The fight against abortion pill reversal

After Atoria Foley took the first pill in the chemical abortion process in August 2021, she regretted it right away. The then-24-year-old sat in the parking lot of the Planned Parenthood in Sacramento, Calif., panicking. That’s when a memory popped into her head—the image of a sign with the words “abortion pill reversal.”

She Googled the words and found the number for a hotline that could connect her with a local doctor to prescribe the treatment. She called, and the operators connected her with Alternatives Pregnancy Center in Sacramento. She drove straight there. Pregnancy center staff prescribed progesterone pills after performing an ultrasound to confirm her baby was still alive. Foley picked up the pills from a local pharmacy, free of charge.

Just a few hours after taking mifepristone—the first part of the abortion pill regimen that halts the body’s production of progesterone—Foley took her first dose of progesterone pills.

Now two years after the experience, Foley said she believes every woman should be able to “choose life and choose anything that could help them sustain a life in their body, even if they initially decided that they wanted to have an abortion.”

But pro-abortion states this year are pushing back on organizations that have helped women like Foley access abortion pill reversal treatment, claiming it is experimental and unsafe for women. A Kansas judge ruled on Monday that the state cannot enforce its new law requiring abortionists to tell patients about the possibility of reversing the effects of an abortion pill when prescribing drugs for a chemical abortion. In California, the government is suing groups that provide abortion pill reversal. Meanwhile, Colorado’s legislature this spring targeted abortion pill reversal through a law later made unenforceable by a recent court ruling. To pro-lifers, that ruling in Colorado signals hope for the future of the potentially life-saving treatment.

The pro-abortion opposition generally focuses on the critique that the treatment is unproven by science. Kansas District Judge Krishnan Christopher Jayaram wrote in Monday’s opinion that the “‘reversal’ therapy theory appears, based upon the record before the court, unproven, theoretical, far from generally accepted within the relevant medical/scientific community, and potentially-dangerous to the pregnant woman—with no credible and evidence-based data that it actually facilitates a ‘reversal’ of a medication abortion.” In September, California Attorney General Rob Bonta filed a lawsuit against pro-life groups that offer abortion pill reversal, making similar claims.

But pro-lifers point to the widely accepted use of progesterone treatments to prevent miscarriages as evidence that the treatment is not dangerous for women. They argue that one study commonly cited as proof of abortion pill reversal’s danger actually shows the harm of mifepristone, not progesterone. Ethical concerns about giving abortion pills to pregnant women limit the types of studies pro-lifers can conduct on abortion pill reversal. But a study published in July shows progesterone is more than 80 percent effective in reversing mifepristone-induced abortions in rats.

Meanwhile in Colorado, Gov. Jared Polis in April signed a law calling the provision of abortion pill reversal “unprofessional conduct” for medical providers in the state.

“The most surprising thing about this law is how much of an outlier it makes Colorado,” said Laura Wolk Slavis, counsel for the Becket Fund for Religious Liberty. Slavis is a part of the legal team representing a Roman Catholic healthcare clinic in Colorado, Bella Health and Wellness, that is challenging the law. She pointed out that legislatures typically allow medical regulators to determine what is or is not professional conduct. But with this law, Colorado became the first legislature to attempt to prohibit abortion pill reversal.

It’s an ironic move for the state, where lawmakers in 2022 passed legislation affirming the “fundamental right” every person has “to make reproductive healthcare decisions free from government interference,” including the “right to continue a pregnancy and give birth or to have an abortion.”

The ban on abortion pill reversal might have taken effect this month if not for a ruling issued in the case on Oct. 21. In the opinion, a federal judge ruled that the law “burdens” the “free exercise of religion” of Bella Health’s employees by preventing them from providing abortion pill reversal treatment, which they see as a religious obligation.

Becket praised the ruling, saying it shows the pro-life clinic is likely to succeed in the ongoing litigation, allowing abortion pill reversal providers in the state to continue prescribing the drug to save unborn babies.

Pro-life legal minds facing similar battles in other states are also encouraged by the victory in Colorado. Paul Jonna, special counsel for the Thomas More Society, said he expects the ruling’s First Amendment analysis will help with some of the arguments in the fight against the California attorney general’s lawsuit. “And I would expect that if these cases make their way up to the Courts of Appeal, their rulings could be relevant to each other,” perhaps with national implications, he said.

Dr. George Delgado, one of the doctors who pioneered abortion pill reversal treatment, said he thinks states like California and Colorado are testing “different tactics” pushing back on abortion pill reversal to see what they can apply in other states. He called the efforts “disheartening.”

“I think it’s very unfortunate that women who want a second chance at life are not being given that chance,” Delgado said. But the opposition from abortion supporters doesn’t surprise him because of how well known and popular the treatment is today. “Women who are in these situations find out about it and they tell others,” Delgado said. “People are excited about this because this is a great breakthrough, being able to reverse chemical abortion.”

After Foley began her progesterone treatment, the father of her child found out she had gone back on her decision to abort. Foley said he threatened to remove all support for both this baby and another child they already had together. Out of fear of losing his support, Foley went to another Planned Parenthood and began the chemical abortion process again.

Even though she never took the second drug needed for a chemical abortion, she bled heavily this time and thought her baby was gone. But she returned to Alternatives Pregnancy Center and again saw in an ultrasound that her baby was still alive. For the second time, she started the abortion pill reversal process. Her daughter is now 1 year old.

“I do vividly remember that, in their exam room, seeing that—and just knowing once I saw her, she’s a survivor and a fighter, and I have to do everything I can from here out to fight for her life and protect her,” Foley said. “I would not have her if I didn’t have the chance to try an abortion pill reversal.”