Abortion pill reversal (APR) remains a controversial subject of debate between life-affirming organizations and proponents of abortion. Ever since Dr. George Delgado published an article in the December 2012 issue of Annals of Pharmacotherapy, in which he was able to stop the abortion process in four out of six women after they had started, but not completed, the two-step medical abortion process by administering large doses of progesterone, the battle has raged. On the pro-life side is the Abortion Pill Rescue Network/Heartbeat International and the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG). On the pro-abortion side is Planned Parenthood and the American College of Obstetrics and Gynecology (ACOG). Since over 50% of abortions in the U.S. are now medication abortions rather than surgical abortions, this dispute is not going to go away anytime soon. Both sides agree on the science of how the abortion pill works. The process involves two pills, taken 24 to 48 hours apart, and can be used in pregnancies up to 11 weeks from the last menstrual period. The first medication is mifepristone, a drug that blocks the hormone progesterone. Without progesterone, the placenta breaks down and is unable to nourish the baby, who essentially starves to death. The second medication, misoprostol, causes the uterus to contract and expel the dead baby and placenta.

Abortion Pill Reversal Protocol

The abortion pill reversal procedure can be used after only the first dose of mifepristone is ingested and is ineffective if the second set of pills (misoprostol) is taken. The protocol involves giving a large dose of progesterone to the pregnant woman within 72 hours of taking the first set of pills. Since progesterone competes with mifepristone for binding sites on the placenta, the rationale is that the placenta is flooded with progesterone and thus protected while the mifepristone is washed out.

Pros and Cons

The American Pregnancy Association has written an excellent synopsis of the opposing views on the safety and efficacy of the abortion pill reversal:

The American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) supports the procedure and, in its public statement on abortion pill reversal, states three important things:

• Progesterone has been safely used during pregnancy for decades without undesired effects. (Many physicians agree but only when it is used properly.)
• For those infants who survive mifepristone, there is no evidence of birth defects associated with the medication. (ACOG itself has research confirming this).
• The efficacy of reversal (62%) is, in fact, higher than “sitting and waiting” alone (7-40%, depending on gestation) to see if a pregnancy continues (this is based on small studies, but this is because there is a small population that chooses reversal in the first place).

There are a few organizations that do not support the use of the reversal procedure, such as NARAL Pro-Choice America, Planned Parenthood, and ACOG (American College of Obstetricians and Gynecologists). Their main concerns are:

• Success rates from APR are from small studies and are very similar to those who only take mifepristone without any progesterone treatment. (It is true that more studies may be needed, but there is a small population that can even be studied, making it a challenge.)
• That offering the reversal procedure undermines a woman’s ability to choose, perhaps by implying that women must not have thought it through, and so need an option to get out. (A woman’s ability to choose does not end the moment she takes mifepristone, and some women have regrets or are initially coerced into getting an abortion.)
• That progesterone therapy, when given improperly, can cause damage to some of the body’s main systems, including the nervous, cardiovascular, and endocrine systems. (When treated by a licensed physician that is a part of a group of physicians that performs and discusses the procedure, there is accountability and a way to determine a “safe” dosage/procedure.)

We have been advised to “follow the science” in making medical decisions, especially in other controversial areas such as whether or not to take novel vaccines against Covid. If we follow the science concerning the abortion pill reversal debate, it makes rational sense to Choose Life!

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Read McKenna Greene’s heartwarming story of welcoming her healthy daughter after successful abortion pill reversal in Live Action’s September 26, 2024 news article. Go to https://www.liveaction.org/news/colorado-banned-abortion-pill-reversal-woman-access/.