West Virginians considering abortion need good information about the procedure; bill might keep them from getting the facts

Mar. 23—While some people who've had abortions in West Virginia regret them, and others say those decisions were best for them, they agree on the importance of accurate information.

But a bill working its way through the West Virginia Legislature would require health care professionals to provide them with one piece of information that isn't supported by research and could amount to, in the words of one state medical group, "unmonitored experimentation" on West Virginians seeking abortions.

Under House Bill 2982, those people would hear that "it may be possible to stop" a medical abortion after taking the first of two pills required for such an abortion. The bill doesn't require they be told that the assertion isn't supported by research, that it's based on taking a medication that isn't approved by the U.S. Food and Drug Administration for the purpose of stopping abortions, or about the potential harm of attempting to stop an abortion.

Supporters of the bill, including some people who've had abortions, say the bill is needed because some women have regrets after beginning the procedure.

Opponents of the bill, also including people who've had abortions, say that it's important for people seeking abortions to understand they're making permanent decisions.

The bill, if it becomes law, would tell people "they don't have to make a decision, that they can be wishy-washy about it," said Hunter Starks, who had an abortion while in an abusive relationship.

"And you can't," Starks said. "You have to make that decision, whether that's easy or hard for you. You have to make that decision."

Starks, a transgender non-binary person, said if they hadn't had that abortion, they would have been tied to that abuser for life.

Opponents of the bill also warn that it's based on the unproven idea that taking progesterone after the first pill in a medication abortion can reverse the process. They note the FDA has not approved progesterone for this use, and that limited research suggests patients' health and safety could be put at risk.

What does the bill do?

When a patient seeks a medical abortion, health care providers provide them with two pills. Mifepristone, the first pill, blocks the hormone progesterone. This thins the uterine lining, so the embryo won't stay implanted and continue growing. Misoprostol, the second pill, causes the uterus to contract and expel the embryo through the vagina.

The original version of House Bill 2982, sponsored by Delegate Kayla Kessinger, R-Fayette, said that providers had to tell patients that their abortion could be "reversed." Lawmakers in the House of Delegates Health and Human Resources Committee changed that wording last week, so the bill now would require health care providers to tell patients that "it may be possible to stop" an abortion.

Delegate Todd Longanacre, R-Greenbrier and a bill co-sponsor, said the bill would help "a young lady [who] realizes the error of her ways, by taking that first pill to terminate a baby's life."

"It's an opportunity for that young lady who may have, in a knee-jerk, emotional state-of-mind decided to take an RU-486 pill, and then woke up the next morning and thought, 'Oh, my gosh, what have I done?'" he said. "This is her opportunity to save that baby's life.

"It's not a perfect bill," Longanacre said. "But you know what, an old general from the World War II era once said — and that guy's name was General Patton — he said a less-than-perfect plan violently executed now is better than the perfect plan executed next week. People are dying; babies are dying. This is an opportunity to save lives."

House Bill 2982 is based on the unproven idea that taking progesterone after the first pill will reverse its effects.

Research on progesterone for this use is so weak, according to a statement from the West Virginia American College of Obstetricians and Gynecologists chapter, that administering it to patients in an effort to reverse or stop abortions "potentially subjects women to unmonitored experimentation," which is "in direct violation of a physician's oath to care."

The bill is supported by West Virginians for Life and the National Right to Life Committee. It is opposed by both the national and West Virginia chapters of the American College of Obstetricians and Gynecologists, Planned Parenthood and the state-level reproductive rights group, WV Free.

Democrats in the House committee last week noted that a study on the effectiveness of progesterone in stopping an abortion mid-procedure was halted early because several women experienced severe bleeding, possibly because they had taken the first pill but not the second.

Researchers aimed to determine whether progesterone could be used to reverse the effects of mifepristone, preventing pregnancy termination, but three patients experienced severe hemorrhaging and had to be taken to the hospital, according to the study, published in a 2019 edition of Obstetrics & Gynecology, the official publication of the American College of Obstetricians and Gynecologists.

Delegate Barbara Fleischauer, D-Monongalia, wanted to amend the bill in committee to warn patients about possible side effects, but that amendment was rejected.

Delegate Ric Griffith, D-Wayne and a pharmacist who said he is anti-abortion, was concerned enough to oppose the bill, saying he worried taking the first pill, but not the second, could lead to birth defects.

"In our desire to protect the unborn, we are potentially causing harm to the unborn," he said.

No medical professionals were called to testify during the meeting.

Karen Cross, who is from West Virginia and lobbies for the National Right to Life Committee, was present but did not testify.

"I've had two abortions, and I regret mine," Cross said in an interview following the meeting. "I know so many women, who are involved in the pro-life movement even, actively, because of the decision they made to abort their children, so that they can help other women not make that mistake."

Delegate Heather Tully, R-Nicholas and an anti-abortion family nurse practitioner, voted for the bill during that meeting, but said in an interview that she did have concerns.

