Governor Doug Ducey let down Arizona’s women when he signed Senate Bill 1318.
This anti-women’s health care law is egregious for many reasons, but its provision on so-called medical abortion reversal is tantamount to quackery.
The provision would require physicians to counsel their patients that a medication abortion can possibly be reversed once initiated; it also requires that the Arizona Department of Health Services website provide information on medication abortion reversal including referrals to physicians who claim to have success with this unproven practice.
The problem is that so-called medical abortion reversal is not FDA approved and has no good evidence to support it.
To have a medical abortion, a woman must take two drugs: mifepristone, followed 48 hours later by misoprostol. The advocates of abortion reversal claim that if a patient takes the first medication and wants to halt the process, then she would be referred to a physician who gives her high doses of progesterone to continue the pregnancy.
First, it should be noted that mifepristone, when taken alone, has a high failure rate, close to 50 percent. So among the rare women who might regret their decision, almost half would have their pregnancy continue without any additional medications. There is no data to show that high levels of hormones after this point would preserve the pregnancy.
Moreover, there are no good, evidence-based studies on using additional progesterone to reverse abortions. The “study” on which this law is founded involved only six women. Using that as a reference for treatment is dangerous and unscientific. In other words, it is bad medicine. The physicians who claim to do this also do not work from any standard protocols, and, if they give high doses of progesterone to these patients, they are not practicing according to the standard of care.
Women’s healthcare should be practiced by experts in the field and standards should be dictated by our national college. Medical care should not be decided by legislators, and certainly not by the special interest groups who pushed this legislation.
It is blatantly wrong for the state of Arizona to force doctors to counsel their patients about voodoo medicine, and wrong for the Department of Health Services to sanction these practices by publishing this information on their website.
Facing an unwanted pregnancy is hard enough. The exceedingly rare woman who does regret her choice to terminate should not have to then be subjected to unproven doses of an unnecessary hormone and its related side effects.
Moreover, this law asks more questions than it answers. Is the patient going to bear the cost of this dubious treatment? Will insurance companies and AHCCCS pay for up to 17 excess office visits and injections that are non-evidence based?
Abortion is an unfortunate fact of life. What we all want is for it to be as rare as possible. The evidence for that is indisputable: Minimize unplanned pregnancies with comprehensive, evidence-based sexual education and access to contraception.
Not with junk science.
It is unfortunate that Arizona will continue to be a standard-bearer for unscientific treatment of women.
–Ilana Addis, M.D., is chairwoman of the Arizona Section of the American Congress of Obstetricians and Gynecologists. Julie Kwatra, M.D., is legislative chair of the Arizona Section of ACOG.