The Case of "Abortion Pill Reversal"

There is increasing evidence that many in the elite of the “reproductive rights” movement are pro-abortion rather than pro-choice. These elite advocates attempt to influence public opinion and public policy through the mouthpiece of organizations such as Planned Parenthood and NARAL. However, they are also embedded in, ostensibly, apolitical medical organizations such as the American College of Obstetrics and Gynecology (ACOG), the American Medical Association (AMA), and the New England Journal of Medicine (NEJM).

Perhaps the best illustration of this unfolding reality is the attempt to scuttle any progress on medication abortion “reversal” bills in state legislatures across the country. If Planned Parenthood, NARAL, ACOG, and the AMA were truly interested in providing women with choice, they would do everything to support women who choose to parent/adopt, as well as though who chose abortion. They would not preference one choice over another. However, in the instance when a woman has a wrenching change of heart during the two day medication abortion process, they are decidedly against choice. They are unwilling to contemplate any therapy to reduce the chance of a completed abortion. This is consistent with a pro-abortion rather than a pro-choice orientation.

During a medication abortion, a woman takes the first abortion pill, mifepristone, on day 1, and then the second abortion pill, misoprostol, 24-48 hours later. Many women have changed their mind about abortion after taking the first pill, but before taking the second. Reproductive rights activists refuse to believe these women exist, much less explore the possibility of mitigating the effects of the first of two abortion pills. Fortunately, prolife researchers in several countries have tried to address the plight of these women by devising protocols to inhibit the effects of mifepristone and increase the likelihood that a pregnancy will continue.

In 2019, North Dakota passed an “abortion reversal bill” (HB 1336) that is similar to bills introduced in other state legislatures (including Colorado’s).(1) The bill asks physicians, as part of the informed consent process, to let patients know “that it may be possible to reverse the effects of an abortion-inducing drug, if she changes her mind, but time is of the essence”. At the behest of the American Medical Association (and others), a federal district court has recently issued a preliminary injunction to block enforcement of the law.(2) AMA President Patricia Harris stated that “with this ruling, physicians in North Dakota will not be forced by law to provide patients with false, misleading, nonmedical information about reproductive health that contradicts reality and science.” Planned Parenthood, NARAL, and ACOG, along with numerous media outlets denounced the law as propaganda that had no scientific basis. They have testified in legislatures across the country against abortion informed consent legislation. NEJM previously had published an editorial “Abortion ‘Reversal’ – Legislating without Evidence” deploring the efforts by state legislatures across the country to facilitate a dialogue on mitigating the effect of abortion drugs in informed consent legislation.(3)

So how strong is the evidence that medication abortion could be “reversed”? Are the protocols used to moderate the impact of mifepristone “quackery” as critics suggest? To answer those questions we need to wade into the scientific process and how physicians weigh evidence when providing advice to patients.

The fact is that most of what physicians recommend to patients reflects expert opinion which is the lowest level of clinical evidence. The highest level of evidence is derived from “randomized, double-blind, placebo-controlled trials”. Unfortunately, only a small fraction of any physician’s practice is governed by this level of evidence. The remainder of a physician’s practice is informed by lesser degrees of clinical evidence including from a contemporary series of cases compared to historical controls or lesser quality clinical trials. The evidence for abortion “reversal” falls into this latter category.

Every good science-based medical therapy starts with a plausible scientific justification. Progesterone is the hormone that stimulates the lining of the uterus to grow and support the developing pregnancy. Mifepristone avidly attaches to progesterone receptors in the lining of the uterus and thereby interferes with the action of progesterone to maintain the pregnancy.(4) The abortion “reversal” process involves flooding the body with additional progesterone to dislodge mifepristone from progesterone receptors and allow progesterone to exert its beneficial effects on the uterus.5 The “reversal” protocols administer abundant progesterone in either an oral or injectable form.

Ideally, before pursuing a trial of a new therapy in humans, it is best to look at animal models to find evidence to support the approach. In 1989, a Japanese researcher demonstrated that giving progesterone to pregnant rats treated with mifepristone allowed 100% of the fetal rats to survive compared to only 33% survival in rats given mifepristone alone.(6) This would suggest that at least in one animal model, progesterone can antagonize the effect of mifepristone.

