Abortion-pill reversal: The next frontier of informed-consent laws?

August 15, 2017 CNA Daily News News Briefs 1 Print

Indianapolis, Ind., Aug 15, 2017 / 06:04 am (National Catholic Register).- Medication abortions are on their way to becoming the dominant method of abortion in the U.S. But lawmakers are starting to look at whether to change their state’s informed-consent laws to let women know of an experimental treatment that could possibly reverse the effects of a progesterone-blocking abortion.

Indiana state Rep. Ronald Bacon, (R-Chandler), told the National Catholic Register that he heard about the “abortion-pill reversal” technique during a presentation by Fort Wayne obstetrician-gynecologist Christina Francis. Bacon, who is Catholic, thought that women contemplating abortion, or who have taken mifepristone – the first pill in the two-pill RU-486 abortion process – should at least know the possibility existed.

In the event they wanted to reconsider their choice for abortion, Bacon said they should know about this possibility and who they should contact from the information packet that abortion doctors are required to give their patients.

“We should at least try to give women as much information as possible,” he said.

Bacon’s legislation passed Indiana’s House of Representatives Feb. 27 on a 54-41 vote, but never made it through the state senate. Other pro-life lawmakers balked at the law, citing the need for more studies.

Still, Bacon said the media coverage of the debate did create awareness.

“I felt at least the word got out there,” he said.

Rapidly Changing Industry

First-trimester abortion accounts for 91 percent of all abortions performed in the U.S. But RU-486 medication abortions account for nearly a third of all abortions, according to the Guttmacher Institute. That figure is rising, and in some states, RU-486 accounts for half of all abortions.

In Scandinavian countries, that future has already arrived: Medication abortions account for 96 percent of abortions in Finland, 91 percent in Sweden and 86 percent in Norway.

Mifepristone is the first drug taken in the two-step RU-486 chemical abortion regimen. The first pill (also known as Mifeprex) blocks the hormone progesterone from bonding to the uterine wall, causing it to shed, killing the embryo by literally starving it to death. Approximately 24-48 hours later, a second pill called misoprostol (commercially known as Cytotec) is ingested to expel the deceased unborn child with the other contents of the uterus.

However, Dr. George Delgado, medical director of Culture of Life Family Services in San Diego, California, that runs the AbortionPillReversal.com program and its 24/7 hotline, has developed protocols designed to block the effects of mifepristone by flooding a woman’s body with progesterone, ideally within 72 hours of taking the abortion pill. The concept involves overwhelming Mifeprex with progesterone in order to save the uterine lining and allow women to exercise their choice to continue their pregnancies.

Delgado said he is in the process of submitting an article for publication to a peer-reviewed medical journal that “will describe over 200 cases of successful reversals.”

The article will build on another study published in the spring 2017 edition of Issues in Law and Medicine by his colleague Dr. Mary Davenport, which reviews studies on women who took mifepristone alone for abortion. The review, he said found the embryo survival rate to be between 8 and 25 percent.

Delgado said that upper limit of 25 percent will form the “historical control group” for comparing the embryo survival rates from their best progesterone-treatment protocols, which their data puts in the range of 60-70 percent.

“It does make a difference if a woman who changes her mind undergoes our reversal protocols,” he said.

Abortion-Pill Reversal

Many pro-life physicians and pro-life health centers across the country have now made abortion-pill reversal a treatment option to women.

Kathleen Eaton Bravo, founder of the Obria Medical Clinics and president of the Obria Foundation, told the National Catholic Register that Obria provides the progesterone treatment to women who request it. She said that as Obria’s telemedicine platform expands in more states, it will provide another mechanism for women searching for help after taking the first abortion pill.

“We have a much better opportunity to save lives this way,” she said. Bravo, who is a post-abortive mother, said when she had time to reflect on her surgical abortion decades ago, it was too late to do anything to save her child. But the woman who takes mifepristone in a doctor’s office actually has time in the privacy of her home to consider whether she really wants to go through with abortion before taking the second pill. At that point, she said, a woman who changes her mind and wants to keep her baby will turn to her smartphone and start searching for help.

“We have a much larger window of opportunity to save this child’s life if we can reach them through their smartphones,” Bravo said. “This is a much bigger opportunity to save lives than we’ve ever had through surgical abortions.”

Bravo said the best prevention against medication abortion is building relationships with abortion-vulnerable women so they never end up taking the abortion pill in the first place. She pointed out that Planned Parenthood’s abortion business model today is based on pre-existing relationships with clients: It utilizes telemedicine to connect with women and men and is providing them with health services. She noted that in California, Planned Parenthood is expanding into primary care and is starting to rebrand as “Melody Women’s Health.”

Bravo said that Obria is seeking to build those pre-existing relationships with women and men by connecting to them through Obria’s telemedicine platform and providing them with medical care and social support so that if they are in a crisis situation, they will turn to Obria first for help.

Model Legislation

So far, just three states have enacted changes to informed-consent laws related to informing women about abortion reversal.

