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Abortion Pill Reversal in Canada

The Abortion Pill, called Mifegymiso in Canada, is made up of two different medications. If you have only taken the first drug, mifepristone (also called Mifeprex), less than 72 hours ago, and have not yet taken the second medication, misoprostol (also called Cytotec), you may be able to preserve the pregnancy if you act quickly.

Abortion Pill Reversal Network: 1-877-558-0333

For the Patient

The Abortion Pill, called Mifegymiso in Canada, is made up of two different medications. If you have only taken the first drug, mifepristone (also called Mifeprex), less than 72 hours ago, and have not yet taken the second medication, misoprostol (also called Cytotec), you may be able to preserve the pregnancy if you act quickly.

The first drug you were given, mifepristone, acts to block your natural hormone progesterone which is needed to nurture and sustain your pregnancy.  The second medication, misoprostol, acts to prepare your cervix and induce labour.[1]  If you have not yet taken the second medication, then the abortion pill reversal process provides you with extra progesterone which acts to counter and reverse the effects of the first drug you took.

This “reversal” process offers no guarantee of success.  However, as of September 2017, more than 300 babies have been born successfully to mothers who underwent the reversal process and there have been no recorded birth defects.[2]

If you’ve only taken the first drug, mifepristone, and you do not take the second drug, the chance of a successful pregnancy is approximately 15-25%.[3]  However, if you take the progesterone as part of the abortion pill reversal process within 72 hours of taking the mifepristone, your chance of a successful pregnancy increases to 55% and possibly even to between 60-70%.[4]

Some mothers express concern over possible birth defects caused by starting the medical abortion procedure. The American College of Obstetrics and Gynecology states that “No evidence exists to date of a teratogenic effect of mifepristone.”[5]  In other words, the first medication you took, mifepristone, does not appear to cause birth defects.[6]  Secondly, the abortion pill reversal process simply requires the mother to take progesterone, and progesterone already naturally exists in your body.  Progesterone has been used safely in pregnancy and pregnancy support for over 50 years.[7] There is no record of birth defects caused by progesterone.

You may have been told or led to believe that once you have taken the first medication in the two-step medical abortion process that you must take the second medication.  That is not the case.  If you would like to keep your baby, you have two options:

  • Call the Abortion Pill Reversal Network and they will connect you with a local doctor. The number is 1-877-558-0333.
  • If there isn’t a doctor who is registered with the network in your area, please take this letter immediately to your family doctor, specialist, or walk-in clinic.

Dear Colleague

Thank you for seeing this patient. She has taken mifepristone, the first part of the two-step Mifegymiso medical abortion drug protocol.

She has decided that she would like to reverse the effects of mifepristone to attempt to stop the medical abortion process.

Provided that she has not taken the second medication, misoprostol, and provided that it has been less than 72 hours since she took the first medication, you can help her do just that, easily and safely.

She needs supplemental progesterone to counter the effects of mifepristone, which is a progesterone receptor antagonist.   Neither progesterone nor mifepristone has been associated with any birth defects.[8]

Progesterone Protocols Based on Published Data

Based on these new data, two reasonable preferred protocols can be suggested for women who seek to reverse the effects of mifepristone. (An information sheet on the protocol may be downloaded here.)

  1. Progesterone micronized 200 mg capsule two by mouth as soon as possible and continued at a dose of 200 mg capsule two by mouth twice a day for three days, followed by 200 mg capsule two by mouth at bedtime until the end of the first trimester.
  2. Progesterone 200 mg intramuscular as soon as possible and continued at a dose of 200 mg intramuscular once a day on days two and three, then every other day for a total of seven injections.[9]

If the patient does nothing and does not take the second medication, embryo survival is about 25%.[10]  If she is given the above regimen of progesterone, the rate of survival increases to approximately between 64-68%.[11]  Your help is invaluable, but time is of the essence, so please do not delay.

If you require more information, there exists an information line on the medical abortion reversal procedure at 1-877-558-0333. Phones are answered seven days a week.

Sincerely,

The Board of Directors
Canadian Physicians for Life

Resources

[1] Creinin, M, Gemzell Danielsson, K. Chapter 9 Medical abortion in early pregnancy in Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care Published Online: 22 May 2009 DOI: 10.1002/9781444313031.ch9.
[2] A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone, Issues in Law & Medicine, Volume 33, Number 1, 2018.
[3] Embryo Survival after Mifepristone: A systematic review of the literature, Issues in Law & Medicine, Volume 32, Number 1, 2017.
[4] A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone, Issues in Law & Medicine, Volume 33, Number 1, 2018.
[5] Medical Management of First Trimester Abortion. ACOG Practice Bulletin 143 March 2014, reaffirmed 2016.  Bernard N, Elefant E, Carlier P, Tebacher M, Barjhoux CE, Bos-Thompson MA, Amar E, Descotes J, Vial T, Continuation of pregnancy after first-trimester exposure to mifepristone: an observational prospective study. BJOG. 2013 Apr;120(5):568-74. DOI: 10.1111/1471-0528.12147. Epub 2013 Jan. Regine Sitruk-Ware a, Angela Davey , Edouard Sakiz. Fetal malformation and failed medical termination of pregnancy. The Lancet, Volume 352, Issue 9124, Page 323, 25 July 1998.
[6] Bernard N, Elefant E, Carlier P, Tebacher M, Barjhoux CE, Bos-Thompson MA, Amar E, Descotes J, Vial T, Continuation of pregnancy after first-trimester exposure to mifepristone: an observational prospective study. BJOG. 2013 Apr;120(5):568-74. DOI: 10.1111/1471-0528.12147. Epub 2013 Jan.
[7] Dante G, Vaccaro V, Facchinetti. Use of progestogens in early pregnancy. Facts, Views and Vision ObGyn. 2013 5(1): 66-71.
[8] Progesterone. https://www.asrm.org/detail.aspx?id=1881(accessed December 3, 2016). Progesterone package insert. https://www.drugs.com/pro/progesterone-capsule.html. (accessed December, 3, 2016).
[9] A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone, Issues in Law & Medicine, Volume 33, Number 1, 2018. .
[10] Embryo Survival after Mifepristone: A systematic review of the literature, Issues in Law & Medicine, Volume 32, Number 1, 2017.
[11] A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone, Issues in Law & Medicine, Volume 33, Number 1, 2018.