Abortion Pill Reversal (APR) is just what it sounds like. It’s a protocol used to reverse the effects of the abortion pill process. (The abortion pill is also known as medication abortion, medical abortion, RU-486, or chemical abortion). If you regret talking taking the abortion pill, reversal offers the opportunity to continue the pregnancy. There is hope and help available for those who change their minds and want to continue a pregnancy at the APR helpline 877.558.0333 and the APR website.
A woman who chooses to reverse the effects of mifepristone and continue her pregnancy should call the Abortion Pill Rescue hotline at 877.558.0333 or go to the APR website to begin a live chat. The APR Healthcare Team is waiting to help.
For those seeking abortion pill reversal, the goal is to start the protocol within 24 hours of taking the first abortion pill, mifepristone, also known as RU-486. However, there have been many successful reversals when treatment was started within 72 hours of taking the first abortion pill.[1]
Even if 72 hours have passed, call our hotline (877) 558-0333. We are here to help. It may not be too late.
No, it is always your choice to change your mind. Even if you have started the abortion process with medication, reversal may still be a choice for you.
Spotting or bleeding is common during reversal treatment. It is important and safe to continue the progesterone even if you experience spotting or bleeding unless directed otherwise.
If you experience heavy bleeding, faintness, severe abdominal pain, or fever, seek emergency medical attention immediately. This could be an effect of the mifepristone and would require immediate care.
It is important to have an ultrasound to confirm that your baby is in the uterus as soon as possible.
Please call our hotline number (877) 558-0333. You may still be pregnant. It may not be too late.
The second medication is called misoprostol or Cytotec. Its purpose is to cause the uterus to contract and expel the baby.
Misoprostol/Cytotec is not needed if you want to try to reverse the effects of the abortion pill.
You will have an ultrasound as soon as possible to confirm the heart rate, placement, and dating of your pregnancy.
The doctor or other medical provider will prescribe progesterone for you. Your progesterone may be given as a pill (taken orally or vaginally) or given by intramuscular injection.
The treatment will usually continue through the first trimester of pregnancy.
Progesterone is the natural hormone in a woman’s body that is necessary to nurture and sustain a pregnancy.[2] Mifepristone blocks progesterone’s actions by binding to progesterone receptors in the uterus and the placenta. By giving extra progesterone, the hope is to outnumber and outcompete the mifepristone to reverse the effects of mifepristone.[3]
Initial studies of APR have shown that APR has about a 68% success rate.[4] Without the APR treatment, mifepristone may fail to abort the pregnancy on its own. In other words, your pregnancy may continue even without APR if you decide not to take misoprostol, the second abortion drug likely prescribed or provided to you when you took mifepristone. APR has been shown to increase the chances of allowing the pregnancy to continue.
However, the outcome of your particular reversal attempt cannot be guaranteed.[5]
The American College of Obstetricians and Gynecologists (ACOG) in [its Practice Bulletin Number 225, October 2020], states that: “No evidence exists to date of a teratogenic effect of mifepristone.”[6] In other words, it does not appear that mifepristone, RU-486, causes birth defects.
Progesterone has been safely used in pregnancy for over 50 years. Initial studies have found that the birth defect rate in babies born after the APR is less than or equal to the rate in the general population.[7] Neither Mifepristone nor progesterone is associated with birth defects. [8],[9]
Progesterone may cause sleepiness, lack of energy, lightheadedness, dizziness, gastrointestinal discomfort and headaches. Increased fluid intake might help relieve these symptoms.
It is important that you follow all of the instructions of your APR provider carefully. If you have any questions, contact your provider.
If you are allergic to peanuts or peanut oil, notify your provider before beginning APR. Progesterone may include this ingredient, so it is important that you notify your provider of any of these allergies before taking progesterone. An alternative form of progesterone may be available for those with an allergy.
The cost of the treatment varies depending on the progesterone used. Insurance plans may cover treatment. Women who do not have insurance or financial means to pay for treatment should discuss this with their medical provider.
