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INTRODUCTION

Emergency contraception is a way to lower the risk of pregnancy after unprotected sex. It does not end a pregnancy that has already started.

Emergency contraception is intended for occasional use, not as a primary form of birth control. More information about different birth control options is available separately. (See "Patient education: Birth control; which method is right for me? (Beyond the Basics)" and "Patient education: Hormonal methods of birth control (Beyond the Basics)" and "Patient education: Barrier and pericoital methods of birth control (Beyond the Basics)" and "Patient education: Long-acting methods of birth control (Beyond the Basics)" .)

WHEN TO USE EMERGENCY CONTRACEPTION

You might choose emergency contraception if:

● You had unprotected vaginal sex any time within the last five days (120 hours).

● You used your regular method of birth control incorrectly, or your regular method of birth control might have failed within the last five days (120 hours). Reasons why a regular method of birth control could fail include:

• A condom breaks, slips off, or is not used the whole time you are having sex.

• You normally take birth control pills containing both estrogen and progestin but forgot to take your pills two or more days in a row.

• You normally take birth control pills containing just progestin (called the "minipill") and took your pill more than three hours late.

• You normally use injections of depot-medroxyprogesterone acetate (brand name: Depo-Provera) but are more than two weeks late for your injection (some providers recommend emergency contraception only if you are more than four weeks late).

• A diaphragm or cervical cap moves, breaks, tears, or is removed too soon.

• A birth control skin patch comes off, is removed too early, or is put on too late.

• A birth control vaginal ring comes out, is removed too early, or is inserted too late.

• Your partner does not "pull out" or withdraw in time and ejaculates inside your vagina or on your genitals.

• A spermicidal (sperm-killing) tablet or film fails to melt before sex.

• You use the "rhythm method" and made a mistake figuring out the "safe time" in your cycle, or you have sex during your "fertile window" (days when you are more likely to conceive).

• An intrauterine device (IUD) accidentally comes out.

Emergency contraception can also be used after sexual assault, in cases when a person was forced to have unprotected sex against their will. (See "Patient education: Care after sexual assault (Beyond the Basics)" .)

Is emergency contraception safe?  —  Yes, the different types of emergency contraception are safe in most people. IUDs can be used by most people. The pills used in hormonal emergency contraception contain the same hormones found in hormonal birth control methods (birth control pills, skin patches, vaginal rings, and certain IUDs). These hormones have been used safely for years.

Even people who cannot use estrogen-containing hormonal birth control as their primary method of contraception (such as those age >35 years who smoke or those with a history of heart attack, stroke, clotting disorders, migraine headaches, or liver disease, or who are breastfeeding) can use emergency contraception because the hormones are taken for only one day.

Some types of emergency contraception do not contain any hormones. These types are the copper IUD and a pill containing ulipristal acetate.

HOW EMERGENCY CONTRACEPTION WORKS

The main way that emergency contraception pills work is by preventing ovulation (release of the egg from the ovary). Ulipristal acetate (ella) does this a little later in the menstrual cycle (closer to the time of ovulation) compared with oral levonorgestrel (Plan B); this may explain its slightly higher efficacy. (See 'How well does emergency contraception work?' below.)

All methods of emergency contraception work by reducing the chance that an egg will be fertilized by sperm. Intrauterine devices (IUDs), and to a lesser extent ulipristal acetate, may also reduce the chance that a fertilized egg will implant and begin a pregnancy.

Emergency contraception cannot reverse a pregnancy that has already started. In other words, if a fertilized egg has already implanted itself in the uterus, emergency contraception will not interfere with or harm the pregnancy. Emergency contraception is not the same as medication abortion (sometimes called the "abortion pill"), which contains different medications.

TYPES OF EMERGENCY CONTRACEPTION

There are two main types of emergency contraception, and each is discussed below.

IUD  —  An intrauterine device (IUD) can also be used for emergency contraception. There are two types of IUDs:

● Copper-containing IUD (brand name: Paragard).

● IUDs that release the hormone progestin (this only applies to IUDs that contain 52 mg of levonorgestrel; brand names: Mirena, Liletta).

An IUD must be inserted into the uterus by a health care provider. While IUDs are much more effective at preventing pregnancy than the pill methods, they do require an office visit and may be more costly in the short-term. They are a good choice for people who want an ongoing method of birth control. (See "Patient education: Long-acting methods of birth control (Beyond the Basics)" .)

Pills  —  Oral emergency contraception involves the use of pills that either contain hormones or interfere with hormones.

Ulipristal acetate  —  Ulipristal acetate (brand name: ella, ellaOne) is not a hormone, but it works by preventing the hormone progesterone from having its normal effect on ovulation and the inside of the uterus. Ulipristal acetate comes in a single-dose pill and is available only by prescription.

Levonorgestrel  —  Levonorgestrel is a synthetic hormone. This type of emergency contraception (sample brand names: Plan B One-Step, Next Choice One Dose) is available without a prescription at many drug stores and at clinics like Planned Parenthood. Levonorgestrel can be given as one pill or two, depending on the dose. Which type is available depends on where you are. Be sure to read the instructions carefully to make sure you know how many pills to take and when.

Mifepristone  —  This medication is available for emergency contraception in some countries, although not in the United States. The dose used for emergency contraception is much lower than that used for medication abortion (eg, 10 mg versus 200 mg).

Birth control pills  —  Regular birth control pills can also be used as emergency contraception. This does not work as well as the other methods and is more likely to cause nausea (see 'Side effects of emergency contraception' below), but it might be a good option in some situations.

If you use birth control pills for emergency contraception, you have to take more than one pill at a time, and a second dose 12 hours after the first. The table tells you which birth control pills you can use for emergency contraception, which color pills to take, and how many ( table 1 ). Birth control pills require a prescription in the United States. Talk to your health care provider to make sure you are taking the correct pills and dose.

HOW WELL DOES EMERGENCY CONTRACEPTION WORK?

Intrauterine devices (IUDs) are more effective than pills, and the copper IUD is the most effective form of emergency contraception. Both the copper and hormonal IUDs prevent more than 99 percent of pregnancies when inserted within five days of unprotected sex. If you weigh 165 pounds (75 kilograms) or more, you might want to consider an IUD instead of pills. Both types of IUDs work very well to prevent pregnancy regardless of body weight.

