Q&A with Dr. George Delgado: Abortion reversal pill a second chance to embrace life

Abortion advocates place emphasis on a woman’s right to choose: to choose what happens to her body, her baby and her life. But what if her choice changes?

Dr. George Delgado is the founder of Abortion Pill Reversal, an initiative for women who have changed their minds after taking mifepristone (RU-486), the first of two drugs used in a chemical or medical abortion. A 24-hour helpline connects women with doctors in their area who can prescribe progesterone treatments, reversing the pill’s effects. 

Delgado’s research offers hope to women who do not want to follow through with a chemical abortion after beginning the process. His knowledge about the functioning of mifepristone and progesterone in the female body helped him publish the first peer-reviewed article in the medical literature about abortion pill reversal in 2018.

This past January, state Sen. Joni Albrecht introduced LB209 in the Nebraska Unicameral. The bill would add a new section to Nebraska’s informed consent law mandating the inclusion of information to help women seeking abortion pursue abortion pill reversal.

“I think they need all the information to make an informed decision,” Albrecht said. “If they know that there’s the ability to have a pill reversal, to change their mind after they take that first pill, it would make a tremendous difference to the woman and of course the child and the family of that baby.”

Albrecht already has 25 cosponsors for the legislation and has made it her priority bill, giving it a greater likelihood of advancing to the floor of the Legislature.  

The Catholic Voice spoke with Delgado about his research in abortion pill reversal, the work he has done for women in crisis pregnancy situations and his thoughts on the potential impact of LB209. 

Q: How did you become interested in abortion pill reversal?

I had studied mifepristone, the abortion medication, since even before it was approved in the United States, when it was known as RU-486. I knew exactly how it worked, and then I also had a lot of experience using progesterone in pregnancy through my NaProTechnology training, so I had those two parts of my knowledge base.

Then I received a phone call one day in 2009 from a woman who is a sidewalk counselor by the name of Terri Palmquist. Terri was in Bakersfield, California, but she had received a phone call through her website from a woman in El Paso, Texas, who had taken mifepristone and had changed her mind, and was asking Terri for help, and Terri in turn called me to ask me for help.

At that point, I had never heard of anybody ever attempting reversal of mifepristone, but I stopped and I thought again about what I knew about it, that it blocks progesterone receptors, and I knew about using progesterone in early pregnancy in women who have low progesterone levels in order to prevent miscarriage. So the Holy Spirit guided me, and I thought, well, if this situation is somewhat analogous, maybe if I give extra progesterone, we can outcompete the mifepristone at the receptor site and block its effects, allow it to wash out of the system, and save the baby.

The one challenge, however, was that the patient was in El Paso, Texas, and I was in San Diego, so I found a doctor in El Paso, Texas, Dr. Jonalynn Belocura, and she happened to have progesterone in the office. She knew how to use progesterone. I recommended a protocol to her and she agreed to use it. She treated the patient and the baby was saved, so that’s how I first got involved in it.

Q: Should people be concerned about the number of chemical abortions compared to surgical abortions?

Well, I think yes and no. Yes, in that there certainly is the risk with the chemical abortions being more available and becoming more common. These days, 35 to 45 percent of all abortions in the United States are medical abortions and the trend is going that way. In some European countries, it’s 80 percent. We may see this as less invasive and more available so that it may lower a woman’s threshold to choosing abortion. So in that case, yes.

I also say no because an abortion is an abortion. Whether it’s a surgical abortion or a medical abortion, there are two things that happen. The baby is killed and the mother is victimized by the medical abortion complex, so I think it is just like any other abortion. Now the one difference between the two, between the medical and surgical abortions, of course, is that with the surgical abortion, once the instrument enters the uterus, it’s over, there’s no turning back, but with the medical abortion, there’s a window of opportunity after the woman has taken the first medicine, the mifepristone, but before she’s taken the second drug. If she changes her mind, we have the opportunity for reversal.

Q: What are the pills used in medical abortions and how do they work?

The first medicine is called mifepristone, also known as RU-486, and it’s a progesterone receptor blocker, and by blocking progesterone, it of course blocks the effects of progesterone. Progesterone is crucial to the health of the pregnancy, so when the effects of progesterone are blocked by mifepristone, one of the things that happens, the key thing in the abortion, is that the placenta separates from the wall of the uterus, and when that happens, then the baby stops getting nutrition and dies, and that’s what leads to the death of the embryo or the fetus. The second drug, misoprostol, causes the uterus to contract, and that then leads to the expelling of the remains of the preborn baby.

Q: Tell us about the abortion pill reversal process and how effective it is.

So the process, with our best protocols, it’s 64 to 68 percent effective. It’s also very safe. There’s no increased risk of birth defects compared to the general population, and the preterm birth rate is actually lower than the general population.

There are two main protocols that are used these days. Probably the most common is called the high-dose oral protocol, where the patient takes oral progesterone twice a day for three days, and then at night for the remainder of the first trimester. The other one is a series of progesterone injections.

Q: How easy is it to obtain the reversal medication and can you get it without a prescription?

It’s very easy. The oral progesterone capsules are available at most, if not all, pharmacies. I’ve never run into a pharmacy that did not have it, so it is very readily available. It does require a prescription, so that’s why when women call the Abortion Pill Rescue hotline, if they choose to have a reversal, they are connected with a physician, nurse practitioner, physician assistant, midwife or clinic close to them in their area who can then assume the care and prescribe the progesterone.

Q: Why is it important for a woman seeking a medical abortion to be informed of her ability to reverse it?

Well, because like anything else, knowledge is power, and women sometimes do change their minds, and if a woman changes her mind, she has a right to know that she has a second chance at choice. So it only makes sense that she should be well informed about first of all, all the risks of the medical abortion, but also that if she happens to change her mind, there is an avenue for reversal.

Q: How long has the reversal treatment been available?

It’s been widely available since about 2010 when we started really ramping up, and more widely available since 2012 when we started our hotline and the website.

Q: What are the trends in the numbers of women who are using it?

We have documented more than 500 babies born after successful reversal and about another 100 women are pregnant. The hotline gets between 120 and 150 calls per month, so as people learn more about it, more and more calls are coming in and more people are wanting reversal.

Q: A new piece of legislation, LB209, was introduced in the Nebraska Unicameral in January by Sen. Joni Albrecht, which would add a new section to Nebraska’s informed consent law to include information to help women choose abortion pill reversal. What effects might this law have?

As far as affecting the abortion rates, I think it will probably be negligible, but maybe have a slight trend towards decreasing them, and I say that because when people become aware that some women change their minds and seek reversal, and that reversal is possible, then I think they pause and think about the whole abortion process. It makes them think that, “Well, if women are changing their minds, then maybe abortion isn’t such a great thing after all,” and that might cause women to think twice before having an abortion, and maybe that really it isn’t as good of a thing as the pro-abortion forces make it out to be, so I think that’s one thing.

The other is that it will lead to more and more people being informed, so that if a woman does start the medical abortion process and changes her mind, then she’ll know or her friends will know and can tell her, “Hey, there’s a way to reverse this,” and so I think that will lead to more timely access to the reversal process, so I think those are all good things. And I think it’s also unfortunate that up until now, the abortion centers have not been forthright with this information and have actually been suppressing the information about the ability to reverse the abortion pill, and it’s something that really should be well known.

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