UPDATE, 8/8/24: On August 6, the Centers for Disease Control and Prevention (CDC) updated their “U.S. Selected Practice Recommendations for Contraceptive Use.” The document provides additional evidence that mainstream medical authorities are aware that progesterone (which is used for so-called “Abortion Pill Reversal”) can interfere with the efficacy of mifepristone. It clearly states that “concurrent administration of DMPA [synthetic progesterone] with mifepristone might slightly decrease medication abortion effectiveness and increase risk for ongoing pregnancy.”
Screenshot from updated CDC practice recommendations for contraceptive use
2/10/24: On Tuesday, February 6, the Thomas More Society published a press release detailing their petition to the California Supreme Court for dismissal of a lawsuit filed by California Attorney General Rob Bonta against their clients — Heartbeat International (HBI) and RealOptions Obria Medical Clinics.
The lawsuit alleges that the two pro-life organizations are “misleading patients” by offering them information about the administration of progesterone to attempt to counter the effects of the abortion pill mifepristone. This treatment is most commonly referred to as “abortion pill reversal“ (APR). The suit accuses HBI and RealOptions of making “false or misleading statements” and engaging in “unlawful, unfair, and fraudulent business practices.”
THE TRUTH ABOUT APR
To support these allegations, Bonta’s lawsuit claims that APR is “an unproven and largely experimental procedure” which is “not backed by credible science.” In their petition filed on Tuesday, Thomas More Society attorneys cite ample evidence to the contrary.
Live Action News has repeatedly reported on APR’s mechanism of action – it essentially works by supplementing the mother with the hormone progesterone to counteract the effects of mifepristone (the first drug in the abortion pill regimen), which inhibits the pregnancy-sustaining action of the woman’s naturally occurring progesterone. Live Action News has also reported on APR’s stated safety and efficacy and has published numerous stories of women who were said to have been able to save their children’s lives by following the APR protocol.
WHAT DO PRO-ABORTION SOURCES SAY?
It’s interesting to note, however, that even the pro-abortion American College of Obstetricians and Gynecologists (ACOG) has previously noted that progesterone can inhibit the efficacy of mifepristone.
In ACOG’s 2020 medication abortion practice bulletin, which provides information to doctors who prescribe the abortion pill, it states: “[A]dministration of DMPA on day 1 of the medication abortion regimen may increase the risk of ongoing pregnancy.”
DMPA is a method of long-acting birth control frequently referred to by its brand name, Depo-Provera. It relies upon synthetic progesterone for its contraceptive efficacy. In layman’s terms, ACOG’s above statement essentially warns doctors that administering progesterone – even in its synthetic form – immediately after mifepristone can prevent the abortion pill from being “successful.”
This is precisely what APR advocates assert, and this is the exact same mechanism of action relied upon by the APR protocol.
The ACOG practice bulletin references a 2016 study, which found that “[o]ngoing pregnancy after initial abortion treatment was significantly more common” in women who had been given DMPA with mifepristone compared to those who had been given DMPA after their abortions were complete.
A more recent (November 2023) study in the journal Contraception reached the same conclusion: “Concurrent administration of DMPA with mifepristone may decrease medication abortion efficacy.”
The World Health Organization (WHO) also states on its “abortion care guideline” page: “Immediate initiation of intramuscular depot medroxyprogesterone acetate (DMPA) is associated with a slight decrease in the effectiveness of medical abortion regimens.”
Similarly, the pro-abortion Reproductive Health Access Front claims that “there is some evidence that Depo Provera decreases the effectiveness of mifepristone. Patients who choose Depo after a medication abortion … can receive the shot the same day if they accept possible decrease in effectiveness[.]”
Innovating Education in Reproductive Health, another pro-abortion organization, likewise claims: “Mifepristone binds to progesterone receptors; its affinity for the receptor is higher than that of progesterone itself. Administering progesterone in the depot or implant form at the same time could potentially out-compete mifepristone and decrease its efficacy.”
O&G Magazine, a publication of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, also warns: “In the context of medical abortion, there is some concern that initiation of DMPA at the time of mifepristone administration may impair the progesterone-blocking action of mifepristone, reducing medical abortion efficacy.”
In other words, numerous sources, none of whom have any affiliation with APR, and many of whom actively promote abortion, make the same claim that APR providers do, namely: progesterone can decrease the effectiveness of the first drug in the abortion pill regimen after it has already been ingested.
AN INSIDIOUS DOUBLE-STANDARD
Some of the above sources not only affirm this claim, but emphasize that women should be informed about it. The 2023 study published in Contraception states: “Patients seeking medication abortion should be informed about these findings to help guide post-abortion contraceptive choices.”
And O&G Magazine agrees: “Women having a medical abortion should … be advised that there may be a slightly higher risk of continuing pregnancy if DMPA is initiated at the time of mifepristone administration.” Even ACOG says “[p]atients who select depot medroxyprogesterone acetate (DMPA) for contraception” after taking the abortion pill “should be counseled” about DMPA’s ability to impact the efficacy of mifepristone.
But when pro-life organizations attempt to do exactly what is advised by these publications – namely, inform women that progesterone can stop a chemical abortion already in-progress – they face lawsuits and other forms of retaliation from abortion advocates.
There is an insidious double-standard at play here. The exact same information is hailed as “science” when pro-abortion sources report it, but is denounced as quackery when proclaimed by pro-lifers.
Clearly, in the eyes of abortion advocates like AG Rob Bonta, the real crime being committed by organizations like HBI and RealOptions is that of saving lives by utilizing this information — which is in no way “pseudoscience.” Accusations that they are disseminating “misinformation” are merely a flimsy cover for what is solely and decidedly an ideology-driven attack.
Editor’s Note 7/30/24: This post has been updated for clarification.
