A similar but much larger case series (also authored by the medical advisor to Abortion Pill Rescue and medical director of Culture of Life Family Health Care) reports that it was approved by an institutional review board. It still remains deeply flawed, according to experts. This series, published in Issues in Law & Medicine in 2018, looked at data from 754 pregnant people who called an unspecified hotline between June 24, 2012, to June 21, 2016, and explained that they had taken mifepristone but not misoprostol and were interested in continuing their pregnancies. Just over 200 potential participants were excluded for various reasons, like deciding to continue with the abortion or a lack of follow-up. Out of the 547 participants included in the analysis who received progesterone, 257 gave birth, but again, that doesn’t translate into scientific proof that “abortion reversal” works. There was no consistency in terms of where or how the patients received progesterone, how far along they were in the pregnancy, or whether or not they had an ultrasound before the “reversal” to confirm if there even was still a viable embryo present.
Trying to base medical protocols and legislation on this kind of fundamentally flimsy research goes against both science and the moral responsibilities of health care providers.
The unethical and dangerous nature of “abortion reversal” laws
Elizabeth Nash, senior state issues manager at the Guttmacher Institute, says that “abortion reversal” laws are “such an example of overreach” that reproductive advocates were surprised to see more states propose bills after Arizona’s got shot down in 2016.
“On top of creating a policy based on incomplete evidence, these laws get into a very important question on informed consent,” Nash tells SELF, explaining that no ethical physician would move forward with an abortion unless they were absolutely sure of their patient’s choice.
“I can’t emphasize strongly enough that when people enter an abortion facility, the only thing on the provider’s mind is whether this decision and process is what a woman clearly wants,” Lisa Harris, M.D., Ph.D., a professor of obstetrics-gynecology and medical ethics at Michigan Medical at the University of Michigan in Ann Arbor and coauthor on the “abortion regret” systematic review mentioned earlier, tells SELF. “It was already an ethical breach to offer [‘abortion reversal’] care, and now it’s even more so because there are legitimate safety concerns. If someone in my community offered this, I would say it is outside the bounds of what’s considered efficacious and safe.”
Bonnie Steinbock, Ph.D., a professor emerita of medical ethics at Albany/State University of New York, agrees, telling SELF, “I don’t think [there’s] any justification for offering something, much less mandating that doctors [provide it], when they simply don’t know what the safety of the thing they’re offering is.”
Drs. Harris and Grossman have concerns regarding how these laws might influence patients’ decisions if they incorrectly believe “abortion reversal” is actually possible.
“It could mislead some women into thinking they don’t have to be 100% sure of their decision because they could just change their mind after taking the pill,” Dr. Grossman says. He compared these laws to recent bills attempting to require physicians to “re-implant” ectopic pregnancies, which he and Dr. Creinin say is biologically impossible.
Both types of legislation “mandate medical treatment that is completely unproven and potentially dangerous,” Dr. Grossman says. “That’s the new fact of the anti-abortion movement, and that’s very concerning. I cannot think of another example where, essentially, legislators are making up a treatment or basing it on the poorest quality evidence. It’s only related to abortion where we allow that to take place.”
The question now is how lawmakers will react to new worries about the risks of trying to “reverse” an abortion.
“I really hope that the well-being of people seeking abortion is first and foremost in the hearts and minds of legislators, and that with this new evidence, they might reconsider the requirement,” Dr. Harris says. “If legislators are unwilling to consider that, it’s going to be increasingly hard for me to imagine that laws like that come at all from compassion for people seeking abortion care.”