In a season four Black Mirror episode, one character (it isn’t a spoiler if I don’t say who, right?) attempts to end another’s pregnancy with emergency contraception in her breakfast smoothie. Folks, EC and abortion pills are two totally different things.
Let’s go through this chronologically. If you have a functioning uterus and ovaries, your body embarks on a weeks-long project each month to mature and release (usually) a single egg cell. If sperm is present when the egg is released, the two cells can unite and then you’re on the road toward having a baby.
You don’t get pregnant the moment you have sex. Sex is just the step where you collect sperm for future use. Hours to days later the sperm are still alive, hanging out in the fallopian tubes, and can fertilise the egg if they’re lucky enough to be present when the egg is released.
As the uterus owner, if you wish to not get pregnant, you have many options for birth control, including condoms and IUDs. But since there seems to be some confusion over which pills do what, these are the pills that can make you not be pregnant:
- Oral contraceptive pills: You take these before you have sex, once per day. The pills contain either progestin or a combination of oestrogen and progestin. These hormones act in different ways but both result in the egg not being released, so sperm and egg will never meet. Oral contraceptive pills require a prescription.
Emergency contraception (EC): You take these immediately after you have sex, if you had not previously been taking oral contraceptives. Perhaps you were counting on using a condom, but it broke or slipped off or you just plain forgot. Or maybe you were raped or were the victim of stealthing.
EC is a massive dose of oral contraceptives, and it’s a last-ditch attempt to stop an egg from being released. Most forms of EC are 95 per cent effective if you take them in the first 24 hours after sex, with effectiveness dropping off pretty quickly in the next few days. The sooner the better, so definitely don’t wait until breakfast time to put the pills in your smoothie; you’re racing the clock.
Fortunately, EC is available over-the-counter. If it’s not available in your area, there are services that will express-ship the pills.
Medication abortion: These are the only pills that can end a pregnancy if you’re already pregnant. At this point, you aren’t taking a “morning after” pill; it’s an abortion.
In the Australia, you’ll have to visit a professional, perhaps at a clinic, and you’ll have to have some medical tests done. You'll also have to have a consultation with a doctor to obtain your informed consent to end the pregnancy.
Typically you take the pills in two doses: Mifepristone first, then misoprostol a day or two later. Medication abortion is usually an option during the first nine weeks of the pregnancy.
Unfortunately, spiking somebody’s drink with abortion pills is a real thing. A woman had her 17-week pregnancy tragically ended against her will when her doctor boyfriend served her tea with a massive dose of misoprostol.
So if you’re writing some dystopian fiction — or anything, really — take note. Emergency contraception is just what it sounds like: Contraception that you have to take right away before fertilisation occurs. And medication abortion is an abortion achieved by taking medication. If you’re already pregnant, only the second one of those will do anything.