"I would be very concerned about a non-approved FDA medication, but obviously, this procedure has been done in some places, maybe not necessarily within the state of West Virginia, or within the confines of the border," she said.

Tully, who noted that she doesn't work in reproductive medicine, said abortion pills also come with risk. She's had patients change their minds about other procedures, she said. And patients have a right to withdraw consent, she noted.

"I think that this bill, it really quite honestly strengthens the informed consent process for a patient that may change their mind," she said.

Ten states have passed similar legislation, and others are working on their own bills, according to Cross. Courts have blocked implementation in several states. Six states have the law in place, according to a March 1 statement from the pro-abortion rights Guttmacher Institute.

The House of Delegates Judiciary Committee, where delegates would normally discuss the legality of bills, passed the bill with no discussion of those court cases Thursday.

The bill is up for second reading in the House on Tuesday, during which time delegates may offer amendments. It's tentatively scheduled for a final House vote on Wednesday, and would then have to pass the state Senate and get the approval of Gov. Jim Justice to become law.

Lived experiences

While some West Virginians who've had abortions made the right decision for them and others have regrets, several people interviewed agreed on the important of being informed.

But while the bill does require doctors to tell patients about an option, it doesn't tell them anything about the lack of research supporting that option and the potential harmful effects of it.

Suzi Bragg, of Morgantown, still supports the bill. She regrets her two abortions, and would rather anti-abortion lawmakers become involved than rely on doctors.

"I'm 63 and to this day, I do not trust when doctors tell me things," she said.

Bragg said when she was 16 and in foster care, a young man blackmailed her into sex. She said her social workers took her to Pittsburgh for the abortion when she was about 18 weeks pregnant.

She said they injected saline into her abdomen, which was extremely painful, and held her down when she yelled for them to stop. She said the experience was "extremely traumatic, because I wasn't told the truth about what would occur."

She said she was told the experience would be no more painful than menstrual cramps, and the fetus was a clump of cells. She didn't realize until seeing a Newsweek magazine later on that a fetus is more developed than that at about 18 weeks.

"I remember just screaming, 'They lied to me,'" she said.

Bragg said she went on to develop post-traumatic stress disorder. She didn't want to eat. She didn't want to socialize with friends. She said the trauma was due in part to being coerced into both the act of sex, and the abortion. During a second abortion in her 20s, she declined pain medication. She felt like she deserved the pain.

Back then, information about abortion was less readily available to women, she said.

Hunter Starks, of Charleston, was 19 and in an abusive relationship when they sought their first of two abortions in 2012.

Starks, who was assigned female at birth, took pain pills for the first abortion, which was medical, so pain wasn't significant, they said, and they experienced no pain for the second, which was surgical.

Starks said they were in a fragile mindset at the time and it was mainly their partner's decision, but they still don't regret the choice.

While Longanacre, the bill co-sponsor, said some abortions may be "knee-jerk reactions," ACOG-WV and some West Virginians who've had abortions say the bill itself would actually encourage people to see abortion as something they don't have to be sure about.

In their statement, leaders of the state OB/GYN group wrote that if the bill becomes law, it would create "an environment of confusion and stigma."

Starks already felt confused and scared going into the abortion, without doctors telling them that the decision could be stopped or reversed.

"Everyone should have agency over their own decisions with their body, and doctors shouldn't be making that any more confusing or difficult," they said.

Starks does regret one thing — going to the clinic alone. Protestors screamed and name-called.

Maggie McCabe, whose mother worked to start the last remaining abortion clinic in West Virginia, the Women's Health Center in Charleston, was 16 when her mother flew her to Washington, D.C., for an abortion in the days before the U.S. Supreme Court legalized abortion in its Roe v. Wade decision in 1973.

A professor at BridgeValley Community and Technical College who worked for a health insurance provider for 28 years, McCabe was just getting ready to start her life.

She said she wouldn't have wanted "wishy-washy" information when seeking an abortion, and said patients deserve "concrete, appropriate information."

"My abortion had no negative effect on me," she said. "It's made me a stronger woman, because I believe in helping others in any way that I can. Telling my story is my contribution to helping other women in their decisions."

McCabe, of Charleston, criticized lawmakers for involving themselves in health care decisions and called abortion bills a form of sex discrimination.

She noted people with fewer resources and less support couldn't have flown to D.C., like she did.

"The right-to-lifers are using a very offensive, very un-Christian campaign to keep women oppressed, and to keep women in a lower class controlled," she said.

Jamie Miller, an abortion rights advocate who lives in South Charleston, was almost 17 when she received an abortion.

She had already gotten approval from a mental health professional for the abortion to avoid telling her family, and saved up money.

Miller said if after all that, she arrived at her appointment and providers told her the process could be stopped or reversed, she would have wondered whether she could trust them and if she needed to attempt a possibly deadly abortion on her own.

"I would have felt like they weren't on my side," she said.

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