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Medical community slams study pushing “abortion reversal” procedure

San Diego doctor's work is being used in anti-abortion policymaking around the country.

by Carter Sherman
Apr 5 2018, 4:30pm

Anti-abortion lawmakers across the country have embraced a doctor who says he can halt abortions that are already underway using a controversial, scientifically unproven procedure. Now, that doctor, George Delgado, has released a study that he says can back up claims that his “abortion reversal” works — but medical professionals remain unconvinced by his research.

Over the past few years, multiple state legislatures have passed bills mandating that abortion providers tell patients that it’s possible to “reverse” a medication abortion midway through. The Idaho legislature became the latest state to pass such a bill last month, while Arizona, Arkansas, and South Dakota already have similar laws on the books.

Typically, patients undergoing medication abortions take two pills, mifepristone and misoprostol. Delgado, who opposes abortion and who has championed abortion reversal for years, claims the abortion will stop midway if a woman doesn’t take the misoprostol and instead takes several doses of the hormone progesterone.

Read more: Meet the doctor who convinces women he can reverse abortions

His new study, which was released Wednesday, analyzed 547 women who called Delgado’s informational “Abortion Pill Reversal” hotline between 2012 and 2016. (Delgado and his researchers initially sought to include more than 700 women, but they had to exclude several due to varying factors, including the fact that they “lost contact” with 112 of the women.)

Out of those 547 women, 257 gave birth to live children. Overall, Delgado wrote, the women’s pregnancies continued about about 48 percent of the time, leading him to conclude that abortion reversal is “safe and effective.”

“The science is good enough that, since we have no alternative therapy and we know it's safe, we should go with it,” Delgado told the Washington Post.

The medical community, however, says that Delgado’s abortion reversal method lacks scientific evidence. The American College of Obstetricians and Gynecologists (ACOG) doesn’t recommend the procedure, calling it “unproven and unethical.” And Delgado’s latest study, which builds on a 2012 study he authored involving seven women, didn’t change the group’s opinion.

Read more: Trump officials discussed attempting to reverse an undocumented teen’s abortion

“It is poorly designed and falls far short of providing sufficient evidence to recommend this course of treatment,’” Hal Lawrence, a doctor and ACOG’s executive vice president and CEO, said in a statement. He added that the study “does not meet clinical or methodological standards.”

“Women need to make informed decisions about their health care based on scientifically sound and rigorously evaluated information, and ‘abortion reversal’ procedures do not meet these standards,” Lawrence said. “It is dangerous for outside parties like politicians to force physicians to steer their patients toward experimental treatments whose safety and efficacy is unproven.”

Daniel Grossman, a physician and the director of the Advancing New Standards in Reproductive Health research group, and Monica McLemore, an assistant professor at the University of California San Francisco’s School of Nursing, also told VICE News that Delgado’s study fails to prove that doctors should tell patients about “abortion reversal.”

While Grossman agrees that giving women progesterone is likely safe, it’s possible that the progesterone had no effect on whether these pregnancies continued. “There are studies that looked at mifepristone by itself, and found that it wasn’t a very good abortion-causing drug,” Grossman explained, citing one study that found that women who take only mifepristone face a 25 percent chance that their pregnancy will still continue.

Plus, the study does not make clear whether any of the women who were admitted to the study underwent ultrasounds, which could have confirmed that their pregnancies continued after they took the misoprostol, explained McLemore, who also works with Grossman’s research group. The fraction of women whose pregnancies were already terminated at that point could thus have been excluded from Delgado’s study, artificially increasing his findings.

“It ends up inflating the success rate,” Grossman said. “If they’re essentially weeding out the people who come to them, who have already essentially had an abortion, because the pregnancy has stopped developing, they’re not reporting on the full number of people that potentially want this treatment.”

Delgado’s study appears in Issues in Law and Medicine, which frequently publishes articles with anti-abortion views. In 2014, for example, the journal published “Complications: Abortion’s Impact on Women,” by Angela Lanfranchi, a physician who espouses the belief that abortion increases a woman’s risk of breast cancer and of dying a violent death. (Indianapolis OB-GYN Katherine McHugh told VICE News in March that those claims were “blatantly false.”)

In any case, McLemore said, Delgado’s study is unlikely to change the way medical providers talk to patients about abortion.

“The scientific enterprise is really about redundancy and really about building on data. And this is one additional study,” McLemore said. “To suggest that we should have any policy change, or to suggest that we should have any change in clinical practice, or how we counsel a patient, based on this study, is a problem.”

Cover image: An exam table stands in an operating room at the Whole Woman's Health abortion clinic in San Antonio, Texas, on Tuesday, Feb. 16, 2016. (Photo: Matthew Busch/Bloomberg via Getty Images)