Claims & Truths

Scientific evidence does exist. The real dispute is over how that evidence should be evaluated.

Published studies, clinical data, biological research, and comparisons with pregnancies exposed to mifepristone alone support the conclusion that progesterone can increase the likelihood of pregnancy continuation.

The Attorney General’s experts criticized the limitations of the available studies, but scientific limitations are not proof that APR is ineffective. The Attorney General also acknowledged that observational evidence can be used in medicine, and his experts could not definitively testify that APR does not work.

The State also identified no woman harmed by APR and no patient complaint alleging that the treatment failed because Heartbeat’s communications were false or misleading.

The State has conflated “not conclusively proven” with “proven false,” without identifying a woman who was harmed.

The trial did not establish that progesterone causes serious bleeding or other significant complications. Progesterone has been used in pregnancy care for decades.

Most importantly, the State identified no woman who was harmed by Abortion Pill Reversal. It presented no patient complaint against APR, Heartbeat International, RealOptions, or a pregnancy help organization related to the challenged communications.

One of the Attorney General’s principal expert witnesses and a leading critic of APR, Dr. Mitchell Creinin, could not testify under oath that APR is unsafe or ineffective.

When directly questioned at trial, Dr. Creinin acknowledged that he could not say APR does not work or that it is unsafe. His position was ultimately: “We just don’t know.”

The State bears the burden of proving Heartbeat’s statements false or misleading. Its own expert’s inability to conclude that APR is ineffective or unsafe, combined with the absence of an identified harmed woman or consumer complaint, undercuts the Attorney General’s repeated claims.

The State produced no harmed woman, no consumer complaint, and no expert who could testify that APR is unsafe or ineffective.

The American College of Obstetricians and Gynecologists publicly criticizes APR, but testimony from ACOG representative Dr. Christopher Zahn revealed the limits of that position.

Dr. Zahn acknowledged that ACOG is not aware of any good-quality or even fair-quality evidence establishing that APR does not work. He also testified that ACOG has not formally evaluated APR’s efficacy or safety through its established clinical-guidance process.

Instead, ACOG’s guidance on APR was provided by its government relations team and is not a graded clinical recommendation.

ACOG may criticize the quality of evidence supporting APR, but its public position is not evidence proving APR ineffective.

Heartbeat and RealOptions provide women with safety information and emergency-care instructions, including information drawn directly from the FDA-approved mifepristone warning label.

Women are informed that bleeding, cramping, and miscarriage symptoms may occur after taking mifepristone. RealOptions’ materials specifically instruct women experiencing heavy bleeding, faintness, severe abdominal pain, or fever to seek immediate medical attention.

The State argues that these warnings should be presented differently and should attribute bleeding more directly to the APR process. But no evidence established that progesterone itself causes hemorrhage.

The State also identified no woman harmed by APR and no patient complaint alleging that Heartbeat or RealOptions concealed a medical risk.

Heartbeat provides information to help women make informed decisions.

The 64–68% range comes directly from a published, peer-reviewed study of specific progesterone protocols. It was not invented by Heartbeat.

The study reported pregnancy-continuation rates of 64% for one protocol and 68% for another. Heartbeat recommends the high-dose oral protocol associated with the higher reported rate and identifies the figures as results from initial studies.

California focuses instead on the study’s combined rate across all protocols, but the medical and public health fields generally prioritize communicating the most effective option clearly rather than presenting a full menu of success rates for every alternative.

Heartbeat’s success-rate statements came from published, peer-reviewed research.

“Abortion Pill Reversal” describes what women are seeking: an opportunity to counteract the effects of mifepristone and attempt to continue their pregnancies.

Women frequently use words such as “reverse” when searching online for urgent help after taking the first abortion drug. This language enables them to find time-sensitive information and connect with medical professionals. “Reverse” accurately describes the mechanics of competitive antagonism.

Prohibiting the term would not merely regulate a label. It could make assistance harder to find during the narrow window when a woman is searching for another choice.

No woman came forward to complain that the term deceived her or caused her harm.

Using the words women actually search helps them find time-sensitive care.

Heartbeat offers women information, compassionate support, and access to medical professionals. We do not promise that APR will work for every woman, and no medical intervention can guarantee a particular outcome.

Women who contact the Abortion Pill Rescue Network are not passively responding to advertising. They are actively and urgently searching for help because they have changed their minds and want to know whether continuing their pregnancies may still be possible.

Their vulnerability is not a reason to withhold information. It is a reason to respond quickly, honestly, and compassionately.

California portrays these women primarily as vulnerable consumers. We recognize them as women exercising their right to seek help continuing their pregnancies. We offer that help to them for free.

The State identified no woman who complained that APRN offered her false hope and no woman who was harmed by receiving this information.

Regret is a powerful motivator. Hope is not deception, and no woman should be denied information because she is frightened or has changed her mind.

A recent federal ruling protecting Mayday Health’s abortion-pill advertising undermines that claim.

Mayday is a nonprofit that provides free information and links women to third-party abortion-pill vendors. Although it solicits donations and sells merchandise, a federal court concluded that its advertisements were not commercial speech and temporarily blocked South Dakota from restricting them. Read the July 17, 2026 order.

Heartbeat likewise does not sell medication, charge women for information, or receive referral fees. Yet California argues that our communications become commercial because we fundraise and connect women with APR providers.

The ruling was preliminary and involved a different law, but its reasoning exposes a troubling double standard: Free information about obtaining illegal abortion pills is treated as protected speech, while free information about continuing a pregnancy with a legal medication is treated as commercial advertising.

