By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Read just the headline, or read the entire article, and you’d surely be convinced that a recent study of abortion pill reversal (APR) showed the process to be dangerous to women.
For example, the Washington Post’s Christmas Eve headline read, quite directly, that “Some lawmakers push ‘abortion reversal’ treatments. A study shows how dangerous they are.”
But that’s not true. That is the abortion industry and its media allies spin.
The truth is when undergoing a chemical abortion, taking the first drug only, and then doing nothing else, is what is dangerous to women. It is not the abortion pill reversal protocol where a woman not only does not take the second drug, she also takes another drug to ward off the impact of the first drug. APR is safer and more effective at reversal.
And contrary to the spin, that is exactly what the study they’re talking about showed!
Babies being saved
As NRL News Today has explained on many occasions, Heartbeat International has reported that over 900 babies have been or are in the process of being saved by APR. APR depends on a woman not taking the second of two drugs (misoprostol), and boosting progesterone in a woman’s system to overwhelm the effect of the first drug (mifepristone).
After reporting on a few successful cases in 2012, George Delgado and several colleagues published results of a much larger scale study in 2018 in which the APR method was linked to 257 successful reversals with subsequent healthy births.
Dubious of the success, noted abortion researcher and chemical advocate Mitchell Creinin announced that he would be doing his own “scientific” study to determine whether abortion pill reversal was possible. It began in December 2018 and was supposed to involve 40 women randomly selected for either a progesterone boost (APR) or a placebo.
But Creinin abruptly ended his study early after recruiting just 12 patients when three ended up in hospital with bleeding issues. The article by Post reporter Kayla Epstein (picked up or cited by newspapers all across the country) adopts Creinin’s spin and turns the results of the study on it head.
Blaming APR for Mifepristone’s Problems
The Post article, in introducing Creinin’s study, makes no distinction between outcomes experienced by women who received the APR protocol and those who hadn’t. It simply says that “some of the women who participated in the study experienced dangerous hemorrhaging that sent them to the hospital.”
But here’s the critical distinction. Creinin’s patient data shows that there were bleeding issues, yes, but primarily with the placebo patients, not the APR patients who received the progesterone. Two of the three who suffered the most serious bleeding events never received the abortion pill reversal treatment.
Compounding the confusion, Epstein seems to have the numbers reversed. She reports that two of the hemorrhaging women were receiving progesterone and that only one of the women with the bleeding problem was receiving the placebo. Creinin’s study and published data clearly show the two worst bleeding cases involving women taking the placebo, rather than the progesterone, which was involved in just one of the three cases.
The other patient with a bleeding issue who took the progesterone boost that was part of the APR treatment bled as her chemical abortion was completed but did not require surgery or transfusion, as did the other two who received the placebo.
To emphasize, there were bleeding issues, but the most serious ones tended to be associated with the placebo patients who never received with the APR progesterone boost.
This is quite a different message than the one popularized by the press.
The Post makes it sound as if APR poses the risk and triggers severe bleeding. However, the evidence points in the direction of mifepristone, the abortion pill, being the culprit. If anything, the APR progesterone boost seems to be associated with a lower bleeding risk.
And, of course, APR gives the baby a better chance to survive.
Largely ignored is the original point of the investigation – to see if APR works.
Because the study was halted prematurely, Creinin told the Post that his team was unable to determine whether or not APR worked. Creinin told Epstein that he felt “really horrible” that he couldn’t finish the study, that “the women…had to go through all this.”
Creinin appears to have forgotten comments he made in an article that appeared in Vice News in April 17, 2019. There he gave the following criteria for determining whether or not APR worked:
“If there’s a difference between the groups and it shows that the group with the progesterone continued the pregnancy more and the group with the placebo lost the pregnancy more, then that shows the progesterone does something.”
Though the numbers are smaller because of the study’s hasty ending, this is still precisely what Creinin’s data showed. Four of the five patients (80%) receiving the APR progesterone boost were still pregnant at the end of their two weeks on the trial. This was true of only two of the five patients (40%) who received only the mifepristone and the placebo.
The Real Risk in Abortion Industry’s Protocol
Creinin tried to shift the focus elsewhere. He said they were able to uncover a “very significant safety signal” about disrupting the approved chemical abortion protocol. He found his limited study data sufficient to determine that “patients in early pregnancy who use only mifepristone may be at high risk of significant hemorrhage.”
Though the Post article is written as if this was one of the reversal options being considered, it has been abortion advocates, not APR providers, who have suggested that taking mifepristone [the first drug] and simply foregoing the misoprostol [the second drug] would be just as effective as the progesterone boost (see Grossman, New England Journal of Medicine, 10/18/18).
Clearly, given the data from Creinin’s study, that advice from abortion pill advocates is both inaccurate and dangerous.
If a woman takes mifepristone and changes her mind about abortion, it appears to be much safer and more effective for her to take the APR progesterone boost than to skip the misoprostol and hope the chemical abortion fails.
Epstein writes that Creinin believed his study showed the “dangers of antiabortion laws” that push “disinformation and unproven treatments.”
If anything, it was abortion advocates who were pushing “disinformation and unproven treatments. ” They were claiming that women desiring to reverse their chemically-induced abortions could just avoid taking any further drugs and hope they were ones for whom the mifepristone failed. The APR method with the progesterone boost referenced in these laws was, on the other hand, demonstrated by Creinin’s own study to be both safer and more effective for these reversals.
Medical Associations Ignore the Science
Epstein cites a statement from the American College of Obstetricians and Gynecologists (ACOG) that claims of abortion reversal “are not based on science and do not meet clinical standards.” While providing a link, it does not directly tell the reader that the ACOG statement was from August 2017, before Delgado and colleagues published a study involving more than 250 successful cases of reversal in the Spring 2018 edition of the peer reviewed journal Issues in Law & Medicine.
American Medical Association President Patrice A. Harris also joined in the chorus complaining about laws requiring women be told about the abortion pill reversal procedure. Harris told the Washington Post last July that such laws “actually compel physicians and other members of the health-care team to provide patients with false or misleading information that’s not based on evidence, that’s not based on science.”
If we consider Delgado’s 2018 results and those from Creinin’s more recent study, the “science” appears to support Delgado’s APR progesterone boost protocol, not the abortion industry’s dangerous “wait and see” approach.