If you choose pills for emergency contraception, several different things can affect how well they work, including how soon you take the pills after sex, where you are in your menstrual cycle, how many times you had unprotected sex, and how much you weigh. In general, the sooner you take the pills after unprotected sex, the better they work. When used within three days (72 hours) of unprotected sex:

● Ulipristal acetate – After taking ulipristal acetate (brand name: ella, ellaOne), the risk of pregnancy is 1 to 2 percent. This means that 1 to 2 people out of 100 who use this type will get pregnant anyway.

● Levonorgestrel – After taking levonorgestrel (sample brand names: Plan B One-Step, Next Choice One Dose), the risk of pregnancy ranges from 1 to 7 percent. This means that 1 to 7 people out of 100 who use this type will get pregnant anyway.

● Mifepristone – Mifepristone is as effective as levonorgestrel in preventing pregnancy. This method is only available in select countries and is not available in the United States.

● Birth control pills – Taking a combination of birth control pills will lower the risk of pregnancy, but it is less effective than other methods.

WHERE TO GET EMERGENCY CONTRACEPTION

Over-the-counter  —  In the United States, you can buy levonorgestrel (sample brand names: Plan B One-Step, Next Choice One Dose) without a prescription from a pharmacy or clinic. A person of any age can purchase levonorgestrel, and you do not need to show an ID.

Even though emergency contraception may be available without a prescription, it is not always easy to get to a pharmacy when you need to take the pills. Also, not all pharmacies carry the medications or make them easily available on the shelf. As a result, if you choose not to get an intrauterine device (IUD) or another long-term form of birth control, it is a good idea to buy emergency contraception pills to keep on hand in case you need them in the future. If you do this, check periodically to make sure the medication has not expired.

Prescription required  —  Ulipristal acetate (brand names: ella, ellaOne) and standard birth control pills (estrogen and progestin) require a prescription, regardless of age. An IUD must be placed by a health care provider.

Online access  —  If you need emergency contraception, it is a good idea to talk with your health care provider about your options, if possible. However, in some areas, you can get emergency contraception (including ulipristal acetate and levonorgestrel) through online services such as PRJKT RUBY (www.prjktruby.com/emergency-contraception) and Nurx (www.nurx.com).

HOW TO TAKE EMERGENCY CONTRACEPTION

You do not need to have a physical examination or any laboratory tests to take over-the-counter emergency contraception. However, if you need emergency contraception because you were sexually assaulted, you should seek the help of a counselor or other health care professional. A doctor should rule out pregnancy by taking your medical history, doing a physical examination, and/or ordering laboratory testing before giving you a prescription for emergency contraception. (See "Patient education: Care after sexual assault (Beyond the Basics)" .)

Timing  —  You can take emergency contraception pills any time during your menstrual cycle. It does not matter when you had your last period.

● Ulipristal acetate is effective up to five days (120 hours) after unprotected sex.

● Both the levonorgestrel pills and estrogen-progestin pills are most effective when taken as soon as possible after unprotected sex, ideally within three days (72 hours). You can take them up to five days (120 hours) after sex, although they become less effective as more time goes by.

● The intrauterine device (IUD) can also be inserted up to five days (120 hours) after unprotected sex, and is possibly as effective if inserted beyond this time period.

Emergency contraception medication and dose

IUD  —  The best way to prevent pregnancy after unprotected sex is to have an IUD inserted. While there are over 35 studies showing that the copper IUD is the most effective method for emergency contraception, a new study showed that the hormonal IUD is also highly effective. This is a good choice if you would like to leave the IUD in place and use it as your ongoing method of birth control. IUDs are discussed in detail separately. (See "Patient education: Long-acting methods of birth control (Beyond the Basics)" .)

Levonorgestrel  —  Levonorgestrel is a hormone. This type of emergency contraception (sample brand names: Plan B One-Step, Next Choice One Dose) is available without a prescription at many drug stores and at clinics like Planned Parenthood. Depending on the brand and dose, you might need to take one pill or two. Be sure to read the instructions carefully to make sure you know how many pills to take and when.

Ulipristal acetate  —  Ulipristal acetate comes (by prescription) in the form of a single 30 mg tablet.

Birth control pills  —  No estrogen-progestin pill is available in pill packets specifically for emergency contraception. However, many birth control pills contain these two hormones. The table provides information on which birth control pills you can take as emergency contraception and how many pills to take for each dose ( table 1 ).

Side effects of emergency contraception  —  Nausea and vomiting are the most common side effects of emergency contraception pills. This is more likely with birth control pills than with ulipristal acetate and levonorgestrel. The IUDs can cause cramping and spotting at the time of insertion. These symptoms are usually mild and go away in one or two days.

Preventing nausea and vomiting  —  If you are worried about developing nausea and vomiting, you can take a medication to prevent these side effects:

● Meclizine (sample brand names: Antivert, Bonine, Dramamine) is a nonprescription medication that helps prevent nausea and vomiting. If you use one of these medications, be sure to follow the dosing instructions on the box or bottle.

● Metoclopramide (brand name: Reglan) is another medication that helps prevent nausea and vomiting, but you will need to get a prescription for it from your health care provider.

What to do if you vomit  —  If you throw up less than one hour after taking birth control pills for emergency contraception, you will need to take them again.

WHAT TO EXPECT AFTER TAKING EMERGENCY CONTRACEPTION

When will I get my period again?  —  You should get your period within about one week of when you would normally expect it. If you took ulipristal acetate, do not be surprised if your period is a few days late; this is normal. But, if you do not have a normal period within three or four weeks, no matter which form of emergency contraception you took, you should take a home pregnancy test. If the test is negative, wait for your period for one more week. If you still have not had a period by this time, call your health care provider for further instructions. If the test is positive and you are pregnant, your provider can talk to you about your options and what to do next. If you are bleeding more than a normal period or have abdominal pain in your belly, you should also see your provider.

Birth control  —  If you have unprotected sex again after you take emergency contraception pills, you could get pregnant. Be sure to use some form of birth control until you get your period. The highest risk of pregnancy is for people who have additional unprotected sex in the same month after using oral emergency contraception pills. This is not an issue if you had an intrauterine device (IUD) inserted for emergency contraception, as it will provide ongoing birth control for as long as you have it in.

