What is Abortion Pill Reversal Therapy?

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Abortion Pill Reversal (APR) is a safe and effective therapy that reverses the abortive effect of mifepristone. This therapy has saved over 5000 lives in 93 countries.1

The Abortion Pill: Mifepristone and Misoprostol

The abortion pill2 uses two drugs: mifepristone followed by misoprostol 24-48 hours later. Progesterone is a natural hormone that plays a critical role in supporting a healthy pregnancy. It prepares the uterus for embryo implantation, promotes placental development, and suppresses uterine contractions.3,4 Mifepristone (Mifeprex) competitively inhibits the mother’s progesterone, separating the embryo from the mother’s uterus, and causing embryo death.5  Misoprostol (Cytotec) causes uterine contractions and expels the embryo.6

Abortion Pill Reversal is Effective

APR therapy involves giving the mother progesterone by a capsule (oral or vaginal) or injection. The APR protocol utilizes progesterone to halt the abortion process. Progesterone administration increases the mother’s progesterone concentration level, improves the progesterone-receptor binding rate, and reverses the effect of mifepristone. Progesterone treatment continues through the end of the first trimester at a minimum and beyond that if needed. Research shows that 66% of women who receive progesterone soon after starting the abortion pill can safely continue their pregnancies.7,8

Abortion Pill Reversal Is Safe

Doctors have safely used progesterone during pregnancy for over 50 years.9 Major OB-GYN medical organizations endorse APR as a safe and effective therapy.10 Nonetheless, some pro-abortion medical organizations state that APR is unproven and unsafe.11 The only medical evidence they cite is a small clinical trial of 10 women. Five women received mifepristone plus placebo, and five received mifepristone plus APR therapy. Study results showed that two of five women (40%) in the placebo group needed an emergency medical procedure, and one also required a blood transfusion. However, none of the women in the APR group required medical intervention. In addition, 4 of 5 women (80%) in the APR group had a living embryo at follow-up.12

Legal Attacks on Abortion Pill Reversal Providers

Clinical providers are taking legal action to preserve a woman’s access to APR healthcare. Several pro-abortion groups have sought, for ideological reasons, to block access to APR therapy. They filed lawsuits, passed laws, and threatened medical license revocation to stop clinicians from providing women with life-affirming APR healthcare. Clinical providers are taking legal action to defend access to APR.13, 14, 15, 16 Although pro-abortion groups state they support a woman’s “right to choose,” their legal attacks stop women from choosing to preserve their pregnancy. 

Abortion Pill Reversal Informed Consent

Women have the right to know the facts about APR therapy. APR is a time-sensitive therapy. Women who seek to reverse the abortion pill after taking mifepristone must urgently receive progesterone. However, many women are unaware of APR therapy because abortion pill providers withhold this information from them. This lack of knowledge can cause a delay in receiving APR, which can result in embryo death. Clinicians must inform women of APR therapy because they have a right to know all their options before taking the abortion pill. 

Additional Information

Download APR Fact Sheet. Women should visit AbortionPillReversal.com to learn more about APR therapy. Physicians should visit APRNworldwide.com/join to join the medical network. Those seeking to understand the medical evidence supporting APR should visit APRScience.org

References

  1. Heartbeat International et al. v Letitia James, Attorney General of the State of New York. 2024. Verified complaint, paragraph 68. https://shorturl.at/nqmFd. ↩︎
  2. The abortion pill is also known as “medication abortion” or “chemical abortion.”   ↩︎
  3. Coomarasamy, A., H. Williams, E. Truchanowicz, P. T. Seed, R. Small, S. Quenby, P. Gupta, et al. 2015. “A Randomized Trial of Progesterone in Women with Recurrent Miscarriages.” New England Journal of Medicine 373 (22): 2141‐2148. https://doi. org/10.1056/NEJMoa1504927. ↩︎
  4. Scarpin, Katherine M., J. Dinny Graham, Patricia A. Mote, and Christine L. Clarke. 2009. “Progesterone Action in Human Tissues: Regulation by Progesterone Receptor (Pr) Isoform Expression, Nuclear Positioning and Coregulator Expression.” Nuclear Receptor Signaling 7 (December): e009. https://doi.org/10.1621/nrs.07009. ↩︎
  5. AAPLOG. 2022. “The Reversal of the Effects of Mifepristone by Progesterone, Practice Guideline 6.” https://aaplog.org/wp-content/uploads/2023/01/ PG-6-Reversal-of-the-Effects-of-Mifepristone- by-Progesterone.pdf.  ↩︎
  6. ACOG. 2020. Medication Abortion Up to 70 Days of Gestation. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-days-of-gestation. ↩︎
  7. Delgado George, Condly Steven J., Davenport Mary, Tinnakornsrisuphap Thidarat, Mack Jonathan, Khauv Veronica, Zhou Paul S. 2018. “A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone.” Issues in Law & Medicine 33 (1): 21‐31. PMID: 30831017 ↩︎
  8. DeBeasi, Paul L. C. 2023. “Mifepristone Antagonization with Progesterone to Avert Medication Abortion: A Scoping Review.” The Linacre Quarterly 90(4): 395-407. https://doi.org/10.1177/00243639231176592. ↩︎
  9. Di Renzo Gian Carlo, Tosto Valentina, Tsibizova Valentina. 2020. “Progesterone: History, Facts, and Artifacts.” Best Practice & Research Clinical Obstetrics & Gynaecology, Progesterone In Obstetrics And Gynaecology 69 (November): 2‐12. https://doi.org/10.1016/j.bpobgyn.2020.07.012. ↩︎
  10. AAPLOG. 2022. “The Reversal of the Effects of Mifepristone by Progesterone, Practice Guideline 6.” https://aaplog.org/wp-content/uploads/2023/01/ PG-6-Reversal-of-the-Effects-of-Mifepristone- by-Progesterone.pdf.  ↩︎
  11. ACOG. 2022. “Medication Abortion Reversal Is Not Supported by Science.” Accessed June 25, 2024. Accessed June 25, 2024. https://www.acog.org/en/advocacy/facts-are-important/medication-abortion-reversal-is-not-supported-by-science↩︎
  12. Creinin Mitchell D., Hou Melody Y., Dalton Laura, Steward Rachel, Chen Melissa J. 2020. “Mifepristone Antagonization with Progesterone to Prevent Medical Abortion: A Randomized Controlled Trial.” Obstetrics and Gynecology 135 (1): 158‐165. https://doi.org/10.1097/AOG.0000000000003620. ↩︎
  13. “Letitia James v. Heartbeat International & CompassCare, et Al.” 2024. Accessed June 25, 2024. https://www.thomasmoresociety.org/case/ny-ag. ↩︎
  14.  “The People of the State of California v. Heartbeat International & RealOptions.” 2024. Accessed June 25, 2024. https://www.thomasmoresociety.org/case/apr. ↩︎
  15. “Bella Health and Wellness v. Weiser.” 2024. Becket. Accessed June 25, 2024. https://www.becketlaw.org/case/bella-health/. ↩︎
  16. AAPLOG. 2022. “The Reversal of the Effects of Mifepristone by Progesterone, Practice Guideline 6.” https://aaplog.org/wp-content/uploads/2023/01/ PG-6-Reversal-of-the-Effects-of-Mifepristone- by-Progesterone.pdf.  ↩︎

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