New York attorney general sues facilities promoting ‘abortion pill reversal’

The organization behind an international network of anti-abortion facilities is misleading people with claims that abortions can be “reversed”, a lawsuit filed on Monday by Letitia James, the New York attorney general, alleges.

The organization, Heartbeat International, is affiliated with more than 2,000 facilities that aim to convince people to continue their pregnancies. In recent years, many such centers, which are often Christian and sometimes known as crisis pregnancy centers, have started to promote a controversial practice known as “abortion pill reversal”, which claims that people can halt a medication abortion midway through.

The first randomized, controlled clinical study to attempt to study this “reversal” protocol’s effectiveness came to an abrupt stop in 2019, after three participants landed in the hospital hemorrhaging blood. The American College of Obstetricians and Gynecologists, the pre-eminent membership group for OB-GYNS, has said that claims about abortion reversal are “not based on science and do not meet clinical standards”.

James’s lawsuit accuses Heartbeat International and a slew of New York-based crisis pregnancy centers of making claims about abortion pill reversal that violate New York laws against deceptive business practices, false advertising and fraud. The lawsuit calls for the defendants to pay thousands of dollars in civil penalties.

“Obtaining accurate information can be especially difficult in the context of reproductive healthcare, where opponents of abortion intentionally distort and obfuscate facts to convince, scare, shame, or guilt people facing unintended pregnancy into deciding not to obtain or complete abortions at a moment when they are particularly vulnerable,” alleges James’s lawsuit. When it comes to abortion pill reversal, the lawsuit continues: “Defendants’ consumer-oriented statements distort the evidence and mislead New Yorkers to undergo this experimental ‘treatment’, believing that it has been proven safe and effective, when it has not.”

Heartbeat International did not immediately reply to a request for comment.

Last week, Heartbeat International and the other centers named in James’s lawsuit fired a pre-emptive legal strike against the attorney general, who had alerted the organization of her plan to sue days beforehand. They filed a lawsuit that accused the Democrat of waging “a politically motivated campaign against pregnancy organizations in general” and trampling over the anti-abortion organizations’ rights to free speech and free exercise of religion.

The lawsuit also denied that any of the crisis pregnancy centers associated with the case had made any false or misleading statements about abortion pill reversal.

Abortion rights supporters have spent years struggling to regulate crisis pregnancy centers and claims about abortion pill reversal, because these centers operate within a kind of regulatory dead zone. Many are not licensed medical clinics, so they aren’t subject to the kind of oversight usually imposed on such clinics (such as abortion clinics). At the same time, since the centers are usually faith-based, judges are reluctant to infringe on their religious rights.

Crisis pregnancy centers’ promotion of abortion pill reversal works in tandem with their demonization of medication abortion, according to James’ lawsuit. Medication abortion, which is typically induced using doses of two different drugs, now accounts for more than 60% of US abortions and has become a prime target of anti-abortion activists since the supreme court overturned Roe v Wade two years ago.

Medication abortion typically entails two drugs: mifepristone, which blocks progesterone, a hormone required for a pregnancy to continue, and misoprostol, which causes the uterus to empty and contract. If a woman takes mifepristone and regrets it before taking misoprostol, activists who support abortion pill reversal say that she can skip the second drug and instead take doses of progesterone to counter the effects of mifepristone.

Dr George Delgado, who helped develop the abortion pill reversal protocol, is now one of the doctors challenging the availability of mifepristone in a US supreme court case. The justices are expected to issue an opinion on that case in June.

More than 100 studies have found that it is safe to use mifepristone to end a pregnancy.