Arkansas explicitly requires women to be told that it might be possible to reverse a mifepristone abortion. South Dakota’s legislation states that a woman does not have to continue the two-step abortion regimen if she changes her mind, and to look to the state health department’s website for information on reversal – none of which can be found there. Arizona passed and then repealed legislation requiring women to be informed that medication abortion could be reversed after a court challenge.

Lawmakers in a handful of other states have attempted to bring similar bills to their statehouses for consideration based on model legislation developed by Americans United for Life (AUL).

Denise Burke, AUL’s vice president of legal affairs, told the National Catholic Register that the organization believes women should know there’s a “possibility” that they could increase their chances of keeping their children with this treatment.

“This is empowering women to make the best decision for them and their families,” she said.

Burke said AUL has been in contact with a number of legislators that are contemplating bills for 2018. She hopes that the results of Delgado’s forthcoming study will bolster the case for lawmakers for making this knowledge part of the informed-consent process for abortion.

ACOG Opposed

The American Congress of Obstetricians and Gynecologists (ACOG), however, has weighed against states changing their informed-consent laws. An ACOG spokesman referred to a position paper noting abortion-pill reversal has not been substantiated by the body of scientific evidence and is not recommended in ACOG’s clinical guidance on medication abortion.

ACOG’s paper noted that pregnancy will continue in 30-50 percent of women who take mifepristone alone and do not take misoprostol.

“Available research seems to indicate that in the rare situation where a woman takes mifepristone and then changes her mind, doing nothing and waiting to see what happens is just as effective as intervening with a course of progesterone,” it stated.

Dr. Gretchen Stuart, director of the University of North Carolina School of Medicine’s Department of Obstetrics and Gynecology’s family-planning division, told the National Catholic Register that “laws that affect medical practice should be based on scientific evidence.”

“The American College of Obstetricians and Gynecologists states that medication abortion reversal is not supported by scientific evidence, and, therefore, this approach is not recommended,” she said.

Stuart also noted that Delgado’s previous report in the literature of women receiving progesterone injections was “too small a sample size to make scientific conclusions.”

In contrast, the American Association of Pro-Life Obstetricians and Gynecologists has lent its support to Delgado’s work.

Studies on the Way

Delgado told the National Catholic Register his latest findings will be published over the next several months. However, he stated the ACOG position paper cited figures for incomplete abortion, which are not the same figures as embryo survival. In the studies where doctors checked for the embryo’s survival with ultrasound, the embryo was already dead, even though the woman’s body had not begun the process of expelling the uterine contents.

In principle, he said women should know that reversal is an option “in case they change their minds” and be assured no scientific data indicates either mifepristone or progesterone treatments cause birth defects.

“We have evidence that using progesterone to reverse the effects of a mifepristone abortion is both safe and effective,” Delgado said.

Further studies demonstrating the effectiveness of Delgado’s technique will likely be needed before more legislators act on it. Rep. Bacon said he intends to bring his bill back to the statehouse once he can approach his fellow Indiana lawmakers with “more clinical proof.”

“I definitely will bring it back then.”

 

This article was originally published by the National Catholic Register.

 

If you value the news and views Catholic World Report provides, please consider donating to support our efforts. Your contribution will help us continue to make CWR available to all readers worldwide for free, without a subscription. Thank you for your generosity!

Click here for more information on donating to CWR. Click here to sign up for our newsletter.

Related Articles

No Picture
News Briefs

Data contradict Harvard professor’s assertions about homeschooling

May 7, 2020 CNA Daily News 1

Denver Newsroom, May 7, 2020 / 05:29 pm (CNA).- A Notre Dame sociologist is using data to challenge a Harvard Law professor’s assertions that homeschooling is “dangerous”, and detrimental to society.

The controversy stems from a recent paper by professor Elizabeth Bartholet in which she calls for a presumptive ban on homeschooling in the United States.

Bartholet, as quoted in a Harvard Magazine piece based on her paper, points to unspecified “surveys of homeschoolers” to assert that “up to 90 percent” of homeschooling families are “driven by conservative Christian beliefs, and seek to remove their children from mainstream culture.”

“Some” homeschooling parents are “‘extreme religious ideologues’ who question science and promote female subservience and white supremacy,” she writes.

David Sikkink, associate professor in the Department of Sociology at the University of Notre Dame, analyzed surveys of homeschooling families— including a 2016 government survey—  and found that these families are not overwhelmingly Christian nor religious, and are not as universally closed-off to the outside world as Bartholet asserts.

In the analysis Sikkink conducted, just 16% of homeschooling parents said they were homeschooling primarily for religious reasons. The number one reason homeschooling parents cited was a concern about school environment, such as safety, drugs, or negative peer pressure.

Eleven percent of parents reported homeschooling because their child has special needs.

While approximately half of the homeschooling parents surveyed mentioned religion as a factor in their decision to homeschool, Sikkink notes that the parents who cited religion as a reason were, on the whole, more highly educated than those parents who did not.

In terms of Bartholet’s assertion that some homeschooling parents “believe that women should be totally subservient to men and educated in ways that promote such subservience,” Sikkink’s analysis did not find evidence that religious households oppose higher education for girls.