There has also been at least one study published in the contraceptive literature which may have some bearing on the effects of supplemental progesterone administration to interfere with the efficacy of medication abortions in humans. In a multinational randomized trial, women who received depot progesterone (as a long term contraceptive) at the time of mifepristone administration during a medication abortion were 4 times more likely to have a continued pregnancy compared to the women who did not.(7)

The use of progesterone in early pregnancy has a long and safe history. It has been used for decades early in pregnancy in women with a history of recurrent miscarriage.8 Only recently was it determined that progesterone is largely ineffective to prevent miscarriages, except in women with a history of multiple miscarriages.(9-10) Nonetheless, the use of progesterone for threatened abortion is not a new concept in humans.

Based on the scientific plausibility and known safety of progesterone administration in early pregnancy, Dr. George Delgado began offering women, who had changed their mind after taking mifepristone, high dose progesterone. In 2018, Dr. Delgado published his case series which included 547 women.(5) He found that 64-68% of women who took high dose oral/injectable progesterone had a continued pregnancy. This was much higher than historical controls of approximately 25%. Others have published small case reports supporting the conclusion that high dose progesterone might be an effective therapy to preserve a pregnancy after the administration of mifepristone.(11)

Critics have pounced on this data in efforts to discredit its conclusions. They point out that the efficacy of mifepristone as a single agent abortifacient drug depends on the gestational age of the embryo/fetus. Dr. Delgado’s protocol clearly was less successful very early in pregnancy and more successful later. Therefore, giving progesterone may be no better than placebo. However, when you adjust Dr. Delgado’s experience for gestational age, a continued pregnancy is still nearly twice as likely after progesterone.(3) The kicker - because of the small sample size of the historical controls used by critics –is that the results are not “statistically significant”. By low balling (5,12) the success of mifepristone historically, critics attempt to completely dismiss any potential therapeutic value of progesterone administration.

The bottom line is that there is a scientifically plausible rationale to administer progesterone to “reverse” the effects of mifepristone. There is animal data supporting this approach. There is data in the contraceptive literature demonstrating that progesterone interferes with medication abortions. And now there is a large case series suggesting that progesterone administration after mifepristone leads to a higher percentage of continued pregnancies compared to historic controls. While this is not high level evidence, clearly, this is not “no evidence” as NARAL, Planned Parenthood, ACOG, AMA, and NEJM would have you believe. To say otherwise betrays an intellectual dishonesty that is unbecoming these professional organizations.

The next step is to gather randomized trial data to lend further support to the use of progesterone to “reverse” the effects of mifepristone in a medical abortion. Dr. Mitchell Creinin from the University of California, Davis, is an abortion rights advocate. He has begun a trial in which 40 women will be randomized to be given oral progesterone or placebo after mifepristone administration to assess the efficacy of the “reversal” protocol.(13) Typically, you would design the study protocol to maximize the chance to demonstrate efficacy of progesterone as a mifepristone antagonist. Unfortunately, the trial protocol begins the progesterone the day after mifepristone which might diminish its effectiveness and lead to inconclusive results. Furthermore, the small sample size will make it hard to demonstrate the statistical significance of any benefit. Nonetheless, he should be applauded for at least attempting to address the clinical question.

Having demonstrated that there is indeed low to moderate level evidence to support giving progesterone to antagonize the effects of mifepristone, it is perfectly reasonable that states include this tentative information in their abortion informed consent laws – otherwise abortion providers would likely ignore it. When making policy that can potentially save the life of another human being, the medical community and legislators should not require high level evidence before they act. During testimony on Colorado’s “Abortion Pill Reversal Information Act” in 2017, three women tearfully recalled their own change of heart midway through their medication abortions. They were extremely grateful that all three delivered healthy babies after utilizing the progesterone “reversal” protocol. They passionately made the case that this information should be available to other women contemplating medical abortions so that they indeed can make informed choices.

The reproductive rights elite including NARAL, Planned Parenthood, ACOG, AMA, and NEJM show little interest, much less compassion, for women who choose life during a medical abortion. It is time the American public recognizes that they are nominally pro-choice, but in practice, firmly pro-abortion.

