Judge blocks Indiana law requiring doctors to inform patients about abortion pill reversal

Pregnancy test Credit Ernesto Andrade via Flickr CC BY ND 20 CNA 5 11 15 Ernesto Andrade via Flickr (CC BY-ND 2.0).

A federal judge in late June blocked a law in Indiana, set to take effect July 1, which would have required doctors to inform women procuring medical abortion that it is possible for the effects of the first drug in the regimen to be reversed. 

In a lawsuit filed May 18 in the U.S. District Court in Indianapolis, several pro-abortion advocacy groups, including Planned Parenthood, had asked a judge to block the law, which Gov. Eric Holcomb signed into law in April. 

U.S. District Judge James Patrick Hanlon issued a temporary injunction while legal challenges to the law play out. He ruled that the state had not yet proven the effectiveness of the reversal process, and that the law could violate free speech rights of abortionists. 

Medical abortions, procured by way of a two-drug abortion pill regimen, have become an increasingly common method of abortion in the United States, making up 30-40 percent of all abortions. 

The method accounted for 55% of all abortions performed in Indiana in 2020, according to state statistics, up from 44% in 2019. The total number of abortions in Indiana increased 1.6%, to 7,756, during 2020.

The two drugs involved are mifepristone and misoprostol. Mifepristone effectively starves the unborn baby by blocking the effects of the pregnancy hormone progesterone. The second drug, misoprostol, is taken up to two days later, and induces labor.

The Indiana law would require doctors to inform women that it is possible to halt the medical abortion process if the woman changes her mind after taking the first pill. The reversal process entails ongoing doses of progesterone for the mother. 

The Indiana law would also ban the ordering of medical abortions in the state via telemedicine. While U.S. Food and Drug Administration rules require the first drug to be dispensed in clinics or hospitals by doctors or other medical providers who are specially certified, they do not require that providers see patients in person. As a result, some clinics allow women to consult via video.

The abortion pill law is not the first anti-abortion law passed in Indiana to be blocked in court. In 2019, a ban on dilation and evacuation abortion— a second-trimester procedure by which a fetus is removed from the womb using medical instruments such as clamps, forceps, and scissors— was also blocked by a federal judge’s preliminary injunction. 

The pro-abortion groups who proffered the present lawsuit assert that there exists “no credible or reliable scientific evidence” that the effects of mifepristone can be reversed. 

However, a study published in 2018 in Issues in Law and Medicine, a peer-reviewed medical journal affiliated with the pro-life organization Watson Bowes Research Institute, examined 261 successful abortion pill reversals, and showed that the reversal success rates were 68 percent with a high-dose oral progesterone protocol and 64 percent with an injected progesterone protocol.

Dr. Mary Davenport and Dr. George Delgado, who have been studying the abortion pill reversal procedures since 2009, authored the study. Delgado sits on the board of the American Association of Pro-Life Obstetricians and Gynecologists, and co-founded the Abortion Pill Rescue Network. 

Delgado told the Washington Post that he believed more research should be done on abortion pill reversal, but that he believes there should be nothing to stop doctors from using the progesterone protocol in the meantime.

“[T]he science is good enough that, since we have no alternative therapy and we know it's safe, we should go with it,” he said.

The director of a women’s clinic in Denver told CNA in April 2018 that she has found the abortion pill reversal protocol to be safe and effective with her patients, and her clinic has successfully treated several women who come in seeking a reversal after taking the first pill.

“I think the fact that we have now over 300 successful reversals is evidence that it works,” nurse practitioner Dede Chism, co-founder and executive director of Bella Natural Women’s Care in Englewood, CO, told CNA at the time.

The progesterone protocol is safe, Chism said, because it is a naturally occurring hormone in pregnant women that has been used for the treatment of pregnant women in various situations.

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“This isn’t make-believe and it isn’t coincidental,” she commented.

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