To the Editor: Women’s Health Response

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I appreciate the opportunity to address some of the issues raised by Ms. Bost in her September letter to the editor regarding the article on the East-West event that appeared in your August issue. I am the Clinic Manager and Co-Medical Director for the Pregnancy Centers of Central Virginia. Part of my mandate as an employee is to ensure medical accuracy of information we give to our clients, so the concerns she raised are ones that deserve to be discussed.

First, the American College of Obstetricians and Gynecologists (ACOG) is a professional group that is not neutral regarding abortion. Their position statements advocate for increased abortion access and increased training of abortion providers at all levels, to include family physicians and mid-level providers (such as nurse-practitioners.) Their statements about pregnancy resource centers and abortion pill reversal need to be viewed in that light.

The other groups she referenced for unbiased information carry similar biases—the Guttmacher Institute is the research arm for Planned Parenthood, the largest provider of abortions in the United States. Whole Woman’s Health is also an abortion provider, and the other groups mentioned are pro-abortion also when you visit their webpages. 

In the interest of space, I’d like to address a few of the concerns she raised. First, the answer is not definite for the breast cancer/abortion link. Though the official opinion on the National Cancer Institute website is that there is no risk, other studies refute this. A 2014 analysis of studies in Chinese women showed a statistically significant increase in breast cancer after one abortion, and the increase grew with second and third abortions suggesting dose effect. 

There are similarly conflicting data on mental health, premature birth (not infertility), and abortion risks. There are studies on both sides of these issues—it’s not as simple as it may appear.

I would like to address in more detail the issue of abortion pill reversal.  The first pill in the abortion pill regimen is a medication called mifepristone that blocks a hormonal receptor on the placenta—which is the link between the embryo and the mother.  An attempt at reversal consists of giving large doses of the progesterone hormone being blocked if the patient has taken the first pill only—to try to get more of the hormone to the receptor before the abortion pill gets to it.  Competition for receptors is basic biochemistry and is logical from a medical standpoint.

I am frequently asked if the babies born after reversal have increased birth defects. ACOG itself in its medical abortion bulletin in 2014 states that the mifepristone does not cause birth defects, and the study results bear that out.  The reversal hormone progesterone is already safely given to women in situations of threatened miscarriage.

Women can and do change their minds after beginning a medical abortion and this gives them hope that the pregnancy may be saved. In a study recently published in Issues in Law and Medicine in 2018, the rate of success in abortion pill reversal is 64-68% in over 750 patients to date. If the woman just takes the first abortion pill and doesn’t complete it with the second pill taken 24-48 hours later, the rate of her continuing her pregnancy is no more than 25%.  

We have women who are post-abortion come to us for counseling about mental health concerns. There may have been some confusion in the article—we are not providing medical services post-abortion but refer them to the emergency room or their regular health provider as appropriate. 

However, I am a fully-licensed board-certified family physician and our centers do provide medical services legitimately—including early pregnancy diagnosis including limited obstetrical ultrasound and sexually transmitted infection (STI) testing and treatment. Our medical volunteers (physicians, nurses, and sonographers) all hold valid Virginia licenses or certifications. All of our services are provided at no cost to our patients. 

I would encourage Ms. Bost or anyone who is curious about our services to visit one of our centers personally. I appreciate the opportunity to clarify these issues.

Karen D. Poehailos, MD
Clinic Manager/Co-Medical Director, Pregnancy Centers of Central Virginia

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