# what's the difference between the morning after pill and RU486 (abortion pill)??



## loving-my-babies (Apr 2, 2004)

just saw someone mention they are not the same. I had no idea.

can someone explain?


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## mthomas (Mar 20, 2004)

well from what I understand the MAP are 4 reg. dose bc pills taken w/in 72 hrs of possible conception. You take 2 at once and then 2 24 hrs later I believe. The MAP prevents implantation. Someone else will have to explain how RU486 works, but I know it can be taken much later than 72hr after conception.


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## RubyV (Feb 4, 2004)

PPFA.org can give you the details.

Short version:

MAP works only within 72 hours of unprotected sex to stop ovulation. RU486 ends a pregnancy. MAP is just a mega dose of bcp. RU486 is a different combo of meds entirely.

busy at work, will try to post more info later.


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## Shonahsmom (Mar 23, 2004)

Generically, the morning after pill prevents implantation or fertilization of an egg.

RU486 induces abortion.

ETA: RU486 is only used and approved for up to 49 days after the first day of the last menstrual period.

from http://www.plannedparenthood.org/lib.../Mif_fact.html

"Mifepristone, formerly known as RU-486, is an antiprogesterone drug that blocks receptors of progesterone, a key hormone in the establishment and maintenance of human pregnancy. Used in combination with a prostaglandin such as misoprostol, mifepristone induces abortion when administered in early pregnancy, providing women with a medical alternative to aspiration (suction) abortion."


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## RubyV (Feb 4, 2004)

http://www.plannedparenthood.org/lib...l/ecandma.html

Quote:

There is considerable public confusion about the difference between emergency contraception and medical abortion because of misinformation disseminated by anti-choice groups. Emergency contraception helps prevent pregnancy; medical abortion terminates pregnancy. According to general medical definitions of pregnancy that have been endorsed by many organizations including the American College of Obstetricians and Gynecologists and the United States Department of Health and Human Services, pregnancy begins when a pre-embryo completes implantation into the lining of the uterus (ACOG, 1998; DHHS, 1978; Hughes, 1972; "Make the Distinction&#8230;" 2001). Methods of contraception, including emergency contraception, prevent pregnancy by inhibiting ovulation, fertilization and/or implantation (ACOG, 1998). Medical abortion terminates a pregnancy without surgery. By helping women to prevent unplanned pregnancies after unprotected intercourse, emergency contraception has the great potential to decrease the rate of abortion. By helping women terminate unwanted pregnancies up to 63 days after their last menstruation, medical abortion is a safe and effective option.
this page give a detailed explaination.

HTH


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## menudo (May 21, 2002)

Someone I know called planned parenthood and she was told it is now a "120 hour" pill and they made an appointment for over a day or so later. She went-has anyone ever heard of this?


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## Greaseball (Feb 1, 2002)

I thought the MAP prevented implantation of a fertilized egg if taken within 72 hours, and RU486 could end a pregnancy up to 7 weeks along.


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## loving-my-babies (Apr 2, 2004)

just out of curiosity.. (I am super pro-life so I wouldn't ever do it) what happens if you take the abortion pill AFTER 7 weeks?


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## loving-my-babies (Apr 2, 2004)

and how do you get the abortion pill here in this country? (again, I'm pro-life so I'm not gonna, I want tons of kids so this is just because I am from another country and I am curious) and is it like super expensive to get? (is it legal?)


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## Greaseball (Feb 1, 2002)

I think a doctor has to precribe both of them. Although for the MAP, I hear you can get it from a county health dept while for RU 486 you have to see your own doc.

Even as a semi-pro-choice person, RU 486 just scares me. It's too new. And I know a lot of people who have taken MAP and some of them bled a lot for a long time.


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## Shonahsmom (Mar 23, 2004)

You can get it from Planned Parenthood and similiar providers. It is legal and costs range from $350-575.


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## Jane (May 15, 2002)

It's available at the usual clinics. The only places that can offer it also have to be able to do regular abortions as well, in case the pill doesn't work.

If it doesn't work, you are required to have a suction abortion. The aborficant is likely to have severely damaged the fetus.

It's a combo of a pill to kill the fetus and another one to start contractions. The first pill (I think) can be either the RU486 drug or different chemotherapy drug. After people fought to keep RU486 out of the US, it was all for not-much, because doctors could simply use the other medication for off-label use.
I'm still not sure if RU486 is sold in the US or if it's all the chemo drug, I've got my global info mixed up with my US info.