If you normally use birth control pills, a patch, or a vaginal ring, but you missed some doses, you should resume those methods the day after taking emergency contraception, although you will need to use a backup form of birth control (such as condoms) for at least seven days. However, if you took ulipristal acetate and you normally use birth control pills, wait at least five days before starting your regular pills again if you missed more than two days of pills. This is because ulipristal acetate can interfere with the way birth control pills work. If you missed only one or two days, then restart your birth control pills right away. Even after you start taking your pills again, you should still use a condom every time you have sex until your next period. (See "Patient education: Hormonal methods of birth control (Beyond the Basics)" .)

If you normally use condoms, a diaphragm, or a cervical cap, go back to using those methods right away. (See "Patient education: Barrier and pericoital methods of birth control (Beyond the Basics)" .)

If you have unprotected sex again, you can take emergency contraception again.

WHERE TO GET MORE INFORMATION

Your health care provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our website ( www.uptodate.com/patients ). Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.

Patient level information  —  UpToDate offers two types of patient education materials.

The Basics  —  The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Emergency contraception (The Basics) Patient education: Care after sexual assault (The Basics) Patient education: Hormonal birth control (The Basics) Patient education: Barrier methods of birth control (The Basics) Patient education: Intrauterine devices (IUDs) (The Basics) Patient education: IUD insertion (The Basics) Patient education: IUD removal (The Basics)

Beyond the Basics  —  Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: Barrier and pericoital methods of birth control (Beyond the Basics) Patient education: Hormonal methods of birth control (Beyond the Basics) Patient education: Long-acting methods of birth control (Beyond the Basics) Patient education: Permanent birth control for females (Beyond the Basics) Patient education: Vasectomy (Beyond the Basics) Patient education: Care after sexual assault (Beyond the Basics)

Professional level information  —  Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Intrauterine contraception: Candidates and device selection Contraception: Issues specific to adolescents Emergency contraception Evaluation and management of adult and adolescent sexual assault victims in the emergency department

The following organizations also provide reliable health information.

● National Library of Medicine

( https://medlineplus.gov/healthtopics.html )

● National Institute of Child Health and Human Development (NICHD)

Toll-free: (800) 370-2943

( www.nichd.nih.gov )

● National Women's Health Resource Center (NWHRC)

Toll-free: (877) 986-9472

( www.healthywomen.org )

● Planned Parenthood Federation of America

Phone: (212) 541-7800

( www.plannedparenthood.org )

● The Hormone Foundation

( www.hormone.org )

• Patient Care & Health Information
• Tests & Procedures
• Morning-after pill

• Plan B One-Step

Plan B One-Step is a type of morning-after pill that can be used after unprotected sex to prevent pregnancy. Plan B One-Step contains the hormone levonorgestrel — a progestin — which can prevent ovulation, block fertilization or keep a fertilized egg from implanting in the uterus.

The morning-after pill is a type of emergency birth control (contraception). Emergency contraception is used to prevent pregnancy for women who've had unprotected sex or whose birth control method has failed.

The morning-after pill is intended for backup contraception only, not as a primary method of birth control. Morning-after pills contain either levonorgestrel (Plan B One-Step) or ulipristal acetate (ella).

Levonorgestrel is available over-the-counter without a prescription; ulipristal acetate is available only with a prescription.

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• A Book: Mayo Clinic Guide to a Healthy Pregnancy

Why it's done

Morning-after pills can help prevent pregnancy if you've had unprotected sex — either because you didn't use birth control, you missed a birth control pill, you were sexually assaulted or your method of birth control failed.

Morning-after pills do not end a pregnancy that has implanted. They work primarily by delaying or preventing ovulation.

Keep in mind that the morning-after pill isn't the same as mifepristone (Mifeprex), also known as RU-486 or the abortion pill. This drug terminates an established pregnancy — one in which the fertilized egg has attached to the uterine wall and has begun to develop.

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Emergency contraception is an effective option for preventing pregnancy after unprotected sex, but it isn't as effective as other methods of contraception and isn't recommended for routine use. Also, the morning-after pill can fail even with correct use, and it offers no protection against sexually transmitted infections.

The morning-after pill isn't appropriate for everyone. Don't take a morning-after pill if:

• You're allergic to any component of the morning-after pill
• You're taking certain medications that can decrease the effectiveness of the morning-after pill, such as barbiturates or St. John's wort

If you're overweight or obese, there's some indication that the morning-after pill won't be as effective in preventing pregnancy as it is for women who aren't overweight.

Also, make sure you're not pregnant before using ulipristal. The effects of ulipristal on a developing baby are unknown. If you're breast-feeding, ulipristal isn't recommended.

Side effects of the morning-after pill, which typically last only a few days, might include:

• Nausea or vomiting
• Breast tenderness
• Bleeding between periods or heavier menstrual bleeding
• Lower abdominal pain or cramps

How you prepare

For maximum effectiveness, emergency contraception should be started as soon as possible after unprotected intercourse, and within 120 hours. You can take emergency contraceptive pills anytime during your menstrual cycle.

What you can expect

To use the morning-after pill:

• Follow the morning-after pill's instructions. If you use Plan B One-Step, take one Plan B One-Step pill as soon as possible and less than 72 hours after unprotected sex. If you use ella, take one ella pill as soon as possible and less than 120 hours after unprotected sex.
• If you vomit within two hours after taking the morning-after pill, ask your health care provider if you should take another dose.
• Don't have sex until you start another method of birth control. The morning-after pill doesn't offer lasting protection from pregnancy. If you have unprotected sex in the days and weeks after taking the morning-after pill, you're at risk of becoming pregnant. Be sure to begin using or resume use of birth control.

Using the morning-after pill may delay your period by up to one week. If you don't get your period within three to four weeks of taking the morning-after pill, take a pregnancy test.

Normally, you don't need to contact your health care provider after using the morning-after pill. However, if you have bleeding or spotting that lasts longer than a week or develop severe lower abdominal pain three to five weeks after taking the morning-after pill, contact him or her. These can indicate a miscarriage or that the fertilized egg has implanted outside the uterus, usually in a fallopian tube (ectopic pregnancy).

• Kaunitz AM. Emergency contraception. https://www.uptodate.com/contents/search. Accessed March 29, 2018.
• American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin #152: Emergency contraception. Obstetrics & Gynecology. 2015;126:e1.
• Frequently asked questions. Contraception FAQ114. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Emergency-Contraception. Accessed March, 29, 2018.
• Emergency contraception. The National Women's Health Information Center. https://www.womenshealth.gov/a-z-topics/emergency-contraception. Accessed March 29, 2018.
• Ella (prescribing information). Parsippany, N.J.: Watson Pharma Inc.; 2014. http://pi.watson.com/data_stream.asp?product_group=1699&p=pi&language=E. Accessed March 29, 2018.