Among the homeschooling families in the survey who use a religious curriculum, there was no difference in their self-reported educational expectations— i.e., what education level they expected their children to reach—  for their male children vs. their female children.

Several past studies have shown that homeschool students typically outperform their public and private school counterparts on things like standardized tests and college performance. A 2016 study from the National Council on Measurement in Education showed that, when adjusted for demographic factors, homeschool students were on par academically with their demographically-similar peers.

Moreover, the data Sikkink analyzed suggests that after family background and demographic controls are accounted for, about 64% of homeschoolers “completely agree” that they have much in life to be thankful for, compared to 53% of public schoolers.

On feelings of helplessness, or lack or goals or direction in life, homeschoolers do not substantially differ from their public school counterparts, the analysis suggests.

In the Arizona Law Review, Bartholet argues that while homeschool children may perform as well as their peers on standardized tests or in college, they are also often isolated from their peers and denied experiences and exposures that would make them more productive citizens.

Bartholet claims in her article that “a very large proportion of homeschooling parents are ideologically committed to isolating their children from the majority culture and indoctrinating them in views and values that are in serious conflict with that culture.”

“Isolated families,” she asserts, “constitute a significant part of the homeschooling world.”

In contrast, Sikkink’s analysis found that among the schooling groups surveyed, homeschooling families had the highest level of “community involvement” of all school sectors.

“Community involvement” activities included attending sporting events, attending concerts, going to the zoo or aquarium, going to a museum, going to a library, visiting a bookstore, or attending an event sponsored by a community, religious, or ethnic group.

Homeschooling graduates are almost identical to their public school counterparts in likelihood to vote in federal and local elections, Sikkink found.

Furthermore, the total number of volunteer and community service hours for homeschooling graduates is very similar to or slightly higher than public school graduates, the analysis found.

Bartholet asserts that some homeschoolers “engage in homeschooling to promote racist ideologies and avoid racial intermingling.”

In contrast: “The reality is that about 41% of homeschooled children are racial and ethnic minorities,” Sikkink writes.

“When asked about four closest friends, about 37% of young adult homeschoolers…mention someone of a different race or ethnicity—exactly the same as public schoolers.”

This diversity also extends to schooling practices— increasingly, Sikkink says, homeschooling adopts new forms, including “hybrids” that combine the benefits of home and institutional schooling.

“About 64 percent of homeschoolers are using some form of instruction outside the family,” Sikkink told CNA in an email.

“That includes using tutors, private or public schools, colleges or universities, or homeschooling coops. That percentage would be higher if we included those who reported obtaining curriculum from formal institutions, such as public schools.”

Moreover, about a third of homeschooling parents obtain their curriculum or books from a public school or school district.

“Altogether, 46% of homeschoolers have some pedagogical relationship with public schools,” Sikkink asserts.

Bartholet argues that homeschooling puts children at risk of abuse by their parents, while if children were in public schools, they would be among teachers who are mandatory reporters of any suspected abuse that may be taking place.

“The issue is, do we think that parents should have 24/7, essentially authoritarian control over their children from ages zero to 18? I think that’s dangerous,” Bartholet asserts in the Harvard Magazine piece.

“I think it’s always dangerous to put powerful people in charge of the powerless, and to give the powerful ones total authority.”

Sikkink says Bartholet’s image of a child confined to the home “24/7…from ages zero to 18” is not consistent with the data.

“When we look at the use of homeschooling for each year of the child’s upbringing, we only find a small percentage that report that the child was homeschooled for all their years of schooling,” Sikkink told CNA in an email.

Many of these students are part-time public schoolers— about 25% of homeschoolers receive some instruction in public schools during their school-age careers, he wrote.

Homeschooling regulations vary widely by state. Sikkink told CNA he hopes future studies will examine the effects of state-level variation in regulation on homeschooling quality.

“The question of schooling oversight remains, of course, but it would be short-sighted not to keep homeschooling and other creative schooling options in the mix, including the hybrid models that cross sector boundaries,” Sikkink concludes.

[…]

1 Comment

  1. We’ve entered the new easy access to abortion and easy procedure. The stats in Scandinavia are likely the future for the entire West, entire world. The reversal procedure is fine but will be virtually ineffective in reducing abortions. As with the pill sexual activity increased due to reduced pregnancies. This will have similar increasing effect since it much further reduces the instance of pregnancies. The only viable response is renewed moral instruction, thru sermons and personal counsel not simply on serious sin regarding abortion. We must address clearly and consistently the serious sin of sexual relations outside of marriage. Fornication must be called for what it is. Serious sin. Cohabitation is serious sin. Hierarchy must recalibrate their clergy formation agenda on the seriousness of sexual immorality. The protection of a human life made in God’s image is infinitely more vital for Man’s salvation than socio economics and green issues.

    Reply

Leave a Reply

Your email address will not be published.

All comments posted at Catholic World Report are moderated. While vigorous debate is welcome and encouraged, please note that in the interest of maintaining a civilized and helpful level of discussion, comments containing obscene language or personal attacks—or those that are deemed by the editors to be needlessly combative or inflammatory—will not be published. Thank you.


*