Meeting Public Comments

Lauren Hartwell

According to Dr. Mitchell Creinin and his study(PMID 31809439) on the safety and efficacy of a medical abortion reversal pill which has been attached, it is inaccurate to claim that reversing a medical abortion is possible or safe. The study was ended due to safety concerns for participants and unable to draw conclusions on whether such a regimen would be effective after multiple hospitalizations due to massive hemorrhage. This bill is asking physicians and other health care workers to provide false information to their patients which could cause them direct harm. The signage proposed by this bill is misinformed, misleading, and not scientifically supported to be safe or effective.

Kimberly Laube [Lutheran Family Service]

Women who exercise their right to choose should also have the right to be fully informed about that choice. Women who choose to have a medically induced abortion using RU486 should be informed about all their options, including the option now available to reverse the procedure should they choose to change their minds and save the life of their baby.In this medically induced abortion regimen, RU486 acts like a poison to deteriorate the placenta causing the death of the unborn baby. However, a study published in Law and Medicine in 2017 indicated that RU486 is effective about 75% of the time. So, to ensure a complete abortion, a second drug is administered which causes the uterus to contract expelling the baby and placenta. The natural hormone progesterone can act as an antidote blocking the action of the RU486 poison and prevent the death of the baby. It is a safe procedure shown to be effective 68% of the time in a case series authored by Doctors George Delgado M.D. and Mary Davenport M.D published in Issues in Law & Medicine, Volume 33, Number 1, 2018. Thus, it is possible to reverse the action of RU486 before taking the second drug in a chemical abortion. Additionally, the study found there was no increased risk of birth defects or preterm births when compared to the normal population when women and babies receive this medical protocol.We all believe in informed consent. Should not women facing this emotionally charged decision be FULLY informed? Woman facing an unplanned pregnancy are often afraid and they just want the problem to go away. Decisions are often made in haste. But after that initial pill is taken, they may start to think about what they have done and what that pill will do to their baby and be filled with regret. How often have any of us wished we could take back a decision we made in haste? Women should have the information that this is a decision that can potentially be reversed safely and effectively.Women who have the right to choose chemically induced abortion should also have the right to be informed of the option to change their minds and prevent the death of their baby and the emotional wounding for themselves. Giving vital health information to a mother about lifesaving medical protocols to prevent the death of her child is never something we should have to think twice about. It is clearly the right thing to do and I speak in favor of this bill.

Tom Chapman [Iowa Catholic Conference]

The Iowa Catholic Conference has registered in support of the bill. Women considering abortions deserve to have information about the abortion procedure, possible consequences of an abortion, the development of the unborn child, and services available as alternatives to abortion. In 2019, 68 percent of abortions in Iowa (2,404 out of 3,542 abortions) were medication abortions. The drug reversal process offers a chance for the woman to rescue her child when she has changed her mind about abortion, as well as spare herself the pain and regret of losing a baby.Because of Iowas sameday abortion regime, we think a woman can get both a positive pregnancy test and the first dose of the chemical abortion at the same office visit. We believe this makes the disclosure even more relevant.Data from the 2019 clinical trial mentioned by opponents may be easily misinterpreted. I believe that study actually points to the riskiness of the abortion pill itself because two of the three patients that needed treatment for severe bleeding had received the placebo, not progesterone proposed for use in the bill, after taking the first abortion pill.The actual study concludes with the observation We should not dismiss mifepristone antagonization as impossible, referring to the drug therapy described in this bill.Iowa, unfortunately, has distinguished itself nationally as a pioneer and leader in remote chemical abortions. Abortion supporters will continue efforts to expand access, potentially with less qualified supervision. That makes the obligation to fully inform even more important. This bill could help mothers and children in Iowa a second chance at choosing life. Thank you.

Laura Hessburg [Iowa Coalition Against Domestic Violence]

The Iowa Coalition Against Domestic Violence (ICADV) represents 22 crime victim service provider agencies across Iowa and the collective experience of agency staff who dedicate their lives to supporting victims of violent crime, specifically survivors of domestic violence and sexual abuse. Our direct service providers routinely witness the pain and suffering of crime victims, as well as their stunning resilience in surviving repeated violent acts (often over the course of months and years), inflicted on their minds and bodies by people they know and care about. We urge you to reject HF 53, legislation requiring physicians to provide women seeking medication abortion information that is not consistent with evidencedbased scientific data and medical consensus. At best it is misguided to think women need the socalled protections provided by this legislation or that physicians are wellserved by legislators telling them how to practice medicine. At worst, this bill is irresponsible and dangerous to womens health because it doesnt just impact access to care it REQUIRES health care providers to MISINFORM women about a safe medical procedure. Abortion reversal bills are dangerous mandates that harm and misinform women. The claim that medication abortion can be reversed lacks scientific credibility and has been soundly rejected by medical professionals, including Iowa OBGYNS.Reproductive health services are an essential component of routine medical care for all women, and victims of domestic and sexual violence have an acute need for timely access to the full range of reproductive health services, including abortion care. The link between intimate partner violence and negative reproductive health consequences is profound. Undermining access to abortion is harmful to womens health and will not stop women from seeking abortion care. These policies have a far greater impact on the safety of health services women receive than whether women choose to terminate a pregnancy. And for victims of violence this bill negatively impacts their options for safety more broadly. Reproductive coercion is an element of domestic violence that occurs when a male partner uses intimidation, threats, or violence to impose his intentions upon a womans reproductive autonomy. This includes rape, sabotaging contraception, and coercing a woman to become pregnant and carry a pregnancy against her will. Iowa service providers report that overcoming barriers to accessing abortion care increases a survivors risk for harm. Women denied access to abortion often return to an abusive relationship they wanted to leave and carry unintended pregnancies to term at great risk to themselves and other children.The dynamics of domestic violence include isolating women financially and physically, i.e. taking car keys, taking her to/from work, monitoring every hour of her day. Each of these levers of control make it extremely difficult for victims of violence to access timely medical care. For survivors seeking abortion care, the availability of safe, legal medication abortion has been an important option in reducing barriers to health care access. Unintended pregnancy is the primary reason women seek abortion care. It also doubles the risk for domestic abuse during pregnancy. And regardless of the prevalence of domestic violence, homicide by a partner is the number one cause of death for pregnant women. Erecting barriers to health care for women functions just like reproductive health coercion and requiring doctors to violate their medical training and the ethical practice of medicine is a new low. Please protect womens health and reject HF 53.