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

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Plan B One-Step (1.5 mg levonorgestrel) Information

Plan B One-Step is an emergency contraceptive, a backup method of birth control. Emergency contraception is used to reduce the chance of pregnancy after unprotected sex (if other birth control failed or was not used). It is not for routine contraceptive use. Plan B One-Step is available as a nonprescription (over-the-counter or OTC) drug.

A brief history of Plan B and Plan B One-Step is as follows:

• On July 28, 1999, FDA approved a new drug application (NDA) for the original product, Plan B, for prescription use.
• On August 24, 2006, FDA approved a supplemental NDA permitting nonprescription availability of Plan B for women 18 years and older and by prescription for women 17 years and younger.
• On July 10, 2009, FDA approved a supplemental NDA permitting nonprescription availability of Plan B for women 17 years and older and by prescription for women 16 years and younger. Plan B has been discontinued and is no longer being marketed.
• On July 10, 2009, FDA also approved Plan B One-Step (PBOS) (levonorgestrel) tablet, 1.5 mg as a nonprescription product for women ages 17 and older, and as a prescription-only product for women ages 16 and below. Plan B used a two-dose regimen with 0.75 mg of levonorgestrel in each tablet to be taken 12 hours apart, while PBOS is a single dose tablet that contains 1.5 mg of levonorgestrel.
• On June 20, 2013, FDA approved PBOS for nonprescription use without age restrictions.

Q. What is emergency contraception? A. Emergency contraception is a method of preventing pregnancy to be used after another contraceptive fails or after unprotected sex. It is not for routine contraceptive use. Drugs used for this purpose are called emergency contraceptive pills, post-coital pills, or morning-after pills. Emergency contraceptives contain hormonally active drugs.

Q. What is Plan B One-Step? A. Plan B One-Step is an emergency contraceptive, a backup method to other birth control. It is in the form of one levonorgestrel pill (1.5 mg) that is taken by mouth after unprotected sex or contraceptive failure. Levonorgestrel is a synthetic hormone used in birth control pills for over 35 years. Plan B One-Step is available as a nonprescription (over-the-counter or OTC) drug.

Q. How does Plan B One-Step work? A. Plan B One-Step works before release of an egg from the ovary. As a result, Plan B One-Step usually stops or delays the release of an egg from the ovary. It is one tablet that contains a higher dose of levonorgestrel than birth control pills and works in a similar way to prevent pregnancy.

Q. Is Plan B One-Step effective? A. The most important factor affecting how well emergency contraception works is how quickly it is taken after unprotected sex or contraceptive failure. Therefore, FDA recommends that all people using levonorgestrel emergency contraceptives follow the product directions exactly and take the product as soon as possible within 72 hours after unprotected sex or contraceptive failure.

FDA recommends that consumers talk to their health care provider about emergency contraception in advance of needing it and understand the importance of using these products as intended.

Consumers and health care professionals are encouraged to report adverse reactions from the use of Plan B One-Step to the FDA’s MedWatch Adverse Event Reporting program at www.fda.gov/MedWatch or by calling 1-800-FDA-1088.

Q. Is Plan B One-Step an abortifacient (causing abortion)? A. No. Plan B One-Step will not work if a person is already pregnant, meaning it will not affect an existing pregnancy. Plan B One-Step prevents pregnancy by acting on ovulation, which occurs well before implantation. Evidence does not support that the drug affects implantation or maintenance of a pregnancy after implantation, therefore it does not terminate a pregnancy.

Q. Why was the mechanism of action modified on the Drug Facts label and Consumer Information Leaflet in 2022? A. The applicant for Plan B One-Step submitted a supplemental new drug application (labeling supplement), as amended, to FDA requesting approval to modify some the mechanism of action information on the Drug Facts label and in the Consumer Information Leaflet.

Based on careful consideration of the applicant’s labeling supplement, as amended, and additional scientific evidence, FDA determined that the labeling for Plan B One-Step should be updated to have the mechanism of action information be primarily in the Consumer Information Leaflet. The mechanism of action in the Consumer Information Leaflet was updated so it is now consistent with the best available scientific evidence.

Q. Why was the mechanism of action in the Drug Facts label changed to remove wording about fertilization and implantation? A. In response to the submission of the applicant’s labeling supplement, as amended, FDA reviewed currently available scientific evidence regarding the mechanism of action for Plan B One-Step. FDA determined the current science supports a conclusion that Plan B One-Step works by inhibiting or delaying ovulation and the midcycle hormonal changes. The evidence also supports the conclusion that there is no direct effect on fertilization or implantation. FDA also determined that the most appropriate placement of mechanism of action information was primarily in the Consumer Information Leaflet rather than in the Drug Facts label. Accordingly, FDA removed information directly related to the mechanism of action from the “Other Information” section of the Drug Facts label and updated the mechanism of action information in the Consumer Information Leaflet to be consistent with the best available evidence.

The mechanism of action is rarely included in nonprescription drug labeling (and, more specifically, the Drug Facts label) and is not required under FDA’s regulations for nonprescription labeling, as this information is not needed for the safe and effective use of nonprescription drugs in general. Because consumers may be interested in how Plan B One-Step works, information on the mechanism was kept in the Consumer Information Leaflet and updated to be consistent with the best available evidence. Also, both the Drug Facts label and Consumer Information Leaflet retain statements that are consistent with the mechanism of action—that the product will not work if the woman is already pregnant.

Q. Why was the mechanism of action in the Consumer Information Leaflet changed to modify wording about fertilization and implantation? A. In response to the submission of the applicant’s labeling supplement, as amended, FDA reviewed currently available scientific evidence regarding the mechanism of action for Plan B One-Step. FDA determined the current science supports a conclusion that Plan B One-Step works by inhibiting or delaying ovulation and the midcycle hormonal changes. The evidence also supports the conclusion that there is no direct effect on postovulatory processes, such as fertilization or implantation. Accordingly, FDA updated the mechanism of action information in the Consumer Information Leaflet, which included removing references to the mechanisms not supported by the best available scientific evidence (that is, effects on fertilization and implantation).

