ROCHESTER — Abortion pill reversal, a controversial and harmful practice intended to ‘reverse’ an abortion halfway through, is still being advertised by more than a quarter of crisis pregnancy centers in Minnesota — some of which are state-funded.
Advocates claim that medication abortion, which involves taking two pills in sequence within the first 11 weeks of pregnancy, can be halted in the middle by skipping the second dose and taking a high dose of progesterone instead. However, abortion pill reversal is “not supported by science,” according to the American College of Obstetricians and Gynecologists.
“The data is totally unproven,” said Laura Dodge, an obstetrics and gynecology professor at Harvard University. “It doesn’t work, and it is dangerous.”
Minnesota crisis pregnancy centers receive almost $3 million in taxpayer funds each year through the
Positive Alternatives Grant Program
– more than half a million of which goes to five crisis pregnancy centers that promote abortion pill reversal, according to a Post Bulletin analysis. The grant program, which was established by the Minnesota Legislature in 2005 and assigned to the Department of Health for implementation, grants money to nonprofit organizations that promote healthy pregnancy options outside of abortion.
“Crisis pregnancy centers provide a stunted version of reproductive health care,” said Asha Hassan, a researcher at University of Minnesota’s Center for Anti Racism Research for Health Equity. “Yet despite sharing inaccurate medical information with patients, the state department awards crisis pregnancy centers a significant amount of money.”
Crisis pregnancy centers – faith-based, nonprofit medical clinics that seek to deter people from obtaining abortions – outnumber abortion providers 12:1 in Minnesota. With advocates across the state calling for increased prenatal and maternal support, reproductive health experts question the state’s decision to fund crisis pregnancy centers that promote unfounded science instead of steering funds towards licensed comprehensive health care facilities.
Promoting ‘unfounded science’
Michael Schommer, communications director for the Minnesota Department of Health, said that the department continues to evaluate grantees regularly and monitors and updates program materials provided to grantees as evidence warrants. MDH has ceased funding for several grantees due to lack of compliance, however, the department is not authorized to regulate or license grantees or oversee crisis pregnancy centers generally, Schommer said.
“It is important that information provided to Minnesotans be accurate and up-to-date based on the body of scientific evidence,” Schommer said. “Production and dissemination of materials focused on abortion pill reversal would not be an allowable use of funds. However, grantees may get funding from other sources and the department would not have jurisdiction over materials developed using outside funds.”
Proponents of abortion pill reversal cite a small
2012 case series
and other research as evidence for the treatment’s efficacy, but the
American College of Obstetricians and Gynelogists
said it does not support prescribing progesterone to stop a medication abortion as this research does not meet clinical standards and is “unproven and unethical.”
The only ethically approved study to test the effectiveness of abortion pill reversal was halted due to safety concerns in 2019.
The University of California Davis
, which intended to enroll 40 women, never made it past 12 after three of the participants required ambulance transfers to the hospital for severe bleeding. Researchers reported that any further attempts to market the treatment as a method to reverse abortion would be “human experimentation.”
Three years after the study,
First Care Pregnancy Center
, a crisis pregnancy center, which operates clinics in southeast Rochester and the Twin Cities metro area, still offers free doses of the medication to its patients after an assessment. It also refers patients to a 24/7 Abortion Reversal Hotline administered by Heartbeat International, a Christian anti-abortion organization that supports the largest network of crisis pregnancy centers in the world.
“A woman should have the right to withdraw her consent for an abortion she no longer wants,” said Tammy Kocher, the executive director of First Care Pregnancy Center. “If she changes her mind and wants to continue that pregnancy after taking the first pill, she should be supported in that decision.”
Kocher said that administering progesterone is safe and effective and has been used for decades to support women at risk for miscarriage. However, Dodge, a reproductive epidemiologist, said while it is true that progesterone is sometimes prescribed to support early pregnancy, this doesn’t mean it can be safety used to reverse medication abortion.
The Post Bulletin reached out to all 85 crisis pregnancy centers in Minnesta, including the 24 that promote abortion pill reversal, but no one, besides Kocher, responded. First Care Pregnancy Center is not a Positive Alternatives grantee.
First Care Pregnancy Center has licensed health care providers on staff and provides a range of free services to support patients facing unexpected pregnancies, Kocher said, such as comprehensive STI testing and treatment, pregnancy tests, limited scope ultrasounds to determine gestational age, housing assistance support and prenatal/parenting educational resources.
“I know the accusations out there against pregnancy centers, and they are categorically not true of us,” Kocher said. “We want women to know that they have three viable options for their pregnancy, (not just one) and if they want to continue their pregnancy, but lack resources or support, we will walk alongside them in support, not just for their pregnancy, but for years to come. We also provide support for those who choose abortion, and need or want ongoing support afterwards.”
The spread of misinformation
While most won’t take issue with crisis pregnancy centers supporting women who wish to adopt or carry pregnancies to term, researchers and abortion providers say that crisis pregnancy centers don’t only promote abortion pill reversal on their websites, they also often provide inaccurate medical information to deter patients from obtaining abortions.
First Care Pregnancy Center, for example, writes on its
that “many women” who receive abortions will struggle with infertility and have increased risk for substance abuse and ectopic pregnancies — pregnancies in which the fertilized egg develops outside the uterus and cannot survive. Dodge said there is no evidence to support the clinic’s claims. Other crisis pregnancy centers falsely link abortion to breast cancer.
