Doctors Chafe Against Arizona Mandate to Tell Women Abortion Is Reversible
Governor Doug Ducey's approval of a new law that would force doctors to inform women that a medication-induced abortion can be reversed has the healthcare community roiling.
The statute he signed into law Monday, formerly known as Senate Bill 1318, draws its theory from a case study published in the December 2012 issue of the peer-reviewed journal The Annals of Pharmacotherapy. Researchers George Delgado and Mary Davenport gave six pregnant women high levels of the hormone progesterone after they had taken one of the two pills required to terminate pregnancy. Two women aborted after treatment, but four went on to deliver healthy babies.
Supporters say women deserve to know their options. Critics argue, however, that the study -- the only one published on the topic -- is too small to be conclusive and any treatment derived from it should be considered experimental.
The American Congress of Obstetricians Tuesday declared that administering progesterone in an attempt to reverse abortion is "not supported by the body of scientific evidence" and is "not recommended."
Delgado and Davenport did not approve the intervention with an institutional review board or an ethical review committee, according to ACOG. Because researchers did not use any experimental controls, ACOG stated, it is impossible to attribute the results of their study to progesterone therapy. Research shows that, even without treatment, between 30 and 50 percent of women who take only the first pill will not abort.
"The state of Arizona has now become an evidence-free zone," said Dr. Kathleen Morrell, an OBGYN with the New York-based advocacy group Physicians for Reproductive Health. "There is literally no evidence this works."
As an abortion provider, Morrell said she wouldn't feel comfortable telling her patients the therapy was an option because she is "hesitant" to administer it. The U.S. Food and Drug Administration has not formally indicated progesterone for use during pregnancy.
"I don't do things that aren't proven," she said. "I would think my patients would want me to practice that way."
Dr. Eric Reuss, a Scottsdale-based OBGYN, echoed her frustration.
"I think our Legislature has chosen to practice whatever kind of medicine they want to achieve their political and religious goals," said Reuss, treasurer of the Arizona section of the ACOG, adding that, "I don't appreciate being forced to tell my patients things that aren't true."
Despite the experimental nature of the procedure, however, at least two Arizona OBGYNs have already given abortion reversal a try.
Dr. Allan Sawyer, of Glendale, and Dr. Clint Leonard, of Gilbert, said they have successfully used the progesterone regimen to treat women who changed their mind after taking the first pill.
"Now they have healthy pregnancies," they wrote in a joint editorial published in The Arizona Republic.
Across the country, more than 80 women who underwent a similar treatment have given birth to healthy babies, the doctors reported. About 60 more have gone on to have healthy pregnancies.
A woman "deserves" to know that she may be able to change her mind a "save her child's life," they wrote.
"For those who desire to have 'safe, legal abortions,' giving a woman the ability to make an informed choice should be a no-brainer," Sawyer and Leonard wrote. "The bills passed are saving lives -- both of the mother and her preborn child."
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