In cases of financial hardship, the APR Network will help you find ways to reduce the cost of the treatment.
We are here to help support pregnant women and their developing babies. Contact us and we can connect you to the support you need to make the best decision possible for you and your baby.
If you think parenting might be an option for you, but you have concerns about money, baby supplies, insurance or your parenting skills, there may be local help available.
Call us at (877) 558-0333. We will help you find the resources you need for your particular situation. Most women might need a little (or a lot) of help. There are over 3,000 organizations around the world who help women and families with information and support with material assistance, peer and professional consultations, and even housing.
No, they are different. The “morning after pill” or “Plan B” is marketed as an emergency contraception method. The most commonly used preparation contains a high level of a progestin and can be taken up to 72 hours after sexual intercourse. New insights into how it works make it clear that it can prevent implantation of the young human embryo into the lining of the uterus. This is an abortifacient effect, not a contraceptive effect.
The abortion pill, mifepristone, is taken up 70 days (10 weeks) into a pregnancy with the intention of causing an abortion. It works by blocking progesterone receptors. Progesterone is the necessary hormone that nurtures and supports a pregnancy.
The newest morning after pill, Ella, is very similar to mifepristone in its action in that it blocks progesterone receptors. It is approved by the FDA for use up to five days after intercourse and also has abortifacient effects.
The American Association of Pro-Life Obstetricians and Gynecologists, a 2500-member organization, supports offering Abortion Pill Reversal (APR) to women who regret initiating the abortion pill process, after appropriate informed consent.
2. Progesterone Treatment to Help Prevent Premature Birth. March of Dimes Web Site. https://www.marchofdimes.org/complications/progesterone-treatment-to-help-prevent-premature-birth.aspx. Published 2018. Retrieved September 8, 2018.
3. Hormones in Pregnancy. Niger Med J. 2012 Oct;53(4):179-83. doi: 10.4103/0300-1652.107549.
4. Delgado, G, M.D., Condly, S. Ph.D., Davenport, M, M.D., M.S.,Tinnakornsrisuphap, T Ph.D., Mack, J., Ph.D., NP, RN, Khauv, V., B.S., and Zhou, P. A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone. Issues in Law & Medicine, Volume 33, Number 1, 2018. Retrieved January 17, 2023, from https://pubmed.ncbi.nlm.nih.gov/30831017/
5. Ibid.
6. American College of Obstetricians and Gynecologists. (2020, October). Medication abortion up to 70 days of gestation. ACOG. Retrieved January 17, 2023, from https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-days-of-gestation (Practice Bulletin Number 225 replaces Practice Bulletin Number 143, March 2014. Reaffirmed 2022)
7. Delgado, G, M.D., Condly, S. Ph.D., Davenport, M, M.D., M.S.,Tinnakornsrisuphap, T Ph.D., Mack, J., Ph.D., NP, RN, Khauv, V., B.S., and Zhou, P. A Case Series Detailing the Successful Reversal of the Effects of Mifepristone Using Progesterone. Issues in Law & Medicine, Volume 33, Number 1, 2018. Retrieved January 17, 2023, from https://pubmed.ncbi.nlm.nih.gov/30831017/
8. Unleashing the power of a woman’s cycle: Progesterone Support in Pregnancy. NaPro Technology Web Site. https://www.naprotechnology.com/progesterone.htm. Retrieved July 11, 2018.
9. Progesterone and Pregnancy: A Vital Connection. Resolve Web Site. https://resolve.org/infertility-101/the-female-body/progesterone-pregnancy-vital-connection/. Published 2018. Retrieved July 11, 2018.
10. American Association of Pro-Life Obstetricians and Gynecologists. (2019). 2019 AAPLOG statement on abortion pill reversal. AAPLOG. Retrieved January 17, 2023, from https://aaplog.org/wp-content/uploads/2019/02/2019-AAPLOG-Statement-on-Abortion-Pill-Reversal.pdf
