Birth Control and Abortion: How They’re Different

Birth control and an abortion are different. Birth control prevents pregnancy from happening in the first place. An abortion ends an existing pregnancy.

“There is a huge difference,” says Sophia Yen, MD, clinical associate professor of pediatrics at Stanford Medical School. While one prevents pregnancy, the other terminates it.

The birth control process

Birth control prevents an egg and sperm from connecting and leading to pregnancy.

It works in several ways:

  • It stops ovulation, so you don’t release an egg.
  • It stops fertilization, so that a sperm does not reach and fertilize an egg.
  • It stops implantation, so a fertilized egg does not stick to the lining of your uterus.

The contraceptive pill, for example, prevents you from ovulating. It replaces your natural hormones giving you a steady flow of hormones to prevent ovulation. “If you take it correctly, no egg is released and no conception takes place,” says Tara Scott, MD, a gynecological surgeon at the Institute of Gynecology in Chicago.

Hormonal birth control, like a hormonal IUD, works by thickening your cervical mucus so that it is as if cement and semen cannot get into your uterus. A copper IUD prevents sperm from reaching an egg because copper is toxic, so the sperm bypasses your uterus.

“Others work by thinning the lining of your uterus, so if the egg and sperm connect, the embryo cannot adhere to the lining,” Yen explains. If it can’t stick to the liner, also called implantation, it can’t get the nutrients it needs to thrive.

The abortion process

An abortion is a medical procedure. It’s done after three things:

  • A sperm fertilizes an egg.
  • The embryo implants itself in the lining of your uterus.
  • Your body begins to make human chorionic gonadotropin (hCG), which is the hormone that pregnancy tests look for.

There are two types of abortion: a surgical abortion and a medical abortion. “To end the pregnancy, you have to scrape the implanted embryo or shed the lining of your uterus,” says Yen.

During a surgical abortion, doctors remove the embryo from your uterus. With a medical abortion, you take a pill that causes your uterus to contract and lose its lining and embryo.

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Emergency contraception

Emergency contraception is a type of birth control, not an abortion. “It disrupts ovulation or stops fertilization of the egg that has already been released. It does not cause an abortion of an already fertilized egg, ”says Nicole Williams, MD, gynecological surgeon at the Gynecology Institute in Chicago.

Pills like Plan B and Ella, which prevent sperm from reaching and fertilizing an egg, are a type of emergency contraception. You can also use a copper IUD as emergency contraception by preventing sperm and egg from connecting, fertilizing, and implanting in the uterus.

How birth control affects your body

Birth control has certain risks and disadvantages, as well as benefits.

“Birth control stops your hormone production,” Scott says. It may take a while for hormones to be produced after stopping.

Some studies suggest that you may have a higher risk of cervical and breast cancer the longer you stay on the birth control pill. The estrogen in combination hormonal contraceptives like the pill, patch, and ring can also increase the risk of breast cancer and blood clots.

On the other hand, the pill, patch and ring can prevent endometrial, ovarian and colorectal cancer.

The effects of an abortion on your body

A surgical abortion carries risks associated with surgery. You may have bleeding, infection, damage to your uterus, or risks associated with the anesthesia.

With a medical abortion, the risks include incomplete abortion, bleeding, infections, fever, nausea, vomiting, chills, diarrhea, and headache.

An abortion can also have short-term psychological effects, such as mixed emotions, relief, loss, sadness, and guilt. “It may also take a month or two for your body to return to your pre-pregnancy state,” Scott says.

Research shows that the long-term risks of abortion are low. Studies also show that abortion is unlikely to lead to fertility problems, breast cancer, mental health problems, or other problems.

But you may have a higher risk of a preterm birth if you have had two or more abortions before giving birth for the first time, or if you become pregnant within 6 months of having an abortion.

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How much do they cost?

It can vary, but the cost of birth control is different from the cost of an abortion. “A surgical abortion can cost thousands of dollars,” says Williams. “Birth control, if covered by insurance, can cost a few dollars a month or even free.”

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Sources

SOURCES:

Sophia Yen, MD, MPH, Pandia Health.

Guttmacher Institute: “Contraception is not an abortion: the strategic campaign of anti-abortion groups to persuade the public otherwise.”

Tara Scott, MD, Institute of Gynecology of Chicago, Ltd.

Nicole E. Williams, MD, Institute of Gynecology of Chicago, Ltd.

American College of Obstetricians and Gynecologists: “Access to Contraception”.

Mayo Clinic: “Medical abortion”.

The National Academies of Science, Engineering and Medicine: “The Safety and Quality of Abortion Care in the United States (2018)”.


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