A grave oversight is underway in California's medical community, one that allows for dangerous misinformation to be spread by otherwise competent nurses and doctors. As part of their required, postgraduate education, nurses have the option to attend workshops in abortion reversal, provided by known anti-abortion organization Heartbeat International. Nicole Knight Shine's investigation of this course and its underlying political agenda for RH Reality Check, exposes its scientific foundation to be nonexistent, and its long-term impact ultimately damaging for health care providers and their patients.
Using the findings from just one paper, published in 2012, the workshop trains nurses in reversing early-term, pill-induced abortions. This procedure accounts for a fourth of all abortions that take place prior to nine weeks into a woman's pregnancy, and consists of two pills, mifepristone and misoprostol, one administered after another. Mifepristone first blocks the hormone progesterone, which causes the embryo to detach, and misoprostol makes the uterus contract and expel the embryo, thus terminating the pregnancy.
According to this paper, the abortion can be reversed if the woman is injected with progesterone before taking the misoprostol. Four out of the six women involved in the study saw a reversal in the procedure with this method — findings that experts describe as "insufficient."
Shine writes that the medical establishment at large, including the American Congress of Obstetricians and Gynecologists (ACOG), disapproves of this process, flat-out rejecting the scientific claims behind it. "There is really no clear evidence that this works," Daniel Grossman, MD, ACOG fellow and director of Advancing New Standards in Reproductive Health, explained to her. If we look only at the opinions of organizations that prioritize medical care over politics, abortion reversal is nothing more than a myth.
So why are nurses still attending this course? In order to maintain their license in California, doctors and nurses are required to earn continuing education credits from a pre-approved catalog of courses. This is not a bad rule on its own, as its core intent is to ensure practicing healthcare professionals stay up to date on medical developments and techniques. Problems only arise when course providers (who have been approved by registered nurses) offer up courses that are not scientifically sound.
Shine spoke with Christina Sprigg, chief of licensing and administrative services with the California state board, who told her they do not evaluate the courses themselves: “We do not approve courses, we only approve the providers." Between 2012 and 2014, 82% of the 764 applications to the state were approved. After that, Shine writes, "approved providers [must] ensure the class material is lawful."
"There isn’t enough bandwidth to do quality control, so there’s incorrect information out there,” explains Pratima Gupta, MD, a reproductive health advocacy fellow with Physicians for Reproductive Health. It's one thing to get medical misinformation during a frenzied Google search for symptoms, but it's a totally different, much more dire issue, when that incorrect information actually comes from a trusted health care provider.
“It’s obviously going to impact women’s health in that a nurse is receiving information that he or she is then disseminating to their patients,” Dr. Gupta added. The myth of abortion reversal must be removed from the mainstream medical conversation, as it will eventually reach their patients, and could be considered as a safe and viable option.
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