RU-486 reversal gives hope to women who change their minds
A recent study published by The Annals of Pharmacotherapy reveals that it is possible for a woman who changes her mind about her RU-486 chemical abortion to reverse the process and preserve her pregnancy.
To understand the reversal process, first we have to understand how the RU-486 works:
- RU-486 is actually two pills, taken approximately 48 hours apart. It is not the same thing as the “morning-after pill,” for which it is commonly mistaken. RU-486 is a chemical abortion, also called a medicated abortion, meaning that its purpose is to non-surgically end early pregnancies. There is no preventative factor, so to speak, involved, as there is with the morning-after pill; RU-486 is solely an abortifacient.
- The first pill is taken at the clinic, while the second is taken by the woman on her own. The first pill causes the death of the child, while the second causes the dead human embryo to be expelled from the woman’s body.
- The first pill is called mifepristone. For simplicity, we will call this “M1” from here on out. It is like a key that fits into a woman’s progesterone receptors – which are kind of like the corresponding locks. However, M1 is not progesterone. M1 binds with progesterone receptors (twice as well as progesterone!) so that progesterone can’t do its job, which is to help nourish the embryo and supply it with oxygen. The ensuing lack of food and oxygen is what causes the baby’s death.
- The second pill is called misoprostol, which we will call “M2.” The function of this drug is to expel the baby’s body from the mother’s womb, effectively concluding the abortion, barring any complications (for example, if the M2 doesn’t do its job and the baby is not expelled, women can die, and have died, from sepsis).
Therefore, RU-486 essentially causes fetal death by starvation and suffocation (those are the terms we would use if referring to a postnatal child who died this way).
Some women change their minds about their abortions after ingesting the first drug, M1. To help these women reclaim their pregnancies, a number of physicians have administered progesterone, theorizing that the progesterone could compete with the M1 and beat the abortion drug to the progesterone receptors, thereby thwarting the abortion attempt.
Of the seven patients on whom an abortion reversal, so to speak, was attempted, four live, healthy newborn births ensued. Two women did lose their children to the effects of M1, and one could not be located for follow-up, so the result is unknown.
The four women who continued their pregnancies successfully were between the ages of nineteen and twenty-five, and their children were between 7 and 11 weeks’ gestation. They received progesterone injections (and some received an oral progesterone supplement as well) from the time they changed their minds – usually within a day of having taken the M1 — and continued receiving progesterone for most or all of their pregnancies. No birth defects or abnormalities were reported in any of their four children, and none of them were born prematurely.
The article concludes that “the experience of these patients suggests that medical abortion can be arrested by progesterone injection after M1 ingestion prior to M2 due to the competitive action of progesterone versus M1.” A key factor in this equation is that the reversal is sought before M2 is ingested.
The study admits that it needs more opportunities to utilize this method in order to have an evidence basis for the best protocol, but the success observed with the aforementioned four pregnancies assures the administrators that there is reasonable hope for women who change their minds and desire to preserve their pregnancies after ingesting the first dose of RU-486. This should become the standard of care for obstetrician-gynecologists, family physicians, and emergency department physicians to attempt mifepristone reversal on patient request.