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US Judge Blocks Law That Would Have Been First to Ban ‘Abortion Pill Reversal’

Abortion foes claim practice can be used to halt medication abortion while studies don’t support potentially harmful theory

A law that would have been the first in the United States to ban a controversial practice known as “abortion pill reversal” cannot take effect, a judge ruled late Saturday.

US district court judge Daniel D Domenico granted a preliminary injunction in the case, ruling in favor of a Catholic health clinic that had argued the law infringed on its first amendment rights.

“The state generally cannot regulate an activity if that regulation burdens religious exercise, provides for individualized exceptions, fails to regulate comparable secular activities that raise similar risks, and otherwise targets religious activity,” Domenico wrote. “The law at issue here runs afoul of these first amendment principles.”

Abortion foes claim that “abortion pill reversal” can be used to halt a medication abortion, which is typically induced by taking doses of two drugs several hours apart. If an abortion patient takes the first drug and then changes her mind, anti-abortion activists say that she can take the hormone progesterone to “reverse” the first drug and preserve the pregnancy.

The first randomized, controlled clinical study to attempt to study the “reversal” protocol’s effectiveness, however, was suddenly halted in 2019, after three of its participants ended up in the hospital hemorrhaging blood. In an announcement entitled, in part, “Facts Are Important”, the American College of Obstetricians and Gynecologists said claims about abortion reversal are “not based on science and do not meet clinical standards”.

Regardless of the protocol’s efficacy, less than .005% of people choose to continue their pregnancy after taking the first drug in a medication abortion, according to a 2023 study published in the American Journal of Public Health. If someone does decide they don’t want to take the second drug in an abortion medicine, doctors are supposed to keep an eye on them; the pregnancy may continue because the patient didn’t take the second drug.

The Catholic clinic’s lawsuit claims that the clinic has treated dozens of people who wanted to undergo abortion pill reversal.

“Abortion pill reversal is nothing more than supplemental progesterone,” the lawsuit argues. “And there are a multitude of off-label uses of progesterone, which has been widely prescribed to women – including pregnant women – for more than 50 years.”

Before Roe v Wade fell in 2022, at least 14 states passed laws that effectively required providers to suggest to patients that abortion can be reversed, the American Journal of Public Health study found.

Katherine Riley, the policy director of Colorado Organization for Latina Opportunity and Reproductive Rights, one of the organizations that backed the Colorado law, told the Guardian that the law was meant to stop the spread of false information, not target specific religious practices.

Ahead of the ruling, she said a ruling against the law would blur the line between medicine and science.

“These folks can pretty much get away with whatever they want, as long as they just claim they’re doing it in the name of their religion,” Riley said. “Which, to me, is bonkers.”

In his ruling, Domenico said that the Colorado law must meet a legal standard known as “strict scrutiny” in order to stand.

“The state must come forward with a compelling interest of the highest order to maintain the law,” he wrote. “It has not even attempted to do so.”

Facilities that offer abortion pill reversal are often known as crisis pregnancy centers, which are frequently faith-based and usually try to convince women to continue their pregnancies.

Abortion rights supporters have spent years trying to find a way to regulate crisis pregnancy centers. In 2018, the US supreme court struck down a California law that would have required the licensed centers to tell patients about publicly funded family planning services, including birth control and abortion, as well as required unlicensed centers to tell women that they did not have a license. The court, then dominated 5-4 by conservatives, ruled that these requirements violated the centers’ first amendment rights.

More recently, the California attorney general this year sued several crisis pregnancy centers, alleging that they made fraudulent and misleading claims by saying that abortion pill reversal can halt a medication abortion.

Ken Paulson, the director of the Free Speech Center at Middle Tennessee State University, said that the California case is more straightforward than the Colorado law and may succeed. The Colorado law was more complicated, he said.

“The notion that there’s a religious right to market a pill that the state believes is potentially unsafe is a bit surprising,” Paulson told the Guardian ahead of the Monday ruling. Opposition to abortion is not solely a religious issue, nor is it linked to any one religion, Paulson said. “There are literally tens of millions, if not more, of Americans who are opposed to abortion, and they do not all go to the same church.”

While the Colorado preliminary injunction is not a final ruling in the lawsuit, it is set to freeze the law while litigation plays out. That process may take years.

A spokesperson for the Colorado attorney general’s office, which argued in favor of the law taking effect in court, said the office had no comment on the pending litigation.

Source : The Guardian