A Doctor Explains Why "Abortion Reversal" Laws Are So Bad

Photo: Bill Clark/Getty Images.
A new round of abortion restrictions are on the way, starting with new, controversial laws in two states. 

Last week, Arizona's Governor quietly signed a law that requires doctors to talk to patients in need of abortions about a controversial, untested procedure — regardless of whether it's medically valid — and on Monday, Arkansas' Governor signed a similar bill.

These laws require doctors to counsel patients seeking pregnancy terminations — who already have to deal with waiting periods and sometimes hours-long trips from rural areas to providers in cities — on a non-surgical procedure that doesn't exactly exist.

Julie Kwatra, an Ob/Gyn in Scottsdale and Legislative Chair for the Arizona chapter of the American Congress of Obstetricians and Gynecologists, spoke to Refinery29 about Arizona's law and about why "abortion reversals" are bad medicine. While Kwatra does not perform abortions as a part of her practice, she has been a practicing medicine for more than 15 years and is on the board of Planned Parenthood of Arizona.
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Tell me about the new law. How did the "abortion reversal" clause end up there?
"The Arizona House added an amendment to the Senate’s bill — The 'abortion reversal' clause.
The amendment [focuses on] a dubious procedure, which is not evidence based, called 'abortion reversal.' Any doctor doing a medical abortion would have to first counsel their patients that [abortion reversal] is a possibility should she regret having her medical termination. [Ed note: medical abortions involve prescribed medications rather than surgery.]

"In addition, public health services, which is a state agency, would have to publish information about abortion reversal, including a list of who does this quote unquote procedure."

“Abortion reversal” sounds made up. What is it?
"Physicians in ACOG have talked about this. You are forcing physicians to counsel their patients on what is basically an experimental procedure. There are no studies saying it’s real or that it works. The truth is that the demand for this would be very rare, because the majority of women seeking terminations have been counseled appropriately, and most people who aren’t sure they want one don’t get them."

Say a woman did want a reversal. How does it work?
"There are two medications you take to have a normal medical termination. The first is RU-486, and then 48 hours later, you take a second drug called misoprostol. To get to the 95 percent completion rate of medical terminations, you have to take the two drugs.

"Instead of administering the second drug, misoprostol, a doctor would give a high dose of progesterone, which is a pregnancy hormone. If the pregnancy doesn’t end, they say they stopped the abortion. It doesn’t reverse anything. There’s a good chance that the result would have been the same without the progesterone shot. It’s a drug vs. placebo effect. We don’t know more because it hasn’t been subjected to good evidence-based studies."

What  laws are already in place in Arizona to restrict abortions?
"We already have some draconian and strictly regulated abortion laws. We have a 24-hour waiting period, and women have to be counseled by a physician in person. And, physicians who perform abortions have to have hospital privileges, even though for years, most have done them safely in outpatient clinics.

"At end of the day, supporters of this law do not care about women’s health care, do not care about women’s health, and only care about making abortion inaccessible, even if [their methods are] things that are unproven. This is not a standard of care issue for them. These people should not be pushing the practice of medicine. They shouldn’t be passing laws to make doctors practice bad medicine or unproven medicine.

"I feel that it’s wrong for the Department of Health Services to sanction an unproven medical procedure on its website. The spirit of this law is not about care for women, it is to save every possible person from having an abortion that they can."

This interview has been edited and condensed for clarity.

This piece was originally published on April 3, 2015.
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