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​Lawmakers defy science with ‘abortion reversal’ pill bill

by C.S. Hagen | .(JavaScript must be enabled to view this email address) | News | January 15th, 2019

North Dakota State Capitol Building - photograph by C.S. Hagen

BISMARCK – North Dakota legislators introduced a bill to require physicians to provide information to patients about a questionable “abortion reversal” pill.

House Bill 1336 targets the “informed consent” section of the North Dakota Century Code and seeks to legally bind physicians to tell women planning on having an abortion about the possible effects of a reversal to abortion-inducing drugs. 

“It may be possible to reverse the effects of an abortion-inducing drug if she changes her mind, but time is of the essence, and information and assistance with reversing the effects of an abortion-inducing drug are available in the printed materials given to her as described…” the proposed addition to the law states.

“The materials must include information directing the patient where to obtain further information and assistance in locating a medical professional who can aid in the reversal of abortion-inducing drugs, such as mifepristone and misoprostol.”

The pill or substance that is said to reverse the effects of an unwanted abortion is called progesterone. Progesterone is a natural hormone in a woman’s body necessary to nurture and sustain pregnancy, according to the Hormone Health Network.

Representative Rick Becker, a Republican from Bismarck is also a plastic surgeon. He is listed as a co-sponsor of the bill and supports the bill because progesterone offers a chance – no matter how small – at a successful birth to women undergoing abortions who change their minds.

“What it’s looking at is in the course of anything procedurally that a physician does with a patient we have to give risks, benefits, and alternatives, and if one of the alternatives in this two-step process is to be able to change your mind, then I think that is one of the alternatives that needs to be expressed,” Becker said.

“When you think about it, it’s hard for me to think of any medical procedures that occur in two steps in any reasonable amount of time. I would think that you would want to include amongst those “alternatives” that you could start something and potentially reverse it. I think this is probably pretty unique, I haven’t done an exhaustive search, but I can’t think of hardly anything where you do a procedure and it’s actually two procedures over time.”

Representative Jeff A. Hoverson, a Republican from Minot, responded to an email pertaining to his support of the bill.

“Reversal has already saved many lives,” Hoverson said. “Not sure I see what could possibly be a downside to that.” 

The American Congress of Obstetricians and Gynecologists released a press release in 2017 saying that abortion “reversal” is not supported by science.

“Yet, politicians are pushing legislation to require physicians to recite a script that a medication abortion can be “reversed” with doses of progesterone, and steer women to this care,” the press release stated. “Unfounded legislative mandates represent dangerous political interference and compromise patient care and safety.”

The American Civil Liberties Union of North Dakota strongly condemned the proposed bill saying that those supporting the bill are misinformed.

“Facts are important, especially when discussing the health of women and the American public,” the ACLU of North Dakota said in a press release. “Claims regarding abortion ‘reversal’ treatment are not based on science and do not meet clinical standards, according to the American Congress of Obstetricians and Gynecologists. Yet, North Dakota politicians are pushing legislation to require physicians to tell women undergoing a drug-induced abortion false information.”

The decision to have an abortion is personal and private, and best left to a woman, her family, and doctor, Heather Smith, executive director for the ACLU of North Dakota said.

“It’s clear that this bill is motivated by a desire to coerce and intimidate women who have already made a very private medical decision, one that is protected under the U.S. Constitution, and it’s disappointing that North Dakota politicians continue to try to insert themselves into the patient-doctor relationship.

“Unfounded legislative mandates like House Bill 1336 represent dangerous political interference and compromise patient care and safety. The ACLU of North Dakota works to ensure that every woman can make the best decision for herself and her family about whether and when to start a family without undue political interference.”

Becker signed onto the bill because all the risks, all the benefits, and all the alternatives need to be explained to patients, he said.

“I am not sure what the ACLU is against, but if they’re opposed to the fact that I need to explain alternatives to my patients, I guess, I don’t know,” Becker said.

“It doesn’t need to be FDA approved, but from what I’ve been told there a significant percentage and I’m not suggesting it’s a majority, but there is a significant percentage of women who have second thoughts after they take the first pill.”

The fact that there are no guarantees the progesterone will work successfully doesn’t bother him, he said.

“And if there is that possibility I don’t care if there’s a study that shows it’s only 50 percent successful or 70 percent or even 20 percent, if there is a possibility of a procedure that could change things if a woman has changed her mind, I think it’s very important that they should be aware of that. I don’t think many people are aware of that.”

Since 2015 pro-life legislators in approximately 10 states have introduced bills that would require doctors to inform their patients about the “abortion reversal” pill. As of last summer five states including Idaho, Utah, South Dakota, Arizona, and Arkansas adopted legislation regarding the “abortion reversal” pill.

The “abortion pill” consists of two pills, first mifepristone and then one to two days later called misoprostol, according to The Daily Beast article published in 2016 and entitled “‘Abortion Reversal’ Is Scary, Bogus Science.”

Progesterone, which is deemed relatively safe, must be taken after the first pill and before the second pill in order for the hormone to work, proponents say.

“In recent years, the rise of medical abortion has led some anti-abortion activists and lawmakers to claim that the process can be reversed with an emergency treatment after the first pill,” The Daily Beast article states. “But even if they succeed at turning that myth into law, the truth is that science is not on their side.”

In April 2018, a San Diego doctor named George Delgado and six other co-authors published a paper documenting the success rates of “abortion reversal” pills, saying that nearly half of the 547 women who underwent the therapy had successful pregnancies with live births.

Three months after Delgado’s study was published the pro-life journal, Issues in Law & Medicine, and the University of San Diego, a Catholic university, both of which supported the study’s findings, withdrew support “pending technical corrections,” according to Slate magazine.

Delgado’s research is criticized as being observational case studies and not rigorous clinical trials. Critics also say that flooding a body with progesterone doesn’t counter the first abortion pill as the body during a pregnancy is already pumping out the hormone.

Daniel Grossman, a University of California at San Francisco professor, said that it is too soon to draw conclusions to Delgado’s research, and that legislative bodies should not be passing laws about experiments that may not work, according to The Washington Post.

Delgado’s study is currently available for free online, with a correction caveat.

Republican representatives Sebastian Ertelt, Jeff A. Hoverson, Jim Kasper, Rick Becker, Daniel Johnston, David Monson, Bob Paulson, Kathy Skroch are listed as sponsors of the bill. Republican senators Jordan Kannianen, Oley Larsen, Larry Luick, and Janne Myrdal are also listed as sponsors.

All lawmakers were contacted for comment, but only representative Rick Becker and Jeff A. Hoverson replied. 

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