'Abortion reversal' treatments are dangerous and can cause life-threatening bleeding: Study
According to the American College of Obstetricians and Gynecologists, claims regarding abortion 'reversal' treatment are not based on science and do not meet clinical standards.
Treatment to reverse the effect of an abortion pill is bad news. Such a treatment may put patients at risk for life-threatening bleeding, according to a recent study that tried to evaluate its safety and efficacy. The findings come at a time when many US states have signed an abortion reversal legislation.
The research team had to pull the plug on the study, after seeing that the treatment was endangering women. "I feel really horrible that I could not finish the study. I feel really horrible that the women … had to go through all this," the lead researcher Mitchell D. Creinin from the University of California, Davis, told Washington Post.
Abortion pill reversal, which claims to reverse abortion, is unproven. According to the American College of Obstetricians and Gynecologists, "claims regarding abortion 'reversal' treatment are not based on science and do not meet clinical standards".
“All of the evidence that we have so far indicates that this treatment is not effective,” Daniel Grossman, an OB-GYN and the director of Advancing New Standards in Reproductive Health, a research group at the University of California San Francisco, told Vox.
But this has not stopped many organizations around the country to offer the procedure. What is worse, governors in North Dakota, Idaho, Utah, South Dakota, Kentucky, Nebraska, Oklahoma and Arkansas, have signed the abortion reversal legislation. The laws are currently blocked or enjoined in Oklahoma and North Dakota, according to the Washington Post.
"These laws mandate that women who receive mifepristone be informed that it may be possible to reverse the effects of the first abortion pill if they change their minds," write the authors of the study in a commentary.
What is abortion pill reversal treatment?
In 2012, Dr. George Delgado, a family medicine physician in San Diego, California, came up with a method to reverse abortion. His treatment is aimed at women who have had their first dose of medical abortion: a procedure that uses medications instead of surgery to end a pregnancy -- but have changed their minds.
Normally, women can terminate abortion by taking two pills. The first one called mifepristone is taken at the doctor's office. After a couple of hours or days, women are asked to take the second pill called misoprostol. This treatment is most effective during the first trimester of pregnancy, claim experts.
A total of 862,320 abortions were provided in clinical settings in 2017, according to the Guttmacher Institute, about 39% of which were medication abortions.
Women who have had mifepristone alone can go back to being pregnant by taking the hormone progesterone, according to proponents of abortion reversal treatment. To prove that his treatment works, Dr. Delgado published a study that included six patients, who were given progesterone injections after taking mifepristone. According to him, four women were able to continue their pregnancies.
In response, the American Congress of Obstetricians and Gynecologists said that Delgado’s 2012 paper, involving just a handful of patients, was “not scientific evidence that progesterone resulted in the continuation of those pregnancies.” They add that mifepristone is not a standalone treatment to end a pregnancy, as half of patients continue to remain pregnant after taking the drug.
However, say experts from the American Congress of Obstetricians and Gynecologists, when patients combine mifepristone with misoprostol, the procedure works to end a pregnancy about 95-99% of the time. They think that Delgado’s patients who remained pregnant may have been so, even if they did not receive progesterone injections.
Further, there is no data to prove that taking progesterone after mifepristone or throughout pregnancy is safe, as “reversal” patients are sometimes advised to do.
What does the current study say?
To paint a clear picture on the safety and efficacy of the abortion pill reversal treatment, Creinin and his collegaues carried out the study in 40 women who had voluntered to have surgical abortions.
All the women in the study received the first abortion pill, mifepristone. Following this, some women received progesterone, while others were given a placebo, or a control pill. Of the 12 women who enrolled in the study, three of them required ambulance transport to a hospital for treatment of severe vaginal bleeding. The team could not complete the study, as it was too dangerous to put these women through the trails.
Cremin points out that not completing the medical abortion regimen -- taking both pills -- can be dangerous. According to the authors, taking the first pill -- mifepristone -- alone, can lead to complications, including hemorrhage and transfusion.
“It’s not that medical abortion is dangerous,” Creinin tells NPR. “It is not completing the regimen, and encouraging women, leading them to believe that not finishing the regimen is safe. That is really dangerous.”
The study raises safety concerns but could not prove whether the treatment was effective or not. Creinin tells NPR, "Does progesterone work? We do not know. We have no evidence that it works."