Last year, an undocumented 17-year-old referred to as Jane Doe fought the Trump administration for weeks before finally being able to obtain an abortion. But a report from Vice published Wednesday claims that Scott Lloyd, the Trump administration official in charge of the Office of Refugee Resettlement, had considered trying to "reverse" her abortion.
During a medication abortion, a person takes two pills, mifepristone and misoprostol, the second administered 24 to 48 hours after the other.
As Daniel Grossman, MD, a professor of obstetrics, gynecology, and reproductive sciences at the University of California at San Francisco, explains, the first medication, mifepristone, works to block the hormone progesterone, which causes the embryo to detach.
"The idea of a 'reversal' treatment, then, is to flood the body with high doses of progesterone to try to counteract the effect of mifepristone," Dr. Grossman says. In theory, abortion reversal advocates claim, that would reverse an abortion if someone changes their mind after taking the first pill, but before taking the second one.
While Dr. Grossman says that the idea makes some "biological sense," the concept of so-called "abortion reversal" is a myth.
"There is no evidence that any kind of treatment reverses or stops the effect of the abortion pill," he says.
If someone does decide not to go ahead with a medication abortion after taking the first pill, Dr. Grossman says that the best course of action would be to not take the second pill.
"There’s a good chance that the pregnancy would continue, but there’s no evidence that doing any kind of treatment will increase the likelihood of the pregnancy continuing," he says.
As doctors, we have a responsibility not to expose our patients to potential risks when there is no medical benefit.
Jamila Perritt, MD
The Vice report states that Lloyd underwent a deposition as part of the lawsuit between the Trump administration and the American Civil Liberties Union (who represented Doe), during which he said that he and his staff discussed the possibility of abortion reversal. Vice also said that they obtained emails in which officials specifically mention progesterone and how possible it would be to use it "for the purpose of aborting a chemical abortion process." The report doesn't specify whether Lloyd proposed forcing Doe to reverse her abortion, or if he merely wanted to offer it as an option.
Either way, this is a pretty scary prospect, since "abortion reversal" hasn't been supported with actual scientific evidence. Dr. Grossman likened the practice to performing medical experimentation on what he calls "a particularly vulnerable population."
Jamila Perritt, MD, a fellow with the Physicians for Reproductive Health, said in a statement to Refinery29 that it is "appalling" that the Office of Refugee Resettlement might consider pushing any medical process on a person, let alone pushing a procedure without scientific basis on a minor.
"There is simply no credible medical evidence showing that 'reversing' a medication abortion is possible," she wrote. "As doctors, we have a responsibility not to expose our patients to potential risks when there is no medical benefit — to do so would be a violation of medical ethics."
Not only that, Dr. Grossman says that the concept is dangerous because it helps to peddle the misconception that women often change their minds about getting abortions, or even regret abortions, two claims which he says "have been refuted by high-quality research." And if that fallacy is spread any further, it could have a very real impact on the already-stringent abortion laws in our country.
"If this does help to push forward the myth that women regret their decisions, that contributes to policymakers passing more laws that restrict [abortion] access by increasing waiting periods, or any other things they think help women to be sure of their decisions," he says. (And we already know that when abortion is restricted, women don't stop getting abortions — instead, they turn to unsafe abortions that often result in death.)