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Other states are in the process of considering similar laws.
Utah Gov. Gary Herbert signed a bill into law on Saturday that requires doctors to inform women who elect to have medication-induced abortions that those abortions may be reversed. Medical groups, however, say there is little, if any, evidence to support that claim.
The non-surgical pregnancy termination option is often referred to as “the abortion pill,” but that’s actually somewhat of a misnomer. The “abortion pill” isn’t a single medication, it’s two. The first of these pills, mifepristone, blocks the body’s own progesterone. The second pill, misoprostol, causes symptoms very similar to an early miscarriage.
Anti-abortion advocates claim that this whole process can be halted, and reversed through a treatment of progesterone after the first pill is taken. But, the body of scientific evidence is simply not on their side.
What Does the Science Say?
The entire “reversal” claim is based on a just a single study carried out on six pregnant women who reportedly took the first abortion pill, regretted their decision, and sought medical help with halting the process. Of those six women, four carried healthy babies to term.
This study was undertaken by Dr. George Delgado, medical director at the Culture of Life Family Services in San Diego. Delgado claims that his procedure, which involves an injection of progesterone, is responsible for interrupting the mifepristone’s effects and allowing a pregnancy to continue as it would normally.
The mainstream medical community, however, disagrees.
According to a statement from the American Congress of Obstetricians and Gynecologists, “there are no reliable research studies to prove that any treatment reverses the effects of mifepristone.”
In fact, the ACOG says that “available research seems to indicate that in the rare situation where a woman takes mifepristone and then changes her mind, doing nothing and waiting to see what happens is just as effective as intervening with a course of progesterone.”
To put it simply, that fact that the medication abortion procedure requires two pills to be fully effective means that many women will not abort from using just the first medication alone. In 30 to 50 percent of cases where women take just the first drug, but not the second, the pregnancy will continue.
A New Reproductive Battle Ground for State Legislatures
Utah isn’t the first state to put this type of law on the books. South Dakota, Arkansas and Arizona have all passed legislation that requires doctors to inform women that a drug-induced abortion may be interrupted.
Arizona’s law, which was passed in 2015, was eventually repealed in August 2016 after Planned Parenthood argued in federal District Court that the law infringed upon a doctor’s First Amendment rights by making them repeat a mandated message that ran counter to their professional judgement.
State legislatures are increasingly turning their attention to medication abortions at a time when that type of abortion is becoming more common, and these pills are becoming easier to attain.
Although the overall number of abortions in the United States continues to decline, the share of those procedures being done through medication—rather than surgery—is growing. According to the Guttmacher Institute, medication abortions accounted for just 6 percent of all abortions in 2001. In 2014, 31 percent of all abortions were carried out via pills.
More recently, the “abortion pill’ became even more accessible thanks to the Food and Drug Administration. In March 2016, the federal agency relaxed its guidelines for prescribing mifepristone, the first pill of the two-pill combination. Among other changes, the new FDA rules extended the period of time when a woman may take the pill to 10 weeks of pregnancy, from the original seven weeks.
Anti-abortion organizations have been pushing back against this increase in accessibility by urging state lawmakers to enact even stricter regulations on these medications.
Many states already have restrictions in place on this type of medication. Some states, for instance, allow only physicians to prescribe the drugs—rather than also allowing physician assistants or other mid-level providers. And, the state of Ohio, among others, requires that women have a face-to-face meeting with a physician 24 hours before a medical abortion.
The “abortion reversal” legislation is a more recent trend on this same regulatory spectrum and it’s one that has the potential to spread. Americans United for Life, self-described as “the nation’s premier pro-life legal team,” began circulating a piece of model legislation called the “Abortion-Inducing Drugs Information and Reporting Act.” Taking a page out of the playbook perfected by the American Legislative Exchange Council, the AUL hopes that providing this template will spur more states to enact similar bills.
While it’s not clear whether inspiration for new proposals is coming from groups like the AUL, even more states are considering joining Utah, South Dakota and Arkansas in requiring doctors to discuss abortion reversals with their patients.
Quinn Libson is a Staff Correspondent for Government Executive’s Route Fifty based in Washington, D.C.
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