LITTLE ROCK, Ark. – When it comes to healthcare, most patients expect their doctors to give them professional opinions about treatment, alternatives, and the risks, even if it’s not what they want to hear. In the case of abortion, there are disclosures the state forces doctors to make to patients – one of which, some doctors say, isn’t supported by medical science.
‘Fox16 Investigates’ with a look at Abortion Pill Reversal, a law from 2015.
Even a small word change in the law could affect the public. In this case – we’re talking about two sentences on page 9 of a 16-page bill, ordering doctors to tell women an abortion could be reversed even if the doctor doesn’t believe that’s accurate.
2015 Bill: Updating Information and Adding New Requirements
“I’m asking you to give women good information and to pass this bill,” State Rep. Robin Lundstrum, R- Elm Springs, said.
State lawmakers did pass the bill – in 2015 – overhauling what doctors and the Health Department must tell women seeking an abortion, despite objections.
“Requiring physicians to provide medically inaccurate information…” Ashley Wright, with Planned Parenthood of the Great Plains, said.
“If a woman has the choice to have an abortion and she also goes home and says ‘I’m not so sure,’ she still has that choice. It’s a woman’s right to choose,” Rep. Lundstrum said.
Now, in 2017, abortion providers must tell women that a chemical abortion could be reversed after she takes the first pill in a two-part process.
With zero guidance from the health department on what to tell women next, aside from info online and brochures – telling women the potential exists to reverse the abortion, the safety and efficacy have not been established, and to check with their physician if they have questions.
“These tie doctors’ hands and prevent them from providing the best care available to them,” Wright said.
“I’m not forcing a doctor to say anything. But, ethically, a woman has a right to have all the information put in front of her so she can make a decision,” Rep. Lundstrum said.
“So, do doctors have the option not to say that sentence when women come in…?” Fox 16’s Marci Manley asked.
“No, it’s in the law. They need to give information,” Rep. Lundstrum said.
The Science Behind Claims of Abortion Reversal
That information comes from a California, pro-life nonprofit. In 2012, its medical director, George Delgado, made the claim that large doses of progesterone given throughout the first trimester could reverse the abortion pill.
Based on the results of seven women, these patients received high doses of the hormone after taking the first, but not the second, pill in the chemical abortion regimen. Four of the women’s pregnancies reportedly continued.
“There isn’t good data about this kind of treatment for a long-time period throughout pregnancy. There are potential medical risks that haven’t been well-documented,” Dr. Daniel Grossman said.
Dr. Grossman, a professor of obstetrics at U.C. San Francisco, systematically reviewed medical research on the topic and says the treatment is experimental and hasn’t been studied enough to know if it works, compared to simply not taking the second pill.
“Just simply doing nothing, there’s as high as a 50 percent chance that the pregnancy will continue on its own,” Dr. Grossman said.
According to Grossman, and Fox16 Investigates independent research, progesterone has been used to prevent pre-term pregnancy and during in vitro pregnancy efforts. So, progesterone has been used for pregnant women. But according to Grossman, the prolonged period of time is what needs to be studied.
According to Grossman, the evidence-based approach to trying experimental medication treatments would include an Ethical Review Board and other factors, like control groups, to scientifically test the outcomes.
According to Planned Parenthood, its Arkansas doctors are making the statement as part of the informed consent required by law without scientifically-proven information to back it up.
“In no other situation would it be acceptable for a doctor to provide medically inaccurate, scientifically unproven information to patients, except when we’re looking at the issue of abortion care,” Wright said.
“So, it’s not discretionary though on behalf of the doctor… they do have to say that?” Manley asked.
“They do have to say that. And wouldn’t we want to all doctors have to give us information. Some of it we like or discard. Any type of medication we take into our body,” Rep. Lundstrum said.
When you search the internet for “abortion pill reversal,” the first item is a link to a website run by that California Non-profit. It claims 300 physicians are part of its network providing the procedure. But those doctors aren’t listed or identified, and women must call a hotline to get more information.
“Those women don’t have set relationships with those physicians. We don’t even know who they are,” Manley said.
“That’s not altogether true… currently that’s a 1-800-number. They’re currently working on having set-ups in emergency rooms where you can go and get the information,” Rep. Lundstrum responded.
“Is there any way I could just talk to a doctor directly…?”
Hotline callers are connected with a volunteer nurse.
We had a woman call for information on the procedure. She was told she couldn’t be connected to a doctor in Arkansas unless she was committed to the reversal. She had been on the phone with the nurse for less than 10 minutes.
“Out of respect for the doctor, I want to have more of a confirmation from you that you’re not just going to say ‘yes,’ me work our doctor, and then change your mind kind of thing,” the volunteer nurse operator said.
“This is not the way medicine is usually practiced. It highlights how concerning it is that state legislatures are intruding into the doctor-patient relationship in this way,” Dr. Grossman said.
“It’s not junk science… It’s new science…” said Dr. Delgado, in a training video posted to the Abortion Pill Reversal website.
In those training videos posted to the website, Delgado says more than 100 pregnancies had progressed by 2015 and 1200 calls were made to the hotline in 3 years. According to the hotline nurse, that number has climbed to 250 pregnancies and an alleged 64% success rate.
“How does it impact my health, taking the reversal?” our hotline caller asked. “Your health in what regard?” the nurse replied.
Healthcare Disclosures: Who Decides?
This debate speaks to a larger discussion of if lawmakers are qualified to write requirements for patient care.
“Is that the place for policy-makers to be in? Definitely not. We know laws like this actually place politics and the will of the legislature in between a woman and her doctor,” Wright said.
“This is upcoming science, and I felt like we needed to — it was one sentence letting women know you have a choice for an abortion,” Rep. Lundstrum said.
The two sides agree that women should have all the information they want to make a decision, but who decides on the quality of the information? Elected officials… or the doctor?
Arkansas is only one of three states that has passed a law with this language.
How widespread is this informed consent on reversal?
One of those states – Arizona – actually back-tracked and repealed its law after a court challenge. South Dakota is the only other state with this language. Last week, Colorado lawmakers rejected similar language. Delgado, in his training video, actually said he personally felt laws like this should be a “last resort.”
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Fox16 Investigates is committed to uncovering truth and problems people face across Arkansas. If you have a story that needs to be investigated, call Investigative Reporter Marci Manley on the Investigations Tipline at (501) 340-4448 or email at investigations@fox16.com.