Can This Procedure Reverse an Abortion?

A slew of local reports regarding the Abortion Pill Reversal (APR) program — which attempts to cancel the effects of RU486, or mifepristone, through its Emergency Abortion Pill Reversal Kit, apparently offered by more than 300 providers across the country — have surfaced on local Fox News stations this week. But how was this procedure established? And is it actually effective? Opinions are split, Yahoo Parenting has found.

According to APR — a program run by Culture of Family Life Services, an “abortion alternatives” nonprofit in San Diego — 137 babies have so far been born without complications following the treatment, and another 76 women who have been treated are currently pregnant.

Story: When Vasectomies Are Not as Reliable as You Think

Mifepristone, according to the FDA, is a drug that blocks the hormone progesterone, which is needed to support pregnancy. And the Emergency Abortion Pill Reversal Kit is a series of progesterone shots that, APR says, is about 60 percent effective in reversing an RU486 abortion if begun within 72 hours of taking half of the standard two-pill dose of mifepristone. Treatment has not worked for women who have already taken the second pill.

“The treatment we give her … floods her system with progesterone so the abortion pill doesn’t work,” APR’s associate medical director, Matthew Harrison, MD, told Fox 46. Harrison, a family practitioner based in Salisbury, N.C., is being touted in media coverage as a “pioneer” of the Emergency Abortion Pill Reversal Kit. The Fox News feature noted that Harrison “may be on the verge of a medical breakthrough” with the treatment he developed.

Story: Did Flu Shot Cause 9-Year-Old to Go Blind, Become Paralyzed?

But Sherry Ross, MD, an ob-gyn with Los Angeles Women’s Obstetrics and Gynecology, tells Yahoo Parenting that Harrison’s recommendations for progesterone treatment are based on “flawed science.” “There is no proof that this works, no clinical studies,” she says, noting that when the procedure was discussed at the American Congress of Obstetricians and Gynecologists last year, the governing body was “very unsupportive and concerned — they did not endorse it.”

Indeed, a systematic review of the “reversal” treatment, published in June in the international reproductive-health journal Contraception, concluded that “in the rare case that a woman changes her mind after starting medical abortion, evidence is insufficient to determine whether treatment with progesterone after mifepristone results in a higher proportion of continuing pregnancies compared to expectant management.”

A co-author of that review, Daniel Grossman, MD, an ob-gyn in Oakland, Calif., tells Yahoo Parenting, “This treatment is not at all proven. Might it work? Yes. But women need to be informed that it’s experimental and needs to be evaluated with rigorous clinical research and oversight to be sure it’s being done ethically and appropriately. Right now, that’s not happening.”

Grossman adds that mifepristone by itself (the first half of a full dose of a medication abortion) is not a very effective abortion-inducing drug. So if a woman changes her mind at that point and doesn’t take the second pill, it’s likely that she will not miscarry — with or without APR’s emergency kit.

But APR medical director and antiabortion advocate George Delgado, MD, argues that “very few” embryos withstand the first dose of a medication abortion. “Studies show that only 7 percent to 20 percent of embryos survived the first drug,” he tells Yahoo Parenting. “The higher incomplete abortion rates of 40 percent that people mention mean that the uterus hasn’t emptied, but the embryo has died — and a mother who wants a reversal doesn’t care if the uterus has emptied; she wants a live baby who can be born.”

Progesterone is FDA-approved and has been used to treat issues such as pre-term labor in the second trimester. “If there’s a deficiency or recurrent miscarriages, a doctor may prescribe progesterone,” says Los Angeles ob-gyn Ross. “That’s well known, based on studies and clinical evidence — it’s safe and it works.” But the APR’s use of progesterone, she stresses, has not been studied enough.

Grossman is also concerned that news coverage of this procedure could make it seem that there are lots of women who regret the choice to have an abortion halfway through the process — when, in reality, that situation is “exceedingly rare,” he says. Ross agrees, telling Yahoo Parenting, “When you are counseled for a medical abortion, we really want to know that a patient is confident that this is the right decision. There are not many women who want to stop in the middle.”

One thing is certain: If a woman who does have regrets searches online for information about canceling mifepristone’s effects, she will find APR. “They have some creative marketing,” Ross says, “and the right tools to get the word out.”

According to the APR website, when a woman calls the 24/7 hotline, she is asked a series of questions to see if abortion reversal is possible. If she’s a candidate for the procedure, she’ll be connected to a local provider to start treatment. After having an ultrasound to confirm that the pregnancy is still viable, the provider prescribes progesterone to be given throughout the first trimester of pregnancy.

Reversal kits are available to medical providers through APR, and Delgado says that they are actively recruiting more doctors to carry them. “We do outreach to expand our network and make sure that any woman who changes her mind and wants to reverse the abortion pill has a doctor nearby who can help,” he tells Yahoo Parenting. “Sometimes we have a client in a certain area where we don’t have a doctor, so we start to make phone calls asking providers to join.”

The APR website repeatedly states that the program is “committed to help” and offers aid for women who are unsure about an abortion but are worried about raising a child. “We won’t help you reverse the effects of the abortion pill and then leave you stranded or alone. We are with you through the pregnancy and beyond. We care about you,” the FAQ reads.

In the Fox News story that focuses on one mother who was treated with APR, footage shows a bright-eyed baby boy named Walker. His mother, Autumn Barnes, talks about how she had been scared to have a second child because of financial difficulties, so she saw a doctor and took the first dose of a medication abortion, mifepristone, before being hit with regret. She then found APR online and was connected with a provider in her area for the progesterone treatment. Walker was born the next May. The report showed Harrison, who identifies as “pro-life” and says he keeps in touch with the moms he has treated via Facebook and text messages, looking at photos of Walker, whom he called a “chunky monkey.”

But Ross noted that the news segment talked about Walker’s heartbeat at 8 weeks while showing images of a sonogram “from about 26 weeks.” “At 8 weeks you see a grain of rice,” she says. “The images and the newscaster were misleading.”

In the end, Ross says, patients have to advocate for themselves. “People need to ask, ‘What am I ingesting? Where is the evidence to prove it’s safe?’” she says. “The APR crosses many lines, and most doctors would say it’s a little misleading, irresponsible, and scary.”

Photo: Abortion Pill Reversal

Please follow @YahooParenting on Facebook, Twitter, Instagram, and Pinterest. Have an interesting story to share about your family? Email us at YParenting (at) Yahoo.com.