Johannesburg — An investigation into the practice of telling women that about 'Abortion pill reversal' (APR) - a controversial treatment first developed by a California-based family physician - has revealed that a American anti-abortionists are promoting it to women across the world, including Nigeria, Uganda and South Africa.
Its proponents claim that high doses of progesterone, taken after the first pill - mifepristone - recommended for medical abortion, can 'reverse' the abortion, according to openDemocracy.
A U.S. trial to test the effectiveness and safety of APR was halted in 2019 after some participants were admitted to hospital with severe haemorrhaging. Global experts say that it is unproven - and unlikely - that taking high doses of progesterone is effective in stopping a medical abortion, according to openDemocracy.
The organisation's Tracking the Backlash project led reporters from 20 countries to call a 24/7 hotline run by US anti-abortion activists.
The undercover reporters posed as pregnant women who had taken the first abortion pill known as mifepristone but were no longer sure they wanted to go through with the termination of pregnancy. Once they made the first contact with the proponents of the treatment, their contact information was taken, passed on to an operator, who then sent them a consent form from Heartbeat International. Once the reporters signed the consent form, the US operators connected them to local doctors willing to prescribe the treatment or sent them dosage instructions to take either to local hospitals and pharmacies or to local anti-abortion 'crisis pregnancy centres.
According to openDemocracy, a South African doctor told one of the reporters posing as a patient to go to any pharmacy, call him from there and he'd then email them the necessary prescription. Heartbeat International, the U.S. group, passed the reporter's contact information to Doctors for Life, a local anti-abortion group, which then connected the reporter to a doctor in Durban and another in Johannesburg.
Reporters in Nigeria and Uganda were sent dosage instructions by email and referred to local anti-abortion groups to get help obtaining the medication.
While in Uruguay, a doctor told a reporter there is "no reason for fear" and that "there are studies" proving that this 'treatment' works, though it is not "standard practice", and in Mexico, a doctor who described himself as an "APR volunteer" emailed a reporter a handwritten prescription including his medical license number.
Reactions to openDemocracy findings
Women's health and rights advocates have reportedly called for urgent action in response to openDemocracy's findings of the spread of "Abortion Pill Reversal" (APR) around the world.
"The problem is that there is no evidence to support that the 'abortion pill reversal' works and telling women that it does is misleading and wrong," said Dr Margit Endler M.D. PhD, an obstetrician/gynaecologist, researcher and senior lecturer at the Women's Health Research Unit of the University of Cape Town said in the report.
"I definitely think that giving the 'treatment' without seeing the patient personally is not recommended. Who would be ultimately responsible for the outcome of this pregnancy and foetus?" said Dr Judy Kluge, a consultant gynaecologist at the University of Stellenbosch Faculty of Health Sciences in South Africa.
Dr Eddie Mhlanga, who trains health workers for South Africa's Department of Health, said that the doctor who prescribes the second drug in the knowledge that the first drug had been taken, will have to take responsibility for any possible short and long-term complications that may occur. He advised that "the best time to change one's choice is best before taking the mifepristone."
Mina Barling, director of external affairs at the International Planned Parenthood Federation (IPPF) said this is "another terrifying example of just how well-funded, and how radicalised this anti-woman movement is." There is an "increasing, global threat to women's health, dignity and lives" from such groups, Barling warned: "It's critical that governments do more to regulate and restrict the dissemination of such initiatives."
Pamela Merritt, executive director of U.S. Medical Students for Choice, called the findings particularly "outrageous" and "horrific" during the Covid-19 pandemic. "We are at a time when it is absolutely critical for people all over the world to be able to trust their local healthcare providers," she said, calling this 'treatment' "a direct violation of the oath that every physician takes.
Associate Director of the British Pregnancy Advisory Service (BPAS) Katherine O'Brien, said she was "surprised" to learn that doctors in the UK were prescribing this "dangerous treatment" and that "it's not good enough to say 'if you stop bleeding, go to A and E' – especially in the middle of a pandemic". She added: "The GMC - which is the body that registers and regulates doctors in the UK - has the power to strike off clinicians if they've been found to be guilty of malpractice and I think this is a very serious case."
UK MP, Nadia Whittome, said "I am shocked that this is taking place in the UK. Women should not be used as guinea pigs by anti-abortion activists. The hotline needs to be shut down immediately."
A spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG) told openDemocracy that it was aware of the U.S. study into this 'treatment' that was halted as it was "associated with a high risk of serious bleeding and consequently dangerous for women, as well as ineffective".
Munira Wilson, another UK MP and Liberal Democrat spokesperson for health said "It is completely unacceptable. Regulators must investigate this as a matter of urgency and put a stop to this harmful practice."
Elizabeth Nash at the Guttmacher Institute, a reproductive health research group in the U.S., called it "incredibly distressing, that this kind of misinformation is being exported around the world." She warned: "Because this is so new in the UK it sounds like the government and medical societies haven't been able to put together information so providers realise that this process is not one that they should be engaging in."
Catalin Tenita, a Romanian member of the European Parliament for the Chamber of Deputies told openDemocracy that "the promotion of an abortion reversal pill, with scientifically unproven effects and no substantial studies proving the lack of risks, is a highly worrying issue." He believes it is "abuse", and that the doctors and nurses who participate "violate the deontological principles of their profession".