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The Truth about Abortion Pill Reversal

Abortion advocacy groups have levied many claims against Abortion Pill Reversal, while claiming the safety of chemical abortion (also known as the abortion pill, medical abortion, or medication abortion). Most notable, a study by Mitchell Creinin is regularly touted as evidence against Abortion Pill Reversal's safety and efficacy. Upon closer inspection, his halted study shows just the opposite. Here are the most common claims followed by the truth. 

CLAIM: The abortion pill is safe

- Guttmacher Institute

TRUTH: The chemical abortion regimen has many serious side effects as well as possible complications including incomplete abortion, heavy and prolonged bleeding, infection, fever, and many more. Often, a woman experiences such complications at home, away from medical care, and alone.

There are many possible complications listed by medical authorities as associated with chemical, medical, or medication abortion; all names for the abortion pill.

These include an incomplete abortion, potentially resulting in the need for a follow-up surgical abortion, heavy and prolonged bleeding, infection, fever and digestive system discomfort, according to the Mayo Clinic.

Numerous other negative side effects have been reported as well, and are noted in the drug’s information, including uterine pain, abdominal and stomach cramps, difficulty breathing, high blood pressure, dizziness, anxiety, tightness in the chest, unusual bleeding or bruising and anaphylactic reaction.

There is also evidence showing that whether one gets a chemical or surgical abortion, there is going to be an increased risk of infertility.

Creinin himself completed a 1999 study affirming the risks of the abortion pill.

Additionally, given the prevalence of the “at-home” circumstance with chemical abortion, when complications occur, the woman is largely left to deal with them at home, potentially alone.

Creinin has been part of producing research indicating that the abortion pill can cause hemorrhaging. A 2020 practice bulletin from the American College of Obstetricians and Gynecologists (ACOG) titled, Medication Abortion Up to 70 Days of Gestation, which was developed in collaboration with abortion providers Creinin and Dr. Daniel Grossman, states that, “limited available evidence suggests that use of mifepristone alone without subsequent administration of misoprostol may be associated with an increased risk of hemorrhage.”

CLAIM: The Abortion Pill Reversal protocol is not supported by science

- The American College of Obstetricians and Gynecologists (ACOG)

TRUTH: The reversal protocol is based upon a treatment that has been used routinely and safely in pregnancy since the 1950s. Providing progesterone to combat the effects of mifepristone is a cutting-edge application of a safe, natural hormone in a woman's body necessary to sustain pregnancy.

The reversal protocol is based upon a treatment that has been used routinely and safely with pregnancy since the 1950s - the administration of progesterone, the natural hormone in a woman’s body necessary to sustain pregnancy, to prevent miscarriage. The APR application utilizes progesterone to combat the effects of the first abortion drug, mifepristone, which blocks progesterone in the pregnant woman’s body.

Creinin himself has been involved in research indicating that progesterone has success in sustaining pregnancy after chemical abortion is begun. A 2020 practice bulletin from the American College of Obstetricians and Gynecologists (ACOG) titled, Medication Abortion Up to 70 Days of Gestation, which was developed in collaboration with abortion providers Creinin and Dr. Daniel Grossman stated that patients who experienced a failed chemical abortion and opt for the progesterone-only form of contraception should be counseled that this “may increase the risk of ongoing pregnancy.” Interestingly, this practice bulletin is linked to on the same page that ACOG claims APR is not supported by science.

A 2018 peer-reviewed study showed positive results with APR, including 64%-68% of the pregnancies saved through the protocol, no increase in birth defects, and a lower preterm delivery rate than the general population.

After APRN provider Dr. William Lile successfully reversed a chemical abortion with twins in 2018, his hospital internal review board deemed his actions in using APR to be “professional, appropriate, and good medical practice.”

To date more than 2,500 lives (and counting) have been saved through the APR protocol. The mothers of those children certainly view the science of the APR protocol as sound.

CLAIM: The Abortion Pill Reversal process is dangerous

- The Washington Post, December 24, 2019

TRUTH: The reversal protocol uses a bioidentical version of the natural hormone produced in a woman’s body when she is pregnant, in an updated application that has been used for decades to combat miscarriage, and has been proven safe.

The reversal protocol uses a bioidentical version of the natural hormone produced in a woman’s body when she is pregnant, in an updated application that has been used for decades to combat miscarriage, and has been proven safe. APR is safer than just not completing the chemical abortion and more effective at maintaining pregnancy.

Progesterone is also used to prevent preterm birth and with in vitro fertilization for women with low estrogen production after transfer of an embryo. Additionally, when a woman suffers from ovarian torsion, doctors sustain the pregnancy by administering progesterone.

In short, the APR protocol is a cutting-edge application of a proven, safe medical treatment to maintain healthy pregnancy.

CLAIM: Not completing the abortion pill regimen is dangerous

- National Public Radio (NPR), December 5, 2019

TRUTH: As noted above, the abortion pill itself is certainly dangerous, but no additional risk is added by providing progesterone to a woman who has decided she no longer wishes to have an abortion - the choice reproductive rights activists want to remove by making this claim.

Creinin said, "Encouraging women to not complete the [abortion pill] regimen should be considered experimental...We have some evidence that it could cause very significant bleeding," and, "It's not that medical abortion is dangerous … It's not completing the regimen, and encouraging women, leading them to believe that not finishing the regimen is safe. That's really dangerous."

However, another abortion provider, Dr. Daniel Grossman, stated in another publication that, “the usual care for women seeking to continue pregnancies after ingesting mifepristone is expectant management with fetal surveillance.”

Thus, if expectant management is considered typical care for women seeking to continue their pregnancy after taking the abortion pill, then adding progesterone to that care should not pose additional risk.

CLAIM: The Creinin study, commonly referenced to put the safety of APR into question, was discontinued for safety reasons related to APR

- National Public Radio (NPR), December 5, 2019

TRUTH: While the Creinin study was halted for safety concerns, the most serious issues were associated with the women who received placebos and never received the APR progesterone treatment - further showing the danger of the abortion pill instead.

There were issues with bleeding among some of the women in the study - but the most serious ones tended to be associated with the women who received placebos and who never received the APR progesterone treatment. The researchers attempted to get 40 women for the study, in which they would take the abortion pill, mifepristone, followed by some women taking a placebo and others taking progesterone. They succeeded in procuring just 12 women, three of whom hemorrhaged. Of those three, two took the placebo. One of those two required emergency surgery and the other one required a transfusion. Additionally, those women were two of five women in the study (40 percent) who took the abortion pill only, and not progesterone. The third woman who bled heavily had taken progesterone, but her bleeding stopped on its own and she did not need surgery. And there is no evidence that the third woman needed to be seen in the ER.

The complications that occurred in the Creinin study reflect some of those that are associated with the abortion pill. These possible side effects of the abortion pill include heavy and prolonged bleeding.

The list of possible complications associated with chemical abortion is long and include an incomplete abortion, potentially resulting in the need for a follow-up surgical abortion, heavy and prolonged bleeding, infection, fever, and digestive system discomfort, according to the Mayo Clinic. Numerous additional negative side effects have also been reported.

Many women who experience complications from the abortion pill do so at home, often alone.

Progesterone is the natural hormone in a woman’s body that helps keep a pregnancy healthy. APR treatment uses a bioidentical version of this hormone. For some women progesterone may cause sleepiness, lack of energy, lightheadedness, dizziness, gastrointestinal discomfort, and headaches. Increased fluid intake might help relieve these symptoms.  

The APRN is prodigious in its follow-up with APR clients.