The North Carolina General Assembly (“NCGA”)House Bill 62 had its first reading today. HB62 is titled the Woman’s Right To Know Addition/ “Ashley’s Law.” It is sponsored by Representatives Pittman, Boswell and Speciale. The first reading is the first time a bill is put before the legislature. Bills are sometimes read and then assigned to committee. Other times, the bill does not go to committee and the second and third readings happen very quickly, resulting in a fast vote on the legislation.
HB62 is one in a long line of proposed statute statutes that place restrictions on access to lawful abortions. Mifepristone is one of the two drugs known as RU-486, it is combined with Misoprostol to bring about an abortion very early in pregnancy. It is 95% effective if taken during the first 50 days of a pregnancy. It is an FDA approved for use in causing medical abortion with a favorable safety profile.
A low cost option, almost 50% of first trimester abortions are performed using the Mifepristone and Misoprostol combination.
HB62 Requires Doctors to Provide Unscientific Information to Patients Undergoing Medical Abortion
HB62 adds the following language to N.C. Gen. Stat. 90-21.86:
[T]he physician or qualified health professional shall inform the woman that (i) it is still possible to discontinue a drug-induced abortion by not taking the prescribed Misoprostol and taking progesterone to reverse the effects of the Mifepristone and (ii) information on how, where, and from whom women can obtain assistance in discontinuing a drug-induced abortion is available on the Department of Health and Human Services’ Internet website.
Immediately prior to administering the drug Misoprostol, the physician or qualified professional shall provide medical proof to the woman that fetal death has occurred.
Similar laws have been passed in Arkansas and Arizona.
The problem with HB62, and it is a big one, is that this bill requires healthcare providers to give patients information that is not supported by scientific evidence. The American Congress of Obstetrician and Gynecologists (“ACOG”) has issued a statement on Medication Abortion Reversal, which states:
Claims of medication abortion reversal are not supported by the body of scientific evidence, andthis approach is not recommended in ACOG’s clinical guidance on medication abortion. There are no ACOG guidelines that support this course of action.
Facts are important.
-Mifepristone, previously known as RU486, is part of a combination of drugs used for medication abortion.
-Mifepristone is the first drug in the combination and is not known to cause birth defects
-Misoprostol is the second drug in the combination, and the evidence-based regimen for medication abortion includes mifepristone taken first and then misoprostol taken at a later point to complete the abortion.
-Because medication abortion requires this combination of medications, many women will not abort just from using the first medication. In 30-50% of women who take mifepristone alone, the pregnancy will continue.
Reliable evidence is not available
-A 2012 case series describes six women who took mifepristone and then had a series of progesterone injections. This paper describes a handful of experiences. [T]hese women received varying regimens of injected progesterone, and this was not a controlled study. Therefore it does not provide evidence that progesterone was responsible for the reported outcomes. In addition, there was no oversight of an institutional review board or an ethical review committee for this intervention.
-Taking mifepristone (without misoprostol) will not always cause abortion by itself, so nointervention may lead to the same result as this case series.
-There are no reliable research studies to prove that any treatment reverses the effects of mifepristone.
The Arizona statute was challenged in Planned Parenthood v. Humble and the law was enjoined by the court. Specifically, the court held that the Arizona law, which is extremely similar to HB 62, was an unconstitutional undue burden on receipt of a safe abortion.
Junk Science Should Not Become the Law
In this case, the NC legislature is creating an incorrect impression that women can change her mind after taking the first drug–which is sufficient to cause abortion in and of itself 50-70% of the time. It is also requiring doctors to provide other non-evidence based supports (high dose progesterone) to the challenged pregnancy in addition to not administering the second drug. The problem is that a large percentage of abortions are complete even without the second drug. This is clearly a thinly veiled attempt to try and force abortion providers to talk their patients out of the abortion and could cause unnecessary emotion distress if a patient changes her mind and the first drug was sufficient to terminate the pregnancy alone. The NC legislature should not require doctors to give patients information that falls below the standard of care articulated by ACOG.
Please, call your NC legislator and tell them not to buy yet another lawsuit by passing a scientifically unsound law. We would rather our tax payer dollars go toward job creation.