Free information about continuing a pregnancy deserves the same constitutional protection as free information about ending one.

California is asking the court to penalize Heartbeat for its speech and restrict what we may say about APR. That necessarily raises serious First Amendment concerns.

The State has aggressively investigated and prosecuted pro-life organizations while failing to apply comparable scrutiny to abortion providers and APR opponents.

The trial record included evidence that women contacted APRN after abortion providers told them there was no hope, withheld information about APR, or made categorical claims that were not supported by the evidence.

The government may investigate actual deception. It may not select one side of an unsettled medical and moral debate and declare that only the favored side may speak, particularly when it has identified no harmed woman or consumer complaint.

The State seeks to restrict one viewpoint despite identifying no harmed woman and no consumer complaint prompting its intervention.

The following documented actions preceded Attorney General Bonta’s lawsuit:

• Following the Dobbs decision, Bonta created the California Reproductive Rights Task Force in October 2022 to protect and expand abortion access.
• Meeting minutes show task force participants discussing possible false-advertising lawsuits against pregnancy centers and specifically raising Abortion Pill Reversal as a potential target.
• Another participant noted there was no evidence at that time that pregnancy centers were violating California’s False Advertising Law.
• Bonta’s office issued investigative subpoenas and interrogatories to Heartbeat International and RealOptions concerning their HIPAA and privacy practices. That investigation did not identify wrongdoing related to those practices.
• Nine months after the task force discussion, Bonta filed the lawsuit against Heartbeat and RealOptions over their APR communications.
• Throughout his tenure, Bonta has publicly advocated for abortion access, defended California’s abortion laws, opposed abortion restrictions in other states, and promoted California as a safe haven for abortion providers and those seeking abortions.

The lawsuit was not prompted by a complaint from a woman who received APR information or treatment. The State ultimately identified no woman harmed by APR or by the challenged communications.

These actions and the documented timeline form part of the record surrounding the Attorney General’s decision to bring this case and call into question whether the action was viewpoint discriminatory.

This lawsuit did not begin with a harmed woman or consumer complaint; it followed a government effort to find a case against pro-life pregnancy help.

Attorney General Bonta publicly launched the California Reproductive Rights Task Force on October 25, 2022, four months after Dobbs, describing its mission as protecting and expanding abortion access across California.

But evidence presented in this case showed the task force was also used to brainstorm legal action against pro-life pregnancy centers.

Meeting records included proposals to pursue pregnancy centers for false advertising and specifically target Abortion Pill Reversal, even though one participant acknowledged there was no evidence that pregnancy centers were violating California’s False Advertising Law.

No complaint from a woman harmed by APR was identified. Nevertheless, the task force became part of the process used to search for a case against organizations whose viewpoint and mission are centered on offering women alternatives to abortion.

The task force discussed targeting pregnancy centers even though no consumer complaint or evidence of false advertising had been identified.

Reproductive freedom must include a woman’s right to continue her pregnancy.

California law recognizes the right to choose to bear a child and protects those who assist women in exercising pregnancy-related decisions. Yet the Attorney General seeks to restrict the very network that helps women who regret beginning a chemical abortion and want to continue their pregnancies.

The State identified no woman harmed by receiving APR information and no woman who complained that the network prevented her from exercising a free choice.

Reproductive freedom must include a woman’s freedom to change her mind and seek help continuing her pregnancy.

The Attorney General is seeking maximum cumulative penalties by counting a woman’s website visit, hotline conversation, and consent form as separate violations under two different statutes.

The State’s post-trial calculations allege at least 5,131 violations of each statute by Heartbeat. At the maximum statutory rate, this theory could expose Heartbeat to more than $25 million in penalties, even though:

• Heartbeat provided its services completely for free.
• The State identified no woman harmed by APR.
• The State presented no consumer complaint against APR, Heartbeat International, RealOptions, or a pregnancy help organization related to the challenged communications.
• The State did not establish that progesterone caused physical harm.
• The State did not identify financial losses suffered by women.
• The challenged statements were grounded in published research and clinical evidence.
• Heartbeat disclosed that treatment could not guarantee pregnancy continuation.

Such a penalty would not simply “correct” particular language. It could cripple Heartbeat International and jeopardize the 24/7 network women rely upon for immediate help.

California seeks more than $25 million in penalties without identifying a harmed woman, a financial loss, or a consumer complaint.

The immediate intended impact of the ruling would be for the organizations and communications at issue in this case. But the legal questions raised by the case could have implications well beyond Heartbeat or Abortion Pill Reversal and potentially even far beyond California.

California is asking the court to treat Heartbeat’s free, nonprofit communications about APR as advertising that can be punished under laws designed to prevent false or misleading business practices. Heartbeat does not sell progesterone used for APR, nor do we charge women for the information, or receive referral fees from the medical professionals who provide care. The State nevertheless argues that these communications fall within its consumer-protection laws because Heartbeat engages in fundraising to support these services it offers women for free.

If the court accepts that approach, it could provide a legal framework that other state governments may seek to use against nonprofit organizations whose mission-driven communications they disagree with, labeling them false or misleading and leveraging consumer protection statutes to silence the disfavored speech. Future cases would still depend on their own facts, laws, and constitutional questions, but that is why the implications of this case could extend beyond the abortion context.

For Heartbeat, the question is bigger than APR: How much power should the government have to restrict the speech of a nonprofit organization when it disagrees with what that organization is telling the public?