References:

1) “North Dakota House Bill 1336”. 2019. Retrieved 9/17/2019 from https://www.legis.nd.gov/…/66-2…/documents/19-0517-03000.pdf.
2) “Court blocks law that would force physicians to mislead patients”. September 10, 2019. Retrieved September 17, 2019 from https://www.ama-assn.org/…/court-blocks-law-would-force-phy….
3) Grossman D, and White K, Abortion “Reversal” – Legislating without Evidence”. New England Journal of Medicine 2018; 379(16): 1491-1493.
4) Soon JA, et.al., Medications used in evidence-based regimens for medical abortion: An Overview. J Obset Gynaecol Can 2016: 38(7): 636-645.
5) Delgado G, et.al., A case series detailing the successful reversal of the effects of mifepristone using progesterone. Issues in Law & Medicine 33(1): 21-31.
6) Yamabe S, et.al., The effect of RU486 and progesterone on luteal function during pregnancy. Nihon Naibunpi Gakkai Zasshi 1989; 65(5): 497-511.
7) Raymond EG et.al., Effects of depot medroxyprogesterone acetate injection timing on medical abortion efficacy and repeat pregnancy. Obstetrics & Gynecology 128(4): 739-745.
8) Hass DM et.al., Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. Cochrane Database Syst Rev 2018; Oct 8;10CDC003511.doi: 10.1002/14651858.CD003511.pub4.
9) Coomarasamy A, et.al., A randomized trial of progesterone in women with recurrent miscarriages. NEJM 2015; 373(22): 2141-2148.
10) Coomarasamy A.J., et.al., A randomized trial of progesterone in women with bleeding early in pregnancy. NEJM 380(19): 1815-1824.
11) Garratt D and Turner JV, Progesterone for preventing pregnancy termination after initiation of abortion with mifepristone. European Journal of Contraception and Reproductive Health Care 2017; 22(6): 472-475.
12) Van Look PFA and Bygdeman M, Medical approaches to termination of early pregnancy. Bulletin of the World Health Organization 1989; 67(5): 567-575.
13) “SFP Research Grant Awards”. 2018. Retrieved September 17, 2019 from https://www.societyfp.org/research-and-grants/grants-funded.

Hern Closes Late Abortion Clinic

By Thomas Perille MD • April 30, 2025
This is cause for celebration. Warren Hern was an outlier in the field of medicine that itself is an outlier. It is the only medical specialty that is devoted to killing human beings rather than restoring health or ameliorating suffering. Hern famously compared humans to a spreading “cancer” on the earth. It is not surprising that he devoted his career to using abortion as a form of population control. He considered pregnancy a disease and felt that no justification was needed to pursue abortion at any time for any reason. The fact that 70% of his late abortion practice targeted healthy women carrying healthy fetuses was often underappreciated or misrepresented by the media. One can hope that the fact that he could not find another physician to assume his grisly late abortion practice may be a sign of hope that the era of unlimited, unrestricted, and unregulated abortion may be nearing an end.

