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You might have heard of abortion pill reversal, sometimes abbreviated APR, in the news.  Groups like Planned Parenthood say it is unproven, unscientific, and harmful to women and babies.  Others in politics are trying to pass laws to prevent the prescription of APR by doctors, nurses, or midwives.  But what is the truth about abortion pill reversal?  How does it work, and is it really safe?  Let’s find out!

            Abortion pill reversal was developed by Dr. George Delgado in the mid-2000s.  He realized that mifepristone, the first pill in the abortion pill regimen, blocks the body’s progesterone receptors causing low hormone levels.  Progesterone is required for a pregnancy to continue and grow, so blocking the receptors causes death to the growing, developing embryo.  The plan was to give bio-identical progesterone to women who changed their minds after taking mifepristone.  If progesterone levels are high enough, they can bind to the progesterone receptors again, allowing the pregnancy to continue.

            The incredible thing about abortion pill reversal is that the treatment isn’t new.  Bio-identical progesterone is prescribed quite often by OB-GYNs and midwives to prevent miscarriage, and has been since the 1950s.  What is new is prescribing it after a woman has taken the first abortion pill, mifepristone.

            So, how effective is abortion pill reversal?  Well, depending on the study, it is anywhere from 64-68% effective.  This means that if 10 women took the first abortion pill and changed their minds and tried APR, then we would expect 6 or 7 of the babies to live.

            Are there concerns about abortion pill reversal?  For the mother, not very many.  Since the progesterone is in the same form as the body naturally makes, she shouldn’t have any major reactions.  The most common side effects are tiredness, nausea, stomach upset, and headaches.  The main concern that needs to be considered is if the mom has a peanut allergy, then there is a special way the progesterone needs to be given since some forms are kept stable using peanut oil.  What about for the baby?  No, there are no known concerns.  In fact, babies born after APR are less likely to be born prematurely and have no increased risk of birth defects compared to babies who mom’s never needed APR.  That’s pretty remarkable!

            If all of this is true, why are people against abortion pill reversal?  Honestly, it’s hard to know for certain.  Some of those who are the most upset about APR are the ones who claim to be pro-choice.  Logically though, wouldn’t choice include the desire to change one’s mind?  Additionally, many critics cite a 2019 study by Mitchell Creinin that claims that APR is dangerous, but when reading the study carefully, the results showed that mifepristone caused an increased risk for bleeding, but taking progesterone actually decreased that risk.  Clearly then, mifepristone is reversible, and the method of reversal using progesterone is safe and effective.

            If you, or someone you know, has taken the first abortion pill and changed your mind, you can call the Abortion Pill Rescue Network’s 24/7 hotline at 877-558-0333 or visit the website AbortionPillReversal.com to start the abortion pill reversal process.  If you pursue reversal, a pregnancy center near you, such as Options PRC, can offer you no-cost ultrasounds to confirm your baby still has a heartbeat and is growing while you continue your reversal treatment.

Women of all ages have questions regarding pregnancy.  Some common questions include: Is it possible for me to be pregnant? What are the risks of becoming pregnant at my age?  While these questions could each be answered at an in-depth level, this post will give a brief overview of each.

First, when is it possible to be pregnant?  Pregnancy is possible during the years that a woman has a menstrual cycle.  This means if a woman is sexually active between puberty and menopause, there is a chance that she can become pregnant.  During the first few years of puberty, the menstrual cycle is irregular, and ovulation may not occur during every cycle, so pregnancy is less likely, though it can and does happen, even with a young woman’s first menstrual cycle.  Similarly, as menopause approaches, cycles and ovulation, become irregular again, so pregnancy is again less likely, but still possible.

With these things in mind, if a young woman in her teen years gets pregnant, what unique challenges will she face?  In the first few years after starting puberty, a woman’s body is adapting to the hormonal changes that happen each month.  This means that the hormonal changes of pregnancy might be more difficult to handle than for women who have had more time to adjust to these hormonal changes.  Also, because she is still likely growing herself, there is an increased risk for the woman to develop a nutritional deficiency, an obstructed labor that requires a c-section (especially for girls under age 15), preterm birth, and small-for-gestational-age babies.  If a woman gets prenatal care early, some of these challenges can be prevented or treated early so both the woman and her baby are healthier.  Some young women try to hide their pregnancies, or they might be in denial, refusing to admit that they could be pregnant, so they do not take a pregnancy test, or see an OB-GYN or midwife, until they are several months into their pregnancies.  An OB-GYN or midwife can help young women prepare for the body changes of pregnancy, teach them how to eat and exercise well during pregnancy, and help quickly treat any complications that might arise as pregnancy continues.  For the healthiest pregnancy possible, it is recommended that young women try to see an OB-GYN or midwife in the first trimester (the first 12 weeks of pregnancy).

