(California Family Council) California Attorney General Rob Bonta spent six weeks in an Oakland courtroom this summer trying to prove that pro-life pregnancy centers mislead women about abortion pill reversal. Abortion pill reversal gives a mother who regrets taking the first abortion pill a chance to save her baby. The trial heard 25 witnesses and nearly 200 exhibits, yet the state never identified a single woman harmed by the treatment, according to defense attorneys with Thomas More Society. Under oath, his own lead expert could not swear that reversal does not work. Alameda County Superior Court Judge Patrick McKinney is expected to rule by mid-December.
The case, People v. Heartbeat International, targets Heartbeat International, an Ohio-based pregnancy center network, and RealOptions, which runs four pregnancy clinics in the San Francisco Bay Area. As California Family Council reported in June, Bonta originally sought $19.86 million from Heartbeat International and $640,000 from RealOptions, plus a court order barring both from speaking about the treatment. After trial, the state expanded its count of alleged violations, and Bonta is now seeking more than $25 million in penalties. The trial opened June 24, and closing arguments wrapped up Sept. 17.
What Abortion Pill Reversal Is
A chemical abortion, often called the abortion pill, uses two drugs. The first, mifepristone, blocks progesterone, the natural hormone a baby needs to stay attached to the mother and fed in the womb. The second, misoprostol, is taken a day or two later and causes contractions that push the baby out.
Abortion pill reversal works in the window between the two pills. If a mother changes her mind after taking mifepristone, a doctor can prescribe extra progesterone to outcompete the drug and help the pregnancy continue. Doctors have used progesterone for more than 50 years to help prevent miscarriage.
Dr. Maralee Bowers, a Northwestern-trained family physician and medical director at Care Net of Paradise in Northern California, has provided reversal to her own patients. “Progesterone is like the glue that keeps the placenta attached,” she told California Family Council. Mifepristone takes that glue away. “The mifepristone is just cutting the baby off from the placenta,” she said.
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What Bonta alleged
When Bonta filed the case in 2023, he accused the two groups of “predatory and unlawful behavior” and said they “took advantage of pregnant patients at a deeply vulnerable time in their lives.” His complaint claims “there is no evidence showing that mifepristone can be ‘reversed’ or that the APR ‘protocol’ contributes to the continuation of a pregnancy.”
The complaint goes further. It accuses the centers of using “emotionally vulnerable individuals who come to them in the midst of a gut-wrenching life choice as subjects in experiments.” It alleges that “APR can cause severe, life-threatening bleeding” and that women are not warned. At trial, Deputy Attorney General Erica Connolly told the court that pregnancy centers “tout false hope.”
Tasha Keirns, a registered nurse and chief executive officer of RealOptions Obria Medical Clinics, has given progesterone to the very women Bonta says he is protecting. While serving as the clinics’ director of nursing, she also spent a year and a half as a nurse on Heartbeat International’s 24-hour reversal hotline, answering calls from women in 29 countries.
“To allege that thousands of committed medical professionals, who stand beside women facing real-life crises, are engaged in deception or false hope is a baseless and ironic inversion of the abortion movement’s own narrative,” Keirns told California Family Council.
She described giving progesterone “to mothers praying for God to save their children” and watching their relief “while performing ultrasounds that confirm a strong heartbeat.”
The women who testified
Bonta’s complaint casts these mothers as victims, but on the witness stand, they told a different story.
Former RealOptions patients Erika Carrillo and Uyen Pham testified about their abortion decision, their regret, and the children alive today because of reversal, Keirns said. Their testimony “transformed these abstract statistics into undeniable living proof of restored families,” she said. Mothers who used reversal said they never felt “harmed, deceived or misled,” defense attorney Paul Jonna told CalMatters.
The state looked hard for a different kind of witness and came up empty. Keirns said the attorney general’s office even set up an online portal to collect complaints. It still “failed to produce even a single woman harmed by abortion pill reversal throughout over three years of litigation,” she said. “Instead, the record reveals only thriving mothers and healthy children born as a result of supplemental progesterone therapy.”
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Keirns said the women who call are not subjects in an experiment. They are mothers trying to undo a decision made under pressure. “I have never sat across from a woman considering abortion that genuinely desired to terminate the life of their child,” she said. “Rather, women have expressed feeling as if they were trapped by impossible circumstances, believing they had no other reasonable option.”
After the first pill, Keirns said, that pressure gives way to something else. “APR patients commonly describe an immediate wave of panic, dread, and profound regret, accompanied by an overwhelming, innate God-given urgency to stop the process and protect their child,” she said.
Too often, the abortion provider will not help. “They are met with callous abandonment,” Keirns said. Some are “threatened with fictitious dangers of birth defects or death, or coldly advised to undergo ‘expectant management,’” which means doing nothing and waiting.
Bowers said none of her own reversal patients have ever reported harm. “I’ve never had anybody complain or have some kind of bad experience because of APR,” she said. Even the mothers who lost their babies were grateful they tried. “They seem to feel really, really good about the fact that they tried.”