Open Letter to Govenor Polis on Public Medicaid Funding for Elective Abortions

By Thomas Perille MD • April 22, 2025
April 17, 2025 Governor Polis, Democrats for Life of Colorado implores you to consider the fiscal implications of signing SB25-183 into law. Research from the Guttmacher Institute published in 2024 demonstrates that in states where Medicaid pays for elective abortions, 62% of abortions are Medicaid abortions. If you apply this figure to Colorado, this means that SB 183 will create a huge financial liability for the Colorado Medicaid system at a time when the state is straining to contain a greater than 1-billion-dollar budget deficit. CDPHE reported that there were 10,368 abortions on in-state residents in 2023. The legislative council’s fiscal note on SB 183 estimates a $800 Medicaid reimbursement for medication abortions and a $1300 Medicaid reimbursement for surgical abortions. The legislative fiscal note also divides abortions into 50% medication and 50% surgical in calculating the state’s financial commitment. This would translate into a total cost of $6,749,568 for the estimated 6428 abortions (using the 2023 CDPHE numbers). If you use Guttmacher estimates for the number of abortions in Colorado, the number would be at least 40% higher. The fiscal liability doesn’t stop with the monetary payment for elective Medicaid abortion, since the Legislative Council adds the loss of $1,721,497 federal matching dollars. This will make the total estimated state’s obligation at $8,471,865 using the more conservative CDPHE numbers. And you can’t count on the misleading Legislative Council analysis for cost savings from “averted births”. This is an overly simplistic analysis for many reasons. Up to 20-30% of miscarriages occur after 6 weeks. This means that many of these “averted births” would have ended in miscarriage and not cost the state the cost for funding an abortion. Most births won’t be “averted” because these women will go on to have pregnancies that go to term later in their reproductive life. We know that the risks of pregnancy complications correlate directly with maternal age. These “delayed” rather than “averted” births, will increase Medicaid costs because of the increased risk of gestational diabetes, preeclampsia, and premature births in these later pregnancies. It is also well established that surgical abortions increase the risk for premature birth in subsequent pregnancies, including extreme premature births. To the extent that this legislation increases surgical abortions, it will markedly increase Medicaid Neonatal Intensive Care Unit costs. Furthermore, there is good data that suggests that women undergoing abortions seek mental health services at a much higher rate, which also will increase Medicaid costs. There is evidence that subsidizing abortions for lower income women, increases abortion rates which will, in turn, increase Medicaid abortion costs. The Legislative Council used a tiny study from Louisiana to estimate the number of additional abortions that will be performed when public funding is available. The Louisiana study demonstrated that only 1% of Medicaid eligible women who were pregnant (and didn’t already abort) would have considered abortion if the state had providing funding. This means the immediate impact on increasing abortion access will be extremely small but likely increase over time. The Legislative Council failed to acknowledge that Louisiana low-income women have very limited access to private abortion funding. This is in stark contrast to the robust private funding for abortion from the Cobalt Fund and the National Abortion Federation funds here in Colorado. Consequently, you can’t rely on the experience in Louisiana to project Colorado’s costs. SB 183 will simply be shifting abortion costs for low-income women from private sources (Cobalt/NAF) to Colorado taxpayers. We are very concerned that Medicaid already fails to reimburse pregnancy services adequately which results in maternity deserts. This new elective abortion financial obligation will likely further compromise pregnancy services and other higher Medicaid priorities. The multimillion-dollar increase in state funding that is necessary to pay for elective Medicaid abortions stands in contrast to the “zero” fiscal impact that Amendment 79 was purported to have based on the Bluebook verbiage. If voters understood that they were voting for a multimillion-dollar tax increase to pay for abortion, it is safe to say that more than 38% of the Colorado electorate would have voted against the amendment. We are opposed to using public funds for elective abortions. However, even if you thought this was required for “equity” purposes, this is not the time or the fiscal circumstances that justify such an expensive measure. Thanks for your consideration. Thomas J. Perille MD FACP FHM President, Democrats for Life of Colorado

Will paying for abortion save the state money?

By Tom Perille MD • March 24, 2025
The campaign to use public taxpayer funds to pay for elective Medicaid abortions has been a sham from the beginning. During the Amendment 79 campaign for the constitutional right to abortion, the Legislative Council’s Blue Book disingenuously stated that “the measure will have no fiscal impact”. This was an attempt to deliberately mislead Coloradans. Now the pièce de resistance, SB25-183 claims that by paying for elective Medicaid abortions, the state will save hundreds of thousands of Medicaid dollars from “averted births”. The Legislative Council made their projection based on a tiny study from Louisiana where 12 pregnant Medicaid women said that lack of public funding was “part of why (they) have not had an abortion”. The Council ignored the fact that only two of these 12 (1.2% of all Medicaid women interviewed for the study), would have still considered abortion if the state paid. Furthermore, in contract to Louisiana, Colorado has generous private funding available for both in-state and out-of-state women seeking abortion. The Legislative Council analysis was clearly designed to produce the desired “cost savings” reported. They offset the millions of dollars of abortion costs with the money from “averted births”. However, they ignored critical facts in this oversimplified analysis. The principal flaw is that “averted births” are illusory since most Medicaid women will simply pursue births later – when the risks of complications and associated Medicaid costs will be higher. It also ignores the number of pregnancies that would have ended in natural miscarriage, the increased costs for premature birth in subsequent pregnancies for women who had surgical abortions, and the increased cost of mental health treatment for those who seek abortion rather than childbirth. Aside from the moral issue, the state will suffer the fiscal consequences of the ill-advised public funding of elective abortion.

Outrage after Abortion Advocates Vote Against Women's Health and Safety

March 20, 2025
I am angry. More than angry, I am sad that our state legislators place allegiance to their “tribe” over the health and safety of the women of Colorado. On Tuesday, March 11, the House Health and Human Services Committee rejected HB25-1252 which would have instructed the Colorado Department of Health to develop evidence-based guidelines to ensure the health and safety of women seeking high risk second and third trimester abortions. The committee heard testimony that 10% of second trimester abortions have complications and 1.7% suffer serious, life-threatening complications. They heard that one in 50 women who had second trimester abortions through the University of Colorado required hospitalization. They heard that mid second and third trimester abortions are riskier than natural childbirth. They heard that the risks of dying from a late abortion are greater than the risk from dying from a procedure at an ambulatory surgical center. Every healthcare facility that poses this kind of risk to women is licensed, regulated, and inspected by the Colorado Department of Health. Late abortion is the only exception. The most heart wrenching testimony concerned the February death of an 18-year-old woman, Lexie. She died of complications from her second trimester abortion at the Fort Collins Planned Parenthood. At this same facility, 911 records documented at least three other emergency transfers already this year. My fel low Democrats have no problem regulating the energy/gas industry to safeguard the health of Coloradans. Do they only regulate industries with which they aren’t politically aligned? Tom Perille MD

