New Law Requires Doctors to Shame Women Over Medical Abortions

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Medical abortion drug mifepristone.
Medical abortion drug mifepristone.Photo: Getty Images

South Dakota will soon require doctors to tell women seeking medical abortions that they can change their minds after taking the pill and possibly prevent the termination. It’s now the third state to do so, joining reproductive hellholes Arizona and Arkansas, which passed similar laws last year.

About 2 million women have taken the first-trimester pill (technically it’s two pills) since it was introduced in 2000 and, in 2011, medical abortions accounted for 23 percent of all non-hospital terminations. In Texas, the figure was as high as 40 percent until a 2013 law was passed that required medical-abortion patients to follow outdated dosing instructions and make three doctor’s visits; after that, it dropped to about 5 percent. The U.S. Food and Drug Administration recently approved labeling changes that would make the pill easier to access in states like Texas, Ohio, and North Dakota. (Arizona, Arkansas, and Oklahoma passed similar legislation but it was blocked by a court order.)

South Dakota’s informed consent process must now include telling women that it’s possible to discontinue a medical abortion between taking the first pill, mifepristone, and the second drug, misoprostol, which causes uterine contractions to end a pregnancy. The bill states that “information on discontinuing a drug-induced abortion is available on the Department of Health website,” but so far nothing about reversal is listed there.

Stat News argues that the new regulations in South Dakota are evidence of anti-choice groups pushing back against expanded access to the pill, which is critical as abortion clinics close. Some states have banned prescription via telemedicine and require in-person visits, an unfair obstacle for women without reproductive-health clinics in their county or their state.

And then there’s the group Americans United for Life, which introduced a handy legislative guide that states can use to promote anti-choice pseudoscience on abortion reversals. Here’s a snippet:

For a woman who quickly regrets her choice to use mifepristone and wishes to continue her pregnancy, knowledge of this potential reversal option could mean the difference between the life and death of her baby … To ensure that women receive accurate and complete medical information, AUL has drafted informed consent language that requires abortion providers to inform a woman prior to a chemical abortion that she may be able to change her mind and reverse the effects of mifepristone, but that time is of the essence.

This is not actually accurate medical information. It’s based on a 2012 case report written by a pro-life doctor who gave progesterone injections to six women who said they regretted taking mifepristone and hadn’t taken misoprostol. Two of the women aborted and four gave birth several months later.

The American College of Obstetricians and Gynecologists said this was not a controlled study and the results don’t drastically differ from what would happen if a woman only took the first drug: between 30 and 50 percent of women would remain pregnant. Plus, progesterone injections can have unpleasant side effects, which women would suffer for no reason at all. (Even if states don’t suggest progesterone as an option and recommend skipping the second drug, there’s a good chance that the information will be misleading.)

Junk science is familiar territory for AUL, the same group that provided a template for bills requiring that abortion clinics meet the standards of ambulatory surgical centers and providers have hospital-admitting privileges like the one in Texas that’s the subject of a Supreme Court case. Medical groups say neither requirement is necessary — they’re just ways to restrict access to health care.

As for pills, Arizona’s abortion reversal law was shut down in October following a lawsuit filed by the American Civil Liberties Union and Planned Parenthood. South Dakota’s law is set to go into effect on July 1 and, thanks to the AUL, it’s not likely to be the last.