How American NGO, Heartbeat International, engages Nigerian health workers to ‘reverse’ abortion for ‘repentant’ women

Unethical practices bordering on criminal medical oddity goes on underground in Nigeria as local healthcare providers work with American NGO to help women ‘reverse’ an abortion already in progress. ANGELA ONWUZOO reports

Investigations into the activities of an American nongovernmental organisation, Heartbeat International, show that the Christian right anti-abortion outfit is secretly propagating the use of Abortion Pill Reversal in Nigeria by connecting willing women to local health workers who prescribe progesterone for them to reverse a medical abortion that is already in progress.

According to the Heartbeat International and its Nigerian medical foot soldiers, a pregnant woman can reverse the course of an abortion with high intake of progesterone.

The way it works is this: A pregnant woman who intends to abort her pregnancy within the first three monthswill first ingest mifepristone, and she is expected to complete the process usually between 24 and 48 hours later with a second medication called misoprostol. This is technically referred to as medical abortion and it must be strictly done under the supervision of a competent physician.

Abortion is illegal in Nigeria except if it becomes imperative for the safety of the mother or for medical reasons as may be advised by a competent physician.

Experts warn that once a pregnant woman takes mifepristone, the abortion will begin and that it is irreversible.

Gynaecologists who spoke with PUNCH HealthWise agree that if a pregnant woman decides not to take the second tablet [misoprostol], there is a risk of harm to the foetus if she continues the pregnancy.

A woman whose blood type is rhesus negative and is between nine to 12 weeks pregnant will need an anti-D injection in hospital, physicians explain further.

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Heartbeat International pooh-poohed the professional insights, though; insisting that by taking Abortion Pill Reversal [APR] — a.k.a progesterone — within 12 hours after the ingestion of the first abortion pill [mifepristone], the pregnancy will continue and the woman will carry it to term.

Rooted in controversy

Heartbeat International’s belief and activities are rooted in a controversial study done by an equally controversial personality named Dr. George Delgado, a family physician based in California.

Between 2012 and 2018, Delgado had published a series of studies on APR and had also carried out a trial on its effectiveness and safety, but the research was halted in 2019 after a quarter of study participants were hospitalised with severe haemorrhaging.

Delgadodoubles as medical adviser for Heartbeat International.

America’s largest association of women’s doctors, the American College of Obstetricians and Gynecologists, has denounced his work as “unproven and unethical.”Again, an article in the New England Journal of Medicine described his work as an “unmonitored research experiment.”

Worse still, the University of California San Diego, where Delgado worked at the department of family medicine as a voluntary clinical associate professor from 2005 till June 2011, has dissociated itself from the physician’s activities. Indeed, UCSD has told Delgado to stop using its name.

Heartbeat International’s hotline from America to Africa, Europe, South America and North America

Findings by our correspondent show that Heartbeat International runs an online hotline from the U.S. across continents. From America to African countries that include Nigeria, Uganda and South Africa; to Europe, South America and North America, Heartbeat International maintains foot soldiers in the health sector that help it to achieve its global ambition of halting ongoing abortions, despite the obvious dangers the under-the-radar interventions pose to the health of pregnant women who patronise its services.

Heartbeat International connects pregnant women willing to reverse ongoing abortions to local health workers who serve as abortion reversal providers by prescribing and administering progesterone injectionson them.

In Lagos, Nigeria, a man who introduced himself as Dr. Isaac Okonkwo to our undercover abortion reversal seeker, serves as Heartbeat International’s linkman.He claims to have offered the treatment to more than four women and had helped them to stop ongoing abortions that they had commenced. The women allegedly contacted himwhen theydecided to keep their pregnancies after they had taken mifepristone.

Health practitioners have described the claim as misleading, warning that it lacks scientific evidence.

No evidence that progesterone stops ongoing abortion —Physicians

In general, progesterone has many uses, including as a treatment for irregular vaginal bleeding and as part of hormone replacement therapy during menopause.

Taking progesterone by mouth and applying progesterone gel into the vagina are effective strategies for treating absence of menstrual periods in premenopausal women.

Experts also say that adding progesterone to hormone replacement therapy protects against side effects of estrogen; and that applying progesterone intravaginally and injecting it into the muscle may have similar effectiveness for increasing pregnancy rates as giving it by mouth.

Physicians who spoke with PUNCH HealthWise say there is no evidence to support Delgado’s claim that progesteronecan reverse abortion that is already in motion.

More worrisome is that the progesterone injection sold in Nigeria has no NAFDAC registration number. Dr. Isaac Okonkwo led our undercover abortion reversal seeker to theChris Health Pharmacy Limited, near Cement Bus Stop, Onilekere, Lagos, where progesterone injections were bought.

When our correspondent drew the attention of NAFDAC to the unregistered prescription drug, the federal agency refused to respond over one week on.

As of the time of filing this report, Resident Media & Communication Consultant to NAFDAC, Mr. Sayo Akintola,had yet to respond to a message sent to him by our correspondent requesting the agency’s response to the unregistered progesterone being sold in Nigeria, even after acknowledging the receipt of the reporter’s message via WhatsApp.

This is even as the owner of Chris Health Pharmacy Limited, one pharmacist Chris, says pharmacies in Nigeria are known to sell drugs that have no NAFDAC registration number. This is contrary to the warning by NAFDAC Director-General, Prof. Moji Adeyeye, that Nigerians must not use drugs that do not bear the agency’s stamp.

Pharmacist Chris said that though his outlet issued a receipt for the progesterone that was delivered directly by the pharmacist right across the counter of the Chris Health Pharmacy Limited, the drug was brought in from another outlet.

Speaking to our reporter on the phone, Chris said, “What actually happened was that we don’t have the progesterone injection in our pharmacy. Was it Dr. Okonkwo that got it for you? Because he called me and I don’t have it. So, I had to go and help him to get it from someone. It was my sales girl that I sent to get it. So, I did not even see it.”

On the lack of NAFDAC registration number on the drug, Chrissaid, “But there are some drugs that we sell that are not NAFDAC approved. There are some drugs from US, United Kingdom that we sell that are not approved by NAFDAC. So, it is not every drug that is approved by NAFDAC. But I doubt if a drug can reverse abortion already in progress.”

Also speaking on the efficacy of progesterone to reverse an abortion that is already in progress, an ex National Secretary of the Pharmaceutical Society of Nigeria, Emeka Duru, explains that no drug is allowed to be sold in Nigeria without having NAFDAC approval, warning that trying to reverse medical abortion already in motion with another drug will certainly have dangerous health effects on the woman.

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