After years of back-and-forth on whether or not it was acceptable to teach experimental, unauthorized medical theories like “abortion pill reversal,” the California Board of Nursing recently amended the guidelines for their continuing education courses that could – and should – prevent  courses on the unproven, unethical  “abortion pill reversal” regimen. [1] Registered nurses in most states, including California, are required to complete continuing education courses every two to three years to maintain their licensure. These courses are supposed to keep nurses updated on new policies and procedures from evidence-based research. [2] While the California Board of Nursing must approve course providers, course content and instructors are left to the provider’s discretion. Continuing education course content must be related to “scientific knowledge and/or technical skills required for the practice of nursing,” or through relation to “direct and/or indirect patient/client care.” [3] Many states allow credit for courses taken in other states so long as they are approved by another board of nursing, meaning that continuing education courses offered by the California Board of Nursing could be taken and transferred as credits by nurses in other states, and because California’s system is much larger than other states, the decisions made by California’s Board of Nursing has a reverberating impact on smaller states and those with less medical infrastructure.

The anti-abortion fake clinic network Heartbeat International is – despite their track record of deceptive, wrong, and harmful health care messaging – a California Board of Nursing-approved continuing education provider. Courses hosted by Heartbeat International staff, including a course titled “Abortion Pill Reversal and Your Clinic” are eligible for continuing education credit. [4]  Although continuing education credits are intended to enhance nurses’ knowledge of new and updated medical information, “abortion pill reversal” is an experimental procedure without the approval of The American College of Obstetricians and Gynecologists or the Federal Drug Administration. Created by Heartbeat International board member Dr. George Delgado,  “abortion pill reversal” alleges that it’s possible to “reverse” a medication abortion through off-label use of medications used in other pregnancy circumstances. Medication abortion in a clinical setting consists of taking two drugs: first, mifepristone, which stops the pregnancy from growing by blocking the hormone progesterone, and second, misoprostol, which causes cramping and bleeding to empty the uterus, similar to inducing a miscarriage. The theory of “abortion pill reversal” claims that individuals who have already taken mifepristone can “reverse” the abortion by loading the body with high levels of progesterone and abstaining from taking the second medication that completes the abortion. Although several states require medication abortion patients to receive counseling on abortion pill reversal, the regimen is an unproven, unscientific theory and has no place in state-sponsored nursing courses.

After years of changing their minds on the validity of Heartbeat International’s “abortion pill reversal” course, the California Board of Nursing recently amended the types of appropriate continuing education content, which was not targeted to Heartbeat’s courses or even abortion care, but a broader, more comprehensive look at the validity of teaching untested protocols to nurses for credit towards licensensing. [5] Under this change, course content relating to experimental medical procedures or treatments (which “abortion pill reversal” certainly falls under) would not be relevant to the practice of nursing unless “1) the underlying treatment’s efficacy is supported by at least two peer-reviewed publicly available scientific journal or studies, published in medical and scientific literature; and 2) the procedure or treatment is generally accepted as effective by the medical community,” which abortion pill reversal is not. [1]

By removing courses on “abortion pill reversal” from state-backed nursing boards, we can stop the spread of the unscientific, unproven, and unethically-imposed theory of “abortion pill reversal” from reaching health care providers who are supposed to provide unbiased, factual information to patients under their care.  Eight states currently require that patients receive biased, medically inaccurate ‘counseling’ that a medication abortion can be stopped after the first dose of mifepristone. [6] This compels speech from providers that is against their best medical opinion and often against the best interests of their patients, who they are charged with caring for. The California Board of Nursing’s recent decision to exclude courses on experimental procedures that are not generally accepted as effective is a step in the right direction toward stopping anti-abortion medical providers from injecting judgmental, stigmatizing ideology into matters of health care.

Annie is supported by Collective Power for Reproductive Justice.

Sources:

1. https://www.rn.ca.gov/pdfs/regulations/isor-ce.pdf
2.  https://nurse.org/resources/continuing-education/
3.  https://www.rn.ca.gov/licensees/lic-renewal.shtml
4. https://rewirenewsgroup.com/wp-content/uploads/2016/01/2015ConferenceBrochureFinal.pdf
5. https://www.rn.ca.gov/pdfs/regulations/modtext-ce.pdf
6. https://www.guttmacher.org/state-policy/explore/counseling-and-waiting-periods-abortion