The XX Factor

The Latest Anti-Choice Lie to Become State Law: “Abortion Reversal”

Mifepristone, also known as the abortion pill, is the latest target of anti-choice state legislation.

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Earlier this month, South Dakota Gov. Dennis Daugaard, a Republican, signed a bill that compels abortion providers in the state to tell people seeking a medical abortion that they can change their minds in between the two doses of medication and request an “abortion reversal.” The law mandates that doctors give their patients inaccurate information that has no basis in scientific evidence.

This informed consent provision may provide momentum for the next wave of anti-abortion legislation. Arizona and Arkansas already have abortion-reversal laws on the books, and STAT reports that Americans United for Life, an anti-abortion law firm, has put together a similar bill for conservative state legislators to use as a model for their own abortion-reversal notification mandates.

A medical (that is, nonsurgical) abortion involves two medications: At the doctor’s office, a patient takes mifepristone, causing her cervix to dilate and her uterine lining to slough off. Later, at home, she takes a dose of misoprostol, which sets off a series of uterine contractions and what amounts to something like a heavy period. Abortion reversal laws claim that if a patient skips the misoprostol and gets a hefty dose of progesterone, she may halt her pregnancy’s termination.

Anti-choice advocates point to a single paper as proof that midway abortion interruption is a legitimate medical practice. The 2012 report details the cases of seven pregnant women who took mifepristone and then, hours or days later, told their doctors they had changed their minds. The physicians gave the women progesterone injections instead of misoprostol. Two women lost their pregnancies anyway; one dropped off the map; and four carried their pregnancies to term.

Since there’s been no scientific study on this procedure with a respectable sample size and controls, some say right-wing advocacy groups are using conservative politicians to pass these laws so they can experiment on women and see if it could actually work. Daniel Grossman, a University of California, San Francisco professor of obstetrics and gynecology, told STAT that any doctor who’d do so is “essentially testing an unproven, experimental protocol on pregnant women.” “As physicians, we can’t just experiment on patients willy-nilly,” he said.

Informed consent laws are notoriously full of misleading statements and flat-out lies, constructed for the sole purpose of forcing a doctor to try to scare a women out of an abortion. In addition to South Dakota’s new abortion-reversal provision, doctors in the state must inform abortion-seekers that “abortion will terminate the life of a whole, separate, unique, living human being”; that a pregnant person has an “existing relationship with that unborn human being”; and that having an abortion will increase her risk of depression and suicide. (It won’t.)

As targeted regulation of abortion provider (TRAP) laws cause surgical abortion centers to shutter around the country, accessible medical abortions have become even more of a critical necessity. They’re only getting more popular—so much so that Berkeley students are protesting for access to the pills on campus. Just last month, the FDA released new guidelines that approved the prescription of mifepristone through the 10th week of pregnancy, a big jump from the original seven-week benchmark. The new guidelines also made medical abortions an easier and more attractive option: They changed the recommended mifepristone dose from 600 milligrams to 200 milligrams, which is just as effective with fewer side effects, and allowed women to take the second pill at home instead of having to come back to the doctor’s office.

So it’s no wonder anti-abortion advocates have made these pills the target of their latest incremental step toward banning abortion. In recent years, right-wing state legislators have tried—and in many cases, succeeded—to ban webcam consultations for medical abortions, which reduced cost and travel time for patients who used them in lieu of face-to-face visits, especially those in rural areas or parts of the country with little access to reproductive health care. Now, these staunch advocates of “protecting women” from their own medical decisions are using them as guinea pigs.