Cynthia's choice
ABORTION | Meet one of the first women ever to undo her medical abortion—and the doctor who made it possible
Nineteen years old and pregnant, Cynthia Galvan had an abortion pill in her mouth and turmoil in her soul. She was unmarried and felt unprepared for motherhood.
A medical abortion was the solution. The day before Galvan had ingested the first drug in the RU-486 regimen, mifepristone, intended to detach the embryo from the uterus. Now she was taking a misoprostol pill, which would cause her body to expel the baby.
Yet she doubted. Her mother was in tears over her decision, and a local pro-life doctor told Galvan over the phone he might be able to reverse the effects of the prior day’s pill.
A call to Planned Parenthood’s staff suggested the opposite: The baby was already dead, they assured her—or if not, it would be born with major birth defects. They warned that unless she took the second drug to expel the pregnancy now, she could experience severe pain.
Galvan spit the pill out, unsure who to believe.
At the time, the doctor she had spoken to, George Delgado, was one of the only people in the world who could have helped her. Delgado is the medical director of Culture of Life Family Services, a Catholic family healthcare clinic and crisis pregnancy center in San Diego. One of the world’s few doctors with experience reversing a medical abortion, Delgado uses injections of the pregnancy hormone progesterone as an antidote to the mifepristone abortion drug. Today he’s building a network of pro-life doctors willing to perform this novel abortion reversal technique for women who second-guess their decision to take RU-486.
When Delgado talked to Galvan over the phone, however, there was no network. Nor was there any established medical procedure for reversing an abortion pill, although some doctors had likely tried it. Delgado himself had never attempted the treatment, though he had been an advisor for a Texas patient who had asked for a reversal. It remained an experimental procedure, and he couldn’t guarantee success.
Galvan—if she was willing to try it—would be a test case. If the treatment worked, it would have major implications for other women in her shoes.
Delgado learned about Galvan’s crisis from a local priest. (Galvan’s Catholic mother, distraught over the abortion, had gone to confession that morning and unloaded her conscience to the priest, who knew Delgado and called him.) The doctor called the young woman and invited her to get an immediate ultrasound at his clinic, just 20 minutes away.
Galvan hesitated. Inside, she told herself the treatment wouldn’t work because her baby was already dead. “I felt like I didn’t have the option, because I had already taken the first pill,” she recalls.
With her mother begging and her boyfriend prodding, she reluctantly agreed to meet Delgado and his wife at the clinic. There, Delgado used an ultrasound to see if the baby was still alive. As he later admitted to me, he wasn’t sure what he would find—it had been as many as 40 hours since Galvan had taken mifepristone.
But what Galvan saw on the ultrasound screen was a flicker of light—the heartbeat of an 8-week-old baby in her womb. “I was just shocked and I couldn’t believe it. … I just expected the baby to not be alive.” Her boyfriend, Jyale Michel, saw it too, and his eyes glistened.
Galvan told the doctor yes. That day Delgado’s wife gave Galvan her first shot—a 200 milligram dose of progesterone, the pregnancy hormone.
Progesterone is naturally produced in a woman’s body, and levels are especially high during pregnancy to support the developing fetus. Delgado’s experience using progesterone grew out of his training in NaProTechnology (natural procreative technology), an approach to fertility treatment that conforms to Roman Catholic teaching. Promoted by the Pope Paul VI Institute in Omaha, Neb., NaProTechnology uses progesterone replacement injections to increase fertility and reduce miscarriage.
The progesterone injections became a regular routine for Galvan, along with ultrasounds to check the baby’s status. She drove to the clinic every other day for shots, and twice a week later on. Delgado’s theory was that by flooding Galvan’s body with progesterone, he could reverse any damage that might have occurred to her placenta.
The abortion drug Galvan had ingested, mifepristone, works by blocking natural progesterone. “When you don’t have the progesterone effect, the placenta and the embryo dies, and you have a medical abortion,” Delgado explains. In essence, mifepristone starves the baby of nutrition and oxygen.
