Ministry of Health refuse pregnant mothers the chance to reverse chemical abortion

New Zealand’s Ministry of Health has issued a scathing position statement against the life-saving intervention known as Abortion Pill Reversal (APR), threatening doctors and anyone who promotes the practice with imprisonment and fines.

A statement published on the Ministry of Health’s website on July 11, 2024, claims that APR “is not established by clinical research trials.” It asserts that the intervention “could lead to severe side effects and adverse outcomes.”

The severe side effects and adverse outcomes are not listed in the statement.   However, links are provided to the position statements of the following bodies, all of whom oppose abortion pill reversal:

• Royal Australia New Zealand College of Obstetricians and Gynaecologists,
• Royal New Zealand College of General Practitioners,
• American College of Obstetrician and Gynaecologists, and the
• Royal College of Obstetricians, the British Society of Abortion Care Providers, the Royal College of Midwives, and the Faculty of Sexual and Reproductive Healthcare (joint statement).

Providers and advertisers threatened with fines and imprisonment

According to the Ministry, those who “sell, distribute or advertise” APR are in breach of section 20(2) of the Medicines Act, 1981.  This section of the Act restricts the sale or supply of new medicines.  Those convicted can face imprisonment of up to six months or be fined up to $20,000.  Convicted body corporates can be fined up to $100,000.

Although progesterone has been restricted in the past, it is not a new medicine.

The Ministry of Health claims in the press release that the breach of the Medicines Act 1981 arises “because progesterone is not approved for this purpose.”  This reasoning does not appear in the actual position statement.

PHARMAC opens access to progesterone in 2022

On December 1, 2022, PHARMAC, New Zealand’s governmental agency that decides which medicines are funded, removed all restrictions on progesterone.

According to PHARMAC’s website, removing restrictions means that progesterone “will be funded for any relevant use.”

The only caveat presented is that prescriptions are administered in accordance with Section 25 of the Medicines Act 1981.  As interpreted by PHARMAC, this section of the Medicines Act provides for authorised prescribers acting within the scope of their practice to “ ’procure the supply of any medicine’ for a particular patient in their care.”  The medication may be “approved” or “unapproved medicines.”

Further, the section allows for “an authorised prescriber to use an approved medicine for an unapproved use. For example, in an unapproved patient population, or with an unapproved dosage regimen, or for an unapproved indication or against a contraindication.”

On their website, PHARMAC provides commentary regarding the use of progesterone in so-called gender-affirming therapy, stating, “We acknowledge the need for funded efficacious and safe treatments for all uses, including for gender-affirming therapy.”  

The governmental agency reaffirms that progesterone will have all funding restrictions removed, placing the responsibility on the prescriber.  “It is the responsibility of prescribers to practice within their scope,” they explain, “and prescribe medicines for relevant use that they and their patient consider safe and appropriate.”

Although the circumstances illustrated above are different to that of attempting to reverse a chemical abortion, the position is consistent with the removal of restrictions.  PHARMAC tasks prescribers with the responsibility of deciding, along with their patient experiencing gender dissonance, what is “safe and appropriate,” therefore, the same logic must apply in assisting mothers wishing to attempt to reverse a chemical abortion.

The Ministry of Health’s position statement and the threat of fines and imprisonment to anyone who prescribes or promotes progesterone use to attempt to reverse a chemical abortion contradicts the position of PHARMAC.

Ministry of Health has a vested interest in protecting chemical abortion

Unlike physicians whose only motivation is to serve both their patients – mother and unborn baby – the Ministry of Health has a vested interest in promoting chemical abortion.  In April 2022, they launched the Decide abortion “telehealth” programme alongside fellow anti-life associates Sexual Wellbeing Aotearoa (formerly Family Planning) and Magma Healthcare (an abortion provider).

The initial governmental start-up funding for Decide was $3.5 million. 

What is Abortion Pill Reversal?

Chemical abortion, often referred to as Early Medical Abortion (EMA) or the “Abortion Pill”, is composed of two drugs taken consecutively within the first ten weeks of pregnancy. 

Mifepristone is taken first and blocks the effect of the naturally occurring pregnancy hormone progesterone.  Mifepristone is followed some hours later by taking misoprostol, which works by causing contractions that will expel the baby. 

Appropriate levels of progesterone are required for a pregnancy to continue and to ensure the newly conceived and rapidly developing human embryo receives all the nutrients needed for survival and healthy growth.

Abortion Pill Reversal is a regimen that works by restoring the progesterone levels blocked by mifepristone. 

The reversal is most effective when initiated as soon as possible after mifepristone is taken.  The window of opportunity extends only to 72 hours.  Timing is critical, with greater success found when the regimen is begun as soon as possible.

The Charlotte Lozier Institute provides an excellent primer, with references, on the process.

Does abortion pill reversal work?

Pregnancy Help News reports that more than 5,000 children have been born after their mothers regretted their decision to take mifepristone and sought to reverse their chemical abortion.  This statistic should speak for itself.

In 2018, Dr. George Delgado, the pioneer of the abortion pill reversal protocol, undertook an observational case series of 754 women who regretted their decision to undergo a chemical abortion.  These women sought intervention after taking mifepristone and before taking misoprostol.

Delgado found that the reversal success rate was 68% for women who took high-dose oral progesterone and 64% for those who were given intramuscular progesterone.

Further, there was “no apparent increased risk of birth defects.”

Delgado concluded that “the reversal of the effects of mifepristone using progesterone is safe and effective.”

Heartbeat International, which currently runs the international Abortion Pill Rescue Network, points out that there are “ethical concerns about giving abortion pills to pregnant women.” It would be unethical to conduct such a study, and therefore, “the types of studies pro-lifers can conduct on abortion pill reversal” are limited.

Opposition to abortion pill reversal is increasing globally.  Those who affirm life work diligently to ensure that objective information and evidence for the intervention are available for physicians to assess themselves.  APRScience is one such educational project.  The website provides a portal of information about abortion pill reversal and answers common questions and objections with medical evidence.  It includes links to studies supporting the use of progesterone to reverse the effects of mifepristone.

Pro-life physicians and others who support them believe that every woman ought to have an opportunity to choose to reverse a chemical abortion if they change their mind.  The use of progesterone to reverse the effects of mifepristone has been shown to be safe and effective.  The thousands of lives that this intervention has saved speak for themselves.  The Ministry of Health, if serious about offering women choice, ought to reconsider its position.