The driving question of this story is, can an abortion be reversed using high doses of a hormone called Progesterone?
As with our last article about abortion, let’s set aside whether you think it is right or wrong and divest ourselves from the emotions those deeply held beliefs can bring and look at the facts.
Here is the issue: Lawmakers and Pro-Life advocates want to bring a bill to the Statehouse that would mandate doctors inform patients before they receive an abortion that, under certain circumstances, it could be reversed if they change their mind.
On its face, the legislation is being posed as an informational boon for patients who may not be fully aware of all of their options.
Where opponents disagree with the legislation is in the content of how that reversal would be described as happening.
Any potential reversal only applies when dealing with a medication-induced abortion using a two-drug process. The two drugs are mifepristone, which is taken first and stops the pregnancy by blocking the hormone progesterone; and a second drug called misoprostol which makes the uterus contract to complete the abortion.
The two drugs are taken separately.
Supporters of the bill want to flood the body with enough Progesterone to counteract the mifepristone. The premise is, if there is too much Progesterone the mifepristone can’t stop it all and the pregnancy can continue; this requires high doses of Progesterone.
Opponents of this process say it is unknown what can happen if high doses of Progesterone are given to women and are fearful that harm could come of doing so.
As with any medical or scientific exploration, studies can be done to try and determine the effects; and in this case, some small studies have been completed.
According to the American Congress of Obstetricians and Gynecologists (ACOG), in 2012 a case series reported on six women who took mifeprestone and were then administered varying Progesterone doses. Four of those women continued their pregnancies.
To supporters, that is a 66% success rate showing the Progesterone saved the pregnancy.
However, scientifically there are problems with that claim.
First of all, a study of six individuals is nowhere near enough to get an accurate read on success or failure, or to determine what if any side effects may occur down to other individuals that do not fit the make-up of the six that participated in the study to begin with.
Then there is the problem of saying Progesterone was the active catalyst to the successful pregnancies post mifeprestone.
According to medical professionals, if a women who is pregnant takes mifeprestone and then decides to stop taking it, and never takes the second drug, misoprostol, there is a 7-40% chance the pregnancy will continue on its own.
In other words, mifeprestone is only successful in stopping the pregnancy somewhere between 60-93% of the time based on a number of variables.
Simply adding more Progesterone to the body may or may not have had an impact on the outcome in that small study is the point, according to the ACOG which said in its report:
This study was not supervised by an institutional review board (IRB) or an ethical review committee, required to protect human research subjects, raising serious questions regarding the ethics and scientific validity of the results.
About a year after this study was published, Rebekah Hagan found out she was pregnant.
She was 18 at the time and already had a 1-year-old son. She says she didn’t think there was any way she could raise a second child as a 19-year-old going to college with no support from the father and a fear her parents would kick her out of their home.
Hagan decided to get a medication-induced abortion.
As she left the clinic around 4pm that day clutching the brown bag with the rest of the mifeprestone and misoprostol she would need to finish the abortion, she says she panicked.
“It was almost like I couldn’t believe what I had done, even though I had just done it; and so instantly I felt panicked and again alone, and really just kind of stuck in my grief and wishing I could just take back the last 10 or 15 minutes of my life,” said Hagan.
At the time high dose Progesterone based abortion reversals were not widely advertised, and as she sat in her car in the clinic parking lot searching the internet for answers on her smart phone, she found a hotline number that connected her with a doctor.
By 10am the next day she was given what would become the first of many Progesterone shots. Six weeks later the shots stopped and at 41 weeks into her pregnancy she gave birth to a baby boy.
The boy is nearly six now, and she believes the process helped her carry her baby to term.
Still, Rebekah says she understands the concern opponents have to the process.
“I think we have to present what we know, present the fact that Progesterone has been used for many, many years, not just with women who have a tendency to miscarry but for women who have all sorts of hormonal issues, and if a woman is presented with the facts and told that, ‘Look, this is experimental and we’re not 100% sure, but here’s what we do know, and here’s what you might go through, and you still may experience the loss of your pregnancy,’ and then she’s given the right to make that decision based on all of that information; I think that we should be able to trust women enough to be able to make that decision; it reminds me of like experimental cancer treatment, or something like that, we still give people that option even though we don’t know 100% what the outcome will be,” said Hagan.
So, back to the question from the top of the article: can an abortion be reversed using high doses of a hormone called Progesterone?
We don’t know for sure.
Some will say, there have been nearly 500 babies born as a result of this kind of treatment and that’s good enough evidence for them to believe the answer is yes.
State Senator Peggy Lehner, one of the impending sponsors of the legislation said as much at a news conference Tuesday.
Others are not yet sold, including a good portion of the medical community that relies on good scientific research and methods to ensure the reduction of unintended consequences and side effects.
Did Rebekah just get lucky?
Should successes like hers be the basis for prompting others to go down the same path?
The report ACOG put out on that small study done in 2012 was posted in August 2017.
Heartbeat International, the group helping Ohio Right to Life push this bill to lawmakers, is sticking to their belief the success rate is around 64% based off of a new study published by Dr. George Delgado in 2018.
This new study is of 754 patients that have all stopped taking mifeprestone and started taking high doses of Progesterone. The study claims a pregnancy success rate of 64%.
In October of 2018, Dr. Daniel Grossman and Kari White, who has a Ph.D. and a Master of Public Health, questioned the Delgado’s methodology in the New England Journal of Medicine saying the statistics are inflated.
Are the statistics good? Should doctors be telling their patients about an experimental procedure they have no idea for sure will work or if there will be side effects? That the procedure itself, even if it does work the way Dr. Delgado says it does, may or may not work without a guarantee?
Some lawmakers, like Sen. Lehner and State Representative Niraj Antani who will be introducing the bill in the Ohio House of Representatives, think they should.
Ohio Right to Life doesn’t like to stick their neck out too far on legislation. According to Stephanie Ranade Krider the Vice President of the organization, as the largest anti-abortion organization in the State, they must maintain their credibility and trust they have built with lawmakers especially.
The organization did not even support the Heartbeat Abortion Bill until about a month before it passed for the second time, always saying they did not support it because it couldn’t get through the courts; that is until the Supreme Court of the United States saw new members.
When Governor Mike DeWine signed the bill that had been so embattled over the years and gone through two prior vetoes by his predecessor, Ohio Right to Life was front and center for the historic occasion.
They gauge a number of factors before deciding what legislation to push, including the science behind it according to Krider.
“The studies that we cited today have been peer-reviewed, the studies that Heartbeat International has provided today are all studies that have been done within the United States as they’ve seen these abortion pill reversals taking place,” said Krider.
And yet, ACOG’s report refutes the validity of those studies.
“Facts are important, especially when discussing the health of women and the American public. Claims regarding abortion “reversal” treatment are not based on science and do not meet clinical standards.”
Meanwhile, NARAL Pro-Choice Ohio Deputy Director Jamie Miracle says, “Time after time what we are seeing is bills introduced in this state legislature that are based on junk science and not actual facts; and the bills that are passing through this legislature should be based in medical science not science fiction.”
While there has been a recent example of a bill promoting something that truly is not medically possible at this time, this bill may not go quite that far.
There are still questions over whether Progesterone is making this happen or not. It could be, but more study is needed and for some in the medical community that study needs to be done in a scientific way that is acceptable in terms of standards.
Until that happens; until there is scientific proof; or until the medical community can be convinced otherwise; we will not know for sure if high doses of Progesterone can save a pregnancy after mifeprestone is taken.
All we have is, it might.