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The Texas Abortion Ban Has Led To Confusion Over Access To Emergency Contraception, And Experts Are Worried

“It is reopening a wound of realizing there's a movement that does not believe in reproductive autonomy,” one advocate said.

Posted on September 10, 2021, at 1:01 p.m. ET

Carlos Kosienski / Sipa USA via AP

People attend an abortion access rally in front of the San Pedro Playhouse in San Antonio, Texas, on Sept. 1, 2021.

Within days of Texas implementing its 6-week abortion ban, fears arose over how the law might affect access to emergency contraception. It doesn't. But how the ban might affect other elements of reproductive health are concerning experts who say they already have to fight misinformation to ensure people know their options.

The recent law, SB 8, bans nearly all abortions after fetal cardiac activity can be detected, usually around the 6th week of a pregnancy. It does not concern emergency contraceptives such as Plan B, also known as the “morning-after pill,” which was approved for over-the-counter sale by the FDA in 2013. But as often happens, confusion over what the law does and doesn’t do has been percolating social media.

“So, can Texas women still take the Plan B pill (morning after pill) if they had unprotected sex or any sex with birth control that is not 100% effective? #TexasWarOnWomen #TexasAbortionLaw,” @meggal asked on Twitter.

In another reaction, @libdrama1 asked how access to over-the-counter emergency contraception pills could be threatened in Texas and what SB 8 could mean for medical providers.

“SB 8 is designed to instill fear and confusion about accessing reproductive healthcare services, so it’s no surprise people are confused about whether it affects access to emergency contraception or basic contraceptive methods,” said Elisa Wells, cofounder and director of Plan C, a website that provides information on medication abortion and how it differs from other reproductive health methods.

She added it’s understandable how the turn of events in Texas has prompted people to question how SB 8 applies to the morning-after pill, despite the fact that emergency contraception is not going anywhere and remains available in the state.

Elise Amendola / AP

A pharmacist holds a generic emergency contraceptive, also called the morning-after pill.

The ensuing confusion is a “deliberate” campaign from proponents of laws like SB 8 to stir hesitancy about all forms of reproductive healthcare, Wells added.

Tracey Wilkinson, a board member at Physicians for Reproductive Health, told BuzzFeed News that Americans have always been confused about the difference between medication abortion and emergency contraception pills. And many don’t even know government-approved medication abortion is an option — only 20% of US adults and one-third of women between the ages of 18 and 49 have ever heard of the abortion pill mifepristone, according to the Kaiser Family Foundation.

A reason for the confusion is that both emergency contraception and abortion pills came to the United States around the same time in the 1990s, Wilkinson said. Their entry to the reproductive field caused a “messy” conflation and confusion despite the fact that the drugs “work in completely different ways,” she said.

Medication abortion is an FDA-approved two-step pill protocol that works within the first 11 weeks of pregnancy by blocking a hormone that’s needed for pregnancy to continue. FDA-approved emergency contraception involves using a hormone that prevents pregnancy from occurring in the days immediately following having sex.

Plan B and other morning-after pills work as an extra layer of security for people who are concerned they could become pregnant by preventing the release of the egg. The $40–$50 pill contains a hormone that can lower the chance of getting pregnant by 75%–89% within three days after sex, but can be taken up to five days after.

“Many people use the term ‘morning after pill’ to refer to emergency contraception, a term that is also occasionally used in reference to the abortion pill,” Foundation Consumer Healthcare, the maker of Plan B, said in a statement. “This reference, and other misinformation about Plan B — including misnomers that incorrectly indicate how Plan B works — can cause significant confusion and conflates the issue."

But construing contraception as abortion has been a longtime issue for the reproductive rights community, Lauren Cross, a spokesperson for the Guttmacher Institute, told BuzzFeed News. Some anti-abortion groups maintain that certain contraception methods constitute abortion and assert that emergency contraception ends, rather than prevents, pregnancy.

Wilkinson said it’s obvious the current situation belongs to a “bigger conversation” that’s more about reproductive autonomy than the single issue of abortion itself. Instead, the debate over abortion rights has broadened to include other elements of reproductive health, such as contraception, she said, adding, “It breaks my heart.”

Plan B was approved in 1999 as the first single-hormone emergency contraception in the country, but it took over a decade of political battles before the pill became available over the counter in pharmacies.

Today, the emergency contraceptive pill is still available without an ID or prescription in pharmacies across Texas and all other US states, according to Foundation Consumer Healthcare.

But abortion clinics in Texas are now under SB 8’s power, and these are often the same places that provide morning-after pills. If these resources shutter as a result of the law, more people will struggle to access birth control, STI treatment, and other forms of care, Wilkinson said. She added that this will disproportionately impact people of color and LGBTQ people who already face higher barriers to safe and affordable treatment.

The medical community is also not immune to misinformation, she said.

“You’re pushing people toward providers who are maybe not as aware or impacted by this law and might have a greater likelihood of misinformation,” Wilkinson said.

This is one of many “downstream” effects SB 8 will have on reproductive rights — as affordable venues for emergency contraception close, people may be forced to pay full price or even forgo taking the drug, she added.

“The unfortunate side effect is the trickling down to all contraception,” Wilkinson said. “It is reopening a wound of realizing there's a movement that does not believe in reproductive autonomy. The silencing impact that’s happening against all reproductive health topics … will have huge impacts on life outcomes.”

A BuzzFeed News investigation, in partnership with the International Consortium of Investigative Journalists, based on thousands of documents the government didn't want you to see.