The challenges faced by older women in pregnancy can be similar to those faced by younger women. Pregnancy in women over the age of 35, which is the age arbitrarily set as the cutoff for “advanced maternal age,” is becoming more common. As a woman ages, her eggs begin to decrease in quality, so the risk for miscarriage gradually increases in her late thirties and through her forties and early fifties until menopause occurs.  Additionally, the risk for chromosomal abnormalities gradually increases over that time, which can cause anxiety for women hoping to get pregnant.  The chance of conceiving multiples, such as twins, also increases with age, which can be exciting but also stressful.  While there isn’t anything a woman can do to affect these three things, having a good support system can help to minimize anxiety and insure a woman has help if she should experience any of these challenges.  A healthy lifestyle can help minimize other risks that come with increasing age.  These other risks include higher rates of gestational diabetes, preeclampsia, large- and small-for-gestational-age babies, and an increased risk for stillbirth in pregnancies that continue past 40 weeks. Part of the increased risks in older age are due to the fact that age gives more time for chronic health conditions to develop or become apparent.  If a woman has a chronic health condition, such as diabetes or thyroid disease, she should work with her doctor to manage this before and during her pregnancy.  If she is actively trying to get pregnant, talking with her doctor might be helpful because any medications she is on might need to be adjusted during pregnancy.  Finally, knowing in advance that doctors will likely recommend more prenatal tests during her pregnancy can help relieve anxiety, as these tests become more routine as women get older.

What are STDs?

Sexually transmitted diseases (STD), also known as sexually transmitted infections (STI), are primarily spread through sexual contact with an infected person.  Some STDs are also called blood-borne infections; these infections can be spread through contact with an infected person’s blood as well as sexual contact.  There are a few STDs that can also spread through contact with infected skin, even without sexual contact.  STDs often have a variety of symptoms, including generalized pain, burning during urination, pain during sex, unusual appearing or smelling discharge, and lesions, such as warts or blisters.  A person can also have an STD and not experience any symptoms.

Are all the above symptoms caused by STDs?

It is important to note that sometimes people have symptoms similar to those listed above, but it’s not related to an STD.  For example, yeast infections are caused by fungi, and bacterial vaginosis is caused by changes in the amount of normal bacteria in the vagina of women.  While these infections are more common among those who are sexually active, both can be experienced by women who have never experienced sexually activity.  Your doctor can tell what kind of infection you are experiencing, and what kind of treatment it requires, by running some tests and going through a health history with you.

Why should I be tested for STDs?

Getting tested for STDs is important!  If you are experiencing symptoms of an STD, this is a good time to schedule an appointment for testing.  Untreated STDs can lead to infertility (trouble becoming or staying pregnant) or, if severe, sterility.  Some STDs can be passed from a pregnant woman to her unborn child, and some STDs, such as HPV, can lead to cancer.

Even if you aren’t experiencing symptoms, current recommendations state that anyone under 25 who is sexually active should get tested annually, plus anytime they or their partner has sex with another person.  For those over 25, anytime you change sexual partners or your partner has sex with another person, you should get tested.  If you and your partner can both guarantee that you have not had sex with anyone else since you were last tested, then there isn’t a need to be retested.

Where should I go to get tested, and what should I expect?

When deciding where to get tested, you have several options.  You can get tested at your local doctor’s office, by your OB-GYN, or at the local public health department.  Some independent clinics also offer STD testing, but you will have to do some research to find out which ones. One thing to consider when deciding where to go is that not all clinics test for the same STDs.  Your OB-GYN or doctor’s office will likely offer the most comprehensive testing.  This is because some tests require a urine sample, others a blood sample, and some a pelvic exam.  Other clinics might not be able to offer such comprehensive testing because it is too expensive, they don’t have the equipment, or they would need to hire additional medical staff that they don’t currently have.  As a result, you should always ask what STDs the clinic is testing for.  If you received test results saying that you were cleared, make sure to verify what STDs you were tested for.  Just because you don’t have chlamydia doesn’t mean you also don’t have HPV.

What happens if I test positive?

If you test positive for an STD, there are different treatments depending on the type of STD that you have.  Some STDs are caused by bacteria, such as syphilis, gonorrhea, and chlamydia.  These are treated by various kinds of antibiotics.  Others are caused by viruses, like HPV, herpes, hepatitis, and HIV, and they are treated by various anti-viral medications or the removal of lesions.  Trichomoniasis is caused by a protozoa and is typically treated with a medication called metronidazole.

            Some STDs can be treated and cured, but others will go into a latent phase.  This means the infection is still in your body, but you won’t have symptoms for awhile.  If this is the case, you want to be on the lookout for the symptoms you experienced at first coming back.  Any time you have symptoms, you will be contagious.  Some STDs are still contagious even if you don’t currently have symptoms, such as HIV.  Talk to your doctor to learn his or her recommendations for treatment for yourself and your partner, and to learn how to prevent spreading the disease to others during active infections and any latent phases.

References:

Foundations of Maternal-Newborn Nursing by Sharon Smith Murray and Emily Slone McKinney; pp. 684, 688-690, 911-913.

https://www.cdc.gov/std/prevention/screeningreccs.htm