Several states now require women who seek medication abortions to
be provided with dubious information that the procedure could be stopped,
allowing a pregnancy to continue.
But
when researchers attempted to carry out a legitimate study of whether these
"abortion reversal" treatments were effective and safe, they had to
stop almost immediately - because some of the women who participated in the
study experienced dangerous hemorrhaging that sent them to the hospital.
By passing these abortion reversal laws, "states are
encouraging women to participate in an unmonitored experiment," Creinin
said.
Creinin
and his colleagues detailed their concerns in a commentary in the journal Contraception, and
they will publish their study in January's edition of Obstetrics and Gynecology.
Medication
abortions, which are used up to 10 weeks into a pregnancy, consist of taking
two pills in sequence. The first pill in the regimen, mifepristone, loosens the
pregnancy's attachment to the uterus. The second pill, misoprostol, forces the
uterus to contract to push out the pregnancy. The pills must be taken
consecutively to complete the abortion, and there's a chance the pregnancy will
continue if the second pill is not taken.
A
total of 862,320 abortions were provided in clinical settings in 2017, according
to the Guttmacher Institute, about 39 percent of which were medication
abortions. Research has shown that using these drugs is a safe way to end a
pregnancy.
Some
antiabortion activists and legislators claim that not taking the second pill,
or giving a woman high doses of the hormone progesterone after taking
mifepristone, can help stop, or "reverse," a medical abortion.
The American College of Obstetricians and Gynecologists firmly
states that "claims regarding abortion 'reversal' treatment are not
based on science and do not meet clinical standards" and say the purported
studies that underpin these antiabortion arguments lack scientific rigor and
ethics.
Despite
this, the claims made in these discredited studies have worked their way to
antiabortion lawmakers, who in turn have put them into abortion reversal
legislation that was signed by governors in North Dakota, Idaho, Utah,
South Dakota, Kentucky, Nebraska, Oklahoma and Arkansas.
The laws are currently blocked or enjoined in Oklahoma and North Dakota.
Because
reliable research on these treatments is nonexistent, earlier this year,
Creinin and his colleagues designed a legitimate double-blind,
placebo-controlled, randomized trial that aimed to observe 40 volunteers who
had already elected to have a surgical abortion.
Their
goal was to see if giving progesterone to women who took the first pill in the
prescribed regimen would effectively and safely halt an abortion.
After
the women took the first pill in the abortion protocol, mifepristone, rather
than take the second pill, misoprostol, they were either given a placebo or a
dose of progesterone.
Researchers only enrolled 12 women before they had to stop the
study.
Bleeding
is normal during a medication abortion. But three of the women who enrolled in
the UC-Davis study experienced far more serious bleeding than anyone could have
anticipated when the second pill was not administered.
One
woman "was so scared she called an ambulance," while another woman
startled by the amount of blood "called 911 and crawled into her
bathtub", Creinin said. A third woman who went to the emergency room
needed a transfusion. One of the women had received a placebo, while two others
had taken the progesterone.
Creinin
and his colleagues halted the study as soon as it became clear that they could
not proceed safely.
"I
feel really horrible that I couldn't finish the study. I feel really horrible
that the women … had to go through all this," Creinin said. Because the
study ended prematurely, the researchers could not establish any evidence that
progesterone was an effective way to stop a medication abortion.
"What
the results do show, though, is that there's a very significant safety
signal" when it comes to disrupting the approved medication abortion
protocol, Creinin said.
Source: Science alerts
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