Not many people use it because it costs more than a regular (that's not the right word, abortions aren't regular, but Ican't think of another word) abortion, and you may end up having to pay for one of those too.
But the main benefit is that you get to be at home, in your own surroundings.
That could be seen as the main disadvantage, too, that you are taking care of yourself during the abortion. It's more personal, to my way of thinking.

_Edit: What they said above. I type slow._


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## TiredX2 (Jan 7, 2002)

The chances of the pill working after 7 weeks goes down. In one country (GB?) it is approved to 9 weeks. Up to 49 days there is an approximately 5% failure rate (so a surgical abortion would be provided at that point).

The costs of a pill abortion & a surgical abortion are similar ($200-400). They increase in cost after approximately 13 weeks ($400-700 for 13-16 weeks and then appx $100 for each additional week).

As for it being a cost issue, though:

Quote:

For each dollar spent by the government to pay for abortions for poor women, four dollars are saved in public medical and welfare expenditures resulting from an unplanned pregnancy carried to term.
http://www.princeton.edu/~owl/owlcall33.html


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## Shonahsmom (Mar 23, 2004)

Quote:


Originally Posted by *Apricot*

Not many people use it because it costs more than a regular (that's not the right word, abortions aren't regular, but Ican't think of another word) abortion, and you may end up having to pay for one of those too.

Three woman that I know have had abortions over the last year and all three chose the non-surgical method.


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## mthomas (Mar 20, 2004)

I thought RU486 wasnt available at all in the US - even for off-label use (or is it off-label use in the case of abortion?) . Seems like I remember reading an article a couple of years ago talking abt the use of RU486 and hormone driven cancers in women. That is was proving useful in European trails but that it still wasnt legal in the US b/c of the abortion use. Am I totally wrong or just out of date?


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## Shonahsmom (Mar 23, 2004)

Mifepristone (formerly known as RU486) was approved by the (FDA) in 2000 and is completely legal (atleast for now).


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## Jane (May 15, 2002)

Quote:


Originally Posted by *Shonahsmom*
Three woman that I know have had abortions over the last year and all three chose the non-surgical method.

Huh. The women I know were scared off by the price. It was going to be $300ish for the medical abortion, with a chance of another $300ish for the surgical abortion. They didn't have the cash for both. Maybe if they had insurance, it'd be different?

Surgical is the word I was looking for before, to replace "regular". Thanks.


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## CookieMonsterMommy (Oct 15, 2002)

RU 486 (medical abortion pill) is 100% legal in America. It is a combo of mifepristone (mifeprex)--one-three pills, and misoprostol (cytotec)2-4 pills taken either orally or inserted vaginally. The cytotec is taken 2 days after the mifeprex.
For example, mifeprex is taken on friday, cytotec taken on Sunday.

The mifeprex is an anti-progesterone, which means it simply blocks the use of the progesterone produced in a normal pregnancy to maintain the development of the zygote/embryo. When this is blocked, the zygote/embryo ceases developing. The cytotec--as many of us know--causes uterine contractions to expell the products of conception. Side effects most common for these two drugs are nausea, vomiting, and diarhhea.

The person must return to the office in order to have a sono and blood test to ensure that all the products of conception (incl. zygote/embryo and chorionic villi/placenta etc). If they are still there (all or partial), the practitioner (doctor/midwife/nurse practitioner) and woman will decide whether to administer cytotec or perform a suction abortion. If the 2nd round of cytotec does not "work", then a suction or D&C is performed.
It must be administered by someone with ability and access to surgical abortions (incl CNMs and NPs who work with an OB/GYN), again for the above reason.

After the 5th-7th week (depending on clinic/practitioner, not law), it becomes riskier because the implantation into the uterus is too deep and hemorrhage becomes a significant issue. Also, there is a much higher chance of the "products" being retained at this point in time, for the above mentioned reason, as well as the embryo's development--it does not rely as heavily on progesterone to continue developing.

It is usually not much more expensive than a surgical abortion, and many more women are choosing this "medical" abortion for the following reasons:
~No risk of perforation (A tool ripping the cervix, vagina or uterus)
~Much less risk of infection
~Non-invasive (no tools are used)
~Much more private (most places will let you take the cytotec at home and therefore "miscarry" either by themselves or with family/friends for moral support
~Feels more natural (see above)
~They can bury or see the products of conception if they wish.

Of course there are downfalls. Increased risk of hemorrhage (mostly because the woman is not being monitored...once found out, it can usually be corrected), the process is much longer (bleeding for 2-6weeks is average, much like the lochia after birth) and harder for some emotionally, it is more unpredicatable (as far as how much bleeding, for how long, and when the bleeding will start), and again, the price is higher, although some insurances and some Medicaid programs will pay for it (I know that in NY they do, not sure about any other state so that's a plus(or a minus, depending on your views)--although more insurences incl. medicaid may pay for a surgical but not medical abortion due to the usually slight cost difference,.

