Clare Bremner: A significant number of women tell us they instantly regretted taking the first tablet
Abortion reversal remains controversial, but why aren't women being told that babies can survive the first abortion pill?
Dr George Delgado, the San Diego physician who invented the "abortion pill reversal" protocol has published new data, which he says proves that the effects of the first abortion pill can be reversed by taking progesterone supplements.
Controversial method
Dr Delgado first presented the idea in 2012, when he published anecdotes from seven women who changed their minds after taking the first abortion pill. Since then, several US states have adopted legislation requiring that women be informed of the option to "reverse" an abortion. Idaho is the latest, following Utah, South Dakota, Arizona and Arkansas. A California nursing body approved training in the procedure in 2017. Such moves have caused fierce controversy, with abortion supporters dismissing any possibility of it being possible to reverse an abortion. (For instance, one publication reports the current story as "Junk Scientist Peddles Junk Abortion Theory in Junk Publication")
Now Dr Delgado has published data on a larger set of women. His report A Case Series Detailing theSuccessful Reversal of theEffects of Mifepristone UsingProgesterone, ?which appears in the Issues in Law and Medicine journal, looks at 754 patients who called an informational hotline in the United States from 2012 to 2016 after taking mifepristone, the first drug in a medical abortion, but before taking misoprostol, the second drug.
How does it work?
A dose of Mifepristone, which leads to embryonicor fetal demise is given before misoprostol, which bring on contractions to expel the dead baby. The abortion reversal protocol involves taking high doses of progesterone, a hormone produced in the ovaries that helps prepare the tissue lining of the uterus for pregnancy and can be given orally, by injection or vaginally.
The study says that of the 547 patients who took progesterone within 72 hours of taking mifepristone and had outcomes that were known, there were 257 live births. Another four women remained pregnant with what seemed to be viable fetuses, but were lost to follow-up tracking after their 20th week of pregnancy. The overall rate of a pregnancy continuing, Dr Delgado wrote, was 48 percent, which he compared to a control figure of 25% of babies surviving mifepristone with no intervention.
Research not conclusive
The research is limited in that it consists only of observational case studies, rather than being a randomized placebo-controlled trial. (Although, as Dr Delgado notes, a placebo-controlled trial in the population of women who regret their abortion and want to save the pregnancy would be unethical.)
Daniel Grossman, a professor at the University of California at San Francisco who focuses on reproductive health issues, has been one of the most vocal critics of abortion-reversal laws. He says "it makes some biological sense" that flooding the body with progesterone could counter the effect of the first abortion pill. But, he continues, there's also logic to the argument that progesterone is elevated in a normal pregnancy and so a pharmaceutical dose won't make much difference.In addition, he said, "mifepristone by itself is not a very effective abortion-causing agent. If you use it just by itself there's a good chance the pregnancy will continue on its own."
Raises an important point
For Clare Bremner, counsellor with the Abortion Recovery Care and Helpline, this is in itself an important point that women are not made aware of. "A significant number of women tell us they instantly regretted taking the first tablet," she says. "Sadly, they believed it was already too late as women are not being told that many babies can survive the first tablet."
Informed choice?
The new study also brings up the claim that a baby that survives the first abortion pill would be born with birth defects, and abortion reversal should not be attempted for this reason. He concludes that "Mifepristone is embryocidaland feticidal but not teratogenic; progesterone is not associated with birth defects."
According to Clare Bremner, the claim an abortion must be completed as the baby will be damaged is commonplace. "We regularly hear from women who don't want to take the second tablet.We find that many of them are given, to put it mildly, misleading information about the risk of the baby being disabled, despite there being no evidence of such risk. Some have even been mislead about their own health.This surely goes against medical ethics, 'trusting women' and informed choice."
She concludes: "We would like to see far more support and appropriate care in this country for women who don't want to take the second tablet, and even more so, steps taken to support and inform women properly in the first place so that ambivalence and coercion are noticed and dealt with appropriately."
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