The State’s own expert
The attorney general’s lead expert was Dr. Mitchell Creinin, who ran the only randomized trial of reversal at the University of California, Davis. Keirns called him “the abortionist and researcher relied upon by California to discredit abortion pill reversal.” On cross-examination, Jonna asked Creinin whether he could swear under oath that reversal does not work. “No,” Creinin answered, according to Thomas More Society. Asked whether he could swear it is unsafe, he said, “Qualified, no.”
“Notably, even the State’s own expert medical witnesses admitted under oath that progesterone therapy poses no harm to mother or child,” Keirns said. Creinin’s own study consent form told women that mifepristone and progesterone “are not known to cause birth defects,” Thomas More Society reported.
Creinin’s trial is also the basis for Bonta’s bleeding claim. Researchers stopped it early in 2019 after three women had severe bleeding. But only one of the three had received progesterone. The other two had taken the abortion pill and a placebo. Both needed emergency surgery, and one needed a blood transfusion. The progesterone patient’s hospital chart listed her complaint as “vaginal bleeding minor,” the defense showed at trial.
“The bleeding would be from the mifepristone,” Bowers said. “The progesterone is going to help prevent bleeding.”
The safety record presented at trial
The real-world numbers point in the same direction. Heartbeat International gave the state data on about 8,800 reversal cases during the lawsuit. Out of those cases, only three women needed blood transfusions, 11 were admitted to a hospital and 88 went to an emergency room, according to the Thomas More Society. That is about 1 in 100 cases needing an emergency room visit and about 1 in 3,000 needing a transfusion. Asked at trial whether that data shows reversal is safe, Creinin answered, “If the data was true, yes.”
RealOptions’ own clinical data show a 72% ongoing pregnancy rate after progesterone treatment, Keirns said, with 49 children born since 2016, including three sets of twins. The largest published study of reversal, released in 2018 by Dr. George Delgado, the San Diego physician who developed the protocol, found babies survived 64% of the time with progesterone shots and 68% of the time with high-dose progesterone pills.
Bonta’s office says the centers need a randomized trial before calling reversal reliable. Bowers said that would mean giving half the women who call a fake pill. “You give 50 of them progesterone and 50 of them sham treatment,” she said. “That would be unethical.”
Keirns said the evidence leaves the state with nothing. “This complete absence of evidence resoundingly shatters the State’s unfounded and abhorrent allegations and unequivocally validates the safety and efficacy of APR,” she said.
What is at stake
Keirns says the prosecution’s failure to meet its burden of proof “exposes this litigation for what it truly is: a baseless lawfare campaign driven by a radically opposing ideology as a targeted attack devoid of any factual merit.”
Bonta’s lawyers said repeatedly at trial that they were not trying to stop clinics from giving the treatment, Keirns said. She called that a distinction without a difference. By “silencing the pro-life pregnancy help movement and blocking all public awareness efforts, the State effectively ensures that women remain entirely unaware of APR providers,” she said.
The penalties carry their own threat. Keirns warned they could bankrupt Heartbeat International and shut down its hotline, “extinguishing the only global lifeline and abandoning mothers around the world in their most desperate hour.”
“At RealOptions we firmly believe that no woman should be forced to complete an abortion that she no longer consents to,” she said. “The true casualties of this lawsuit are women in crisis who are being systematically stripped of accurate information, medical autonomy, and their freedom to choose life.”
Bowers said the lawsuit sends a brutal message to the families reversal has saved. “It says you shouldn’t have been born. You shouldn’t have had a chance,” she said. “They so much push that a woman has the right to choose what happens to her body, and yet they’re taking away this choice.”
“No one tells a dying man that a rescue attempt is false hope,” said Greg Burt, vice president of California Family Council. “Rob Bonta spent three years hunting for a victim and never found one. What he found instead were mothers holding the children abortion reversal pills saved. This lawsuit was never about protecting women. It is about an attorney general so hostile to pregnancy centers that he is willing to slander the nurses and doctors who give mothers a second chance. We pray Judge McKinney sees through these false accusations and delivers a just ruling for these ministries, for the women they serve, and for the children who are alive today because someone offered their mothers hope.”
McKinney will rule by mid-December. Until then, Bowers asked believers to pray “for conversion of hearts of all those involved that they see the truth.”
For any mother who has taken the first pill and wants to stop, Keirns had a message. “If your original abortion provider turns you away or attempts to discourage you, compassionate, expert medical assistance is available around the clock through the Abortion Pill Rescue Network Hotline at 1-877-558-0333,” she said. “The Hotline nurses are ready to talk, answer any questions you may have about APR, and connect you to a provider in your area if you choose to pursue treatment.”
Editor's note: This article was published by California Family Council and is reprinted with permission. Heartbeat International manages the Abortion Pill Rescue® Network (APRN) and Pregnancy Help News. Heartbeat is currently the subject of two lawsuits brought by state attorneys general concerning sharing information about Abortion Pill Reversal.
