Law passed to protect her right to know

This past winter, North Dakota became one of the first states to require women considering an abortion be told about the possibility of abortion pill reversal.

The new law is simple. North Dakota requires a set of printed materials be given to every woman considering an abortion. These materials contain information on pregnancy, fetal-development, abortion and abortion alternatives. The new law directs the department of health to update the materials to include information that “it may be possible to reverse the effects of an abortion-inducing drug but time is of the essence.” It also states that the materials “must include information directing the patient where to obtain further information and assistance in locating a medical professional who can aid in the reversal of abortion-inducing drugs, such as mifepristone and misoprostol.”

In addition, the new law requires that the abortionist inform the woman that “it may be possible to reverse the effects of an abortion-inducing drug if she changes her mind, but time is of the essence, and information and assistance with reversing the effects of an abortion-inducing drug are available in the printed materials . . .”

The legislation passed both chambers by large margins and was signed by Governor Burgum, but opponents of merely notifying women about this procedure continue to mislead people about it. Here are the facts.

North Dakota law requires that abortion-inducing drugs be administered according to the protocol approved by the federal Food and Drug Administration (FDA). The FDA approved protocol consists of mifepristone, followed by misoprostol taken 24 to 48 hours later. The mifepristone blocks the production of progesterone, which is stabilizes the uterine lining, which in turn is necessary for the development of the unborn child. By blocking the production of progesterone, mifepristone cuts off blood and nourishment to the unborn child, usually causing he or she to die. The second drug, misoprostol, forces the body to expel the dead unborn child or in some cases a live child. We know this because some women who do not take misoprostol have their pregnancies continue.

Since physicians know exactly how mifepristone works (i.e., by blocking progesterone), they also know that treating a woman with progesterone can “kick off” the mifepristone (i.e., displace mifepristone from the progesterone receptors). This allows the woman's body to respond naturally to the progesterone and to effectively fight the effects of the mifepristone-induced blockage.

Progesterone itself has been used safely in pregnancies for decades. Using progesterone to reverse the effects of mifepristone is a targeted medical response that is safe for the woman and the baby. We also know that use of mifepristone alone does not cause birth defects. Indeed, the rate of birth defects for children who survive just the mifepristone is the same as the general population. That means that even if, as some opponents claim, a dose of progesterone does “nothing,” it clearly would not harm the woman or the child.

The fact that the effects of the abortion-inducing drug mifepristone can be reversed or blocked should not be disputed. Hundreds of babies among us attest to that fact. Those who oppose merely informing women about the possibility of reversing the abortion drug process, point to the absence of large-scale studies explaining how the process works. The number of women at issue, however, is so small that large-scale controlled studies are difficult to conduct. Nevertheless, even the opponents of informing women have noted that reversal makes “biological sense” and there is no evidence that abortion pill reversal does not work or is not safe. Indeed, initial studies show that without abortion pill reversal, the chances that an unborn child will survive mifepristone are around 15%. However, if the mother receives the progesterone-based rescue, then 65-70% of the unborn children will survive.

An OB-GYN physician in Bismarck testified in support of the bill and other physicians wrote to the legislature indicating that they have or would be willing to provide this important service. Opponents did not cite any study showing that the procedure was dangerous to either the woman or the child. Nor could they point to any study indicating that the procedure does not work. 

The opposition, though sometimes couched in medical terminology, was mostly philosophical. They oppose anything that “interferes” with the abortionist’s trade. The Supreme Court has, however, repeatedly recognized that abortion is not like any other medical procedure, partly, because it involves another human life and, in part, because of recognition that abortion can have greater consequences on a woman and the medical profession than other medical procedures. 

Thankfully, a majority of the legislature and the governor saw through the false concerns of the opponents and enacted this important update to North Dakota’s Woman’s Right to Know law.