by Grattan Brown, STD, and Matthew Harrison, MD
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In the current legal fight to ban mifepristone, the first pill in a two-part pill regimen for a chemical abortion, it is easy to lose sight of the issue that makes elective abortion controversial in the first place: deliberately ending the life of a human being. But that is what makes women hesitate to choose abortion. It is also what makes women who have started a chemical or medication abortion try to reverse it.
In the story below, Dr. Matthew Harrison tells about his first encounter with such a woman, how his clinic welcomed her, and how he figured out how to save her child.
Meeting Ashley
Late one Thursday morning in the clinic, I received a call from the local Crisis Pregnancy Center. They had a young woman who had gone to an abortion clinic, had taken the abortion pill, and had changed her mind. The desperate mom then went to the Crisis Pregnancy Center wanting to know what she could do to save her baby.
At that time, chemical abortions were so new that I had no idea what I could do. But the best thing is always to meet these moms face-to-face and offer any help you can. So I told the caller to send the young woman right over.
Ashley was 19 years old and was distraught. She had a boyfriend who had always promised that if she ever got pregnant, he would support her and the baby. She was reluctant to be intimate with him because she came from a Christian family, but she loved him and thought that they would spend the rest of their lives together.
When she did become pregnant, he told her to get an abortion. He said that if she didn’t, then her parents would not understand and would kick her out of the house, that she would have to quit school and that she would never fulfill her dreams. He would not support her and her baby and gave her the $265 to go to the abortion clinic and have it “taken care of.”
She reluctantly went to the abortion clinic. The clinic’s staff estimated her pregnancy at just over seven weeks, but they did not let her see the ultrasound and the baby’s heartbeat. They handed her mifepristone, also known as RU-486, the abortion pill. They said to take it right there and would not let her leave with it. After she took the pill, they gave her the misoprostol to take 48 hours later.
Ashley knew it was wrong and immediately felt regret. She left the office hoping she could throw up or somehow get rid of the drug. Twenty-four hours went by, and she was getting desperate. Thankfully she went to her mother and told her what had happened. To Ashley‘s relief, her mother was supportive and loving. She said “Let’s see what we can do to get help.” That is when they went to the local Crisis Pregnancy Center that led her to me.
Undoing An Abortion
Back in 2006, Ashley’s story amazed me. I had never heard anything like it. I was familiar with the abortion pill, which the FDA had approved in 2000. By 2006, it was being used in about 15% of all abortions.
I had no idea what to do if a woman wanted to stop a chemical abortion once it had started. They do not teach this in medical school. But I’ve always known not to give up and not to make snap decisions in these life or death situations.
Ashley had not started bleeding or cramping yet, so I thought there might still be time to save her child. I asked her to excuse me as I went to my office and thought about it. I pulled out the Physician's Desk Reference and reviewed mifepristone’s mechanism of action. It is a powerful progesterone blocker that was initially developed as an adjunct cancer treatment for hormone-dependent tumors which cannot be resected.
Mifepristone mimics the action of naturally occurring progesterone and attaches to the progesterone receptors in layers of the placenta. When that happens, the placenta does not grow the blood vessels that supply nutrition and oxygen to the developing embryo or fetus, which dies. Mifepristone also prevents naturally occurring progesterone from getting into the receptor, which would support life.
I went back to thinking about how to counteract the abortion pill. Was there any type of antidote that we could use to improve the chances of survival? And then I started to ask the bigger question “How did I get here?” How did I get to a place where doctors in our society were using the art of medicine to take life, and I was sitting in my office researching how to undo what they had done?
Because of my background in biology, and specifically in protein-receptor mechanics, I knew that mifepristone could be out-competed by an abundance of progesterone, which would reactivate the progesterone receptor. If we supplied enough good keys into this patient’s system, then we could override the bad keys locking the progesterone receptor.
I had never heard of progesterone being used in this way, but I did know that taking progesterone was safe in pregnancy, especially the bio-identical type that we used. I could give it to Ashley immediately because we kept some in our office as a fertility treatment for women who had low progesterone.
I took this idea to Ashley, and she was ready to do whatever it would take to save her baby. We gave her an injection of progesterone and hoped for the best. The next day she started to bleed, and we asked her to go to the emergency room for an ultrasound. The ultrasound showed the formation of a blood pocket on her placenta, which was starting to separate from her uterus. But she was also able to see her baby's heartbeat for the first time. Later, she told me that alone would have made the treatments worth it.
The emergency room doctor told her to go home and hope for the best. By Monday, she had stopped bleeding and came by our office. We were able to confirm a heartbeat, and we continued progesterone replacement.
The rest of her pregnancy was unremarkable. She continued progesterone replacement until about 28 weeks. At 40 weeks, Ashley gave birth to a beautiful baby girl, Kaylie. Her daughter had no birth defects, and Ashley’s placenta was normal. Today, Kaylie is a healthy 16-year-old girl.
Over the years, a protocol to counteract mifepristone developed. I teamed up with Dr. George Delgado and Dr. Mary Davenport to support the Abortion Pill Reversal Network. In 2016, the network had expanded so much that we turned it over to Heartbeat International. To date, there are more than 2000 providers in 65 countries that will offer Abortion Pill Reversal, and there have been more than 4000 babies born healthy through the protocol.
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