Medical abortions accounted for 63 % of abortions in New Brunswick in 2019 (1). Medical abortions are not surgical abortions. A medical abortion requires the pregnant woman to take two different medicines; conveniently available in Canada as a combo-pack called Mifegymiso. Much has changed in the five short years that Mifegymiso has been available in Canada. A woman is now able to take both medicines in the combo-pack at home. All she needs is a prescription for Mifegymiso from a health care provider and she can get the pills at a pharmacy (2). If she has a NB Medicare card, the medicine is free of charge (3). The Government of Canada now says women no longer need an ultrasound to determine the age of the baby nor to rule out the possibility of an ectopic pregnancy (4). Medical abortions are now approved in Canada for babies who are up to 63 days old. Because of Covid, when there was concern that access to timely abortion could be difficult to obtain, medical abortion was approved off-label by the Society of Obstetricians and Gynecologists of Canada (SOGC) for 11-week-old fetuses (77 days since LMP) (5),(6).
Label Key:
1. pigmentation within the retina of the right eye
2. external portion of right ear
3. mouth
4. outline of ribs
5. umbilical vein within umbilical cord
6. umbilical arteries
7. loops of bowel in base of umbilical cord (a normal event called physiologic herniation)
8. right ankle
9. right knee
The first pill to use in the Mifegymiso package is Mifepristone, which blocks progesterone receptors. Progesterone is essential for pregnancy and the baby cannot survive for long without it. The second medicine the woman takes is Misoprostol. It’s in a package containing 4 tablets taken 24-48 hours after taking the first drug. It’s the same medication that some women are given to encourage contractions during labour and delivery (7); but Misoprostol is used at a much higher dose (800 mcg) than during delivery as the body is not naturally ready to contract and expel the baby at this time. Sometimes not all the contents of the uterus will be expelled, and the women will still need more medication, an ultrasound, blood work, or a surgical abortion (8).
Since abortion is a choice in Canada, what if after the woman takes the first pill she realizes that she made the wrong choice? What if she decides she doesn’t want to end her baby’s life? What if she realizes she made a mistake? Is it too late?
Since the first pill, Mifepristone, blocks the body’s ability to use progesterone effectively, extra progesterone administered throughout the first trimester is needed to reverse the effects of Mifepristone (9). This is known as Abortion Pill Reversal (APR). The doctor-prescribed progesterone is natural and almost identical to the progesterone made in a woman’s body. Supplemental progesterone has been used for over 50 years to support pregnant women. It has been used to help women at risk of miscarriage; those who are undergoing IVF; and it’s been used to stop pre-term labor. There is no record of birth defects caused by progesterone. (10).
In Abortion Pill Reversal (APR), “the medical provider will prescribe bioidentical progesterone to outnumber and outcompete the mifepristone in order to reverse the effects of the mifepristone. An ultrasound is performed as soon as possible to confirm heart rate, placement, and dating of the pregnancy. The progesterone treatment will usually continue through the first trimester of pregnancy in an attempt to reverse the effects of the mifepristone.” (11) The woman must take extra progesterone as soon as possible (less than 72 hours) after taking Mifepristone and she must not have taken Misoprostol. If a woman follows the protocol, she has about a 65-68 % chance of reversing the effects of Mifepristone and saving her pre-born baby(9).
Although APR is criticized by the SOGC (12) and Planned Parenthood (13) it should be common sense that progesterone is the antidote to the abortion pill Mifepristone.
Anyone who needs Abortion Pill Reversal can call the 24/7 Helpline: [updated Nov. 14, 2023] 1- 888 – 612 – 3960 The helpline will connect the caller with one of the medical professionals who can guide the woman towards reversing the effects of the abortion pill. Chat is also available 24/7 on the website: https://abortionpillreversal.ca
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3.https://www2.gnb.ca/content/gnb/en/services/services_renderer.201433.Medical_Abortion_Program.html
5. https://www.youtube.com/watch?v=hbAmh9mnQaE
6. https://caps-cpca.ubc.ca/AnnokiUploadAuth.php/c/cf/Clinical_SOGC_Induced_Abortion-_Updated_Guidance_during_Pandemics_and_Periods_of_Social_Disruption.pdf
8. https://ppt.on.ca/factsheets/abortion/
9. https://pubmed.ncbi.nlm.nih.gov/30831017/
10. https://lozierinstitute.org/abortion-pill-reversal-a-record-of-safety-and-efficacy/
11. https://lozierinstitute.org/abortion-pill-reversal-a-record-of-safety-and-efficacy/#_ftn17
12. https://sogc.org/en/content/featured-news/SOGC_Statement_on_Abortion_Medication_Reversal.aspx
