(Corrects that Vaughn amendment to bill failed. Committee chair first said it passed then clarified that it failed)
A bill requiring physicians to notify women that their drug-induced abortion can be reversed is back in play in the Kansas Legislature after a similar bill was stopped by Democratic Gov. Laura Kelly four years ago.
The House health committee on Monday passed a bill out of committee, which is based on the controversial idea that a medical abortion can be stopped halfway through a two-drug regimen. The Legislature couldn’t override the governor’s veto of a similar bill in 2019.
Supporters of the bill said the legislation was intended to give more information to women who might have second thoughts about having an abortion when they’re vulnerable.
Opponents said there’s no credible evidence that a medical abortion can be reversed and that it’s based on studies that are questionable and the mandated information is misleading.
Republican state Rep. David Buehler of Lansing supported the bill, saying it made more information available to women.
“I don’t see this as providing confusion or doubt. I see it as exactly the opposite,” Buehler said.
“I think there is an obligation for our medical community to provide the range of options and treatment in this situation,” he said.
“If anything, by not providing this information it is withholding information from a patient about their range of choices.”
But Democratic state Rep. Lindsay Vaughn of Overland Park said the bill provides bad information to women seeking an abortion.
“This is a really bad idea,” Vaughn said.
“It’s just allowing state-mandated deception and further stigmatization of abortion when this is a safe procedure,” she said.
Vaughn unsuccessfully tried to amend the bill by adding a sentence telling patients that abortion pill reversal is not approved by the Food and Drug Administration and may have side effects including hemorrhaging. The amendment was first announced as passed when it failed.
The bill would require any clinic providing medical abortions to post a sign — in at least three-quarter inch boldface type — telling women it’s possible to reverse the process once it has begun.
The sign would read as follows:
“NOTICE TO PATIENTS HAVING MEDICATION ABORTIONS THAT USE MIFEPRISTONE: Mifepristone, also known as RU-486 or mifeprex, alone is not always effective in ending a pregnancy. It may be possible to reverse its intended effect if the second pill or tablet has not been taken or administered.
“If you change your mind and wish to try to continue the pregnancy, you can get immediate help by accessing available resources,” the notice would read.
The bill also would require physicians to inform women that a medical abortion could be reversed within 24 hours of administering the first drug. Women would have to be notified in writing and by telephone or in person.
The bill also would apply to pharmacies that prescribe the drug mifepristone, which is used for inducing an abortion.
A violation on first offense would be a misdemeanor. A second or subsequent conviction would be a felony.
Four years ago, Kelly vetoed a similar bill, saying it was “unnecessary” and “would interfere with the relationship between women and their physicians.”
“It forces health care providers to adhere to a government mandate not adequately supported by medical science,” she said at the time.
The Senate voted 27-13 to override the veto. The House came up two votes short of an override, voting 82-43 to pass the legislation. As originally passed, the bill had support from 85 members in the House.
Kansas and other states have responded to research by California physician George Delgado, who published a 2012 article in the Annals of Pharmacotherapy explaining how the effects of the first abortion pill could be reversed.
The protocol employs two steps: first with the drug mifepristone and a second with the drug misoprostol.
The first drug blocks a hormone critical for starting the pregnancy. The second drug, administered to 24 to 48 hours later, flushes the uterus by causing cramping and bleeding similar to a miscarriage.
Delgado’s initial research said that when the hormone progesterone was introduced between the first and second pill, four of six women studied brought their pregnancy to term.
He published an article more recently in Issues in Law and Medicine that examined a larger group of women.
The later study examined 547 patients who took progesterone within 72 hours of taking the first abortion pill. The study found there were 257 live births.
Opponents of the bill have questioned Delgado’s research.
The American Civil Liberties Union said Delgado’s first study in 2012 was not supervised by an institutional review board nor an ethical review committee to protect human research subjects.
The ACLU said Delgado didn’t examine long-term effects of the drug protocol including the woman’s health, pregnancy complications or the chances for birth defects.
Testifying before the House health committee, Kansans for Life lobbyist Jeanne Gawdun cited an article from Pregnancy Help News that reported that 4,000 babies had been saved from the reversal protocol.
