Google Map showing Care Net locations in the Puget Sound area

OPINION | ‘Abortion Reversal’ Doesn’t Exist. A Northwest Anti-Abortion Group Is Pushing It Anyway

by Megan Burbank

Long before Roe v. Wade was overturned, Care Net, a national network of evangelical anti-abortion pregnancy centers, employed free pregnancy tests and promises of pregnancy counseling in an effort to dissuade pregnant people from having abortions. The organization, which operates 12 locations in the Puget Sound area, is one of the nation’s largest networks of crisis pregnancy centers, defined by reproductive rights policy organization the Guttmacher Institute as “organizations that provide counseling and other prenatal services from an antiabortion (prolife) perspective.”

These centers are not licensed medical clinics, and the information they spread about abortion is sourced from debunked studies and right-wing organizations, like The Heritage Foundation and Focus on the Family. I know because I investigated two Care Net locations in 2011. At one, in Lakewood, I watched a video that claimed women who had an abortion were likely to die in the following year.

This claim is not supported by science, and neither is “abortion reversal,” Care Net’s latest grift in its ongoing crusade against legal abortion — and a popular myth propogated by the anti-abortion movement more broadly. There’s no scientific backing for the procedure at issue — prescribing progesterone to stop a medication abortion — but it’s gained enough traction in recent years that the American College of Obstetricians and Gynecologists (ACOG) felt moved to issue a statement saying it isn’t grounded in evidence-based medicine. “Claims regarding abortion ‘reversal’ treatment are not based on science and do not meet clinical standards,” said the organization. “The American College of Obstetricians and Gynecologists (ACOG) ranks its recommendations on the strength of the evidence and does not support prescribing progesterone to stop a medication abortion.”

The above claims also ignore the reality of how clinicians and patients make decisions around abortion. “First, anyone who actually does abortions tries really hard to make sure that patients are 100% certain about their abortion decision before proceeding,” said Dr. Sarah Prager, professor of obstetrics and gynecology at the University of Washington. “If I ever have a patient who seems unsure, I would recommend they consider their decision more and return when they have more certainty.” Prager says patients don’t often change their minds, “as decisional certainty is actually very high for patients seeking abortion. Much higher than with many other medical procedures.” 

The research available on “abortion reversal” is plagued by ethical problems and deviations from medical best practices. A 2012 case series suggested women could continue pregnancies after taking mifepristone followed by progesterone, but ACOG points out that the study had no control group, nor was it supervised by an ethical review body, “raising serious questions regarding the ethics and scientific validity of the results.” 

A 2020 study on the subject that was supervised by an institutional review board was stopped prematurely due to safety concerns.

You wouldn’t know any of this from Care Net, which promotes “a 64–68% success rate” for “abortion pill reversal” based on the discredited 2012 case series, which, it should be noted, was led by an anti-abortion doctor.

“Regret taking the first pill? Reverse your abortion. Even after taking the first pill, you can still change your mind,” reads the large-text copy on Care Net’s “Reverse Your Abortion” webpage, beside an image of a woman huddled under a blanket, staring at a pill in the palm of her hand, “11 lines” long and skeptical on her brow, her other hand cupped around a stemless, water-filled wine glass. “Even after taking the first pill, you can still change your mind.”

The pills this language is referring to are mifepristone and misoprostol, the two-drug regimen used to induce a medication abortion in pregnancies of up to 11 weeks of gestation. Medication abortion is an increasingly popular option for abortion care — one made newly accessible during the COVID-19 pandemic; in 2021, the Food and Drug Administration under the Biden administration changed the dispensing requirements for mifepristone, allowing it to be prescribed through telehealth in states where such access is legal. (Washington is one of them.)

Since the reversal of Roe v. Wade, medication abortion has taken center stage as a route to self-managed abortion that looks nothing like the ones that threatened pregnant people’s lives before 1973. Given the idea’s prominence, it’s not surprising to see it incorporated into Care Net’s efforts to stop abortion. There’s just one problem: If a patient has only taken mifepristone, their pregnancy might continue anyway.

That’s because mifepristone doesn’t work by itself to end a pregnancy; it inhibits the hormone progesterone, which halts a pregnancy’s development. The second pill, misoprostol, induces the uterine contractions that expel a pregnancy. Care Net claims that giving patients progesterone “within the first 72 hours after taking Mifepristone [sic]” can “overpower” the drug and “save the pregnancy.”

There is no medical evidence to support this. “Mifepristone alone can cause an abortion, but it does so inconsistently and inefficiently, which is why the second medication, misoprostol, is also used as part of the medication abortion regimen,” explained Prager. “What that means is, regardless of any intervention with prostaglandin medication, some people who take the mifepristone [and] then change their minds will have an ongoing pregnancy.”

According to ACOG, up to half of pregnant patients who take mifepristone without misoprostol will continue their pregnancies. A study to evaluate whether giving patients prostaglandins increased rates of continued pregnancy might’ve gleaned more insight into this, says Prager, but it was stopped early because study subjects hemorrhaged and ended up needing emergency care. “Ultimately, we don’t know if giving progesterone actually helps or if those pregnancies would have continued anyway, and [the progesterone carries] a potential risk for heavy bleeding [and] hemorrhage,” said Prager.

If a pregnancy does continue, it’s not because the abortion has been reversed. It’s because it was unsuccessful.

Care Net even acknowledges much of this within their own materials, writing “Without the [abortion pill reversal] treatment, the first abortion pill may fail to abort the pregnancy on its own. In other words, your pregnancy may continue even without APR if you decide not to take the second abortion drug likely prescribed or provided to you.”

This information is buried in an FAQ page nesting-dolled into a separate FAQ page alongside questions about peanut oil in progesterone and inaccurate descriptions of emergency contraceptives as “abortifacients.” You’re not going to find this information if you’re truly in crisis.

And that seems to be by design. Confusion around shifting access to abortion creates a knowledge vacuum — and an opportunity for misinformation to fill the gap. Even in a city like Seattle, in a state like Washington, abortion disinformation can muddle health care decisions and obscure facts. Confusion can mean delay, and when it comes to abortion, delay can mean denial. As it was in 2011, the misinformation is the point.

In an upcoming Emerald article, I’ll take a closer look at some of the crisis pregnancy centers here in Seattle and how they are impacting our neighborhoods and communities.

The South Seattle Emerald is committed to holding space for a variety of viewpoints within our community, with the understanding that differing perspectives do not negate mutual respect amongst community members.

The opinions, beliefs, and viewpoints expressed by the contributors on this website do not necessarily reflect the opinions, beliefs, and viewpoints of the Emerald or official policies of the Emerald.

Megan Burbank is a writer and editor based in Seattle. Before going full-time freelance, she worked as an editor and reporter at the Portland Mercury and The Seattle Times. She specializes in enterprise reporting on reproductive health policy, and stories at the nexus of gender, politics, and culture.

📸 Featured Image: Screenshot of Google Map showing Care Net locations in the Puget Sound area. Map Data © 2022 Google.

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