Tennessee's abortion pill reversal law temporarily blocked

Pregnancy Test Credit Flickr Ernesto Andrade  CNA Ernesto Andrade via Flickr.

A federal judge on Tuesday temporarily blocked a Tennessee law that requires doctors to inform patients seeking medical abortion that the procedure could be reversed if the patient acts quickly.

The law, which was signed by Gov. Bill Lee in July, requires abortion providers to notify patients that medical abortions can be reversed; a procedure that is becoming more common among pro-life doctors, but which has not yet been evaluated by the FDA.

Medical abortions made up around 40% of at U.S. abortions in 2017, according to the pro-abortion Guttmacher Institute. The FDA allows the two-pill regimen of mifepristone and misoprostol to be used until 10 weeks gestation.

Tennessee's law required the physician to offer notification of the possibility of reversal at least 48 hours before the abortion, again in writing after the first pill of the regimen has been administered, and written on "conspicuously" displayed signs in private offices, ambulatory surgical treatment centers, facilities, and clinics that have provided more than 50 abortions in the previous calendar year, CNN reported.

Tennesee's five abortion clinics, along with Planned Parenthood and the ACLU, filed suit against the law in August.

The federal judge, William Campbell, wrote that he was "unable to assess fully the competing expert opinions as to whether the mandated message is 'truthful and not misleading,' in the absence of the experts' testimony," but also that the plaintiffs had demonstrated "a strong or substantial likelihood" that the mandate violates the First Amendment.

The judge's block on the law will last until Oct. 13.

Several other states, including Oklahoma, North Dakota, Arkansas, Kentucky, and Nebraska have passed laws requiring abortion providers to inform patients about abortion pill reversal. A district judge granted a preliminary injunction against North Dakota's requirement during Sept. 2019. 

In July, a federal judge overruled FDA requirements that women visit with a doctor in-person before they can be prescribed a medical abortion.

Since 2000, the FDA has placed the chemical abortion protocol of mifepristone and misoprostol under its Risk Evaluation and Mitigation Strategy list, requiring it to be prescribed in-person in a hospital, clinic, or medical office. The patient must sign a form acknowledging that she has been adequately informed of the risks.

Pro-abortion groups, however, have pushed for the pill to be dispensed remotely via telemedicine during the coronavirus pandemic, due to apparent difficulties women could face traveling to a clinic in-person.

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

Side effects that women suffer from the pills, such as heavy bleeding, abdominal pain, or severe infections, are usually treated at emergency rooms, which are not required to report the incidents to the FDA.

After the federal judge's decision, pro-life leaders and senators asked the FDA to remove the abortion pill from the market altogether by classifying it as a public health hazard. Nearly two dozen pro-life leaders said that pro-abortion groups were "using the coronavirus pandemic as a ruse" in their efforts to deregulate the pills.

A 2018 study, published in Issues in Law and Medicine, a peer-reviewed medical journal, 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.

Both procedures significantly improved the 25 percent fetal survival rate if no treatment is offered and a woman simply declines the second pill of a medical abortion. The case study also showed that the progesterone treatments caused no increased risk of birth defects or preterm births due.

The study was authored by Dr. Mary Davenport and Dr. George Delgado, who have been studying the abortion pill reversal procedures since 2009. Delgado also sits on the board of the American Association of Pro-Life Obstetricians and Gynecologists.

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The Abortion Pill Rescue Network, which Delgado serves as a medical advisor, has claimed to have saved over 500 babies from abortion. The network is a program of Heartbeat International, a longstanding network of pro-life pregnancy assistance.

The American Congress of Obstetricians and Gynecologists, which tends to oppose abortion regulations, has criticized the scientific claims behind abortion pill reversal.

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