California's case against abortion pill reversal unravels during state expert’s testimony
The state's lead expert acknowledged key limitations in his testimony when attorneys challenged the research underpinning California's case.
California's case against abortion pill reversal (APR) came under intense scrutiny after cross-examination exposed flaws in the research and testimony from the state's lead expert, which included omitted findings, conflicting medical records, and admissions under oath that he could not say APR is unsafe or ineffective.
Dr. Mitchell Creinin, who has performed more than 5,000 abortions, served June 24 as the state's lead expert in People v. Heartbeat International & RealOptions. The lawsuit was filed by California Attorney General Rob Bonta and alleges the pro-life organizations Heartbeat International and RealOptions spread "false or misleading" information about APR, according to a July 7 article from the Thomas More Society (TMS).
Creinin's 2020 University of California, Davis study, which enrolled 12 participants before it was stopped early because of safety concerns, became a central focus of cross-examination. According to the Thomas More Society, hospital records presented at trial contradicted Creinin's characterization of one participant in the progesterone group as having experienced a "severe hemorrhage." The records showed she experienced minor bleeding, was never diagnosed with a hemorrhage, and required neither a transfusion nor surgical intervention. Only one participant in the study required a blood transfusion, and she had received the placebo rather than progesterone.
The TMS also said emails presented during trial showed Creinin's private characterization of the study differed from how he later described it in the published research. After researchers warned they could not produce a matching placebo, Creinin privately described the study as "pseudo-blinded." He nevertheless later published it as a double-blind study and defended that characterization during trial.
Cross-examination also identified Creinin's research history. According to the TMS, he acknowledged a 2002 federal warning letter citing deficiencies in his research practices, including failures related to informed consent, study procedures, and recordkeeping.
Unpublished peer-review responses presented during trial showed Creinin privately estimated that only about 8% of pregnancies continue after mifepristone alone but chose not to include that figure in the published study. The TMS said the estimate conflicted with Creinin's argument that pregnancies continuing after APR were simply the result of mifepristone failing rather than progesterone reversing the effects of the first abortion pill.
Creinin also testified he never reviewed Heartbeat International's deidentified dataset of approximately 8,800 APR cases, despite it being provided to the attorney general during the litigation.
At the close of cross-examination, Creinin replied, "No" when asked whether he could say APR does not work, adding that progesterone is not known to cause birth defects and agreeing there is no evidence the drug causes birth defects, according to the TMS. Asked whether he could say APR is unsafe, he answered, "Qualified, no.”
