American Medical Association sues after North Dakota passes abortion 'reversal' law

AMA says North Dakota is trying to turn abortion doctors into 'government mouthpieces'
Woman at the Gynecologist
The American Medical Association has sued the state of North Dakota to block a new law that they say forces doctors to “act as the government’s mouthpiece” and lie to women seeking abortions.Keith Brofsky / Getty Images

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By Corky Siemaszko

The American Medical Association has sued the state of North Dakota to block a new law that they say forces doctors to “act as the government’s mouthpiece” and lie to women seeking abortions.

“The Compelled Reversal Mandate forces physicians to tell their patients that medication abortions may be reversible, a claim wholly unsupported by the best, most reliable scientific evidence, contravening their ethical and legal obligations as medical providers,” the AMA stated in the 23-page complaint filed last week in U.S. District Court in Bismarck.

House Bill 1336, which was passed by the state’s Republican-dominated legislature, also violates physicians’ First Amendment rights by requiring them to tell patients that abortion terminates “the life of a whole, separate, unique, living human being.”

“The Compelled Personhood Mandate forces Physicians to act as the government’s mouthpiece to speak a message that is unrelated to the medical details, risks and benefits of the procedure,” the complaint states.

The AMA said that when this law goes into effect on Aug. 1. doctors will be forced — under the threat of criminal penalty — to deliver a “controversial and ideological message about fetal personhood that is unmoored from medical science.”

“The patient-physician relationship is the cornerstone of health care, and depends upon honest, open conversations about all of a patient’s health care options," AMA President Patrice Harris said in a statement to NBC News. "North Dakota’s law undermines this relationship by requiring physicians to mislead and misinform their patients with messages that contradict reality and science. The AMA will always defend science and open conversations about all health care options available to patients.”

Tammi Kromenaker, director of the Red River Women’s Clinic in Fargo, which is the only abortion clinic in North Dakota, echoed Harris.

“North Dakota’s laws are forcing us to say things that violate our medical ethics and are simply false and not backed up by science,” said Kromenaker.

The North Dakota Attorney General’s office is reviewing the complaint, public information office Liz Brocker said in an email to NBC News.

The prime mover behind the new law, Kromenaker said, was Rep. Daniel Johnston, a Republican from Kathryn, North Dakota. He is a married father of eight and Army vet, according to his official biography. He is not a doctor.

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Johnston did not return an email and call from NBC News seeking comment.

Women seeking abortions in the first 10 weeks of pregnancy generally have two options: a surgical procedure or a medication-based abortion. It’s the latter procedure that HB 1336 targets.

To terminate a pregnancy using medication, women take mifepristone and then misoprostol 24 hours apart.

Mifepristone blocks progesterone, which is a hormone that helps sustain a pregnancy. Misoprostol makes the uterus contract and expel the embryo through the vagina.

Under the new North Dakota law, the suit states, doctors would be required to tell women 24 hours before an abortion that “it may be possible to reverse the effects of an abortion-inducing drug if she changes her mind.”

“There is no credible evidence that medication abortion administered via the combined mifepristone/misoprostol regime can be reversed,” the suit states.

It notes that several witnesses testified before lawmakers about an “experimental practice proposed by a physician in San Diego, who believes he can ‘reverse’ the effects of mifepristone prior to the administration of misoprostol.”

That, Kromenaker said, was a reference to Dr. George Delgado. He has claimed in published studies that women who had taken mifepristone — and then changed their minds about having abortions — were able to carry their pregnancies to term after receiving progesterone injections.

Delgado is a founding member of the Abortion Pill Rescue Network, which has championed his claims. Legislators in Kentucky, Kansas and Nebraska are also looking at bills similar to the North Dakota law.

But the American College of Obstetricians and Gynecology has taken a dim view of Delgado’s claims, saying his findings are “not scientific evidence that progesterone resulted in the continuation of these pregnancies.”

"Yet, politicians are pushing legislation to require physicians to recite a script that a medication abortion can be “reversed” with doses of progesterone, and to steer women to this care," the ACOG said in a statement last year. "Unfounded legislative mandates represent dangerous political interference and compromise patient care and safety."

Other critics have accused Delgado of inflating his success rate.

"A systematic review we coauthored in 2015 found no evidence that pregnancy continuation was more likely after treatment with progesterone as compare with expectant management among women who have taken mifepristone," Dr. Daniel Grossman, a gynecologist at the University of California, San Francisco, and University of Alabama sociologist Kari White wrote in the New England Journal of Medicine.

Meanwhile, gynecologist Mitchell Creinin has launched a study funded by the Society of Family Planning to see whether so-called abortion pill reversal actually works, National Public Radio reported in March.

NBC News reached out to Delgado via the Abortion Pill Rescue Network. He did not return an email for comment. But Heartbeat International, which manages the network, released a statement.

"It is unfortunate that the AMA would recommend that doctors deny information and care to women who may regret taking the abortion pill," the statement said. "Every woman should know about abortion pill reversal so she can have hope if she changes her mind."