If the bill sitting on Republican Governor Doug Ducey desk is signed today, doctors in Arizona will be required to tell a patient receiving a medical abortion that she can change her mind, even after the abortion is underway.
It’s the first reversal language of its kind to make it through a state legislature, and should it become law, will join a long list of information that doctors in The Grand Canyon State are forced to relay to patients seeking an abortion—much of which providers know to be misleading and aimed less at informed consent and more at dissuading women from choosing the procedure.
According to the Guttmacher Institute, women in 17 states must be counseled on points that are wholly unsupported by the medical and scientific community at large, like the link between abortion and breast cancer (five states), fetal pain (12 states), or long-term mental health risks from abortion like depression and suicide for women (eight states).
The provision in Arizona’s SB 1318 states that at least 24 hours before a woman takes Mifepristone—the first of two medications taken to complete a medical abortion—a doctor must inform a patient “orally and in person” that “it may be possible to reverse the effects of a medication abortion if the woman changes her mind but that time is of the essence.”
The clause was added to what was initially just a ban for abortion coverage through the Affordable Care Act, after testimony from Dr. Allan Sawyer, a pro-life advocate and obstetrician practicing in Glendale, Arizona. Dr. Sawyer testified before the legislature that he had personally reversed a woman’s abortion by administering a high dosage of the hormone Progesterone. Sawyer stated then, as he has before, that women undergoing the elective procedure of abortion “do not understand the true nature of the risks” and “often change their minds.”
With bill sponsor Senator Nancy Barto, Phoenix Republican, smiling in agreement behind him, Sawyer told a House panel this month, “abortion is not health care.”
“Women who have initiated a medical abortion process and who change their minds for whatever reason should not have their babies stolen from them because Planned Parenthood or any abortionist withheld life-saving facts or withheld information,” he said.
One committee member asked whether in addition to his anecdote, there existed any medical research to back up his claim or any studies testing the safety of Progesterone for the mother and fetus when the drug is used to reverse the effects of Mifepristone.
“These studies are ongoing,” Sawyer replied. “Those numbers are being tallied.”
Despite the lack of scientific support, the measure passed both chambers.
“It makes no sense,” said Dr. Anne Davis, an abortion provider in New York and advocate with Physicians for Reproductive Health, who also noted Dr. Sawyer’s anecdote on the Progesterone reversal was misleading, as about half of women who take only the first pill, but skip the second—a dose of Misoprostol which causes the uterus to contract—will continue to be pregnant anyway.
“We have a mountain of good scientific evidence showing us how to practice the best way [to perform an abortion] and we’re told that legally we can’t provide the best care we know how to,” Davis said, pointing at another 2014 Arizona law blocked by the Supreme Court that restricted the off-label use of RU-486, a law that would sidestep medical research and innovation made in the 14 years since the medication was approved.
“And on the other hand we are being forced to tell patients about a treatment that is untested, unproven, for something that addresses a created need,” Davis said. “If you had told me 10 years ago people would have to practice like this I wouldn’t have believed it.”
Dr. Leah Torres is an OB-Gyn in Salt Lake City, and outspoken critic of the anti-abortion movement. Torres said the waiting periods, the forced ultrasounds, and the undermining and unproven state-mandated counseling that abortion providers must read to their patients, convey two things: Pregnant people are stupid and doctors who perform this procedure can’t be trusted.
Torres practices in Utah, a state where 97 percent of Utah’s counties are without an abortion clinic and patients must wait 72 hours (the longest period in the nation) after mandated counseling before their doctors can perform the procedure. Physicians there must inform abortion patients about what state legislators have determined are the procedure’s mental and physical health risks.
Torres said she already talks to her patients about the small, but real risks associated with abortion, but in addition, she has to inform them of something called “post-abortal syndrome,” a condition she says won’t be found in any medical encyclopedia.
“There’s no such thing... That’s very disturbing for me to have to say, and I have to follow it up with ‘This does not exist.’ It’s got to be confusing for the patient.”
That jarring experience, she said, is specific to doctors who provide abortion.
“No one has to go through state-mandated information for a colonoscopy. No one has to go through state-mandated information for a prostate removal surgery. No one has to go through state-mandated information for breast augmentation. None of these other procedures require a physician to read inaccurate information to their patients. It doesn’t happen anywhere else in medicine,” she said.
Should the Arizona bill become law, the American Civil Liberties Union will be among the groups opposing its enactment. “We are fighting this bill as we are fighting all abortions restrictions that inappropriately interfere with women’s access to safe, legal health care,” said Hayley Smith, an advocacy and policy associate with the ACLU.
The ACLU is currently involved with 13 abortion-rights cases nationwide. As of March 1, according to the Guttmacher Institute, state legislators have introduced 244 new abortion restrictions this year, compared to 40 that protect access to reproductive health care.