St. Petersburg, Russia, Aug 6, 2021 / 06:30 am (CNA).
In 2016, the Russian physician Alexey Fokin received a call from a friend who wanted advice on helping a woman who had taken an abortion pill but then regretted it.
Not long after, another person rang him asking for the same guidance.
“I understood that it is not a rare situation,” the doctor based in St. Petersburg, in northwestern Russia, told CNA.
“We have more than 500,000 chemical abortions annually in Russia and they are very affordable and easily available everywhere,” Fokin said in an interview via email.
“This means that many women take mifepristone very instantly, impulsively, without strong decision. This means that thousands of women want to go back, reverse the mifepristone effects, and save babies.”
Mifepristone, also known as Mifeprex and RU-486, is a pill that pregnant women commonly take first when seeking a medical abortion (also known as a chemical abortion), followed later by a second pill containing misoprostol.
Spurred by the inquiries, Fokin found the website abortionpillreversal.com, overseen by Heartbeat International (HBI), an international network offering pro-life pregnancy help, based in Columbus, Ohio.
The website guides women who have taken mifepristone through a process it calls “abortion pill reversal” (APR), in which a doctor prescribes progesterone.
The website says that “the goal is to start the protocol within 24 hours of taking the first abortion pill, mifepristone, or RU-486. However, there have been many successful reversals when treatment was started within 72 hours of taking the first abortion pill.”
Fokin contacted Dr. George Delgado, a medical adviser to the program who practices at Culture of Life Family Health Care in Escondido, California.
The Russian doctor and his colleagues then translated the progesterone protocol and adapted it to local progesterone formulations.
Russia became the first country in the world to legalize abortion in 1920, following the revolution led by the Bolshevik Party of Vladimir Lenin.
In the decades that followed, the Soviet Union had one of the world’s highest abortion rates, with millions of abortions performed each year.
Official figures suggest that since the turn of the millennium, the number has fallen, with around 450,000 abortions formally recorded in 2020 in a country of 144 million people.
But these statistics cover only municipal or federal medical institutions offering mostly free surgical abortions. Commercial clinics providing medical abortions are thought to under-report their activities, meaning that, while the number of recorded surgical abortions is decreasing, chemical abortions are increasing.
In major cities such as St. Petersburg, which has a population of almost five million, and the capital, Moscow, which has almost 12 million residents, pro-lifers believe that the majority of abortions are medical and not reported to official bodies.
One of Fokin’s colleagues, Anna Fenina, oversaw the creation of an APR group on the popular Russian social media network VKontakte, while Fokin launched a website, peredumala.ru.
“In 2018, we published the first video on YouTube with APR instructions in Russian,” he recalled. “We were very surprised by the number of visitors to our website and groups, requests, and views of the video. We had 20,000-30,000 views and about 2,000 visitors per year.”
Fokin said that the response convinced the group that there was a high demand for APR in the Russian-speaking world, which extends far beyond the borders of Russia itself.
Typically, the group’s clients get in touch after seeking information about how to stop the effects of mifepristone using the search engines Yandex and Google or social media platforms such as VKontakte, Facebook, and Instagram.
“After watching the video [on the group’s YouTube channel] or reading the site, most women don’t need our direct advice and consult their local gynecologists,” Fokin explained. “Under MD supervision, they start progesterone therapy.”
“Some women contact our coordinator, Anna, or our gynecologist on a hotline on WhatsApp and Viber. The hotline number is available at our site and our groups.”
Fokin stressed that he and his colleagues always encourage clients to consult with their family doctors or OB-GYNs before starting progesterone therapy.
“After completion of the course of progesterone therapy, many women go back with gratitude to us for providing the APR technique,” he said.
“We are very happy that the APR protocol gives so many women a second chance and the opportunity to correct the mistake.”
Abortion advocates and the pro-choice media have repeatedly attacked APR, claiming that it is “unproven” and “unethical.”
Fokin said that he had never encountered such criticisms in Russia, where the procedure is relatively new.
But the doctor said that if he were practicing medicine in the U.S., he would assure critics that APR is “absolutely ethical, highly efficient, and safe.”
“Mifepristone induces chemical ‘miscarriage.’ It is the mifepristone, which blocks the natural development of pregnancy and kills babies, that is unethical. Mifepristone is a legalized poison,” he argued.
“Why? Poisons are substances that can cause death, injury, or harm to organs and tissues. Poisons block or inhibit normal processes. Pregnancy is a natural and normal process and condition. Mifepristone blocks progesterone receptors and causes the death of a normal and healthy baby.”
Progesterone, he said, has been used for decades and is known to be an “effective and safe drug for the treatment of miscarriage.” He noted that the hormone is a natural substance produced by the human body.
“Giving progesterone, we unblock progesterone receptors and turn back the natural process in the right direction. This is absolutely ethical,” he underlined.
“Moreover, all women are fully informed about possible side effects, positive and negative outcomes. They freely choose APR and provide consent for the reversal therapy. Informed consent is the cornerstone of ethics in medicine.”
Critics of APR often cite a U.S. study of the treatment that was stopped in 2019 after some participants were admitted to emergency rooms.
In response, HBI has said that the principal investigator on the study, Mitchell D. Creinin, M.D., of the University of California, Davis, was affiliated with Physicians for Reproductive Health, which describes itself as a “doctor-led national advocacy organization.” Creinin is listed among “Physician Members” on the organization’s website.
A 2018 article for the New England Journal of Medicine noted that Creinin “reports receiving consulting fees from Danco Laboratories.” Danco Laboratories distributes mifepristone under the brand name Mifeprex.
HBI has argued that the 2019 Creinin study “actually showed that the abortion pill carries major health risks to a mother.” It has also pointed to an earlier study that the physician took part in which, it suggested, “showed that the abortion pill regimen resulted in the very type of hemorrhaging reported in Creinin’s latest study, confirming that the bleeding is attributable to mifepristone and not progesterone.”
Another pro-life group, the Charlotte Lozier Institute in Arlington, Virginia, has also suggested that the 2019 study is misleading.
On its website, HBI cites a 2018 peer-reviewed study indicating that 64-68% of pregnancies were saved through APR, with no increase in birth defects. The study, by Dr. George Delgado and six others, concluded that “the reversal of the effects of mifepristone using progesterone is safe and effective.”
Asked if he believed that APR was likely to be recognized by Russia’s medical authorities, Fokin said: “There were preliminary discussions with corresponding bodies of the Ministry of Health, and indeed we’ve got positive feedback.”
He pointed out that health officials are deeply concerned about Russia’s demographic crisis. The population fell by more than 700,000 in 2020, the largest annual decline since 2005.
“Demography is a headache of our Ministry of Health, and APR can increase the birth rate a little bit,” Fokin observed. “We will try to get APR therapy included in the current standard of care for miscarriage or develop a new standard of care.”
The doctor said that he and all the members of his team were Orthodox Christians.
“However, we help all women including Muslims, atheists, and others,” he said. “I know that human life begins from conception and I believe that new life is a precious gift from Our Lord. Let’s work together to have more babies on Earth and more happiness.”
Disclaimer: CNA’s Executive Director, Alejandro Bermúdez, is a board member of HBI.
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