‘Misleading and wrong’: South African experts condemn ‘abortion pill reversal’

openDemocracy discovered that doctors on four continents – Africa, Europe, South America and North America – are offering women this ‘treatment’.

In the UK, a doctor told our undercover reporter that “about 100 women” had already taken it. In other places, APR seems new and it’s unclear how many women have been involved. No medical authorities in the countries included in openDemocracy’s investigation recognise the procedure.

South African health experts explained that it is unproven – and unlikely – that taking high doses of progesterone is effective in stopping a medical abortion.

If the abortion does not happen, it is probably because the woman hasn’t taken the second abortion pill (misoprostol). If it is not taken within 24-48 hours of the first pill (mifepristone), an abortion will happen in only 8-46% of cases.

Nigeria and Uganda

In Nigeria, another openDemocracy undercover reporter contacted the US group’s activists via its online chat function. She was not connected to a local doctor, however. Two days after signing the ‘consent form’, she heard from one of these US activists: “We are still working hard to find a provider.”

The following day, she received dosage instructions via WhatsApp, contacts for two anti-abortion organisations and the message: “See if they can help or if they know a doctor who could prescribe the progesterone for you.”

Our reporter in Uganda was also sent dosage instructions, by email, and was referred to local ‘crisis pregnancy centres’ for help in accessing the medication.

Doctors for Life, the South African anti-abortion group that contacted our undercover reporter, told openDemocracy that APR is “officially proposed by the American Association of Pro-Life Obstetricians and Gynecologists”, referring to another network of anti-abortion doctors based in the US.

In response to openDemocracy questions, Graeme Birdsey – the South African doctor who offered to prescribe APR to our undercover reporter – sent two emails.

He said that had the woman gone to a pharmacy, he would have spoken to the pharmacist “about the suggested progesterone regimens and the potential problems with it”, and that he would have spoken to the woman to get her details, explain the treatment’s risks and make a follow-up appointment.

In a later email he said “if a woman comes to me wanting help for whatever situation she finds herself in, it is unethical for me to refuse her such help” and “it is time that we all put aside our agendas and try more care for the genuine interest of the person that crosses our path, whatever the desire of that person is.”

He said he wasn’t sure the trial that was halted in 2019 “really holds much proof of anything”, that it was “extremely small” and that haemorrhaging also occurred in patients that did not take the progesterone protocol.

In response to questions from openDemocracy, Heartbeat International said APR is “a cutting-edge application of a time-tested, FDA-approved treatment used for decades to prevent miscarriage, preterm birth, and support ongoing pregnancy.”

The group suggested that the lead researcher of the APR trial that was stopped in 2019 is biased towards abortion access and claimed that his study “actually showed that the abortion pill carries major health risks.”

“More than 2,000 women have successfully stopped an abortion and saved their children through the life-saving intervention of APR,” the group claimed.

Additional reporting by Kiki Mordi

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