Kocher said that “the information we provide on abortion comes directly from the Minnesota Department of Health,” however the
makes no links between abortion and ectopic pregnancies or substance abuse, and writes that infertility only occurs in rare circumstances when complications develop. The other risks First Care Pregnancy Center lists from MDH are technically accurate, Dodge said, such as hemorrhaging, but they lack necessary context as to how rarely they occur.
When asked about these inaccuracies in an interview, Kocher declined to respond saying she didn’t have the source information handy.
Many crisis pregnancy centers in Minnesota, including
First Care Pregnancy Center
, also list psychological repercussions as risks to abortion – referring to these feelings as abortion-related post traumatic stress syndrome. While any emotions are normal and valid, Dodge said Post-Abortion Syndrome is not a medically-recognized term nor evidence based.
Sarah Traxler, chief medical officer of Planned Parenthood in North Central States, said the misinformation that Minnesota crisis pregnancy centers spread impacts her work. She oversees four of the state’s seven abortion clinics — Planned Parenthood offices in Rochester, Minneapolis, St. Paul and Brooklyn Park as well as virtual care.
Traxler said she has had many experiences where patients visited a crisis pregnancy center before making an appointment at Planned Parenthood, and her team had to spend time backtracking and explaining that the medical information patients had received previously was inaccurate.
This sentiment was echoed by Nisha Verma of American College of Obstetricians and Gynecologists and Sharon Lau of Whole Women’s Health Alliance, which operates an abortion clinic in Bloomington.
“That can be confusing and upsetting to patients because they realize that they have been lied to and misled,” Traxler said. “It creates a harder environment for us as far as building trust and rapport.”
Traxler said what she sees most often with patients is inaccurate pregnancy dating. Some of her patients were told by the crisis pregnancy center that they were in their first trimester and had plenty of time to make a decision about abortion, when they were actually in their second trimester.
An ultrasound misreading can change the course of care, she said. If patients seeking abortion miss the 11-week gestational cut off, they will have to undergo in-clinic abortion (also known as surgical abortion) instead of medication-based abortion. In-clinic abortion is more expensive and could involve more travel since only two out of Minnesota’s seven abortion clinics provide second trimester abortions. Sometimes the delays can push patients past the state’s limit for legal abortions — generally referred to as 24 weeks.
On the other side, Traxler has seen some patients who were told they were too far along to have an abortion when they were actually within the legal limit.
According to an
by Gender Justice in 2021, which Dodge collaborated on, most Minnesota crisis pregnancy centers do not have medical providers on staff and few provide prenatal care or referrals.
“It’s hard for me to know for sure if crisis pregnancy centers are being intentionally deceptive about ultrasound readings,” Traxler said, “or if it is simply because these are not trained medical professionals who know how to accurately interpret an ultrasound.”
Traxler did not mention First Care Pregnancy Center, and Kocher said there have never been any reported inaccurate ultrasound readings at her clinics.
The need for government oversight
Last month, Minnesota Rep. Kaohly Vang Her, DFL-St. Paul, shared publicly at a St. Paul abortion rally that a crisis pregnancy center she once visited didn’t recognize she had an ectopic pregnancy after giving her an ultrasound and encouraged her to continue on with the pregnancy. The fertilized egg cannot survive in an ectopic pregnancy and, if left untreated, the growing tissue can cause life-threatening bleeding, according to Mayo Clinic’s website.
“Crisis pregnancy centers are incredibly dangerous for our patients,” said Verma, an obstetric gynecologist and fellow at the College of American Obstetricians and Gynecologists. “And because they exist outside the health care system, they operate without regulatory oversight … and should not receive government dollars.”
Erin Maye Quade, advocacy director for Gender Justice in St. Paul, said crisis pregnancy centers, if they are to continue receiving state funds, need really strong oversight, especially the ones that promote abortion pill reversal and “could endanger the lives of pregnant people.”
Minnesota Legislative Reference Librarian Molly Niehls said the Positive Alternatives Act has not changed substantively since it was enacted in 2005. According to an analysis of the legislative library by the Post Bulletin, there have only been two attempts to increase government oversight of grantees and crisis pregnancy centers generally — neither of which passed.
One of these attempts was by Minnesota Rep. Tina Liebling, DFL-Rochester, chair of the house health finance and policy committee. She proposed an amendment to the Positive Alternatives statute in 2019 that would have required grantees to provide medically accurate written materials and set guidelines for how to determine accuracy. It also would have required the health commissioner to establish a stricter evaluation process each grant cycle. However, the amendment never made it past the conference committee.
“There’s nothing wrong with helping women who want to be pregnant, have a healthy pregnancy and a healthy baby,” Liebling said. “And I wasn’t saying let’s get rid of the program because I knew that would never fly. But I thought, you’ve got to have some oversight. What’s the problem with saying that you can’t mislead women? What would really be controversial about this?”
There is no definitive source in Minnesota listing working crisis pregnancy centers. The Post Bulletin analyzed
detailing crisis pregnancy centers located in Minnesota. Duplicates and errors across datasets have been removed. A full list of the crisis pregnancy centers in Minnesota that the Post Bulletin identified
are aggregated here.
The Post Bulletin removed six organizations from the aggregated list because they did not clearly resemble pregnancy clinics –
Bethany Christian Services in Plymouth
City Life Center
Cradle of Hope
. However, these organization are anti-abortion and/or affiliated with crisis pregnancy centers. Cradle of Hope and Philomena House receive state funds through the Minnesota Positive Alternatives Grant Program.