THE LATEST: This year, Colorado passed a law that directs the state medical board, nursing board, and pharmacy board to promulgate regulations, by October 1, on whether “medication abortion reversal” is a generally accepted standard of practice. These boards are collecting comments on this issue in advance of finalizing a regulation, and there is a need for science- and evidence-based information to support a regulation that is based on clinical best practices.
In response to the proposed rule, a comment by the American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine (SMFM), and the Society for Family Planning (SFP) commends the boards for protecting pregnant people from deceptive and dangerous practices but also makes clear that based on the current evidence base, use of “abortion reversal” is not a generally accepted standard of care.
“Abortion reversal” is an unsupported practice that purports to “reverse” a medication abortion, following the administration of mifepristone, with doses of progesterone. This practice also involves a patient not taking misoprostol, the second medication in the two-step regimen of medication abortion. There is no reliable evidence to support this practice, and it is not proven to be safe or effective. Far-right and extremist groups purposely attempt to blur the line between anti-science and ideological claims about medical practices and legitimate patient care. This deceptive approach can cause real harm to patients, and becomes even more dangerous when these extremists attempt to use this disinformation to impact policy and legislation.
The proposed rule does not state that medication abortion reversal is (or is not) a generally accepted standard of care, but rather that complaints regarding “abortion reversal” will be investigated by the Board on a case-by-case basis. The proposed regulation states that whether a case falls within the generally accepted standard of care will depend on the “scope and nature of information exchanged” between the patient and their physician, specifically whether documented fully informed consent includes all information necessary—risks, benefits, and likelihood of intended outcome both with and without treatment—for a patient to make an informed decision.
These leading medical organizations in their comment highlight for the state the need to combat misinformation by making clear that “abortion reversal” is not a generally accepted standard of practice. The practice is unsupported by scientific evidence; the cases that purport to lend credence to the use of “abortion reversal” involved compromised data, compared outcomes to flawed control groups, and lacked oversight by an Institutional Review Board. Those that support “abortion reversal” have been active in spreading misinformation regarding the practice of medication “abortion reversal,” to patients and policymakers alike. Thus, involvement from health care experts that can explain the harms caused by these deceptive practices will be very important to strengthening the administrative record on which these regulations will be based.
Read the full comment here.