The Myth of "Abortion Pill Reversal" Perpetuates Mistreatment of Women of Color in Health Care

We are increasingly living in a society where it can feel like facts don’t matter, or at least can be acceptably blurred for talking points in a politicking game. This, unfortunately, is a frequent reality that abortion care providers contend with, as conservative politicians have long worked to inject lies into required disclosures before the procedure. Between lying about supposed risks of clinical abortion – which is remarkably safe – and now trying to gag doctors in publicly funded clinics from talking about abortion entirely, their shamelessness in disenfranchising already vulnerable women knows no limits, and its harm is especially felt by women of color and low-income families.

Far from a household name, George Delgado, a doctor in Southern California, has gained some visibility in recent years for claiming that he can stop a medication abortion. The process of abortion with pills involves two drugs, mifepristone and misoprostol, and has been found to be an effective and safe way to end a pregnancy, as documented in the 2018 report, “The Safety and Quality of Abortion Care in the United States.” What Delgado is pushing, on the other hand, is an untested experimental protocol that is part of a larger campaign by abortion opponents to shame women for their decisions, stigmatize abortion care and intimidate providers. The American Congress of Obstetricians and Gynecologists has said that, “claims regarding abortion ‘reversal’ treatment are not based on science and do not meet clinical standards,” adding that, “politicians should never mandate treatments or require that physicians tell patients inaccurate information.”

Unfortunately, anti-abortion politicians have seized on Delgado’s methods, with five states now requiring abortion providers by law to inform patients about the possibility of reversal as part of state-mandated “counseling” – often a tool of abortion opponents to inject stigma into medical settings. Now, the anti-abortion hotline Delgado runs is being handed over to Heartbeat International – a network of crisis pregnancy centers, or anti-abortion fake clinics, which have their own history of deceiving and shaming women about reproductive choices.

“Reversal” made news recently when it was reported that an undocumented minor known as “Jane Doe” seeking abortion while in detention in Texas was not only barred from receiving the procedure she wanted, but that Trump administration officials in charge of her care had sent her to a fake clinic instead. Scott Lloyd, the Trump-appointed director of the Department of Health and Human Services’ Office of Refugee Resettlement, had even discussed using the unproven regimen on another young migrant woman who had begun a medication abortion. In his position, Lloyd is meant to serve as the government’s “guardian” for these undocumented minors, yet he is a longtime anti-abortion activist who has served on the board of a fake clinic in northern Virginia, which advertises the regimen on their website. Notably, Trump’s Supreme Court appointee Brett Kavanaugh was one of the judges presiding over the case of Jane Doe, attempting to block her access to the abortion care she needed.

As Delgado’s throng of acolytes has grown, so has the number of people subjected to his experimental “treatments.” His first study on the practice, published in 2012, involved just six test subjects, and his latest study documents results from hundreds of women. While Daniel Grossman, an OB-GYN and director of Advancing New Standards in Reproductive Health, told The Washington Post, “The study is just not designed in a way that would be useful to determine if this is effective or not,” proponents of the method are crying success. Delgado said, “The science is good enough that, since we have no alternative therapy and we know it’s safe, we should go with it.”

The problem is, “good enough” is not a standard of medical practice, and too many have fallen victim to doctors just going with it in service of medical experimentation. These casualties have been exceedingly people of color, low-income, and often women.

In fact, the practice of gynecology in this country virtually began with the reproductive coercion of Black women. James Marion Sims, who some know as “The Father of Modern Gynecology,” had a vicious record of experimenting on enslaved people without anesthesia. He performed as many as 40 gynecological surgeries on one woman in a five-year period, and though there were other victims, we only know the names of three: Anarcha, Betsey and Lucy. Sims’s name, though, has been carried through history in high regard: Until this April, he had a statue in New York’s Central Park, with the inscription lauding him as a “surgeon and philanthropist” and ignoring his cruel abuses.

Sims’s abuses are just one terrible chapter in the history of racist medical experimentation in the US. There is also the Tuskegee syphilis trials, in which Black men underwent painful experiments for decades, including being told – falsely – that they were receiving treatment, while their health was allowed to deteriorate to serve the research goals of white scientists.

Meanwhile, early versions of the birth control pill were unethically tested on Puerto Rican women before the pill was improved and marketed on the mainland, with informed consent notices provided (if at all) in English as opposed to the island’s predominant Spanish. The doctor leading the trial marveled that if poor, uneducated women could use the birth control pill, anyone could. Doses were more than 10 times what is used in contraceptive pills today, and at least three women died during the trials, while his research gained him fame and esteem in his time.

Today, Delgado’s ongoing experiment with women’s health and bodies is likely being pushed disproportionately on women of color. According to The Guttmacher Institute, Black and Latina women are more likely to seek abortion care, and Delgado’s protocol has been championed by anti-abortion fake clinics like Heartbeat International, which have a track record of lying about abortion and targeting women of color with advertisements and billboards, setting up shop in communities of color and using coercive shaming tactics.

Furthermore, Delgado’s most recent paper on the regimen was withdrawn from the journal where it was published, likely for the authors’ failure to receive ethics board approval to experiment on human subjects.

“It is unclear if patients underwent informed consent and if they knew the treatment they received was experimental,” Grossman told BuzzFeed. The journal, Issues in Law & Medicine, has not publicly commented on the decision to temporarily withdraw the study, but the publication’s past support of staunchly anti-abortion research and claims that have thin scientific backing at best suggests that the issues with this study were more than the “technical error” Delgado has claimed in multiple interviews on the matter.

Proponents of this unethical experimentation on pregnant people don’t care about advancing health care any more than Sims cared about Anarcha, Betsey and Lucy’s reproductive health. If they did, they’d shut down the lies forced on women in the doctor’s office and demand only rigorously researched, peer-reviewed, ethically derived scientific progress.

Delgado and his supporters – anti-abortion advocates and politicians alike – are far less interested in real science than they are in shaming women for their decisions and spreading anti-abortion myths. When ideology is allowed to override medical evidence, women of color and poor women pay the steepest price. It’s hard enough for us to find culturally competent, language-accessible, affirming health care providers. The last thing we need is to fear being fed lies or serving as guinea pigs in an experiment to suit an anti-abortion agenda, and we certainly don’t need compassionate care providers “gagged” from giving information about our legitimate health care options.