The morning after pill, or "Plan B" is, as someone before me stated, a higher dose of birth control pill hormones. What this does is brings on an early menses, therefore preventing the implantation of the potentially fertilized egg. (BTW-Most women who seek Plan B are not even within their regular ovulation window, and therefore most likely do not have an egg to fertilize in the 1st place, but as many see it-better safe than sorry)

Another big difference between the two is that Plan B is available by prescription at just about any pharmacy (although many mom and pop places choose not to dispense them due to their own beliefs--this can usually be avoided by the MW/MD/NP prescribing regular birth control pills and instructing the woman on how to take them). RU486, however, must be dispensed in the providers office. The Mifeprex is taken in the office with the provider present, the cytotec is given to the women at that visit to take home and she is told to take them in 2 days.

I'd have no problems using the morning after pill (never have tho), as I don't consider tihs abortion-I wouldn't think twice. If I decided to have an abortion for whatever reason, I would definately opt for the medical abortion.

Best Wishes,
Kelly


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## applejuice (Oct 8, 2002)

Is the morning after pill diethylstilbeterol? If it is, DES used to be a fattening hormone for cattle, but it is no longer used.'

The irony of using diethylstilbesterol for the morning after pill is that is used to be used to PREVENT miscarriages from 1938-1971 in pregnant women and their daughters had a rare form of vaginal cancer and adenosis. Diethylstilbesterol was also used to dry up breast milk by injecting it into the breasts of recently delivered women.

If I am right, is this explained to these women before they take it?


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## Kylix (May 3, 2002)

How much does the MAP cost? Just curious.


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## Missinnyc (Aug 21, 2003)

Quote:

"Is the morning after pill diethylstilbeterol? If it is, DES used to be a fattening hormone for cattle, but it is no longer used.'
No, I believe the MAP is just a couple of BC pills. I took it once (though I no longer agree with the use of BC, but that's another story), and the NP said it was just three (or 4, maybe) regular OTC BCP, plus an anti-nausea pill, so I wouldn't get sick and vomit them up.


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## wednesday (Apr 26, 2004)

RU-486 (medical abortion) is very similar in price to a surgical abortion. I went with my sister two years ago when she chose to have an abortion and I think the difference in price was maybe $25. Ultimately she chose to have a surgical abortion because the counseling and information we received made it seem like one's recovery is quicker with the surgical. She really needed to go back to work the next day. Whereas with RU-486 we were told she would have to stay home all day. The cramps and bleeding are said to be over faster with the surgical method.

Someone upthread mentioned insurance. I think it is very rare that any insurance plan covers elective abortion for non-medical reasons.

I may be mistaken but isn't RU-486 a good, non-invasive option for women who have an ectopic pregnancy?


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## loving-my-babies (Apr 2, 2004)

i was curious because there was a scandal in chile about this. it was banned out of the country. (both pills)


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## Shonahsmom (Mar 23, 2004)

The morning after pill is available for rape victims in Chile.

http://www.alertnet.org/thenews/newsdesk/N15113020.htm


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## loving-my-babies (Apr 2, 2004)

the morning after pill was banned. there is only limited access to it, for rape victims, but not for the general public. it's illegal for the general public. it reached congress but didn't make it through. and the abortion pill is not available, and the abortion pill is illegal as well.

BUT the morning after pill, it's ridiculous because they take mega-doses of birth control pills and it's the same thing. I can see why the abortion pill is illegal but not the day-after one.


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## cappuccinosmom (Dec 28, 2003)

It depends on how you define pregnancy. If the Chilean government defines pregnancy as beginning at conception, I guess they'd have a problem with both. But it is weird that the MAP is banned but the Pill is OK, since it has the potential to keep a pregnancy from implanting as well. (And it is both forms of the Pill. Even PP has that information on thier page about what the Pill does)


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## loving-my-babies (Apr 2, 2004)

Maggie... it's weird because the catholic church has an inmense influence on the chilean government. I am not sure when they think life begins, though.. I'll have to find that out.


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## mocha09 (Jul 6, 2003)

I got the morning after pill once. I just walked into a pharmacy and told the pharmacist I wanted it. Then I had to sign some sort of form to get it. (This was in Washington state, about four or five years ago.)

They were just BC pills, but I think I got 4(?) and had to take 2 then, and 2 sometime later. I think I want to say it was $70, but I'm not sure the cost. I definitely wasn't more than that.