Statement on the Passage of Amendment 79 - The Right to Abortion in Colorado

November 14, 2024
We want to extend our sincere appreciation for the thousands of people who came together for a cause greater than themselves. The diverse group that opposed unrestricted, unregulated abortion reflected the broad-based coalition formed by Prolife Colorado that defies any simple characterization. We are Democrats, Independents, and Republicans from every race, and ethnicity. We are young and old, rich and poor, native and immigrants, religious and secular. We are defined by our common belief in the value and dignity of every human being and not by any demographic. Amendment 79 passed but that does not mean we failed. We have begun the long and arduous task of educating Coloradoans about the reality of abortion in our state. Few knew that abortion late in pregnancy on healthy women with healthy babies was common. Few knew that high risk second and third trimester abortion clinics were unregulated in our state and that women’s lives are in jeopardy. Few realized the implications of unrestricted abortion on the privileged relationship between parents and their teen daughter. Many underappreciated the fiscal impact of using public funds to streamline access to abortion through all nine months of pregnancy. Our only regret is that we didn’t have the money to share our message more broadly so that every Coloradoan could make an informed choice. The proponents of the measure raised 18 times the money we did largely from the abortion industry and wealthy out-of-state donors. They used their money to spread the myths that “abortion was healthcare” and that abortion saved women’s lives. They frequently tried to conflate elective induced abortions with miscarriages, ectopic pregnancies and treatment for life-threatening complications of pregnancy. We know that not a single women’s death has been the result of abortion restrictions and that recent highly publicized deaths in Georgia and Texas reflect the anticipated complications of drug-induced abortions compounded by physician negligence. We will continue to build a culture that respects every human life here in Colorado and envision a future where women are offered the support and the resources, they need to choose life. Women without financial resources and women of color should not feel that their only path to a successful life is through abortion. We will fight to remove the inequities in pregnancy care throughout our state and remove barriers for women facing unplanned pregnancies during their education and early careers. And yes, we look forward to the day when Coloradoans will vote to remove Amendment 79 from our constitution. Because life matters.

What is "progressive" about Amendment 79?

