Reversing the abortion pill
A medical abortion consists of a woman taking two different medications within about 48 hours of each other – the first, mifepristone, blocks the progesterone that makes the womb an inhabitable place for a baby. The second, misoprostol, is taken 48 hours after the first pill, and makes the uterus contract and expel its contents – the baby.
But what happens if a woman takes the first pill and regrets her decision?
Several doctors throughout the country, including Dr. Bruchalski, do abortion pill reversals, though women are not likely to hear about them from Planned Parenthood or other clinics that prescribe abortion pills.
Typically, women are told that the abortion begins the hour they take the first pill (mifepristone), Dr. Bruchalski said, which is not true.
While the mifepristone blocks progesterone to make the womb uninhabitable, it does not directly affect the fetus or have any direct side effects to the fetus. A woman who takes mifepristone and decides not to take the second pill still has a 7-20 percent chance that her baby will survive.
If she receives abortion pill reversal treatment, which typically involves progesterone injections, her baby’s chances of survival increase to 60 percent.
“So all is not always lost,” said Dr. Bruchalski.
Dr. Edwin Anselmi in Centennial, Colorado also performs abortion pill reversals.
He told CNA that of the babies who survive the first abortion pill and the reversal procedure, the outlook is very good – he is not aware of birth defects in children who have survived the treatment.
Both Dr. Anselmi and Dr. Bruchalski are part of a network of doctors that provide abortion pill reversal throughout the country. If a woman looking to undo the procedure Googles “abortion pill reversal,” the first result is abortionpillreversal.com, a website that is a project of Culture of Life Family Services in San Diego, California, which includes a hotline that connects women to doctors in their area who can perform abortion pill reversal procedures.
Since the launch of the abortion pill reversal hotline in 2012, more than 200 babies have been saved, and over 100 more are expected to be born in the coming months, a representative from the hotline told CNA.
Dr. Anselmi said he is willing to meet with these women at any time, because the sooner they start the reversal process, the better.
“(When) they know that they don’t want to go through with (the abortion), I’ll meet them at the office as soon as possible, in the evening or on the weekends, to get the process started,” he said.
Dr. Bruchalski said that besides medical treatment, his clinic offers patients counseling to deal with any trauma that they may have experienced throughout the process.
“It’s about meeting this woman in a place where you can give her positive affirmation and hope in the middle of a very difficult situation,” he said.
“There’s many different types of counseling, but you have to meet the woman where she is, and you can’t push her, you can’t rush her, she has to do it on her own, and you have to accompany her.”
Follow-up for completed medical abortions can also be problematic, Dr. Bruchalski explained, because women often don’t have a relationship with the clinic where they received the abortion pills, making them less likely to go back for regular follow-up appointments or if they experience complications.
“They’re only going there for a service, they’re not going there for their regular care, usually. It’s like a vending machine. I want an abortion, I go here,” he said.
It’s even more difficult in third-world countries, where abortion pills are increasingly being used in order to expand women’s access to abortion, but where women are less connected to a system of support – many of them don’t have their own phones, or reliable access to transportation, Dr. Bruchalski said.
The after-effects of an at-home abortion
Thorn said that immediately following an abortion, it’s normal for many women to feel relief. It’s afterwards – in the following months and years – that trauma can hit, perhaps when a woman is trying to conceive again, or when she thinks about the person who may be missing from her family.
With medical abortions, the feelings of guilt can be even more intense than women who had surgical abortions, Thorn said.
“A surgical abortion in some respects is much easier on the woman,” Thorn said. “She’ll grieve eventually, but it happened somewhere else, it happened at that clinic, I don’t have to go that clinic anymore, somebody else did it, I for the most part didn’t see the baby.”
“But the issue women have with medical abortion is: ‘I did it’,” she said. “There is no outside party that I can blame or hold accountable...and that bothers women.”
Abortion pill rates are much higher in Europe than in the United States, although its proponents in the U.S. would like to see its use increase. Proponents of the pill argue that it’s easier, more private, and normalizes the procedure of abortion, making it seem more like a normal medical procedure than an intrusive surgery.
But the rhetoric that treats abortion like a non-event is dismissive of the scores of women who experience serious trauma after the procedure, Dr. Bruchalski said.
“In the pejorative, abortion is talked about as no big deal, as this really common procedure. But the reality for me as a doctor? It’s visceral, it goes through my hands and my heart. For these women, it’s going to happen in the privacy of their own home – and it’s not always ‘that easy’.”
Another reason women have a hard time forgetting abortions is because they carry cells from their children inside them for the rest of their lives, Thorn said – a phenomenon known as microchimerism. During an abortion, studies show that more cells from the baby transfer to the mother than during a full-term pregnancy.
“The fact of the matter is there’s still footprints in her body from her baby,” Thorn said. “I carry cells from that child, I can’t forget it, and at some point, I have to resolve it.”
That women are not told the full truth about the trauma they may experience after taking an abortion pill is highly problematic, Thorn added.
“It’s the continuing theme that, in the apparent guise of freedom for women, we get used and abused all the time on all kinds of health issues,” she said.
“The reality of this is that this is not a non-event, which is what people try to portray it as.”