Kansas bills push unproven ‘abortion reversal,’ call for protection of infants ‘born alive’

·9 min read
Emily Curiel/ecuriel@kcstar.com

Earlier this month, Rep. Ron Bryce, a Coffeyville Republican, told the Kansas House colleagues he once responded to a code blue where he found a crying infant that had survived an abortion.

It was the late 1980s and Bryce was a medical resident in Fort Worth, Texas. The infant, Bryce said, wasn’t receiving care so he transferred him to the hospital’s neonatal intensive care unit. The infant died from “irreversible brain damage he had sustained due to lack of oxygen.”

“Abortion takes the life of a child but what if the baby’s too tough to die quickly,” Bryce testified to the House Health and Human Services Committee.

The experience, Bryce said, drew him to support a bill that requires physicians to provide the same care they would give to a newborn of the same gestational age if an infant is “born alive” during an abortion. If they don’t, they could face criminal penalties.

But Bryce’s decades-old story describes a circumstance that the American College of Obstetrics and Gynecology and other experts say does not happen in modern abortion care.

“This is just frankly something that doesn’t happen,” said Dr. Christina Bourne, medical director at Trust Women Foundation, an abortion provider in Wichita.

“These bills, which are laughably nonsensical, overtime they keep layering and continue to add to the stigma and confusion of what providing abortion care is.”

The bill, slated for a Tuesday House debate, is one of two the committee has advanced that would change rules for abortion providers in the state. The other requires providers, pharmacists and the state health agency to notify medication abortion patients that the procedure could be reversible — even though that is not proven.

In the wake of last year’s landslide vote to preserve abortion rights in the Kansas Constitution, anti-abortion lawmakers in the state are seeking to regulate along the edges of the law. Rather than craft legislation targeted directly at abortion access, they’re pointing to unproven medical practices to advocate for legislation that creates additional requirements for abortion providers.

Anti-abortion advocates say this ensures full knowledge for patients and accountability for practitioners. But those abortion rights supporters argue it demonizes abortion care and forces doctors to violate their ethical code by giving patients untrue information.

The bills come in a series of anti-abortion measures pursued in the wake of the August vote. Lawmakers have also advanced various bills aimed at limiting or banning telemedicine abortion, funding anti-abortion crisis pregnancy centers and changing insurance rules for abortion providers.

Republicans promote abortion pill ‘reversal’

The Kansas House Health and Human Services Committee on Monday approved a bill requiring notification to patients who take mifepristone, one of two medications used in the majority of Kansas abortions, that the effects of it could be reversible if they have not yet taken the second pill. No credible medical study has proved that claim.

The Legislature passed a similar bill in 2019, but failed to override a veto from Democratic Gov. Laura Kelly.

Mifepristone is also the medication at the center of a federal lawsuit in Texas challenging its FDA authorization, but Rep. Susan Humphries, a Wichita Republican who introduced the bill, said the legislation was important to reach women while litigation is ongoing.

“Would there be women who have the opportunity to reverse their decision in the meantime, absolutely,” Humphries said.

Abortion pill reversal is a concept promoted by anti-abortion organizations and offered at several crisis pregnancy centers.

The procedure is to give a woman a high dose of progesterone, the hormone that maintains pregnancy, after she has taken mifepristone, which blocks progesterone.

However, very few studies have been done on the practice.

Proponents of abortion pill reversal, called APR, point to a case review conducted by an anti-abortion California doctor, George Delgado, that considered 754 cases and found 64-68% success rate among women who wanted to continue their pregnancy after taking mifepristone.

The study has been steeply criticized for its methodology. Experts have raised concerns about its reliability primarily because it lacked a control group, meaning there is no way to know if the pregnancies that were continued came as a direct result of progesterone or they would have continued anyway if the second pill, misoprostol, was not taken.

The American College of Obstetrics and Gynecology has said the study is “not based in science” and that mandates related to it are dangerous to women’s health as a result

A separate study attempted by researchers at the University of California, Davis, was not completed because three women, two in the control group and one who received progesterone, began hemorrhaging.

“It’s not even science, it’s just junk,” Iman Alsaden, Chief Medical Officer at Planned Parenthood Great Plains, said. “I just find it so appalling that this is the way the government thinks people should be treated and isn’t willing to trust the experts in the field of medicine.”

If a patient regretted taking mifepristone, Alsaden said, she would refer them to a high risk OBGYN.

She noted that this would add to an existing list of things the state requires abortion providers to tell patients, including the disproven claim that abortions can increase a woman’s risk of cancer.

Proponents of the legislation say it’s important to give notice to women that the treatment is available, even if it is unproven.