October 29, 2024
It is becoming more common for ideologues to gaslight the American public to promote their agenda. The latest example is the abortion industry’s attempt to have Coloradoans suspend their common sense, human decency and compassion to place Amendment 79 into the Colorado constitution. State law already protects access to abortion, but they would have us believe it is “progressive” to endorse this constitutional amendment. Amendment would enshrine unrestricted, taxpayer funded abortion into the state constitution. It would prohibit the government from “denying, impeding or discriminating” against the right to abortion. This goes far beyond Roe which was overturned by the Dobbs decision. Roe permitted regulation of abortion in the second trimester to ensure the health and safety of women and allowed states to recognize their compelling interest in protecting the life of a viable baby in the third trimester. Amendment has neither of these important features. If abortion is considered a fundamental constitutional right (unlike any other medical procedure), then a fetus, wanted or unwanted, has no constitutional rights under Amendment 79. Nobody could infringe on the exercise of abortion – no matter the circumstances. Late abortions are common in Colorado. While abortions after the limit of fetal viability only represent 3.2-3.4% of abortions each year, they account for hundreds of abortions. And we know that approximately 70% of these late abortions are performed on healthy women with healthy babies. Amendment 79 would prevent legislators from ever curtailing abortion late in pregnancy for social and economic reasons. The amendment does nothing to address the real needs of women facing financial challenges that forces them to consider late abortion. It leaves them only one regrettable choice. Is it progressive to focus solely on abortion access and forego the hard work necessary to make pregnancy more equitable for low-income women? The Colorado Department of Public Health and Environment licenses, regulates, and inspects thousands of health care facilities in the state to ensure public health and safety. The striking exception is second and third trimester abortion clinics. Abortion extremists pejoratively refer to any laws that regulate abortion clinics as TRAP laws. In their worldview the only motivation for such laws is to impede abortion access. They ignore the fact that second trimester abortions have a 10% complication rate and pose a 1.7% risk of life-threatening complications. While first trimester abortions are relatively safe procedures, the risk of dying from abortion increases by 38% for every additional week of gestation beyond 8 weeks. You would think we would have learned the danger of unregulated/uninspected abortion clinics from the Gosnell tragedy. Dr. Kermit Gosnell was responsible for the injury and death of countless women spanning decades because of the lack of governmental oversight at his Philadelphia abortion clinic. If Amendment 79 passes, legislators will be precluded from instituting prudent health/safety regulations for abortion clinics in Colorado. There would be nothing preventing a Gosnell-like horror in our state. Is it progressive to prioritize abortion access over the lives of women? A 22-week baby born prematurely enjoys all the rights and benefits of other Colorado citizens. Yet, a 22-week, pain-capable fetus in utero can be literally torn apart limb by limb during the D&E procedure favored by most abortionists in Colorado. Later in the second trimester and during the third trimester that fetus can be killed by poisoning before it is extracted during a D&X procedure. Digoxin is commonly utilized. Digoxin can cause hours of agonizing nausea, vomiting, and delirium before eliciting death. Is it progressive to define a human’s value and dignity based solely on their location or to sanction such excruciating deaths? Parental notification prior to a minor’s abortion is current law in Colorado. Guttmacher and other abortion advocacy organizations consider parental notification laws as impediments to abortion access. Amendment would eliminate this. The adolescent brain is still developing prefrontal connections that help modulate their subcortical emotional and impulsive responses to stressful situations, such as unplanned pregnancies. Without parental notification, our teen daughters may face these challenges with more input from their peers, teachers, or counselors than from the parents who love and know them best. And if parental notification is eliminated, sex traffickers will have an easier time eluding law enforcement as they coerce their young victims to have abortions. Is it progressive to remove parents from the most consequential decisions in their daughter’s lives or enable human traffickers? With Amendment 79 in the state constitution, abortions for any reason would be legal. Studies from the US and other countries document the extent that sex selection abortions occur, A Colorado late abortionist recently admitted that he has performed sex selection abortions. Is it progressive to allow abortion for blatantly sexist reasons? We know the answer. No, it is not progressive to promote unrestricted, unregulated abortion in Colorado. Abortion access is already ensured in Colorado. Amendment 79 is unnecessary, inhumane and potentially dangerous. Frances Rossi and Tom Perille MD - Founding members of Democrats for Life of Colorado