Additional information on FDA’s scientific review is available in the decisional memorandum .

Q. Is there information about the mechanism of action that remains on the Plan B One-Step Drug Facts label and the Consumer Information Leaflet that helps inform consumers? A. The Consumer Information Leaflet includes updated information on the mechanism of action to explain that Plan B One-Step works before release of an egg from the ovary. As a result, Plan B One-Step usually stops or delays the release of an egg from the ovary.

The Drug Facts label and Consumer Information Leaflet continue to include information that relates to when in the reproductive cycle Plan B One-Step works.

Specifically, the Drug Facts label retains the following statement in the “Warnings” section, under “Do not use”: “Do not use if you are already pregnant (because it will not work).”

In the Consumer Information Leaflet, the following statements are retained:

• Under the heading “What Plan B One-Step is not,” the following statement will remain: “Plan B One-Step will not work if you are already pregnant and will not affect an existing pregnancy.”
• Under the heading “When not to use Plan B One-Step,” the following statement will remain: “Plan B One-Step should not be used if you are already pregnant, because it will not work.”

These statements are consistent with the mechanism of action described in the Consumer Information Leaflet and remind the consumer that Plan B One-Step does not work when a woman is already pregnant. Therefore, when considering when in the reproductive cycle that Plan B One-Step might work, it will be clear to the consumer that Plan B One-Step works very early in the reproductive cycle (prior to ovulation).

Q. Are there generics of Plan B One-Step and will the labeling for these generics be updated to reflect the same labeling changes for Plan B One-Step? A. There are multiple (11) generics of Plan B One-Step with an active marketing status. The generics for Plan B One-Step are approved for nonprescription use without age restrictions. A generic drug is required to have the same labeling as the reference listed drug except for certain permissible differences, and generic drug holders are expected to update their labeling after FDA has approved relevant changes to the labeling for the corresponding reference listed drug. Accordingly, the generics for Plan B One-Step are expected to update their labeling to reflect the changes made to the Plan B One-Step labeling by submitting their revised labeling as soon as possible.

Additional Resources

• Plan B One-Step labeling from Drugs@FDA
• Decisional Memorandum
• Supplemental Approval letter

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Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-.

Mother To Baby | Fact Sheets [Internet].

Levonorgestrel (plan b one-step®).

Published online: July 2022.

This sheet is about exposure to oral levonorgestrel for emergency contraception in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is levonorgestrel (Plan B One-Step®)?

Levonorgestrel is a medication that has been used to prevent pregnancy. This fact sheet is about oral levonorgestrel used alone as a form of emergency contraception. Emergency contraception has been used to prevent pregnancy after unprotected sex or a contraceptive accident. The oral form of levonorgestrel used for emergency contraception contains 1.5 milligrams of levonorgestrel, which is more than the amount used in birth control pills. It has been sold under the names Plan B One-Step®, Econtra EZ®, Preventeza®, AfterPill®, My Way®, Next Choice One Dose®, and Take Action®. It can be purchased over the counter and does not require a prescription. Plan B should be taken as soon as possible after unprotected sex to be most effective. The use of emergency contraception may be desirable when no other contraceptive was present during sex (such as birth control pills, IUDs, or condoms) or there is reason to think a contraceptive has or may fail (such as a torn condom or not taking birth control pills on the required days). Levonorgestrel as emergency contraception is often referred to as a “morning-after pill” because it works best when taken within 12 hours of unprotected sex. However, it can be used up to 72 hours after unprotected sex. It is not guaranteed that use of oral levonorgestrel will prevent 100% of pregnancies. There is a small chance of having a pregnancy after taking levonorgestrel. The oral form of levonorgestrel used for emergency contraception is not an abortion pill. It will not work if you are already pregnant, or if you think you are.

I have taken levonorgestrel (Plan B One-Step®). Can it make it harder for me to get pregnant?

Taking oral levonorgestrel to prevent a pregnancy does not affect the ability to get pregnant in the future. Taking levonorgestrel may increase the chance of an ectopic pregnancy (when the egg is fertilized and attaches outside of the uterus where it cannot survive). There are studies that have shown a link between pregnancies involving levonorgestrel and ectopic pregnancies. There are also studies that have shown no significant link between the two. The chance of an ectopic pregnancy occurring after taking levonorgestrel is unknown. If emergency contraception fails, contact your healthcare provider if you notice any warning signs of an ectopic pregnancy such as sharp cramping or pain on one side of your body.

Does taking levonorgestrel (Plan B One-Step®) increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Levonorgestrel does not increase the chance for miscarriage. Levonorgestrel is used to prevent pregnancy by delaying or preventing an egg being released from the ovaries (ovulation). Emergency contraception such as levonorgestrel does not end a pregnancy that has already attached to the wall of the uterus (implanted).

Does taking levonorgestrel (Plan B One-Step®) increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Exposure to levonorgestrel in pregnancy is not expected to increase the chance for birth defects above the background risk.

Does taking levonorgestrel (Plan B One-Step®) in pregnancy increase the chance of other pregnancy-related problems?

It is not known if levonorgestrel can cause other pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking levonorgestrel (Plan B One-Step®) in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if levonorgestrel can cause behavior or learning issues for the child.

Breastfeeding while taking (Plan B One-Step®):

Levonorgestrel gets into breastmilk in small amounts. When used as emergency contraception, levonorgestrel is not expected to be harmful to a child that is breastfeeding. A person who takes levonorgestrel as emergency contraception can breastfeed 3 to 4 hours after the dose (or after each dose if the two-dose method is used). Be sure to talk to your healthcare provider about all of your breastfeeding questions.

If a male takes levonorgestrel (Plan B One-Step®), could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?

Studies have not been done to see if levonorgestrel could affect male fertility or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/ .

OTIS/MotherToBaby recognizes that not all people identify as “men” or “women.” When using the term “mother,” we mean the source of the egg and/or uterus and by “father,” we mean the source of the sperm, regardless of the person’s gender identity.

