But there is one additional effort — forcing doctors to discuss a medically unproven “abortion reversal” procedure — that has taken root in multiple states and, in Indiana, inspired ire on both sides of the aisle.
The bill approved Monday by the Indiana House of Representatives would require Indiana doctors who provide chemical abortions, also called medication abortions, to also discuss a procedure that proponents say halts the abortion process and gives women who regret their decision a way out. The state senate is also under Republican control.
A medication abortion is carried out with the help of two pills. The first blocks the hormone progesterone, which the body needs to sustain a pregnancy. The second pill, taken days later, induces cramping and bleeding to empty the uterus, like an early miscarriage.
The reversal procedure, some doctors claim, halts the process by injecting the woman with progesterone before she takes the second abortion pill.
“This is for those who take that first step and regret it,” Rep. Peggy Mayfield (R), a co-author of the Indiana bill, told the Indianapolis Star. “There is an alternative there. There is hope.”
According to medical experts and doctors who oppose the legislation, the procedure is not supported by science.
The notion that it works stems from a 2012 research paper by George Delgado published in the Annals of Pharmacotherapy that describes four of six women who took the first of two abortion pills, were injected with progesterone shots and had healthy babies.
Since then, Delgado has claimed that the procedure produced a 60 to 70 percent success rate among several hundred other women.
But according to the American Congress of Obstetricians and Gynecologists, Delgado’s research is not scientifically sound because the sample size is small, there was no comparison group and the women’s hormone injections were not consistent. The study was not overseen by an institutional review board, according to ACOG, or an ethical review committee.
Because of the loose parameters of Delgado’s research, there is also no way to ascertain if it was indeed the progesterone shots that halted the abortion process. A medication abortion requires the two-pill regimen, so “many women will not abort just from using the first medication,” according to ACOG. In 30 to 50 percent of women who take only the first pill, the pregnancy will continue.
The validity of the study is, to some extent, beside the point. The goal of antiabortion activists is generally to throw whatever obstacles they can in the way of women seeking abortions in hopes of discouraging them or just making it too difficult to terminate a pregnancy. Many of the restrictions have been struck down by federal courts for creating an “undue burden” on the right to abortion.
The Indiana bill even acknowledges that the effectiveness of the procedure is not supported by a medical study, but nevertheless would require doctors to provide their patients with information “orally and in writing” that “the abortion may be possibly reversed.”
Forcing medical professionals to relay information based solely in conjecture, critics say, is a dangerous overreach.
“At this point, the only certainty is confusion,” Rep. Cindy Kirchhofer (R) told the Associated Press. “I do not believe forcing medical professionals to provide medical advice on something that is not proven and incomplete is by any means the right thing to do.”
Rep. Ron Bacon (R) sponsored the bill, and debate on the house floor Monday was dominated by female lawmakers, reported the Indianapolis Star. It passed with a 53-41 vote, according to the Star, with six out of the 21 women present supporting the measure.
“This bill seeks to dictate medical practice based on junk science,” Democratic Rep. Linda Lawson told the AP. “This is not a political event, ladies and gentlemen. This is between doctors and their patients.”
In committee, two Republicans joined all four Democrats to oppose the bill in two separate votes, but it ultimately prevailed.
“We’re just saying you have the right to try,” said Rep. Ben Smaltz (R) told the Indianapolis Star. “We’re not saying it’s going to work.”
Similar laws have been enacted in Arkansas and South Dakota since 2015, the AP reported, and an Arizona law was challenged in court and later repealed. North Carolina and Utah, like Indiana, are debating abortion reversal bills. A proposal in Colorado was killed in a committee earlier in February, according to the AP.
“It’s really concerning that legislatures are passing laws interfering in the doctor-patient relationship and forcing them to tell women about an experimental therapy that is unproven,” Daniel Grossman, a professor in the department of obstetrics, gynecology and reproductive sciences at the University of California at San Francisco, told the AP.
The idea that women often change their mind once they’re begun the medication abortion process isn’t supported by data, Grossman said. The manufacturers of the drug that blocks progesterone through the initial pill is required to report any changes of heart, the AP reported. Between 2000 and 2012, Grossman said, less than 0.004 percent of women did so.
“Women are very sure of their decision by the time they go to the abortion clinic,” Grossman told the AP.
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