“I’ve delivered babies after successful reversal of medication abortion,” Dr. Jonathan Scrafford, a Wichita OBGYN, told the House Health and Human Services Committee Monday.

Scrafford, who supports the legislation, argued that the best way to test progesterone’s effectiveness would not be through a controlled group study because of ethical concerns.

Rep. John Eplee, an Abilene Republican who is a family physician, compared the use of progesterone to stop an abortion to the use of hydroxychloroquine to treat COVID-19.

Hydroxychloroquine’s efficacy against COVID-19 was also unproven and lacked rigorous studies when some physicians began prescribing it at the onset of the pandemic. The World Health Organization advised against its use noting that it could cause additional health issues for patients while there was no proof it helped prevent or treat COVID-19.

Eplee said it is not uncommon for doctors to use medication for something other than its labeled purpose and that he has used progesterone to stop miscarriages before.

“When women are very vulnerable, very emotional, sometimes they want to have a hope if they have a sudden change of heart or change of their mind, and this allows them to pursue that, I think legitimately,” Eplee said. “Granted, it’s not an approved methodology but it is widely done in many other states.”

Abortion doctors view it as a mandate that they provide their patients with bad advice, and warn that public policy should not be built off of a study that does not meet traditional scientific standards.

Alsaden compared the push to require the notification based on one unproven study to recent pushes against the COVID-19 vaccine and other vaccines based on individual cases and non-peer reviewed studies.

“Extrapolating a case review and then applying it to a whole population is like a wildfire of misinformation and possible morbidity and mortality,” she said. “You just can’t make decisions for a whole population based on a handful of people.”

Lawmakers push ‘born alive’ bill

Later this month, the Kansas House is expected to Tuesday to debate a bill that creates criminal penalties if a physician doesn’t provide the same care to an infant “born alive” during an abortion as they would any other infant of the same gestational age.

Similar legislation has been pursued in other states nationwide. The U.S. House passed a “born alive” bill earlier this year after Republicans took control of the chamber, but it is not expected to advance in the Democratic-controlled Senate.

In Kansas, abortion is illegal at and after 22 weeks, meaning most legal abortions in the state take place before a fetus would be capable of surviving in any condition outside their mother’s womb.

“This is a bill addressing a situation that doesn’t really happen,” said Usha Ranji, associate director for women’s health policy at the Kaiser Family Foundation. “I’m not sure what it is that they’re trying to prevent here.”

Proponents of the legislation argue the bill is important to ensure best practices are taken even though they say they know of no contemporary cases in which an infant in Kansas has been born alive during an abortion.

Rep. Brenda Landwehr, a Wichita Republican who chairs the House Health and Human Services Committee, said she is skeptical when abortion providers say this doesn’t happen.

“It seems like in the abortion world there’s more secrecy that revolves around that procedure than other procedures and we just want to make sure that every baby has an opportunity,” Landwher said.

Jeanne Gawdun, a lobbyist for Kansans for Life, the state’s leading anti-abortion group could not name any Kansas during an interview with The Star. She instead pointed to Kermit Gosnell, a Philadelphia abortion doctor who was convicted in 2013 of murder in three cases where he killed an infant that had been born alive during an abortion.

The bill would require Kansas providers to report to the state if an infant is born alive during an abortion. “The reporting is terrific because it’s going to help us know what’s going on in the state,” Gawdun said.

Providers argue the legislation is aimed at creating an image of abortion that is not accurate, demonizing providers and shaming women out of receiving care.

Dr. Kristyn Brandi from the American College of Obstetrics and Gynecology explained that late term abortions when a pregnancy might be viable are extremely rare — usually limited to instances in which a woman could not access care earlier, there is a fatal fetal abnormality or the mother’s health is at risk. When they do occur, Brandi said, care is taken to ensure the fetus’ heartbeat is stopped before administering the abortion.

Nevertheless, the hearing held on the bill painted a picture of abortion providers leaving infants to die or outright killing them, though no evidence could show that situation truly occurs.

While proponents said the goal would simply be to ensure any infants are treated humanely, Brandi warned of a chilling effect on all abortion and unforeseen consequences on neonatal care.

She said the legislation could require doctors to spend time providing useless life saving care to an infant that is certain to die rather than allowing parents the time to spend with that infant if they are born with a fatal abnormality.

“They are trying to portray abortion care as infanticide, which is not at all how abortion care works,” said Dr. Kristyn Brandi from the American College of Obstetrics and Gynecology. “Unfortunately these laws also create a lot of restrictions around compassionate care, often around palliative neonatal care.”