Selected References:

• Carvajal A, et al. 2015. Emergency contraceptive pill safety profile. Comparison of the results of a follow-up study to those coming from spontaneous reporting. Pharmacoepidemiology and Drug Safety, 24(1): 93–97. [ PubMed : 25408302 ]
• De Santis M, et al. 2005. Failure of the emergency contraceptive levonorgestrel and the risk of adverse effects in pregnancy and on fetal development: an observational cohort study. Fertility and Sterility, 84(2):296–299. [ PubMed : 16084867 ]
• Endler M, et al. 2022. Effect of levonorgestrel emergency contraception on implantation and fertility: A review. Contraception 109:8-18. [ PubMed : 35081389 ]
• Leelakanok N. & Methaneethorn J. 2020. A Systematic Review and Meta-analysis of the Adverse Effects of Levonorgestrel Emergency Oral Contraceptive. Clinical Drug Investigation, 40(5):395–420. [ PubMed : 32162237 ]
• Polakow-Farkash S et al. 2013. Levonorgestrel used for emergency contraception during lactation-A prospective observational cohort study on maternal and infant safety. J Matern Fetal Neonatal Med, 26:219-221. [ PubMed : 22928541 ]
• Shohel M, et al. 2014. A systematic review of effectiveness and safety of different regimens of levonorgestrel oral tablets for emergency contraception. BMC Women's Health 14(54). [ PMC free article : PMC3977662 ] [ PubMed : 24708837 ]
• Shurie S, et al. 2018. Levonorgestrel only emergency contraceptive use and risk of ectopic pregnancy in Eldoret Kenya: a case-control study. The Pan African Medical Journal, 31(214). [ PMC free article : PMC6691316 ] [ PubMed : 31447973 ]
• Shaaban OM et al. 2019. Levonorgestrel emergency contraceptive pills use during breastfeeding; effect on infants' health and development. J Matern Fetal Neonatal Med. 32:2524–2528. [ PubMed : 29463142 ]
• Zhang J, et al. 2015. Association between levonorgestrel emergency contraception and the risk of ectopic pregnancy: a multicenter case-control study. Sci Rep 5(8487). [ PMC free article : PMC4325579 ] [ PubMed : 25674909 ]

“ OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.

This work is available under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported license ( CC BY-NC-ND 3.0 )

• Cite this Page Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Levonorgestrel (Plan B One-Step®) 2022 Jul.
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What Is an IEP? Individualized Education Programs, Explained

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Over the past decade, the number of students with disabilities has been increasing , and there’s also a special education teacher shortage.

That has made individualized education programs, which special education students rely on, all the more important, according to experts. All special education students rely on these programs, called IEPs, which allow them to receive educational services tailored to their needs.

In the 2021-22 school year, 14.7 percent of all students nationwide were special education students, reaching an all-time high in 46 years, according to National Center for Education Statistics data.

Even with special education staffing shortages increasing along with special education student numbers, districts are still required to meet the individual needs of these students, according to the U.S. Department of Education.

The Individuals with Disabilities Education Act , or IDEA, is the federal law that mandates special education teachers be appropriately trained and have the knowledge and skills to serve children with disabilities, and that all special education students receive a “free appropriate public education.”

Some states and districts may be skirting the law, the U.S. Department of Education said last year in a letter to state directors of special education. Valerie Williams, the director of the office of special education programs at the education department, warned state directors of special education in a letter that they are still required to meet those requirements.

“In light of a teacher shortage when we are seeing an increase in students with very specific needs, how individualized can we be?” said Brandi Smith, adjunct instructor in the school of education at American University, and a special education teacher.

• Autism spectrum disorder
• Deaf-Blindness , or simultaneous hearing and visual impairments
• Deafness , including total or partial deafness
• Developmental delay , which means delays in communication, motor skills, or cognitive abilities
• Emotional disturbances , such as anxiety disorder, schizophrenia, bipolar disorder, obsessive-compulsive disorder, and depression
• Hearing impairments , including partial or temporary hearing loss, which aren’t identified under the “deafness” category
• Intellectual disability , such as Down syndrome
• Orthopedic impairment , such as cerebral palsy
• Other health impairments , which can include conditions such as ADHD
• Specific learning disability , such as any condition impacting a child’s ability to read (Dyslexia), write (dysgraphia), or do math ( Dyscalculia)
• Speech or language impairment , such as stuttering or difficulty with articulation
• Traumatic brain injury  caused by an accident
• Visual impairment,  including partial and total blindness

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Benefits of an Individualized Education Plan (IEP)

Who Qualifies and What Services Are Provided

What Is an IEP?

• Who Qualifies
• What Is Involved
• Implementation
• Legal Rights
• IEP vs. 504 Plan

An Individualized Education Plan (IEP) helps children with disabilities receive personalized educational assistance. It is a written plan with specific goals in which special resources are delivered to a child for free to help them succeed at school.

After an IEP referral is made, an evaluation is performed to assess multiple factors, such as the child's schoolwork and ability to pay attention. Once a child qualifies, a plan is developed and shared among a team of providers, including school officials, counselors, therapists, and the parents or guardians. 

This article explains who qualifies for an IEP, how the evaluation is performed, and how (and which) services are provided. It also describes the legal right of parents to not only access IEP services but also direct how those services are delivered.

Fat Camera / Getty Images

An Individualized Education Program (IEP) is a legal document provided under Federal law that is used for children in public schools who need special education. It is developed with the child's parents and members of the school system who are trained to administer IEP according to the law.

An IEP is intended for children with disability. An eligible student is any child in public school between the ages of 3 and 21 with a specific learning disability.

The IEP is based on an evaluation of the child describing their current levels of performance, strengths, and needs. Based on the evaluation, a written document is prepared outlining:

• The goals of the plan
• What special accommodations and services are needed
• Who will provide these services
• When and how progress is measured

The IEP is reviewed every year to assess the child's current level of performance, whether goals have been met, and what, if any, modifications are needed to improve performance.

Who Qualifies for an IEP?

A child is eligible for an IEP if they have a qualifying disability that requires special education. Under the definitions outlined in the Individuals with Disabilities Education (IDEA), the disability must have a negative impact on the child's academic performance. 

There are 12 categories of qualifying disabilities:

• Intellectual disability
• Hearing impairment
• Speech or language impairment
• Visual impairment
• Emotional disturbance
• Orthopedic impairment
• Autism spectrum disorder (ASD)
• Traumatic brain injury
• Specific learning disability (such as dyslexia )
• Deaf-blindness
• Multiple disabilities
• Any other health impairment affecting strength, energy, or alertness (such as asthma, ADHD, diabetes, or sickle cell anemia)

In addition, IEPs may be available (in many but not all states) for "gifted students," meaning those who are academically advanced compared to their peer group. This is often referred to as a "Gifted IEP" and exists to meet the academic and social-emotional needs of these unique students.

