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The latest anti-abortion bill introduced in the Michigan Legislature would require physicians to inform patients who are getting medication abortions of a medically unproven procedure known as abortion pill reversal (APR).
Some doctors are concerned that this legislation, if passed, would require them to lie to patients and give them unsound medical advice.
On June 22, state Rep. Sue Allor (R-Wolverine) introduced House Bill 5086, also known as the Women’s Right to Know Act, which would require doctors to provide information on the abortion pill reversal procedure.
Allor said in a press release that she believes the bill will garner bipartisan support, although all 18 bill co-sponsors are Republicans.
“It simply gives women who are pregnant, access to educational material and access to additional resources,” Allor said. “Hopefully, with more complete information, more women will choose life for their unborn child.”
Allor’s staff said she was unavailable for an interview with the Advance about the legislation.
Anti-abortion activists claim that pregnant people who take one of the pills involved in a medical abortion and then change their mind can take progesterone to stop the abortion process.
The procedure is controversial, in part, because some medical providers consider it to be government overreach and also because the evidence behind APR is not heavily-backed by research.
“The fact that we have legislators in this state who would even consider that an option to have a physician lie to a person, no matter what it is about, is really concerning,” said Sarah Wallett, chief medical officer for Planned Parenthood of Michigan.
Michigan isn’t the only state that has introduced legislation around informing patients about APR.
Currently, 14 states have enacted laws requiring this information to be provided, according to the National Right to Life Committee.
The states where these laws are in effect are Arizona, Arkansas, Idaho, Kentucky, Nebraska, South Dakota, Utah and West Virginia. The law will go into effect in Louisiana on Aug. 1 and in Montana on Oct. 1.
Legislation has not gone into effect in North Dakota, Oklahoma or Tennessee, due to pending litigation.
There also has been APR legislation introduced in Congress.
“The Second Chance at Life Act provides hope for babies whose mothers deserve the opportunity to make a fully informed decision on any abortion,” said sponsor U.S. Rep. Doug Lamborn (R-Colo.)
What is the abortion pill reversal procedure?
A medication abortion, commonly known as the abortion pill, is made up of two different medicines to end a pregnancy — mifepristone and misoprostol. It can be done up until the 11th week of pregnancy.
The first pill, mifepristone, blocks the pregnant person’s own progesterone, which the pregnancy needs to grow. The second pill, misoprostol, which is taken up to 48 hours after the first pill, causes the uterus to contract and empty its contents, ending the pregnancy.
An abortion pill reversal process involves a large influx of progesterone into the pregnant person’s system after the mifepristone is taken, but before the misoprostol.
Supporters like Lamborn claim that “chemical abortions can be reversed with zero harm to the child if the pregnant mother develops second thoughts midway through the abortion process.”
However, opponents are concerned that there isn’t enough evidence that abortion pill reversals are safe or effective.
“There’s been very limited research into reversal,” Wallet said. “There have been three case studies that purportedly prove that abortions can be reversed, but none of those studies were done in a way that we consider appropriate for the way medical research can be done.”
One of the studies, done by Researchers from the University of California, Davis, aimed to test the effectiveness of the abortion pill reversal, but the study was stopped early after three of the 12 women involved in the study needed treatment for severe vaginal bleeding.
The researchers decided that the health risks to women were too grave to continue the study, and so there was no conclusion on the effectiveness of progesterone to reverse the effects of mifepristone.
The Women’s Right to Know Act
When a pregnant person seeks an abortion from a medical provider, they are required to sign a form that lists the procedures, consents to the abortion and acknowledges that they have been provided with specified information and given an opportunity to ask questions.
HB 5086 would add to the form: “If I am undergoing an abortion procedure that utilizes the drug known as mifepristone, I have been informed about the existence of treatment to reverse the effects of mifepristone before ingesting misoprostol to increase the possibility of maintaining my pregnancy if I change my mind about terminating the pregnancy.”
The bill also requires abortion providers to check for a fetal heartbeat prior to providing an abortion and disclose the likelihood of a miscarriage. It would create a prenatally diagnosed conditions information website overseen by the Michigan Department of Health and Human Services (DHHS).
The bill received a hearing in the House Health Policy Committee two days after it was introduced, but the committee did not vote on the bill.
“To be really clear, it would force me to lie to patients,” Wallett said. “It would require me] to give them information that is not scientifically sound, that is not evidence-based. … We wouldn’t accept the idea that physicians not only should lie, but are actually required to by law, in any other type of medicine, and so we shouldn’t think it’s acceptable in abortion care, either.”
“This bill is not creating a woman’s right to know all of the medical information before she makes a decision about a treatment or procedure during pregnancy,” Wallett added. “Women already have that right. And to be clear, it is not just women who have that right, but all people who access medical care during pregnancy, including trans-men and gender-diverse Michiganders.”
Dr. Rob Davidson, an emergency physician in West Michigan and executive director of the Committee to Protect Health Care, said the legislation in Michigan is “massive government overreach.”
“When a government decides to intervene and require doctors to either do or recommend treatments that are unproven, questionable and possibly unsafe, that’s a huge problem, whatever the issue,” Davidson said. “This is a supercharged issue, obviously because it’s abortion and it’s so polarizing, but take that out of the equation. … I can’t imagine any of us, on any issue, would think that was a good idea with anything else, if you took out the polarizing issue of abortion.”
Davidson said that throughout his career he can’t recall the state government stepping into and dictating the medical field as they are with HB 5086.
Wallett said the legislation undermines the informed consent process and causes pregnant people to feel like they should be unsure of their choice to get an abortion.
“What we know is that medication abortion is very, very safe. It has been available for more than 20 years in the United States. … We also know that it is important that a woman be certain of her decision before she decides to proceed with an abortion,” Wallett said. “And these medication abortion reversals work against both of those principles. One, it is something that isn’t well-studied and in fact raises a lot of medical concerns that, in fact, it isn’t even safe. And two, it gives people the false idea that they don’t have to be certain about their decision before they start the process. And both of those are really concerning.”
Proponents of the bill, however, say that the bill is about choice.
“It’s not like we’re asking abortion providers to then provide abortion pill reversal procedures, just to notify women who choose chemical abortion, that there is a procedure available, and then it’s up to them if they want to pursue it,” said Genevieve Marnon, Right to Life Michigan’s legislative director. “So it’s about choice. It’s really about changing your mind if you want to.”
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