Abortion Overkill

October 22, 2024
This piece was originally published in the Colorado Springs and Denver Gazette Perspective Column September 22, 2024 by Tom Perille MD (DFLCO President) and Wendy Smith What would it mean if the only medical intervention that is recognized in the Colorado Constitution’s Bill of Rights was abortion? And what would it mean if abortion was the only medical intervention that couldn’t be constitutionally excluded in private and public health insurance? Not access to basic medical care. Not pregnancy care. Not life-saving cancer treatments. Not mental health treatment. Not care for those addicted. Not affordable pharmaceuticals. Only abortion. That is what those who are pushing Amendment 79 (“Right to Abortion”) hope to accomplish. Not only would abortion at any time in pregnancy for any reason using any method become a fundamental right, but anything that “impeded” or “discriminated” against access to abortion would be prohibited. The people of Colorado have a right to know the profound and dangerous implications of such a measure which won’t be reflected in the Blue Book language. In a poll conducted in July by the Strategy Group, 71% of Colorado voters were unaware that abortion is currently legal under all circumstances in our state. Abortion access is guaranteed in Colorado law. Amendment 79 would do nothing to change that reality. Coloradoans have the right to know that with the amendment in the constitution, the people of Colorado and those working for them in the legislature could do nothing to regulate or restrict abortion in the future– even if those changes represented the overwhelming consensus of Coloradoans and protected the health and safety of women. There were between 468-486 late abortions after the limit of fetal viability (21 weeks) reported to the CDPHE in 2022 and 2023. Guttmacher estimates that there were 71% more abortions in 2023 than CDPHE reported making 500 a conservative estimate of the total number of post-viability abortions each year in Colorado. These babies can “kick” their mother, respond to her voice/touch, acquire her taste preferences, and feel pain while in the uterus. They can survive if born prematurely. Babies born at 22-weeks and later can be found lovingly cared for in neonatal intensive care units and nurseries across the state. Based on research from Boulder abortionist, Dr. Warren Hern, 70% of his late abortions are performed on healthy women with healthy babies. That translates into an estimated 350 healthy babies aborted late in pregnancy each year in Colorado for financial and social reasons. Coloradoans have the right to know that Amendment 79 does nothing to address the real needs of these women and simply streamlines access to one, tragic and regrettable choice. With Amendment 79 in place, legislators would be unable to restrict even the most extreme abortions on healthy women with healthy babies in the third trimester. Colorado parents are currently notified at least 48 hours in advance of their minor teen’s pending abortion. The abortion industry, their research allies (Guttmacher), and aligned medical professional organizations (ACOG) all consider parental notification before a minor teen’s abortion to be an impediment to abortion access. Coloradoans have the right to know that banning parental notification would be one of the most immediate consequences of Amendment 79. In practical terms, this means that the people that know and love the teen the most may be unaware of their pending abortion and unable to support their daughter. Even worse, teens may be pressured by peers or an abortion clinic counselor to pursue an action that is inconsistent with their wishes and core values. Parents may be blindsided by the potentially severe physical and mental health consequences of their teen’s abortion. And sex traffickers would be able to hide their nefarious trade by pursuing abortions for their teenage victims without the safeguard of parental notification. Trafficking is a multi-million-dollar criminal enterprise in Colorado. Victims rarely self-identify. Anyone who works with domestic minor sex trafficking knows that the very definition of trafficking involves force, fraud and/or coercion. It is also well known that girls who are trafficked often view their trafficker as their “boyfriend”, lacking the maturity and discernment to know they are being trafficked and in danger. If they refuse to do what the trafficker wants, they are often subject to physical and mental abuse until they submit. There is a growing concern over forced abortion, especially with the availability of medication and telehealth abortions. These girls are not free to choose. Without the safeguard of parental notification, minors may be exposed to continued risk. Keep in mind, minors can be brought across state borders by anyone for abortion, just to be released back to the trafficker/perpetrator. For this reason, parents have a right to know when their daughter is considering abortion so that they can seek help and intervene. Most states have regulations that pertain to abortion clinics and promote the health and safety of women. Colorado is not one of them. The abortion industry pejoratively refers to any regulation that specifically applies to abortion providers as TRAP laws. They view them as impediments to abortion access. Even though thousands of medical facilities and agencies are licensed, regulated and inspected by the Colorado Department of Public Health and Environment, second and third trimester abortion clinics are the glaring exception. This omission is especially perplexing since second trimester abortions have a 10% overall complication rate and 1.7% life-threatening complication rate. The risk of having a complication increases for each additional week of gestation. Furthermore, the risk of dying from an abortion increases 38% for each week of gestation beyond 8 weeks. We should heed the lesson from other states that have tragically witnessed the maiming and death of women when government oversight is lax or non-existent – such as Pennsylvania and Dr. Gosnell. Coloradoans have a right to know that if Amendment 79 passes, the state will be unable to impose prudent health and safety regulations for abortion clinics which may jeopardize women’s health and lives. Another goal of Amendment 79 is to facilitate publicly funded abortions. Currently, Colorado Medicaid only pays for abortions in circumstances of rape, incest, and threats to the life of the mother. If Amendment 79 passes, the prohibition against public funding in the constitution will be removed and the state will be able to underwrite elective abortions for Medicaid patients. In states where public funding for abortion is already law, they spend millions of dollars subsidizing abortion for in-state and out-of-state women. Coloradoans have the right to know that this may take precious tax dollars away from other medical priorities like pregnancy services and mental health. It may even divert money from non-medical budgets for education, affordable housing, and the environment. There is already inadequate private and public support for pregnant women in our state. One of the few shining exceptions is the 58 pregnancy resource centers. They provide millions of dollars of uncompensated care to women during and after challenging pregnancies. However, because they typically don’t offer abortion services or refer for abortions, the abortion industry has been targeting these charitable organizations. Coloradoans have the right to know that the ability of pregnancy resource centers to assist pregnant women in need may be jeopardized by the passage of Amendment 79. Under Amendment 79, the right to abortion would become absolute. Coloradoans have the right to know the implications of such an extreme position. It would strip all rights and protections from the developing fetus, even those that are wanted. The legislature couldn’t proscribe abortion methods that are especially cruel such as second trimester D&E (dismemberment) abortions on pain capable fetuses. It would jeopardize the conscious rights of medical professionals across the state who maintain medical/scientific, moral or religious objections to elective induced abortions. Since the amendment forbids “discriminating” against a woman’s desire for an abortion, even physicians and nurse practitioners who perform abortions would be unable to refuse abortions for reasons they may view as morally repugnant – such as aborting a fetus solely because of their sex (which is already occurring) or because of the ethnicity/race of their father. Abortion access is already guaranteed in Colorado law. Making the right to abortion the only medical procedure recognized in our constitution is extreme and ties the hands of Colorado citizens and legislators. It goes far beyond the abortion rights promulgated in the Roe decision. Coloradoans have the right to know that Amendment 79 would have these many unintended consequences. Given the facts, we hope that Coloradoans reject Amendment 79.

