September 17 marked the final arguments in a California courtroom over the practice of offering abortion pill reversal (APR) to women seeking to save the lives of their unborn children from the feticidal drug mifepristone. We have become used to reading sentences like this, in which so-called champions of choice like the administration of Governor Gavin Newsom (D) and Attorney General Rob Bonta (D) go the last mile to complete abortions women are desperate to avert. The policy is all the uglier because it would fine groups like Heartbeat International and Real Options millions of dollars for attempts to aid such women.

Attorneys for the Thomas More Society, who have fought the battle for life in these cases for three years now, summarized their arguments in their closing trial brief to the California court, saying:

“Abortion Pill Reversal is an accurate, truthful, and non-misleading way to describe the interventions at issue in this case. APR works through competitive inhibition, taking advantage of the fact that mifepristone binds reversibly to the progesterone receptors. It works to undo the effect of the abortion pill, which is a commonplace understanding of the word reverse. The FDA pharmacology review described the effects of supplemental progesterone as antagonizing mifepristone’s abortifacient activity, allowing normal pregnancy and delivery, and ‘reverse’ is ordinary language shorthand for that counteraction.”

The brief points out that this straightforward terminology regarding the biochemical processes involved in APR is the same as the U.S. Centers for Disease Control deploys regarding the use of naloxone to reverse the lethal effects of an opioid overdose. Naloxone, or Narcan, can be purchased and used by anyone from leading pharmacy chains and from the Narcan Nasal Spray web site. The Narcan website states simply, “Anyone can save a life with Narcan Nasal spray. Purchase to keep at home, at work, or for your public service organization.” A single unit of Narcan costs less than $35. For this author, the unit is part of our regular first aid kit. It may seem unlikely, and one prays it is, that we would be called upon to deploy it, but opioid overdoses are the leading cause of accidental death in the United States — some 80,391 in 2024 according to the web site. The chance of encountering someone in desperate need is not nil.

Chemical abortions are even more commonplace. While the federal government and states continue to suffer from ineffective tracking of abortion data, consensus estimates place the annual number of U.S. abortions at over 1.1 million. In 2023, according to the Guttmacher Institute, nearly two-thirds of abortions were effected by chemical agents, that is, 65%. Among the many ironies of current public policy is that the abortion industry has done everything in its power to reduce or eliminate medical supervision in the distribution of abortion drugs — omitting routine medical tests related to pregnancy, mailing the drugs from thousands of miles away or from overseas, transmitting them to unverified buyers for later or even criminal use, and attacking research efforts to detail the risk profile of the abortion regimen under the expanding scenarios in which it is used. APR, in turn, is carried out under medical supervision and requires sustained medical contact, a physician-patient relationship, with the goal of providing adequate progesterone sustenance to a woman who voluntarily chooses to seek restoration of a normal pregnancy.

The best evidence of all are the experiences of the thousands of women who have pursued APR and borne children as the outcome. The lawsuits against Heartbeat and Real Options feature no plaintiffs or complainants from the ranks of these women, dozens of whose stories are recounted at the website of the two organizations that face absurdly devastating fines at the hands of a predatory state.

In June, Heartbeat International published an open letter signed by more than 200 women celebrating their successful decision to reverse the abortion pill and carry their children to term. The language used at Open Arms Real Choices for APR is similarly positive, saying, “The abortion pill is a common abortion method, and some women begin the process while feeling scared, rushed, or unsure. If you’ve taken the first pill and regret your decision, you may still have options. Abortion Pill Reversal may offer a second chance.” Studies showing women’s ambivalence about abortion are incontestably common.

