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Medication abortion is a common, safe, and effective way to end a pregnancy up to 70 days (10 weeks) after the pregnant person’s last menstrual period (LMP). However, in an attempt to spread disinformation and doubt, the anti-choice movement continues to peddle the myth of “abortion pill reversal”: a false and dangerous idea that puts folks seeking abortion care—as well as those who could become pregnant—at risk.

Since its approval by the FDA in 2000, medication abortion has grown increasingly popular; the most recent estimates show that approximately 60% of individuals who are ≤10 weeks pregnant choose to have a medication abortion (as opposed to an in-clinic procedure).[1] The clinical “gold standard” for medication abortion involves taking 200 milligrams of mifepristone, which stops the hormone progesterone which is needed to continue a pregnancy. Twenty-four to forty-eight hours later, the pregnant person then takes 800 micrograms of misoprostol inserted buccally (between the mouth’s cheek and gum to dissolve medication) or vaginally, thereby causing the uterus to contract and empty.[2] Medication abortion is effective 95% of the time; when it is not effective, more medication or an in-clinic procedure is required to remove the pregnancy tissue.[3]

George Delgado, an anti-abortion doctor, is credited with discovering the theory of abortion pill “reversal.” If a pregnant individual changes their mind about a medication abortion after taking mifepristone, Delgado and other anti-choicers recommend throwing away the misoprostol pills and taking shots of progesterone throughout the first trimester to counteract the progesterone blocker capability of the mifepristone.[4] There exists concerningly little research on this experimental reversal process, and the research that does exist doesn’t hold up to scientific muster. In fact, one recent clinical trial to investigate the efficacy of abortion pill reversal had to be prematurely stopped as three of the 12 participants were rushed to the emergency room due to hemorrhage.[5] Nonetheless, Delgado’s research has led to six states implementing policies which require doctors to give their patients medically inaccurate information that medication abortion can be reversed.[6] Abortion reversal is also widely touted by anti-choice Crisis Pregnancy Centers (CPCs) across the country, including many in Maryland.

The abortion reversal theory is grounded in in the idea that people regret their abortion. However, empirical data from the Turnaway Study, a longitudinal study comparing the outcomes of people who were able to get the abortion care they needed versus those who were denied care, shows this to be false. More than 95% of people stand by their abortion decision.[7]  It is morally and medically unethical to tell people they’ll be able to reverse a process that they cannot undo. That is why counselors at abortion clinics make sure that their patients are firm in their decision to end a pregnancy before they take mifepristone. Good public health and public policy come from well-informed, ethical, and thoughtfully conducted research—characteristics which, unfortunately, the abortion pill reversal theory cannot claim.

Have you seen any information that advertises how to obtain the “abortion reversal pill” in Maryland? Email us the links at info@prochoicemd.org with the subject line “Abortion Pill Reversal MD.”

 

[1] Jones, Rachel, Elizabeth Witwer, and Jenna Jerman. 2019. “Abortion Incidence and Service Availability in the United States, 2017.” New York: Guttmacher Institute.

[2]  Cleland, Kelly, and Nicole Smith. “Aligning Mifepristone Regulation with Evidence: Driving Policy Change Using 15 Years of Excellent Safety Data.” Contraception 92: 127–81.

[3] Donovan, Megan. 2018. “Self-Managed Medication Abortion: Expanding the Available Options for U.S. Abortion Care.” Guttmacher Policy Review 21: 41–47.

[4] Delgado G, Davenport ML. Progesterone use to reverse the effects of mifepristone. Ann Pharmacother. 2012 Dec;46(12):e36.

[5] Creinin MD, Hou MY, Dalton L, Steward R, Chen MJ. Mifepristone Antagonization With Progesterone to Prevent Medical Abortion: A Randomized Controlled Trial. Obstet Gynecol. 2020 Jan;135(1):158-165.

[6] “Counseling and Waiting Periods for Abortion.” 2021. Guttmacher Institute. Accessed at: https://www.guttmacher.org/state-policy/explore/counseling-and-waiting-periods-abortion

[7] Biggs MA, Upadhyay UD, McCulloch CE, Foster DG. Women’s Mental Health and Well-being 5 Years After Receiving or Being Denied an Abortion: A Prospective, Longitudinal Cohort Study. JAMA Psychiatry. 2017 Feb 1;74(2):169-178.

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