Who Is Involved in the IEP Evaluation Process?

Depending on the child’s specific needs, the team members involved in the evaluations may include the parents and guardians, along with:

• Counselors or psychologists
• Healthcare providers
• Hearing specialists
• Occupational therapists
• Speech therapists
• Teachers or special education educators
• Physical therapists
• Vision specialists

Implementing the IEP

The implementation process starts with the referral of a child for evaluation and continues until the IEP is reevaluated.

The IEP process can be described in the following 10 steps:

• "Child Find" : This is the system the state uses to identify and locate children with disabilities, called "Child Find." Parents may be contacted and asked if their child should be evaluated, or parents can call the "Child Find" system and ask for their child to be evaluated.
• Evaluation : The evaluation by members of the school system and others assess the child in all areas related to the suspected disability.
• Decision : A group of qualified professionals along with the parents review the evaluation and decide if the child has a disability as defined by the IDEA Act.
• Eligibility for services : After a child is determined eligible, the IEP team has 30 calendar days to schedule a meeting and start drafting the IEP.
• Meeting with stakeholders : The IEP meeting is conducted with all participants, including the parents, teachers, school counselor, school administrator, and any healthcare providers or therapists.
• Formulating the IEP : The IEP is written, providing details about which services are needed and how the program goals are to be measured.
• Delivery of services : The services and accommodations are rolled out in the manner described in the IEP.
• Progress report : The parents are updated as to how their child is progressing. Written progress reports are mandated per the terms of the IEP.
• Annual review : A review is conducted by the IEP team at least once yearly or more often if the parents or school ask for it.
• Reevaluation : This evaluation, called a "triennial," is performed every three years to determine if the child still has a "disability" as defined by the IDEA Act and what ongoing services, if any, are needed.

Your Legal Rights for IEP

Under Federal Law, every child with a disability in public school is entitled to receive a "Free Appropriate Public Education" (FAPE) in the "Least Restrictive Environment" (LRE). This includes the right to special education at no cost when deemed necessary.

There are also legal guidelines, called procedural safeguards, that outline the rights of parents throughout the IEP process.

These include:

• The right to an Independent Educational Evaluation (IEE) if the initial evaluation deems your child is ineligible for IEP
• The right to a first IEP meeting within 30 days of a child being deemed eligible
• The right to give or deny consent to every facet of the IEP
• The right to request an independent mediator if an impasse with the IEP plan is not found

What IEP Services Are Available?

IEP services are the resources available to support a child with disabilities. Sometimes they involve assistance with traveling to and from school or mobility at school. Other children may need counseling or occupational therapy. While this is not a complete list, the following are common examples of IEP services.

Audiology Services

Audiology involves helping children with hearing loss. Services might include identifying a child with hearing problems, evaluating the level of hearing loss, speech and language therapy, and choosing the right hearing aid if appropriate.

Occupational Therapy

Occupational therapists work with children to help them improve, develop, or restore skills or function. Examples of the types of skills occupational therapists can help children with include:

• Activities of daily living : for example, bathing, feeding, and dressing
• Play and social interaction : conversation, sharing, taking turns
• Sensory regulation : controlling stimulation levels by wearing headphones or sunglasses, using fidget toys, calming exercises
• Executive function : using organization and memory aids
• Academic skills : handwriting, coloring, drawing
• Transition to adulthood : shopping, laundry, and cooking, preparing for employment

Parent Counseling and Training

Sometimes parents need help understanding their child's unique needs or their disability. In this case, parent counseling and training may be part of an IEP plan. 

Training can range from information about how to help a child with anger management to exercises to perform at home.

Psychological Services

Psychological services are frequently provided by or coordinated by the school counselor. The counselor or other trained mental health professional can assist in identifying special needs. They might also develop strategies to help with outbursts, behavior modification, emotional coping skills, and more.

These services help children with disabilities learn how to use their recreation and leisure time in a way that is beneficial to them. Recreation services may include after-school or community youth programs. Learning to use leisure time constructively can help improve skills related to the following:

• Physical functioning 
• Attention span
• Decision making 
• Problem-solving
• Team-building
• Anger management
• Stress management

School Health Services

Children with disabilities often require help from school health services for support, such as medication administration, special feedings, managing a tracheostomy , and chronic illness management.

Additional IEP Services

Additional IEP services include:

• Early identification of disabilities
• Interpreting
• Medical assistance
• Physical therapy
• Rehabilitation counseling
• Social work
• Speech-language pathology

Differences Between the IEP and 504 Plan

The IEP and 504 Plan both support children with disabilities at no cost to families. The IEP was created under the Individuals with Disabilities Education (IDEA) Act of 1990, while the 504 Plan was enacted under an anti-discrimination law called the Rehabilitation Act of 1973.

The 504 covers a broader range of disabilities than the IEP and is available for kids with disabilities who don’t qualify for the IEP. Although these children may have a disability that needs assistance, they are not struggling to keep up with their learning or schoolwork.

A few other key differences between the IEP and 504 Plan include:

• Consent : Both require permission from a parent or guardian before evaluation, but the IEP requires written consent.
• Eligibility : An IEP is more appropriate for a child who is falling behind academically while a 504 provides a child with disabilities accommodations. 
• Evaluation : The IEP evaluation process is more formal and lengthy than the 504.
• Family notification : Both plans require notice to parents or guardians before a change, meeting, or evaluation. However, the IEP notification must be in writing.
• Review : An IEP has to be reviewed yearly and reevaluated every three years. Typically states follow these guidelines for the 504, but it can vary.
• Document type : An IEP must be a written document while the 504 does not.
• Who creates it : The IEP is more strict about team members than the 504. 
• What’s in it: An IEP is specific about a child’s performance, goals, and timing of services provided. The 504 states who will provide services and who makes sure the plan is done.

While a child could have both an IEP and a 504, it’s unusual for them to have both. In general, an IEP plan is for a child who is falling behind academically.

An Individualized Education Plan (IEP) helps children with disabilities by providing personalized resources to help them be more successful in school. Once a child is referred, an evaluation period helps determine a child’s eligibility for an IEP.

The school typically schedules an IEP team meeting within 30 days of eligibility. Schools invite parents or guardians to the meeting where the plan is written. They review the plan at least once a year and evaluate eligibility every three years.

