What chutzpah! A consortium of pro-abortion groups that includes Planned Parenthood is supporting the drafting of new legislation to outlaw “deceptive” practices by the many pregnancy resource centers that operate in Colorado. They claim that these centers don’t present an unbiased discussion of pregnancy options and endorse “misinformation.”
It is true that these pregnancy resource centers don’t offer abortion or abortion referrals – but they do discuss these options. They are transparent about this. For instance, the Alternatives Pregnancy Center webpage says, “we do not refer for or perform abortions; therefore, Alternatives receives no financial gain from a pregnancy decision.”
In contrast, one would assume an organization by the name of “Planned Parenthood” would offer women an array of pregnancy-related services that include prenatal care for an ongoing pregnancy. Other than by referral, you would be wrong. If there were truth in advertising, Planned Parenthood should be called “Planned Un-Parenthood.” They have a financial interest in every woman who steps through those doors and obtains abortion services.
It is also true that pregnancy resource centers are motivated by a desire to offer true choice which looks beyond abortion. They facilitate discussions with women who are seeking information on all pregnancy options. Often these women want to further their education and career, don’t consider abortion their best option, but still need resources and support. This contrasts with the implicit or explicit message conveyed at abortion clinics – that pregnancy will hold them back and abortion is the key to their future success.
Rather than disempower women, pregnancy resource centers empower women to believe they truly have options. Pregnancy resource centers make continuing a pregnancy attainable for those with financial insecurity by offering them a wide array of tangible support services, either directly or by referral. They are committed to walking with women throughout their pregnancy and beyond.
What about the “misinformation?” One of the principal objections voiced by abortion advocates is that pregnancy resource centers promote unproven and dangerous clinical practices such as abortion pill reversal.
It seems that abortion proponents don’t even want to acknowledge that women are sometimes ambivalent about abortion and regret their decision. They would have you believe that all women are (or should be) proud of their abortion decision. That simply is not the reality. They ignore the fact that thousands of women have already pursued abortion pill reversal to mitigate the effects of the first of the two-drug medication abortion regimen.
You can start to understand the ambivalence when you realize that abortion decisions often don’t reflect a free “choice.” Women frequently feel restrained by their financial situation or are pressured to choose abortion. For a small minority of patients who have taken the first pill, mifepristone, the feelings of regret are immediate, and they seek ways to reverse what they perceive as a horribly wrong decision. Abortion pill reversal was developed as an option for these women.
The science behind the abortion pill reversal protocol is sound. There is a biologically plausible mechanism – mifepristone competes with progesterone for the progesterone receptors in the uterus that are instrumental in sustaining the pregnancy. By flooding the uterus with high-dose natural progesterone, the adverse effect of mifepristone can be reduced, and the chances of a continuing pregnancy increased.
There is animal-research support for this mechanism. There was also inadvertent proof of the principle demonstrated by a multinational, randomized study that utilized a different progestin agent, medroxyprogesterone. When administered at the same time as mifepristone in an abortion, women who received the progestin were four times as likely to have a continuing pregnancy.
There have been several small case series that have demonstrated the efficacy of the abortion pill reversal protocol. The largest case series using the abortion pill reversal protocol involved 754 women. Compared to historic controls, abortion pill reversal doubled the chances that a woman would have a continued pregnancy (64-68%) after ingestion of mifepristone, but before taking the second abortion pill, misoprostol.
The only randomized, placebo-controlled trial of abortion pill reversal was stopped prematurely due to safety concerns and was too small to render statistically significant conclusions. However, compared to a placebo, abortion pill reversal doubled the likelihood of an ongoing pregnancy. Not utilizing the abortion pill reversal protocol was associated with an increased risk for surgical intervention and transfusion.
The use of progesterone to prevent pregnancy loss in obstetrics is not unique. Progesterone has been widely used and demonstrated to be safe and effective in cases of threatened miscarriage in women with previous miscarriages. It is also utilized to support pregnancies using in vitro fertilization.
This leaves us with a biologically plausible mechanism, animal-research data, several case series that support the use of abortion pill reversal, as well as decades of safe use of progesterone in the practice of obstetrics. This is not high-quality evidence, but evidence nonetheless. For abortion advocates to suggest there is “no evidence” is disingenuous at best. In any other clinical setting, since the risk is very low and the potential benefit very high (a life saved), this would prompt clinicians to promote such an intervention. Why don’t abortion clinics?
There is nothing wrong with insisting on transparency in reproductive health care. Legislation is not necessarily bad. Pregnancy resource centers should be clear that while they discuss abortion, they don’t perform or refer for abortions. Abortion pill reversal should be part of every informed consent process preceding a medical abortion. And abortion clinics should clearly state that they don’t offer prenatal services or directly support pregnancies and that they stand to benefit financially from a woman’s decision to abort.
Thomas Perille, M.D., of Englewood, is a retired internal medicine and hospital medicine physician and president of Democrats for Life of Colorado. He is a fellow of the American College of Physicians and Society of Hospital Medicine.
Linda Pace Saccomano, of Lone Tree, is executive director of Alternatives Pregnancy Center.
Note: The original headline used the word “sound” to describe the science behind abortion-pill reversal. This is the claim made by the authors, but in the essay they have the room to put that claim in the context of evidence. Headlines don’t have room to provide that much context. The use of “sound” in the headline could too easily be interpreted to mean “settled in their favor,” which is neither true nor the authors’ point. The headline was rewritten on March 8 at 6:50 p.m.
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