Anti-choice Louisiana state lawmakers are eager to introduce a new law that would force abortion providers to inform patients of a so-called abortion-pill-reversal technique, which the largest body of obstetricians and gynecologists in the United States says lacks sufficient scientific evidence to support it.
This reversal technique essentially involves interrupting the two-pill abortion medication process by having women stop after taking the first drug, which does not directly attack the embryo, and then giving them multiple injections of a hormone associated with improving pregnancy outcomes.
Speaking at a workshop session during the National Right to Life Convention in New Orleans last week, the host state’s Rep. Frank Hoffmann (R-West Monroe) said introducing an abortion-pill-reversal bill would be a priority of Louisiana’s anti-choice legislative strategy for 2016.
Hoffmann—alongside six of his colleagues in the Louisiana legislature—explained how state lawmakers have together passed about a dozen abortion restrictions and regulations, most within the past five years. He told Rewire following the panel session that most of these laws were initially drafted by Louisiana Right to Life and the Bioethics Defense Fund.
Rep. Mike Johnson (R-Bossier City), who also spoke on the panel, serves as Louisiana Right to Life’s legal counsel and regional director for north Louisiana.
Hoffmann told the audience of anti-choice activists and members of Right to Life affiliates that he and his colleagues have tried to make accessing abortion in the state “more difficult” while “still staying within the laws.”
Many lawmakers’ ultimate goal is to criminalize abortion, said Sen. Ben Nevers (D-Bogalusa), who in 2006 authored the state’s abortion ban trigger law, which will make abortion illegal in Louisiana in all instances except when a mother’s life is endangered if the U.S. Supreme Court ever overturns Roe v. Wade.
“We’re all trying to stop abortion,” Rep. Scott Simon (R-Abita Springs) said. “But we also need to encourage good decision-making.”
As part of encouraging “good decision making,” the legislature passed a law in 2012 requiring abortion providers to offer patients the opportunity to view the ultrasound screen and to hear the heartbeat of the fetus before an abortion and another law in 2011 creating a state website stating that abortion can cause mental illness and that fetuses feel pain at 20 weeks, though neither claim is supported by mainstream medical organizations.
Requiring abortion providers to inform patients about the possibility of reversing their abortions—even though the consequences of this process are not fully understood—fits this pattern of trying to convince women seeking abortion to change their minds.
The concept of reversing abortions—which applies only to abortions induced by specific medications—was introduced by Dr. George Delgado, a family physician who opposes abortion and is the medical director of Culture of Life Family Health Services in San Diego as well as its Abortion Pill Reversal project.
Delgado delivered the first keynote speech of this year’s National Right to Life Convention, in which he explained his method, which he calls “new science.”
Delgado in 2012 co-authored a summary of case reports published in the Annals of Pharmacotherapy, reporting findings of a technique that he says effectively “reverses” a medication abortion, though the study has been criticized for involving only seven test subjects (pregnancies continued for four out of six participants; the seventh never followed up) and no control group. Delgado says he is working on a study involving 200 patients, which he anticipates will be published in late September.
Medication abortion is a common early-abortion procedure that involves taking two types of medicine: mifepristone, which causes the embryo to detach from the uterine wall, and misoprostol, which causes the uterus to expel the embryo. In general, the patient takes the mifepristone at the clinic and then takes the misoprostol at home a day or two later, though some states have required patients to follow an older method initially recommended by the Food and Drug Administration, which involves three trips to the abortion provider’s office.
Delgado’s so-called reversal method consists of stopping the medication abortion process after the patient takes the mifepristone and then giving the patient multiple injections of the hormone progesterone.
Delgado explained during his speech at the convention that he had administered progesterone to women to prevent threats of miscarriage and thus determined a few years ago that administering progesterone after a woman takes mifepristone—which is designed to block progesterone receptors—could have a similar effect.
Delgado said that because many women complete their medication abortions at home, anti-choice sidewalk counselors miss out on an opportunity to change their minds. But the silver lining, he noted, is that medication abortion is a two-part process and can be reversed, mid-procedure.
A hotline on Delgado’s Abortion Pill Reversal website can connect women seeking to reverse their abortions with what the website claims is “a network of over 270 physicians worldwide.”
Delgado claimed that his Abortion Pill Reversal organization has helped more than 100 women try to reverse their abortions and has seen a 55 to 60 percent success rate with no notable birth defects. He noted that about 40 percent of the women who have called the hotline (Delgado said more than 900 calls have been made) have decided to continue with their abortions.
“We want people to know that we’re not twisting anybody’s arm,” Delgado said. “We’re just offering a second choice.”
Critics of Delgado’s method have said there could be unknown negative side effects of this procedure and that, moreover, the findings presented in his limited study do not sufficiently prove the claim that progesterone therapy administered after a woman takes mifepristone will reverse an abortion.
The American Congress of Obstetricians and Gynecologists (ACOG) says, “The claims of medication abortion reversal are not supported by the body of scientific evidence.”
Despite the shaky grounds holding up this procedure, two states—Arkansas and Arizona—have already passed laws that require abortion providers to use state-sanctioned language to explain to their patients that they can reverse medication abortions.
The American Civil Liberties Union (ACLU), the Center for Reproductive Rights, and Planned Parenthood have sued the state over Arizona’s new law, claiming it violates the First Amendment by compelling doctors “against their medical judgment and in violation of medical ethics, to convey to their patients a state-mandated message that is not medically or scientifically supported and that is antithetical to the purpose of informed consent.”
Arizona abortion provider Dr. Gabrielle Goodrick told Rewire this year that doctors could flood women’s bodies with potentially toxic levels of progesterone to an unknown effect. Critics also argue that taking mifepristone alone without the extra doses of progesterone will not necessarily result in an abortion; ACOG says that pregnancies continue for 30 to 50 percent of women who take only mifepristone.
Even an abortion opponent like Republican presidential candidate Dr. Ben Carson, who spoke at the convention’s presidential candidate forum, does not approve of doctors practicing Delgado’s method until more research is conducted.
“Generally speaking, the scientific method requires accumulating data, accumulating evidence and making sure that it’s statistically significant,” the retired neurosurgeon told ThinkProgress.
Hoffmann told Rewire that the Louisiana state legislature is “not quite ready” to introduce the abortion pill reversal legislation, but that lawmakers plan to introduce the bill next year. When asked if the legislature was waiting for more research before endorsing this abortion reversal technique, Hoffmann said no.
He said he was impressed by Delgado’s presentation at the convention and by his “tremendous statistics.”