The Facts on Abortion Pill Reversal

Abortion Pill Reversal (APR) is a safe and effective therapy that reverses the abortive effect of mifepristone. APR gives women a chance to change their mind after taking the abortion pill. This therapy has reversed over 5000 abortions 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 or injection after taking mifepristone. The APR protocol utilizes progesterone to halt the abortion process. APR increases progesterone concentration levels to better compete with mifepristone and restore a normal pregnancy. Research data shows that 66% of women who receive progesterone soon after starting the abortion pill can safely continue their pregnancies.^{7,8,9,10,11,12}

Abortion Pill Reversal Is Safe

Doctors have safely used progesterone during pregnancy for over 50 years.^{13,14,15,16,17} Major OB-GYN medical organizations endorse APR as a safe and effective therapy.¹⁸ Nonetheless, some pro-abortion medical organizations state that APR is unproven and unsafe.¹⁹ 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.²⁰

APR providers taking legal action to preserve a woman’s access to APR healthcare

Groups that advocate for abortion have sought to block access to APR therapy. They filed lawsuits, passed laws, and threatened medical license revocation to stop clinicians from providing women with APR healthcare.^21,22,23 APR providers are taking legal action to defend access to APR.^24,25,26

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 information 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 APR medical evidence 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. Garratt Deborah, Turner Joseph V. 2017. “Progesterone for Preventing Pregnancy Termination After Initiation of Medical Abortion with Mifepristone.” The European Journal of Contraception & Reproductive Health Care 22 (6): 472‐475. https://doi.org/10.1080/13625187.2017.1412424. ↩︎
9. 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. ↩︎
10. 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. ↩︎
11. Turner, Joseph V., Deborah Garratt, Lucas A. McLindon, Anna Barwick, and M. Joy Spark. 2023. “Progesterone after Mifepristone: A Pilot Prospective Single Arm Clinical Trial for Women Who Have Changed Their Mind after Commencing Medical Abortion.” Journal of Obstetrics and Gynaecology Research, November, jog.15826. https://doi.org/10.1111/jog.15826.  ↩︎
12. 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. ↩︎
13. 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. ↩︎
14. ASRM. 2008. “Progesterone Supplementation during the Luteal Phase and in Early Pregnancy in the Treatment of Infertility: An Educational Bulletin.” Fertility and Sterility 89 (4): 789-792. https://doi.org/10.1016/j.fertnstert.2008.02.012. ↩︎
15. NICE. 2021. “Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management, [C] Progestogens for preventing miscarriage.” https://www.nice.org.uk/guidance/ng126/evidence/evidence-review-c-pdf-10889099534.   ↩︎
16. Turner, Joseph V., Deborah Garratt, Lucas A. McLindon, Anna Barwick, and M. Joy Spark. 2023. Progesterone after Mifepristone: A Pilot Prospective Single Arm Clinical Trial for Women Who Have Changed Their Mind after Commencing Medical Abortion. Journal of Obstetrics and Gynaecology Research, November, jog.15826. https://doi.org/10.1111/jog.15826. ↩︎
17. Delgado, George, et al. “A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone.” Issues in Law & Medicine, vol. 33, no. 1, 2018, pp. 21– 31. https://pubmed.ncbi.nlm.nih.gov/30831017/. ↩︎
18. 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.  ↩︎
19. 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.  ↩︎
20. 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. ↩︎
21. “Letitia James v. Heartbeat International & CompassCare, et Al.” 2024. Accessed June 25, 2024. https://www.thomasmoresociety.org/case/ny-ag. ↩︎
22.  “The People of the State of California v. Heartbeat International & RealOptions.” 2024. Accessed June 25, 2024. https://www.thomasmoresociety.org/case/apr. ↩︎
23. Goldstein, R. Commonwealth of Massachusetts DPH. “Reminder to Licensees Regarding Licensure Obligations and Providing Standard of Care.” 2024. Accessed July 11, 2024. https://shorturl.at/wobbk. ↩︎
24. Thomas More Society. “Letitia James v. Heartbeat International & CompassCare, et Al.” 2024. Accessed July 11, 2024. https://www.thomasmoresociety.org/case/ny-ag. ↩︎
25. Thomas More Society. “The People of the State of California v. Heartbeat International & RealOptions.” 2024. Accessed July 11, 2024. https://www.thomasmoresociety.org/case/apr. ↩︎
26. “Bella Health and Wellness v. Weiser.” 2024. Becket. Accessed June 25, 2024. https://www.becketlaw.org/case/bella-health/. ↩︎