The Washington PostDemocracy Dies in Darkness

A North Dakota law requires doctors to say that medication abortions can be ‘reversed.’ It’s being challenged in court.

Medical experts say the assertion is scientifically unsound

By
July 6, 2019 at 9:18 a.m. EDT

Adapted from a story byThe Washington Post’s Kayla Epstein.

A North Dakota abortion law currently requires doctors to tell women that a medication-induced abortion can be “reversed.” But medical experts — including the medical director of the last abortion facility in the state — say that assertion is scientifically unsound.

North Dakota’s legislation is not the only one to include this piece of misinformation about medication abortion; Idaho, Utah, South Dakota, Kentucky, Nebraska, Oklahoma, and Arkansas have passed similar measures. Arizona attempted to enact such a law in 2015, but legislators repealed it after a court challenge.

The American Medical Association has joined the Red River Women’s Clinic and its medical director, Kathryn Eggleston, to argue that the law violates doctors’ constitutional right to free speech by forcing them to lie to patients. The plaintiffs also contest an existing provision in North Dakota law that requires a doctor to tell a woman that the abortion will “terminate the life of a whole, separate, unique, living human being,” a statement they argue is ideologically biased and “forces physicians to act as the mouthpiece of the state.”

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AMA President Patrice A. Harris told The Washington Post that “we will oppose any law or regulation that restricts our ability to talk to our patients honestly about their health, health care, or treatment alternatives."

“Physicians across this country are greatly concerned” about such measures, she said. “The two North Dakota laws actually compel physicians and other members of the health-care team to provide patients with false or misleading information that’s not based on evidence, that’s not based on science.”

North Dakota Attorney General Wayne Stenehjem was reviewing the complaint, according to spokeswoman Liz Brocker.

Claims regarding abortion ‘reversal’

Supporters of these laws argue that a medication abortion can be reversed with doses of the hormone progesterone or by intervening after the first pill is taken. But Molly Duane, the lead lawyer for the Center for Reproductive Rights on the case, told The Post that forcing doctors to refer women to services that claimed to offer such a treatment amounted to a medical “experiment.”

Medication abortions are conducted early in a pregnancy and consist of taking two drugs in sequence: mifepristone, taken first, stops the growth of the pregnancy by blocking the hormone progesterone; misoprostol, taken next, makes the uterus contract to complete the abortion.

If women only take the first pill, mifepristone, there is a chance the pregnancy could continue, as this medication on its own is not always effective.

However, the American Congress of Obstetricians and Gynecologists is adamant that “claims regarding abortion ‘reversal’ treatment are not based on science and do not meet clinical standards.”

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North Dakota’s law

The North Dakota law in question, H.B. 1336, requires health-care providers to tell a 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 to provide her with materials that instruct her on resources to do so. It does not specify what those materials would include, or what such a treatment might entail.

The bill was signed into law by Gov. Doug Burgum (R) in March. The next month, he signed another law banning dilation and evacuation abortions, a method that can be used later in a pregnancy.

When asked for comment on the lawsuit, the governor’s office directed The Post toward Burgum’s statement after signing the law in question. “If it gives hope to even one person who has started the process and wants to try to reverse it, it is worth providing that information,” Burgum said.

Duane said that the plaintiffs hoped the court would act before the bill takes effect next month.

“Physicians shouldn’t be forced to say things they don’t want to say,” she said. “Particularly when those things are untrue.”