UPDATE: The Faculty for Social Wellbeing has since yesterday (27/09/2024) deleted their post – we have included a saved version below.

Abortion cannot be reversed. Any treatments that claim to do so are made without scientific evidence and could be unsafe.

These words are New York Attorney General Letitia James’, uttered as part of a lawsuit brought forward against 11 crisis pregnancy centres and Heartbeat International, an anti-abortion group affiliated with some of them, asking a state court in Manhattan to block them from advertising abortion pill reversal.

That case, brought under New York laws against misleading business practices, remains pending, but just like the University of Malta’s Faculty for Social Wellbeing’s decision to disseminate politically charged promotional material, sits at the very peak of an iceberg that sinks deep into an ideological war against the woman who dares make an unsanctioned choice.

Nevertheless, the American Association of Pro-Life Obstetricians and Gynecologists plans to roll out courses on abortion reversal to hospitals and doctors. The Heritage Foundation, the conservative organisation behind Project 2025, which advocates for restricting medication abortion, is a major funding source for the effort.

What is Medication Abortion?

Medication abortion is a non-surgical method to terminate a pregnancy (any method is currently illegal in Malta), using a combination of two medications: mifepristone and misoprostol. Mifepristone works by blocking the hormone progesterone, which is essential for pregnancy maintenance, while misoprostol induces uterine contractions to expel the pregnancy. This regimen is endorsed by the World Health Organization (WHO), ACOG, RCOG, and other global health organizations as a safe, effective, and evidence-based method of abortion up to the early weeks of pregnancy.

Both mifepristone and misoprostol are necessary for an effective medication abortion. Studies show that without misoprostol, as many as half of the women who take only mifepristone may continue their pregnancies.

Abortion reversal advocates often misrepresent this fact, suggesting that progesterone administration plays a role in reversing mifepristone’s effects when in reality, incomplete abortions can happen even without intervention.

And this has happened before, at the University of Malta

Despite widespread medical consensus against it, some groups continue to promote abortion reversal treatments. In Malta, this controversy first surfaced when an advertisement for abortion reversal appeared in a University of Malta faculty magazine. The paid ad, placed by Life Line Malta (the same crisis pregnancy center which issued the material shared today) claimed that administering repeated doses of progesterone could “reverse” the effects of a medical abortion initiated with mifepristone. However, this claim is not supported by credible scientific evidence and has been widely criticized by the medical community.

The ad was also included in the Faculty’s UNITY magazine, which, after a vociferous appeal from Doctors for Choice Malta, published an informational statement with sources from recognised Health authorities.

Then Health Minister Chris Fearne addressed the issue, stating that prescribing progesterone to women who decide to continue their pregnancies after taking mifepristone is left to the doctor’s clinical judgment. This statement came in response to concerns raised by pro-choice doctors who highlighted the misleading nature of the advertisement. Fearne emphasized that progesterone use is legal when deemed appropriate by the treating physician, aiming to clarify the legal stance amidst the controversy.

Pro-choice advocates, including Doctors for Choice, condemned the advertisement, pointing out that international medical bodies such as the ACOG and the RCOG have declared abortion reversal treatments as unscientific and potentially dangerous. They highlighted that studies supporting abortion reversal are either flawed or have been halted due to serious health risks, such as severe hemorrhaging in participants.

Local experts like Yves Muscat Baron, head of Obstetrics and Gynaecology at Mater Dei Hospital, acknowledged the limited research on abortion reversal but noted that progesterone is safely used to treat miscarriages. Despite this, he admitted that the evidence supporting abortion reversal is insufficient and that existing studies lack robust scientific validation.

The situation in Malta mirrors global tensions, where some anti-abortion groups push for legislative measures to mandate the dissemination of abortion reversal information, despite medical authorities’ opposition. This not only spreads misinformation but also poses significant health risks to women by promoting unproven treatments.

The Claims Around Abortion Reversal

The concept of “abortion reversal” has become a contentious issue in recent years, particularly among anti-abortion groups. The most popular claim is that a medical abortion, once initiated with mifepristone, can be reversed by administering progesterone before the second drug, misoprostol, is taken. Proponents argue that progesterone counteracts mifepristone’s effects, allowing the pregnancy to continue. APRN, for instance, claims success rates of 64-68% for such reversal treatments​

But despite its growing political traction in certain regions, this claim is not grounded in credible scientific evidence. Numerous health authorities, including the ACOG, the RCOG in the UK, and the EBCOG, have strongly opposed the promotion of abortion reversal, labelling it as unproven, unethical, and…

Not Backed by Science

The claim specifies that administering progesterone can reverse a medical abortion is not scientifically supported. As mentioned, ACOG has explicitly stated that prescribing progesterone to stop a medication abortion is not based on sound scientific evidence. Similarly, the RCOG in the UK has condemned abortion reversal as “dangerous” and “misleading,” emphasizing that such practices do not meet the standards of evidence-based medicine.

Misinformation Around Abortion “Reversal”

The key study often cited by supporters of abortion reversal is a 2012 report involving six women who were given progesterone after taking mifepristone. Four of these women continued their pregnancies, but this study had significant scientific limitations. It lacked essential oversight by an ethics review committee and included no control group, making the findings unreliable. In Europe, researchers and ethics boards have widely dismissed this study, noting that such weak evidence cannot be the basis for clinical recommendations. Both EBCOG and the UK’s RCOG emphasize that rigorous, ethical studies are needed to make credible medical claims, and none exist to support abortion reversal.

Further attempts to study abortion reversal have encountered similar issues. In 2019, a more rigorously designed trial had to be stopped early because several participants experienced severe haemorrhaging, highlighting the safety risks involved in administering progesterone in this context. Health authorities across the European Union, including the European Medicines Agency (EMA), have also highlighted the absence of reliable evidence and safety data to support abortion reversal protocols.

Despite these clear positions, some political factions, particularly in the U.S., and at the University of Malta it seems, have advanced claims that a medication abortion can be reversed. These claims, which serve to confuse patients and promote unproven treatments, must be condemned for compromising patient safety and care. The World Health Organization (WHO) has also emphasized that such claims are “unsubstantiated” and that medical care should be driven by reliable evidence, not political ideologies.

A university promoting unproven treatments needs to raise alarm bells everywhere you look. This is political promotion at the cost of human health, sanctioned by the Faculty for Social Wellbeing. Targeted women deserve to make informed decisions about their health in consultation with trusted professionals, free from political or ideological pressures. It is clear that the university has opted to abandon this position of trust, and so we must do all we can to protect the targeted victims.

Let’s repeat. There are no reputable national or international clinical guidelines that recommend the use of progesterone to reverse the effect of mifepristone, and no evidence that it increases the likelihood of continuing pregnancy.

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The views expressed in this article are those of the author/s and do not necessarily represent a position or perspective of this or any organisation

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