contraception is an option, Plan C, an at-home abortion pill service, can help you figure out your abortion options and get support.
— Additional reporting by Lauren Mazzo