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: Google searches for Plan B pills surged as people fear future of abortion rights. But will the ‘morning-after pill’ be enough in a post-Roe world?

People were rushing to Google
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to check the status on emergency contraception pills after a leaked U.S. Supreme Court draft opinion signaled the court would reverse the landmark decision Roe v. Wade. 

The Supreme Court said Tuesday that the leaked draft, published by Politico late Monday night, was authentic but didn’t represent members’ final opinions. If Roe is overturned, the legality of abortion would be left up to states to decide. 

In the 24 hours following the leak, Google searches for Plan B — the most widely available emergency contraception brand — and its shelf life had grown more than 5,000%. As of Wednesday morning, searches for “Is Plan B going to be illegal” were up 1,500%. 

Searches for other contraceptives such as Ella, a similar pill that can be taken up to five days after unprotected sex, also surged on Tuesday evening and Wednesday morning on Google, but they weren’t as high in volume as searches for Plan B.

Walgreens
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,
Amazon
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and Walmart
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didn’t immediately return MarketWatch requests for comment on whether they had seen a surge in Plan B sales after the Supreme Court leak. CVS
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said it didn’t have any updates to share on sales, but added “emergency contraception continues to be available at CVS Pharmacy locations.” Foundation Consumer Healthcare (FCH), the maker of Plan B One-Step, said it does not comment on sales.

“Different from abortion pills that aim to end a pregnancy, Plan B works to prevent pregnancy before it happens. ”

Different from abortion pills that aim to end a pregnancy, Plan B works to prevent pregnancy before it happens. It can lower the chance of getting pregnant by up to 87% when the person takes it within 72 hours of having unprotected sex. With a shelf life of four years, it is widely available in local pharmacies and drugstores, as well as on online retailers such as Amazon. 

Plan B, also known as the morning-after pill, stands out for its relative ease of access to patients over the counter. It’s available without a prescription to people of all ages.  

The interest in the contraceptive pill came as supporters of abortion rights expressed outrage online and in protests in front of the Supreme Court, while many conservative politicians focused their criticism on the draft decision being made public.

As Democratic lawmakers condemned the plan, many people feared that restrictions on birth control and contraception could be next in line, as several conservative states already have varying restrictions in place on abortion pills such as Mifepristone, which was approved by the Food and Drug Administration in 2000.

At the moment, although Plan B One-Step is FDA-approved to sell over-the-counter across the country, several states allow pharmacists to refuse to dispense emergency contraception, such as Georgia and Arizona.

Dr. Selina Sandoval, a practicing obstetrician-gynecologist based in California and a fellow of Physicians for Reproductive Health, said the affordability of contraceptive options largely depends on a person’s healthcare coverage.

A single pack of Plan B costs almost $50 on Amazon, around the same price range as Ella. Although the Affordable Care Act requires most private health plans to cover IUDs without a co-pay, they can cost up to $1,300 without insurance coverage. 

Affordability would not be the only issue. One 2021 article in the Journal of Health Politics, Policy and Law found that a sizable share of each state’s population, ranging from 17% to 53%, lives in “contraception deserts.” The main reason behind is inadequate funding for family planning and the state failing to fully implement Title X, the only federal policy aimed at reproductive health care.

The barrier to getting contraceptives is the same as the barrier to abortion access, Sandoval said. The groups mostly affected by it will be Black and brown women, women in poverty and the LGBTQ+ community. 

Even used correctly, Sandoval also noted that emergency contraceptives have their limits — they only work for people who know that they had unprotected sex the night before, and many women are not aware. The potential failures of contraceptive methods can include condom failures and incorrect use of daily contraceptive pills — and that’s why all kinds of care options, including abortion, are needed, she said.

While search trends suggested a surge of interest in Plan B, the pill also has a weight limit that does not cater to most of the American population. 

Sandoval said the efficacy rates of Plan B drops with people who weigh more than 150 pounds, “which are the vast majority of patients I see,” she said. The average body weight for women in the U.S. is 170.8 pounds, according to data from the U.S. Centers for Disease Control and Prevention. 

Over the years, the effective rate of Plan B pills in relation to body mass index (BMI) and weight is much debated. FDA addressed the concern in 2016 regarding the populations over 165 pounds or with a BMI higher than 25 kg/m2 by doing a data review. In the end it decided “these data are conflicting and too limited to make a definitive conclusion.”

Jessica Shepherd, MD, a gynecologist based in Dallas, told Women’s Health that it’s generally recommended that people go ahead and take Plan B regardless of their weight or BMI. However, the effectiveness might drop.

There are other contraceptives that are more lax regarding body weights. Ella works in a similar manner to Plan B and works well for people with higher body weight, but also it suggests a cap at 195 pounds. An IUD, short for intrauterine device, is a small device inserted into the uterus and works regardless of body weight.

Neither of those options is as easy to access as Plan B: Ella requires a prescription, and an IUD often involves two visits to a healthcare provider. 

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