A network of independent abortion providers are pushing back on the latest string of anti-abortion rhetoric in a big way: They’re demanding accountability from abortion opponents who claim patients can “reverse” their abortions, and they’re calling them out on billboards across San Francisco.
During a medication abortion, patients take mifepristone and then misoprostol in the space of a few days. Abortion opponents now claim that they can interrupt that process with a high dose of progesterone—”reversing” the medication’s effects as part of their “last chance” to decide against an abortion. The procedure is understudied. Its claimed results are unproven. But despite an absence of research, states began inserting misleading information about reversals into mandated counseling beginning in 2015.
“There have been four states where people have introduced a bill to make clinicians lie to patients, basically to presumptively tell them about abortion reversal,” Monica McLemore, a professor, nurse and abortion care provider who is featured on the billboards, explained to Ms. “It is a real problem—first of all, because it interferes with the patient-provider relationship, but second of all, because it’s not based on sound science.”
ACN, an organization that supports independent practitioners, embarked on the billboard campaign to raise public awareness about the junk science behind “abortion reversals”—only the latest in a string of medical inaccuracies gaining traction because of anti-abortion forces. Opponents of reproductive justice have in the last years used debunked theories of “fetal pain” to bolster restrictive abortion laws; for even longer, groups have falsely claimed that abortion was linked to breast cancer.
Researchers know that about 30 to 50 percent of people who don’t complete a medication abortion—without taking any progesterone—undergo an incomplete abortion, but there is very little information about the impacts of following a dose of mifepristone with progesterone. In a single 2012 case study, six patients took a high dose of progesterone after consuming a dose of mifepristone; four of those six patients carried their pregnancy to term. The author of the study did not apply for any ethical approval or use controls for comparison. “The underlying problem about using progesterone to theoretically reverse the effects of mifepristone is that we don’t know if it works,” McLemore said, “or if it is harmful.”
Arizona was the first state to require providers to tell all patients about the progesterone medication; since then, the number of states introducing similar rules has increased. In California, the State Board of Registered Nursing approved classes including information on the procedure. Even though a lawsuit brought by reproductive rights advocates forced Arizona’s governor to repeal the law, misinformation about abortion is still being spread across the country.
“We really believe that this is just another way for people to would like to see abortion access go away to undermine the credibility of providers and to undermine the authority of patients,” Jennifer Thibodeau, Communications and Program Manager at ACN, told Ms. “So we’re really hoping to just start the conversation among people who agree with us and who are working towards increasing abortion access.”
Many of ACN’s billboards appear near so-called Crisis Pregnancy Centers (CPCs), which distribute false information about contraception and abortion in order to deter women from accessing a full range of family planning resources. The billboards were also placed strategically near those from ACN’s ideological opponents. The organization has also launched a parallel petition campaign challenging lawmakers who elevate anti-abortion junk science.
“One of the reasons we chose these areas is there are reversal billboards there,” McLemore said. “It’s really important for us to get people to understand what is real information. We know that people are extremely certain in their decision to have an abortion and this is a political interference in a patient provider relationship.”