A fight is raging in Colorado over whether or not the state can ban medication abortion reversal — a procedure that mainstream medicine says isn’t backed by science.
“I think this is a part of a broader patchwork of tactics by anti-abortion advocates trying to … figure out how they can limit access to abortion … even in states where abortion is legal and protected like it is in Colorado,” Jack Teter, regional director of government affairs for Planned Parenthood of the Rocky Mountains, told MedPage Today.
On April 14, Colorado enacted SB23-190 to banish medication abortion reversal and “to make punishable deceptive actions regarding pregnancy-related services.” This includes deceptive adverting that makes it seem like a clinic offers abortion care or emergency contraception when it doesn’t.
Bella Health and Wellness — which describes itself as “Catholic” and as a “comprehensive, life-affirming ob/gyn practice,” offering “abortion pill reversal” as one of its services — filed its lawsuit the same day the law was signed.
Experts say the case has ramifications beyond Colorado, especially in the wake of the overturn of Roe, which has led to a state-by-state patchwork of dwindling access.
Christine Ryan, SJD, LLM, associate director for religion and reproductive rights at Columbia Law School in New York City, said the case signals a green light for clinics like Bella Health and Wellness.
Other states that want to protect abortion care have been “put on notice now that if you pass laws that attempt to regulate their pseudoscience practices, they will challenge you in court, and there is precedence for them to win,” Ryan told MedPage Today.
Ryan also explained that while this case is unlikely to escalate to the Supreme Court, Colorado may still appeal the decision. In a post-Dobbs context, state-level cases can have a large impact, she said.
“Religious liberty and free speech rights have become a mechanism for the right, particularly the Christian Evangelical right, to supersede reasonable government regulations that are designed to safeguard the health of women, reproduction, and … LGBT people, and protect people from deceptive practices,” Ryan told MedPage Today. “But that is being undermined by these types of lawsuits.”
Three staff members of Bella Health and Wellness also signed up as plaintiffs in the lawsuit: CEO and co-founder Denise “Dede” Chism, PNNP; Chief Clinical Officer and co-founder Abby Sinnett, WHNP; and Kathleen Sander, MD, an ob/gyn at the clinic.
The clinic and providers are represented by Washington, D.C.-based Becket Law, which is also known as the Becket Fund for Religious Liberty and is a “well-resourced” firm, according to Ryan.
When asked to comment on the case, Becket pointed to their most recent press release celebrating a win, particularly for women who were “tricked or forced” into taking the abortion pill.
Defendants in the case include Colorado Attorney General Phil Weiser, a strong advocate for reproductive rights, and many members of the Colorado Medical Board and the Colorado State Board of Nursing.
The Colorado Attorney General’s office declined to comment for this story.
Lee Rasizer, the public information officer for the Colorado department of regulatory agencies, told MedPage Today that “the Colorado Medical Board’s function as a regulatory body is to implement the legislation.”
Rasizer also noted that the Board “does not lobby for, propose, or specifically endorse legislation and is charged with enforcing the Medical Practice Act,” which is revised when the Colorado General Assembly passes statutes.
“The Board was required to enact rules based on Senate Bill 23-190,” he said, adding that the Board cannot comment on ongoing legal cases.
Planned Parenthood’s Teter said there’s overwhelming consensus in the medical field that medication abortion reversal is not backed by science.
“Because there’s no legitimate debate on whether or not it is possible to reverse an abortion, any licensed provider who claims to be able to administer this so-called treatment to a patient is, by definition, conducting an unsupervised medical experiment on their patients,” he told MedPage Today.
Medication abortion most often involves the drugs mifepristone, which blocks progesterone, and misoprostol, which makes the uterus contract to complete an abortion. The so-called medication abortion reversal involves giving a patient who has taken mifepristone and/or misoprostol a dose of progesterone.
The American College of Obstetricians and Gynecologists says the strategy is not science-based, unproven, and unethical. The American Medical Association has previously sued North Dakota over legislation attempting to require physicians to mention it as an option to patients, calling abortion reversal “a patently false and unproven claim unsupported by scientific evidence.”
A randomized controlled trial testing the strategy had to be stopped after enrolling just 12 patients for safety reasons. The work was published in Obstetrics & Gynecology in 2020.
George Delgado, MD, a family physician in Escondido, California and vocal anti-abortion advocate, is known for pioneering medication abortion reversal. Delgado is also one of the plaintiffs alongside the Alliance for Hippocratic Medicine challenging the FDA’s approval of mifepristone.
In 2017, Delgado wrote testimony supporting a proposed Colorado Abortion Pill Reversal Information Act, which would have required providers to mention so-called abortion reversal to patients. The bill was quickly killed.
Delgado is on the board of Bella Primary Care in San Francisco, which is also called Bella Health and Wellness, though staff there said it is not connected to Bella Health and Wellness in Colorado.