Medical abortion:
Medical abortion is the prescribing of the progesterone antagonist; Mifepristone (also known as RU-486) followed 24-48 hours later by the prostaglandin analogue; Misoprostol. Mifepristone acts primarily by competitively binding to progesterone receptors in the endometrium causing detachment of the developing placenta leading to fetal demise. Misoprostol acts by causing uterine contractions to expel the fetal sac, placenta and membranes.
Abortion pill reversal:
It is possible to reverse the anti-progestogen effects of Mifepristone by prescribing progesterone replacement for several weeks. Progesterone should be taken as soon as possible following Mifepristone and has a success rate of 64-68 %. It is not possible to reverse medical abortion if the second drug Misoprostol has already been taken.
Many women describe immediate regret on taking Mifepristone and are given a second chance by taking the abortion pill reversal and this in keeping with the principles of patient autonomy. The American Association of Prolife Obstetricians and Gynaecologists AAPLOG states that Abortion Pill Reversal offers a medically sound choice to attempt to reverse the effects of Mifepristone, to women who have changed their minds about abortion after taking the first pill of the abortion regime.
For links to research papers on the efficacy and safety of abortion pill reversal (click here links to research paper and AAPLOG statements**)
Cyclogest:
In Ireland and The UK progesterone is available as Cyclogest; a vaginal pessary. Cyclogest is licenced for use in the UK for pre-menstrual syndrome, post-natal depression and Assisted Reproductive Technology (ART) programmes. It is also commonly prescribed for threatened miscarriage and to support high-risk pregnancies. Cyclogest is not licenced for use in Ireland but is widely prescribed by GPs, fertility specialists and Obstetricians and dispensed by local pharmacies.
Click here for Cyclogest product specification UK https://www.medicines.org.uk/emc/product/5569/pil
Responsible prescribing:
Cyclogest is prescribed by a medical practitioner registered by the General Medical Council in The UK and the Irish Medical Council in Ireland. The doctor will conduct a consultation with the patient and take appropriate measures to protect confidentiality and keep medical records in line with good professional medical practice. Cyclogest is prescribed to the woman with her informed consent and she will be advised to arrange an early pregnancy ultrasound to confirm a viable pregnancy. The woman will be offered medical follow up and provided with a copy of the prescription for her GP’s records.
For further details on a clinical protocol for use of Cyclogest for abortion in Ireland and The UK click here.
For client consent form (click here PDF)
Responsible dispensing:
Cyclogest is obtained from a pharmacy registered with the General Pharmaceutical Council in The UK and Pharmaceutical Society of Ireland in Ireland according to the principals of responsible prescribing.
Abortion pill Rescue
Heartbeat international operates a worldwide network of prolife pregnancy help organisations. Abortion Pill Rescue is a program of Heartbeat International and operates a 24/7 helpline, email, online chat and website run by a team of healthcare consultants. A woman who contacts abortion pill rescue will be provided with information on APR and directed to an APR provider in her own country. To find out more about the work of Abortion Pill Rescue and / or to join the international network of abortion pill reversal healthcare professionals click here www.abortionpillreversal.com
The founding principles of Abortion Pill Rescue network are:
- Progesterone can reverse the effects of mifepristone and has been safely used in pregnancy for over 40 years.
- It is reasonable and appropriate to respect patient autonomy and a woman’s right to choose to reverse a chemical-induced abortion.
- A woman should never be coerced into starting or continuing an abortion.
- Human beings are valuable and should be protected at all stages of their development.
- Initial studies have found that the birth defect rate in babies born after the APR is less than or equal to the rate in the general population. Neither Mifepristone nor progesterone is associated with birth defects
Medical links:
To find out more about Heart Beat international please click here. www.hearbeatinternational.org
To find out about the abortion pill rescue program click here www.abortionpillreversal.com
To join the international network of abortion pill reversal medical providers click here www.abortionpillreversal.com/pho-network
Clinical protocol for use of Cyclogest for abortion in Ireland and The UK click here PDF
For client consent form click here PDF
For links to research papers on the efficacy and safety of abortion pill reversal click here research links see below
This website is supported by Doctors for Life Ireland click here for link to dr4l. www.irishdoctorsforlife.com
***Research links on the efficacy and safety of Progesterone in threatened miscarriage
- A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone
George Delgado 1, Steven J Condly 2, Mary Davenport 3, Thidarat Tinnakornsrisuphap 4, Jonathan Mack 4, Veronica Khauv, Paul S Zhou. Isssueslawmed: Spring 2018;33(1):21-31
https://issuesinlawandmedicine.com/product/spring-2018-full-issue/
- Effect of progestogen for women with threatened miscarriage: a systematic review and meta‐analysis L Li Y Zhang, H Tan, Y Bai, F Fang, A Faramand, W Chong, Y Hai, 23 April 2020, British Journal of Obstetrics and Gynaecology April 2020. https://doi.org/10.1111/1471-0528.16261
- American Association of Prolife Obstetricians and Gynaecologist statement on abortion Pill Reversal https://aaplog.org/wp-content/uploads/2019/02/2019-AAPLOG-Statement-on-Abortion-Pill-Reversal.pdf
- American Association of Prolife Obstetricians and Gynaecologist: The reversal of the effects of Mifepristone by progesterone . https://aaplog.org/wp-content/uploads/2020/01/FINAL-PB-6-Abortion-Pill-Reversal-1.pdf
- Lek SM, Ku CW, Allen JC Jr, et al. Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage. BMC Pregnancy Childbirth. 2017;17(1):78. Published 2017 Mar 6. doi:10.1186/s12884-017-1261-4
- Wahabi HA, Fayed AA, Esmaeil SA, Bahkali KH. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev. 2018;8(8):CD005943. Published 2018 Aug 6. doi:10.1002/14651858.CD005943.pub5