Colorado Needs to rethink changes to Assisted Suicide Law

By Thomas Perille • March 1, 2024

Science is not immune from politics and ideology 

By Tom Perille • January 31, 2024
We should recognize ideological conflicts of interest in clinical research just as we recognize financial conflicts of interest in clinical research. It doesn't negate the studies, but tells us about potential biases and requires us to look more closely at the methodology and reporting.

Post Roe in Colorado - Initiative 89 and the right to unrestricted abortion  

By Tom Perille MD • January 23, 2024
Cobalt and other proabortion organizations are currently circulating petitions to have Initiative 89 appear on Colorado 2024 ballot. They have the money to pay circulators to get the necessary signatures so there is little doubt it will be on the ballot in November. The ballot initiative is deceptively drafted to make it appear that the primary issue is correcting an “unintended consequence” of Amendment 3. Colorado constitutional Amendment 3 narrowly passed in 1984. It prohibited the use of state public funds for induced abortions unless the life of the mother was in jeopardy. Initiative 89 backers are highlighting the lack of funding for state employees for abortions in cases of rape, incest, issues that “gravely endangers the patient’s health” or when there is a “fatal fetal condition”. They also point out the lack of an exception for state Medicaid funding for issues that “gravely endangers a patient’s health” or for a “fatal fetal condition”. What are they not saying? There already is an exception for the pregnant woman’s life which would encompass anything that “gravely endangers the patient’s health”. They are trying to blur the line between an exception for a condition that jeopardizes a woman’s life and any complication that requires treatment during pregnancy but does not threaten her life. Similarly, Medicaid already offers reimbursement for abortions related to rape or to save the mother’s life. It does not have an exception for the nebulously defined “health” of the mother, which can be treated in the normal course of obstetric practice, or for fetal conditions. A “fatal fetal condition” is a pejorative phrase with little resemblance to reality. For instance, Trisomy 18 is often referred to in this manner. The problem arises because the condition may be as much as 90% survivable if treated with standard interventions (employed on infants without Trisomy 18 diagnoses). It doesn’t mean that there aren’t life threatening fetal conditions or that some infants will have significant disabilities but describing these fetuses as “fatal” is a way to dehumanize them and justify the abortion decision. If they were really motivated to remove the barriers to the < 4% of abortions that occur for reasons of rape, incest, life of the mother, and life-limiting fetal conditions, why doesn’t Initiative 89 simply ask Coloradans add these exceptions to Amendment 3s language? The answer is clear. They want to evoke an emotional response which will override Coloradans’ qualms about unrestricted abortion. Their arguments gloss over the main purpose of Initiative 89 – to make abortion access a constitutional right without any gestational limits for any reason and to use public funding to subsidize it. They would like the public to be unaware of the fact that hundreds of healthy viable (>21 weeks) fetuses gestating in healthy women are currently aborted in Colorado. And that at least one late term abortionist (Warren Hern) has publicly acknowledged that he does abortions for absolutely any reason – including for sex selection. If the public had an inkling of the magnitude of the slaughter of prenatal humans purely for social and economic reasons, they would be appalled. There are so many other legislative initiatives that could be undertaken to provide support for pregnant women and their families so that they don’t feel compelled to consider abortion. Why don’t we focus our efforts on these life-affirming alternatives to the violence of abortion? DFLCO will be participating with Pro-Life Colorado, the state-wide umbrella organization uniting prolife groups, to defeat Initiative 89. DFLCO members should begin talking to their prochoice friends and writing letters to the editor of local media shedding light on the deceptive nature of Initiative 89 and the Trojan horse it represents for constitutionally protected unrestricted abortion. If your contacts don’t recoil at the reality that hundreds of healthy viable fetuses are being aborted for reasons as abhorrent as sex selection, then Colorado is in worse shape than any of us recognize. Initiative 89 should have no place in Colorado.
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