The frequent injections were intended to overwhelm the abortion drug. If progesterone and mifepristone were soldiers in a battle, Delgado’s strategy was to win by superior numbers. Since the treatment had never been studied, his challenge was to figure out “how many soldiers I needed to recruit.”
In the end, he did: He gave Galvan progesterone shots until about 30 weeks into her pregnancy, and on Feb. 24, 2011, Christian Jacob Michel was born. At 6 pounds, 3 ounces, Christian was slightly premature, but had no complications except for jaundice, a common condition in preemies. Contrary to Planned Parenthood’s dire warnings, the baby had no birth defects. “The doctor told me he was born in a praying position,” with “his hands together,” Galvan says.
Last December, Delgado published the first case study and medical protocol for reversing the effects of the abortion pill in The Annals of Pharmacotherapy. The protocol gives doctors the first guidelines for reversing medical abortions, recommending the dosage and frequency of progesterone shots.
For the study, Delgado used information gleaned from Galvan’s treatment, along with patient data from five other NaProTechnology-trained doctors who also treated medical abortions with progesterone. Out of six patients (including Galvan), the doctors blocked four medical abortions, and the women went on to give birth to healthy, normal infants.
In two cases, the babies miscarried. Delgado isn’t sure why, but it’s possible the babies were already dead when treatment began: “The latest we’ve started with success has been 72 hours after taking mifepristone.”
Delgado isn’t aware of any readily available drugs that could reverse an RU-486 abortion once the second pill in the regimen is taken, which starts contractions. That means a woman who decides to have her abortion reversed must make up her mind promptly. (Delgado believes progesterone treatment might also block Ella, the “week-after” abortifacient pill, if started quickly enough.)
Christian’s story has a good ending, but many others don’t. Nearly 200,000 pregnancies in the United States less than nine weeks along ended in medical abortions in 2008, the last year for which data is available. Few women realize the RU-486 process can be reversed once begun.
Delgado hopes to change that. His clinic set up a website last September,AbortionPillReversal.com, with a hotline to give women information on the progesterone treatment and connect them to local doctors willing to give the shots.
Debbie Bradel, the nurse at Delgado’s clinic who answers the hotline, said between September and March more than 70 calls had come in through the website. Most callers are in their 20s and are sorry they took the abortion pill. But many tell her they’re worried about birth defects if they try to stop the abortion. Bradel informs them birth defects are possible but seem to be rare. Medical research indicates mifepristone, if it fails to end a baby’s life, carries a very low birth defect risk afterward.
If a caller wants to pursue abortion reversal, Bradel connects her with one of the four dozen doctors in her fast-growing network of physicians willing to give the progesterone shots. As of March Bradel had doctors in the network from 22 states, plus Nigeria and Australia. Of the women who had called and agreed to pursue abortion reversal, the doctors had saved at least 15 pregnancies. Bradel tries to follow up with all the hotline callers, but many don’t return her messages. “I just pray a lot. I can’t save the whole world.”
The world seems interested, though. “We’ve even had a call from a woman in Poland,” says Delgado.
Galvan is glad she’s among the saved ones. Even though Christian is “going through his terrible twos” right now, she can’t imagine life without him. Christian remembers names and is learning words in both Spanish and English. Galvan, now 22, and her boyfriend-turned-fiancé Michel (they plan to have a Catholic wedding this summer) have an apartment in San Diego, and both are going to school.
“It’s hard. You’re a teenager. Your friends are doing all these things and going out,” Galvan says of being a mom at 19. But she believes the responsibility of a child motivated her and her fiancé to grow up quickly: While her friends went to parties and drank alcohol, she and Michel thought about finding good jobs and supporting a family. Having Christian so young “hasn’t ruined our lives,” she says.
Galvan hopes other young women in crisis pregnancies will think of the joys their baby could one day bring: “It is a blessing … though you don’t see it at the moment.”
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