ABSTRACT
OBJECTIVE: To present a series of cases demonstrating successful reversal of mifepristone effects in women who chose to reverse the medical abortion process. CASE REPORTS: Four of 6 women who took mifepristone were able to carry their pregnancies to term after receiving intramuscular progesterone 200 mg. DISCUSSION: Mifepristone has been available in the US since 2000. By 2008, approximately 25% of abortions prior to 9 weeks were accomplished with mifepristone. Some women who take mifepristone wish to reverse the medical abortion process. Progesterone competes with mifepristone for the progesterone receptor and may reverse the effects of mifepristone. A PubMed literature search from 1996 to May 2012 did not reveal any trials or case studies evaluating the efficacy of progesterone use to reverse the effects of mifepristone. CONCLUSIONS: Health care professionals should be aware of the possible use of progesterone to reverse mifepristone in women who have begun the medical abortion process by taking mifepristone and then change their minds.
Subject(s)
Abortifacient Agents, Steroidal/antagonists & inhibitors , Abortion, Induced/methods , Mifepristone/antagonists & inhibitors , Progesterone/pharmacology , Abortifacient Agents, Steroidal/administration & dosage , Adult , Female , Humans , Injections, Intramuscular , Mifepristone/administration & dosage , Pregnancy , Pregnancy Outcome , Receptors, Progesterone/drug effects , Receptors, Progesterone/metabolism , Young AdultABSTRACT
Health-care providers have been challenged by changes in medical practice to include abortion, euthanasia, and controversial fertility technologies. These procedures go beyond saving lives, healing disease, and alleviating pain, the traditional purposes of medicine. The foundational principles of Western medical ethics, as characterized by the Hippocratic Oath, have been weakened or even rejected. The consequences of abandoning the Hippocratic tradition are illustrated by the eugenics movement, the Nazi Holocaust, the Tuskegee experiments, and contemporary bioethics theories. Physicians and other health-care personnel are under institutional and governmental pressure to succumb to anti-Hippocratic ethics. Conscience clauses are a means of defending medical practitioners from these trends. Characteristics of conscience legislation that protect health-care providers are described. Strong conscience clauses also protect the public by ensuring the survival of healthcare personnel with shared Hippocratic values.