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## TiredX2 (Jan 7, 2002)

You mean w/out a perscription?


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## Jane (May 15, 2002)

Another Washington state perk. No prescription neccesary for the morning-after-pill. Any pharmacist can dispense with only a filled out 1 page form.

Around UW, they are doing a trial with pharmacists prescribing BCP without a prescriptionl, again with a questionaire. I think it's 10+ Bartell's stores that are participating.


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## A&A (Apr 5, 2004)

Quote:


Originally Posted by *applejuice*
Is the morning after pill diethylstilbeterol? If it is, DES used to be a fattening hormone for cattle, but it is no longer used.'

The irony of using diethylstilbesterol for the morning after pill is that is used to be used to PREVENT miscarriages from 1938-1971 in pregnant women and their daughters had a rare form of vaginal cancer and adenosis. Diethylstilbesterol was also used to dry up breast milk by injecting it into the breasts of recently delivered women.

If I am right, is this explained to these women before they take it?


It's just a high dose birth control pill. (Containing estrogen and progesterone.) I heard you can do the same thing by taking 3 or 4 regular birth control pills at once.


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## A&A (Apr 5, 2004)

Quote:


Originally Posted by *Kylix*
How much does the MAP cost? Just curious.


About $30 at the health department.

But, for me, it came with a little lecture about, "you know you have to protect yourself better during sex, right?" Excuse me, I was having married sex with my dh, and the condom broke.

Anyway, Sprawlmart (Walmart) refuses to carry the morning-after-pill, effectively taking away this choice for many women in rural areas.


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## Ann-Marita (Sep 20, 2003)

Quote:


Originally Posted by *applejuice*
Is the morning after pill diethylstilbeterol?


No, it is not. It can be either combination pills, with both estrogen and progestin, or just progestin. Same ingredientes in regular birth control pills, different dose.


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## CookieMonsterMommy (Oct 15, 2002)

Some insurences do....reason? Abortions are cheaper than prenates and baby. Many insurences don't cover the pill either tho...these are the Catholic ones mainly (put it this way, I've never heard of a non-Catholic one with this stance). Yet they'll pay for Viagra....wonder if they make sure the guy is married (to a woman, lol) before covering the charge. I was always tought that a sin is a sin is a sin....










In my State --NY(maybe just my county, but I don't know), medicaid pays for abortions. They just started paying for RU 486 though. Not many tax payers know this, for which I am glad about and thankful of.







:

Best Wishes,
Kelly

PS-Yes, you can just take 3-4 BCPs in place of the "Plan B"...this is what many doctors prescribe this as, so that insurence will pay and it's much less likely that a pharmacy will refuse to fill the script.









PS-Yes, many of those who object to ALL abortions also object to The Pill and IUDs because they have the very real chance of preventing the implantation of a fertilized egg. (The non-hormonal IUD the most...preventing implantation is its main form of birth control...if the egg does implant, it also has a large chance of causing an early miscarriage). In my experience, however, this is explained to all patients, and is DEFINATELY in all the official literature for them to read.


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## Greaseball (Feb 1, 2002)

I wouldn't use an IUD because of the implantation issue (and because the thought of a metal thingie in my uterus creeps me out!) but I am OK with the minipill. I hear with an IUD you conceive and abort each month, while with the pill it's rare that you would actually ovulate.

But soon dh is going to get the operation and then we will be a whole new kind of sinner!


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## TiredX2 (Jan 7, 2002)

T

Quote:

Many insurences don't cover the pill either tho...these are the Catholic ones mainly (put it this way, I've never heard of a non-Catholic one with this stance). Yet they'll pay for Viagra....
Remember, if you have this problem it is generally *not* an issue w/the insurance company but with the purchaser of the plan. Most insurance companies will cover *anything* if the purchaser is willing to pay the cost.


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## CookieMonsterMommy (Oct 15, 2002)

Tired, I see what you're saying, but I worked as a medical assistant and you wouldn't believe how many women would say that their ins wouldn't pay for birth control pills, and the same ins would pay for viagra and such. AND they'd work for the same company! The insurence company it's self was CATHOLIC run and they did not believe in BCPs.

That's what sucks. Along with many other things.


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## TiredX2 (Jan 7, 2002)

Oh, I know







I'm just pointing out that if you (not personally, but in the general sense) are faced with that you should immediately complain to your HR person /benifits director and don't let up until BC is covered (since it IS cheaper to fund birth control than a pg!). The insurance company, meanwhile, will NEVER willingly change on this one
















Kay


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