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California Board of Nursing Sanctions Unproven Abortion ‘Reversal’ (Updated)

Nicole Knight

The approval paves the way for anti-choice organizations to teach abortion "reversal" to nurses for state continuing education credit.

California’s Board of Registered Nursing has approved a course on abortion pill “reversal,” giving credence to the unproven notion that it’s scientifically possible to undo a medication abortion.

A spokesperson for the state Department of Consumer Affairs, a consumer watchdog agency that includes the Board of Registered Nursing, confirmed that an abortion “reversal” class met the department’s scientific standard for nursing education and the “letter of the law.”

The approval paves the way for anti-choice organizations to teach so-called abortion reversal to nurses for state continuing education credit. Jor-El Godsey, president of Heartbeat International, one of the nation’s largest anti-choice groups, told Rewire the organization has “prioritized training nurses on this innovative medical intervention.”

“Every nurse needs to know the truth about abortion—including the truth that a woman can change her mind in some cases even after beginning a chemical abortion,” he said in an emailed statement.

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Only a single paper published in 2012 supports the claim that it’s possible to undo a medication abortion, a regimen involving two types of medications. The paper, co-authored by two California doctors, relies on anecdotes from a tiny sample—seven women in total—and was conducted without an ethics oversight review.

To be effective, medication abortion requires a patient to take both mifepristone and misoprostol over the span of a few days. Anti-choice groups and their Republican allies have latched onto the notion of “reversing” a medication abortion in cases where the pregnant person takes only the first medication, and then is injected with a dose of the hormone progesterone.

But simply failing the take the second medication can also forestall a medication abortion, according to a systematic review of medical literature. “Claims of medication abortion reversal are not supported by the body of scientific evidence,” the Arizona chapter of the American Congress of Obstetricians and Gynecologists said in a 2015 statement. Reproductive rights advocates contend that abortion “reversal” pushes a false narrative of abortion regret. Republican-led states like Arizona that enacted laws requiring doctors to discuss the idea of abortion “reversal” with patients are now on the hook for significant legal fees after losing in court, as Rewire reported this week.

Earlier this year, the Louisiana Department of Health issued a report concluding there is “insufficient evidence to suggest that there is a sound method to reverse a medication-induced abortion.” Louisiana Republicans had asked the department to investigate the possibility of abortion “reversal.”

California regulators for years allowed national anti-choice groups to teach similar unproven ideas to nurses in continuing education classes, as Rewire first reported last year. When Heartbeat International, for example, taught the abortion reversal class at a national conference in 2015, it touted in printed materials that it was approved by the state of California to do so.

Last fall, following Rewire’s reporting, California’s governor signed a bill to crack down on continuing education providers and require the courses to hew toscientific knowledge or technical skills required for the practice of nursing.” The law, sponsored by state Sen. Jerry Hill (D-San Mateo), also requires the state to routinely audit continuing education providers, something it hadn’t been doing.

On Thursday, Michelle M. Cave, spokesperson for the California Department of Consumer Affairs, told Rewire the Board of Registered Nursing approved the abortion reversal course because it met one of the criteria below:

  • Be related to the scientific knowledge and/or technical skills required for the practice of nursing, or

  • Be related to direct and/or indirect patient/client care.

  • Learning experiences are expected to enhance the knowledge of the Registered Nurse at a level above that required for licensure. Courses related to the scientific knowledge for the practice of nursing include basic and advanced courses in the physical, social, and behavioral sciences, as well as advanced nursing in general or specialty areas. Content which includes the application of scientific knowledge to patient care in addition to advanced nursing courses may include courses in related areas, i.e., human sexuality; death, dying, and grief; foreign languages ( conversational); therapeutic interpersonal relationship skills; pharmacology; and those related to specialty areas of nursing practice. Courses in nursing administration, management, education, research, or other functional areas of nursing relating to indirect patient/client care would be acceptable. Courses which deal with self-improvement, changes in attitude, financial gain, and those courses designed for lay people are not acceptable for meeting requirements for license renewal.

The Board of Registered Nursing, Cave noted, reviews “course content for evidence based scientific research.”

Last year, after hearing of the abortion reversal course, the board issued a cease and desist letter to Heartbeat International at the recommendation of Sen. Hill. But Cave told Rewire the board lacked the authority to send the letter and has since rescinded it.

After publication, Sen. Hill told Rewire, “I am concerned about the action by the board and the Department of Consumer Affairs’ response to it, and will be following up on this matter. It is in fact, the board’s responsibility to determine what is and what is not relevant and appropriate to the practice of nursing and the continuing education for registered nurses.”

Godsey contends Heartbeat International has seen abortion “reversal” work. “There are now 300 mothers nationally who have safely and successfully stopped their abortions after taking the first pill in the chemical abortion process, and that is good news regardless of one’s views on abortion,” he told Rewire.

Rebecca Griffin, associate director, California programs, of NARAL Pro-Choice America, said abortion pill reversal claims are unsupported by the body of scientific evidence.

“It’s irresponsible to promote a procedure that isn’t grounded in good medicine and perpetuates offensive ideas about women’s ability to make informed reproductive health decisions,” she told Rewire in an email.

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