Doctors in Arizona may soon be required to tell their patients about an unscientific and unproven method of “reversing” an abortion, if Gov. Doug Ducey (R) approves a bill that the legislature sent to his desk this week.
The bill in question, SB 1318, was originally intended to restrict insurance coverage for abortion services. While that’s still the main function of the legislation, one Republican lawmaker in the state also tacked on a provision requiring doctors to tell patients that “it may be possible to reverse the effects of a medication abortion if the woman changes her mind.” Arizona is the first state to pass this type of requirement, although a similar bill is also currently advancing in Arkansas.
So-called “abortion reversal” involves injecting the hormone progesterone into a patient after she has taken mifepristone, the first dose in the two-part process to terminate a first-trimester pregnancy with medication. This reversal procedure was pioneered by an anti-abortion doctor named George Delgado, who claims that his progesterone method has helped four women who initially took mifepristone go on to have healthy live births.
The concept has become quite popular in the anti-abortion community. Delgado maintains a website, Abortion Pill Reversal, that advises women to call a hotline for more information: “It may not be too late,” the site proclaims. Groups like Priests for Life want to put “abortion reversal kits” in emergency rooms across the country in case women who have initiated a medical abortion end up changing their minds. One crisis pregnancy center in Iowa recently made headlines for advertising its willingness to perform the procedure.
But medical professionals say there’s no scientific evidence to suggest the hormonal injection is effectively reversing the effects of mifepristone. It takes two different medications to end a pregnancy, and mifepristone is not always effective on its own.
“There’s no evidence of any demonstrable effect of the ‘treatment’ these anti-abortion centers are marketing,” Dr. Cheryl Chastine, an abortion provider in Kansas, told reporter Robin Marty earlier this month. “The medical literature is quite clear that mifepristone on its own is only about 50 percent effective at ending a pregnancy. That means that even if these doctors were to offer a large dose of purple Skittles, they’d appear to have ‘worked’ to ‘save’ the pregnancy about half the time.”
Dr. Daniel Grossman, a fellow with the American Congress of Obstetricians and Gynecologists (ACOG) and the vice president for research at Ibis Reproductive Health, has repeatedly said that there isn’t enough proof to justify this particular hormone treatment and ACOG does not feel comfortable recommending it.
Abortion rights groups have condemned SB 1318, calling it yet another example of politicians putting words in doctors’ mouths and allowing junk science to become law. Organizations like Planned Parenthood and the American Civil Liberties Union (ACLU) are urging the governor to veto the legislation.
“It’s just a piece of the larger strategy — using any means possible to dissuade a woman from a decision that she’s already made,” Hayley Smith, the associate advocacy and policy counsel for the ACLU, told ThinkProgress. “Health care providers should never be required to give unsubstantiated, misleading, or false information. This bill is just politics in the exam room at its worst.”
“This is another example of politicians practicing medicine without a license,” Dr. David Grimes, a longtime abortion provider and reproductive health care researcher, added.
Over the past several years, states have imposed a record-breaking number of new abortion restrictions — which means that the lawmakers who want to continue legislating against the procedure have been forced to get more creative this session.
In addition to “abortion pill reversal,” states have recently pursued several other new types of restrictions. In Montana, lawmakers have proposed requiring abortion doctors to administer anesthesia to fetuses, which represents a new way of endorsing the unscientific concept of “fetal pain.” In Oklahoma and Kansas, lawmakers have advanced measures to ban “fetal dismemberment,” which would outlaw a specific type of surgical abortion procedure.
These creative approaches are largely being pioneered by national anti-abortion groups that write draft legislation and shop it around to conservative lawmakers. The abortion pill reversal language, for instance, was included in Americans United for Life’s model legislative guide for the first time this year. That right-wing organization is the driving force behind many of the abortion restrictions that have spread across the country since 2010.
Obviously, reproductive health providers don’t want a woman to go through with an medication abortion if she has any doubts. If a patient appears to be unsure about going through with the procedure, a doctor would likely refrain from giving them the first mifepristone pill to begin with.
But most women are not unsure about their procedures: Research has confirmed that the vast majority of women who decide to visit an abortion clinic have already made up their mind about ending their pregnancy, and nearly 90 percent of women feel “highly confident” about their decision to have an abortion. “It’s exceedingly rare to have a woman change her mind after undergoing abortion counseling and then actually taking the abortion pill,” Grossman pointed out to Vocativ last year, adding that the emphasis on abortion reversal “seems like a lot of hype for something that doesn’t really happen that often.”
Arizona Gov. Doug Ducey (R) signed SB 1318 into law, although he didn’t comment on the portion of the legislation that requires doctors to tell women their abortions can be reversed. Instead, he focused on the need to prohibit insurance coverage of abortion: “The American people overwhelmingly oppose taxpayer funding of abortions, and it’s no different in Arizona, where we have long-standing policy against subsidizing them with public dollars,” Ducey said.