The legislation is aimed at the rising number of medical abortions — also known as the abortion pill — that occur during the first 10 weeks of pregnancy. They are used in roughly a third of all abortions nationally at eight weeks of gestation or less.
Drug-induced abortions are now the most common form of the procedure in Kansas, making up 68% of abortions performed in the state in 2021.
In 2010, medical abortions made up just 26 percent of all Kansas abortions. It became the most common form in 2016.
Brittany Jones, policy and engagement director for Kansas Family Voice, said the state needs to update its informed consent laws to account for the rising number of medical abortions in Kansas.
“It is a new development in Kansas over the last probably five to six years where we’ve seen this growth in this method of abortion,” Jones said.
“A lot of our informed consent laws are not meeting women in this space,” she said.
“Women need this information for this new form of abortion.”
There are now two states – Nebraska and Utah – that require similar notifications for a medical abortion, according to the Guttmacher Institute, a research think tank that supports abortion rights.
Two other states – Indiana and North Dakota – have similar laws on the books that are not in effect as they are litigated in court.
And there are eight states – Arkansas, Idaho, Kentucky, Louisiana, Oklahoma, South Dakota, Tennessee and West Virginia – that would have notification requirements but are moot because they already ban almost all abortions.
If those bans were not in effect, then abortion reversal counseling requirements would be in effect in all but Oklahoma and Tennessee, where there are court cases, according to Guttmacher.
The American Medical Association joined a lawsuit in 2019 seeking to stop North Dakota’s law.
The lawsuit said physicians were being forced to provide information that was not supported by science. The law was temporarily blocked in 2019 but is still pending.
The AMA president said the North Dakota law required physicians “to mislead and misinform their patients with messages that contradict reality and science.”
In the North Dakota case, U.S. District Judge Daniel Hovland – appointed by President George W. Bush – ruled that state’s abortion reversal counseling law violated the First Amendment rights of physicians.
“Rather than focus on relevant medical information designed to assist a woman in making a free choice, (the law), ideological beliefs essentially designed to make it more difficult for women to choose an abortion,” the judge ruled.
“The North Dakota law requires abortion providers to enunciate the State’s viewpoint on an unproven medical and scientific theory, namely whether a chemical abortion can
be reversed,” he ruled.
Abortion rights supporters didn’t personally testify against the bill during a committee hearing Monday, which prompted one lawmaker to remark that perhaps their concerns weren’t that serious.
“I just want to note that if this was truly bad legislation, I find it interesting that the opponents just submitted written testimony and did not come to testify orally in front of this committee,” said Republican state Rep. Tory Marie Blew of Great Bend.
Nevertheless, Rebecca Tong, co-executive director of the Trust Women Foundation, an abortion provider in Wichita, ripped into the bill in written testimony to the committee.
Tong said the bill requires providers to offer “fantasy resources that do not exist in the real world.”
Tong said the bill would require clinics to inform patients that it may be possible to reverse the intended effects of a medication abortion and direct them to resources where they might “‘attempt to reverse the medication abortion.’”
“This is not responsible medicine,” Tong wrote the committee. “It is dangerous guessing that irresponsibly puts our patients at risk of very real complications.”
The bill, Tong said, “sends a message that this legislature is comfortable with promoting fake medicine, at the risk of their constituents’ health and lives.”
“Politics has no place in determining medical best practices,” she said.
“Legislating medical treatments or requiring health care professionals to tell patients inaccurate information is an unwarranted and inappropriate interference in the patient-doctor relationship.”
Republican state Rep. John Eplee of Atchison said he believes there’s an abundance of evidence that the bill is “reasonable and prudent for women who are in a very vulnerable period of their pregnancy when they’re considering an abortion and unsure.”
“This has been done commonly, historically in medicine for pregnancy maintenance when you do progesterone rescue albeit in different forms and different methods,” said Eplee, a physician.
“This certainly is not that unusual, not that atypical and it does provide a modicum of hope for those women who are at a vulnerable time in their pregnancy.”