Services vary based on a child’s individual needs. Examples include physical therapy, occupational therapy, anger management, speech-language therapy, and more.

Kurth JA, Lockman-Turner E, Burke K, Ruppar AL. Curricular philosophies reflected in individualized education program goals for students with complex support needs .  Intellect Dev Disabil . 2021;59(4):283-294. doi:10.1352/1934-9556-59.4.283

Department of Education. Sec. 300.8 Child with a disability .

National Special Education Advocacy Institute. Gifted IEP .

U.S. Department of Education. A guide to the Individualized Education Program .

Chen HC, Wang NM, Chiu WC, et al. A test protocol for assessing the hearing status of students with special needs . Int J Pediatr Otorhinolaryngol . 2014;78(10):1677-1685. doi:10.1016/j.ijporl.2014.07.018

Institute for Quality and Efficiency in Health Care, What is occupational therapy?

Center for Parent Information and Resources. Specifying related services in the IEP .

Cystic Fibrosis Foundation. Individualized Education Programs (IEPs) and 504 plans .

By Brandi Jones, MSN-ED RN-BC Jones is a registered nurse and freelance health writer with more than two decades of healthcare experience.

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Definition of plan B

Examples of plan b in a sentence.

These examples are programmatically compiled from various online sources to illustrate current usage of the word 'plan B.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

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1977, in the meaning defined above

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“Plan B.” Merriam-Webster.com Dictionary , Merriam-Webster, https://www.merriam-webster.com/dictionary/plan%20B. Accessed 13 May. 2024.

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Definition of Plan B noun from the Oxford Advanced American Dictionary

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Meaning of Plan B in English

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• So far this plan has not produced much money at all, so what is Plan B?
• Always have a plan B in case your original choice becomes impractical for any reason .
• He has strong reservations about whether a new president could be hired by year's end and said the board needs a Plan B just in case .
• alternative
• dissimilarly
• dissimilitude
• non-comparability
• non-comparable
• non-congruent
• non-identical
• non-typical
• untraditional
• untraditionally

Plan B | Business English

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Four things to know about Seattle’s plan to explore closing schools

Seattle Public Schools is looking to close some elementary schools to solve its budget woes, but a lot is still unknown about which school communities could be affected, and when.

Last Wednesday, the School Board voted to give Superintendent Brent Jones permission to start drawing up a preliminary list of schools that could be shuttered, plus an analysis of the impacts; that vote didn’t commit the district to closing schools quite yet. Jones has proposed reducing the number of elementary schools from 73 to about 50.

Here’s what we know so far.

Why is the district looking to close schools?

Seattle Public Schools has a long-running budget deficit — and a vision for “a system of well-resourced schools.” This idea refers to schools that have stable funding, art, music, P.E., inclusive classrooms and multiple teachers per grade — in other words, what students need to succeed.

It’s difficult to fund all of those things in buildings with low enrollment, district officials say. Twenty-nine of the district’s elementary schools have fewer than 300 students.

The district also has a structural deficit that it’s trying to close: a $105 million gap this year and another $129 million next year, according to the district’s estimates.

How did we get here? The district’s expenses have been higher than the public dollars that fund it. However, federal COVID-19 relief aid and a series of one-time funding boosts allowed the district to plug the gaps. Now, a bulk of the aid has run out.

The district has also lost more than 4,000 students since 2019, and it does not expect enrollment to reach pre-pandemic levels in the next decade. While the district has pointed to declining birth rates and the smaller share of Seattle-born children enrolling in its elementary schools, some parents have said they’ve left SPS for private schools or other options. 

An expensive teachers union contract, which increased staff support for special education services, also added to the deficit.

But district officials say there are other factors at play, too. The state does not cover all of the costs associated with educating children, even after the 2012 McCleary decision increased K-12 funding.  The district has to pick up extra expenses not covered by the state for special education services, transportation, insurance increases and inflation.

SPS has said it will save money by closing buildings. However, in the presentation prepared for the school board’s meeting on Wednesday, Jones said that without closures, the district would need to make more cuts. It may also have to increase student-teacher ratios, eliminate or reduce preschool, postpone adopting new curriculum and further reduce the staff who work at the central administrative office. Even with those changes, the district has said, some school sites may still close. 

Which schools could close?

At this point, no one knows. 

The district is looking at elementary schools with fewer than 300 students. But it will also take into consideration factors such as a building’s age, academic support available in the building, the distance students have to travel to get to another school, equity and the distribution of elementary schools across the city.

The district spends more per pupil, on average, at the smaller elementary school sites than it does at schools with larger numbers of students, district officials say.

Bigger schools typically have more staff — and more full-time teachers and staff in specialized roles. A school with about 468 students would have three to four teachers per grade, a part-time assistant principal, a nurse two days a week, a counselor or social worker and full-time teachers for art, music and P.E., district officials say.  A school with 217 students would only have one or two teachers per grade, no assistant principal, a nurse one day a week, and a part-time counselor or social worker.

One other thing:  A school will not automatically be slated for closure simply because it has fewer than 300 students. It could instead be one of the schools — because it’s in a newer building, has more space for students, or is easy to get to — that will take new students.

How can parents and caregivers share feedback?

The district is expected to release dates and locations for a series of community information sessions in May and June. Officials have said they will share their proposals with the community and collect feedback.

“We can’t do this in isolation, without the insight, wisdom and knowledge of both internal and external folks to the district,” Jones said. “We value it, and I think it’s an essential piece of what we do.”

Some parents raised concerns that the preliminary proposal and some feedback sessions are scheduled toward the end of the school year, when parents might be out of town or occupied with end-of-the-school-year rituals.

Board President Liza Rankin said that parents and families shouldn’t wait for the legally required public comment periods to tell the board and district what they think. They can offer feedback starting now. 

What happens next?

The district’s timeline is not set in stone.

Jones is expected to deliver his preliminary proposal to the School Board next month.

If the board accepts the proposal, the public will then have 30 days to weigh in. There will also be hearings at each of the school sites slated for potential closure. Once there’s a final recommendation from the district, there will be another 14-day public commenting period, followed by a final School Board vote, which is expected around November.

Fred Podesta, the district’s chief operations officer, said the district is hoping to finalize its plans in the fall so that families and staff will have about a year to make the transition.

“We think it’s important to understand what families and students need to make transitions and that we give them as much time as possible,” he said. 

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