The absurdity of the California and New York action against APR — i.e., its rank persecution of the women affected — should not be lost on anyone. Mifepristone is a non-naturally occurring drug promoted and distributed by companies that do nothing else for pharmaceutical therapy or the cause of medicine. They exist solely to speed and profit from the destruction of unexpected pregnancies. The drug displaces progesterone, the naturally occurring hormone that supports pregnancy and is routinely used to help women with a history of miscarriage, from the developing child’s bonding site in the womb. The result is fetal demise. APR involves the administration of the natural hormone progesterone to displace mifepristone, reestablish the nourishing role of progesterone, and give the child a chance to live.

APR opponents insist instead on a tragic outcome and what they are resisting is one of the oldest canons of Medicine, the Hippocratic Oath, and one of the oldest of medical interventions, the antidote. The Hippocratic Oath binds the physician not to give a woman a drug or device to end her pregnancy. It dates back to centuries before the time of Christ and is a practical as well as ethical doctrine, subsequently embraced in the Western intellectual and religious traditions but not foremost a matter of religious doctrine. The recent renewal of the Geneva Consensus Declaration on Promoting Women’s Health and Strengthening the Family, endorsed by representatives of 43 nations, confirms the commitment of many secular governments, including the United States, to “reaffirm the inherent ‘dignity and worth of the human person,’ that ‘every human being has the inherent right to life,’ and the commitment ‘to enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.’”

APR manifestly serves all these interests. Given the position of the United States as a signatory of the Declaration, our federal government can and should take one or more steps to blunt the efforts by the abortion industry in California and New York to deny women even the ability to change their minds about the chemical annihilation of their child in utero. This could occur via such steps as the enactment of the legislation introduced by Reps. Diana Harshbarger (R-Tenn.) and Kevin Hern (R-Okla.) called the Protecting Life from Chemical Abortions Act, which would reverse the FDA’s demedicalization of abortion pills under the Biden administration, or passage of Senator Josh Hawley’s (R-Mo.) bill, the Safeguarding Women from Chemical Abortion Act, which would withdraw FDA’s approval of mifepristone and provide a private right of action for women injured by the drug.

Therapeutic medicine proceeds by a variety of mechanisms, each of which the Hippocratic Oath characterizes as “doing no harm” or engaging in the healing arts. Some therapies proceed by altering body chemistry or attacking cells and tissues that have gone astray and threaten health or life. Other therapies, such as treatment of fractures, reset the body in its original condition and allow the body’s own mechanisms, via stem cells and other specialized cells (and time), to repair the injured tissue.

In other instances, since the dawn of medicine, practitioners have sought to identify and use antidotes, drugs, or preparations that interfere with poisons and counter the damage they do. Antivenoms fall into this classification and they must typically be used promptly if the venom involved is particularly potent (just ask Cleopatra). A fascinating article on the development of antidotes from the time of the ancient king Mithridates describes how today’s world has led to encounters with a growing variety of poisons in everyday use. The author observes, “The evolution of human lifestyles necessitates a reorientation of the future of toxicology which needs to focus more on the prevention of poisoning than antidotes.” That truth would seem to apply to mifepristone.

One other thought about the absurdity of the California and New York courtroom dramas comes to mind. In his first term, President Trump successfully pursued “right to try” policy for drugs not yet approved for use by the Food and Drug Administration. The law signed in May 2018 allows terminally ill patients to access drugs not yet approved by the FDA if they have no other recourse and no way to participate in a clinical trial of a medicine. In the case of mifepristone, there is no way to conduct a formal clinical trial without the malpractice of giving placebos to women to arrest an abortion they have begun. What would distinguish a woman seeking a “right to try” progesterone for the sake of her now terminally ill child from a woman seeking a drug to save her own life? A woman clearly has a right to try progesterone, a substance familiar to her own body, for the sake of another’s life and, perhaps, the future well-being of her own.

A ruling from the California court is expected in a few months. As one woman who used progesterone to save her daughter’s life haltingly said, “I wanted, I wanted, to have the baby but I wanted someone to help me.” Heartbeat and Real Choices are leading providers of that help. There is no more important decision pending in our nation today than these trials of APR — which, in truth, are trials of our basic humanity.