Reproductive health experts like Monica McLemore, a professor at the University of Washington nursing school, theorize that women like Medina could give birth not because of the administration of progesterone but because they did not take the latter abortion pill.

McLemore said that Delgado's movement is full of "ethical lapses," which include exaggerating the possibility of abortion regret — a rate that research has found is very low. The use of large doses of progesterone remains "untested and unstandardized," she said, and existing data are "weak" and lack routine scientific standards such as randomization and control groups.

"Abortion reversal is a misnomer. It is impossible to reverse a procedure," McLemore said in a video promoted by UC San Francisco, where she used to teach. "This intervention is not known to be safe or efficacious."

In Supreme Court records, though, Delgado described women in need of his help. He said abortion pill reversal has been "emotionally taxing" work for him.

"I see women who have a great deal of regret from undergoing the chemical abortion drug regimen," Delgado said in a declaration submitted to the court. "They are distressed, sad, and feel terrible about what they have done."

In his efforts to convince the court he had legal standing, Delgado also said that abortions are bad for his business.

"When my patients have chemical abortions, there is a tangible financial loss to my practice in losing the opportunity to render professional prenatal care for the mother or to care for babies who are never born," Delgado said in the declaration.

Medication abortion is the most common way to terminate a pregnancy, and the FDA declared it safe and effective more than 20 years ago. Five million women in the U.S. have used the medication since then, and major adverse events occur in less than 0.32% of patients, according to a study touted by major medical groups including the American College of Obstetricians and Gynecologists.

Still, Delgado has called abortion pill access as it stands, available by mail order with a prescription from a medical provider, "the Wild, Wild West" and warned that a patient "could die in the bathroom of her own home."

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In 2018, Delgado's career catapulted to new heights when he handed over his grassroots network promoting abortion pill reversal to Heartbeat International — a Christian-based organization that oversees thousands of crisis pregnancy centers dedicated to preventing abortion.

The organization now operates a 24/7 "abortion pill rescue" hot line that connects patients to providers willing to administer progesterone in attempts to keep a pregnancy going. Heartbeat International claims that more than 5,000 babies have been born because of abortion pill reversal, and that they receive 150 calls about it a month from women who took the first pill and then changed their minds.

Delgado, who serves as a medical advisor for Heartbeat International, has helped the organization provide women "with a second chance to choose life," spokesperson Melissa Hawkins said.

California's Democratic leaders view the clinics differently: as spreaders of "lies and misinformation," California Attorney General Rob Bonta said at a news conference last year where he announced a lawsuit against Heartbeat International and a San Francisco Bay Area chain of crisis pregnancy centers, alleging false advertisement of abortion pill reversal.

But crisis pregnancy centers that offer abortion pill reversal have so far evaded attempts at regulation despite the controversy.

Bills in the California Capitol last year that aimed to hold the centers accountable for false or misleading statements stalled before they made it to the governor's desk. That failure, in a state that favors maintaining legal access to abortion, indicates how difficult regulating abortion pill reversal may prove to be, as proponents pursue 1st Amendment arguments for religious freedom.

"We think our case is going to be successful," Bonta told The Times this month. "People in vulnerable positions when it comes to healthcare deserve the truth."

Hawkins said that California and New York — where the attorney general has filed a similar lawsuit — are "attempting to silence" their mission and are thus forcing abortions.

"Women deserve the right to make informed choices, and denying them access to this truth is unjustifiable," she said.

Delgado's recent Supreme Court case is just one chapter in his years-long mission to change abortion laws. He has testified before state legislatures and in courtrooms about abortion pill reversal, and launched a nonprofit dedicated to expanding his research and changing "public opinion and policy" on the issue.

And his use of his medical degree to promote his beliefs has been questioned. During the height of the pandemic, he worked to help a San Diego church sue Gov. Gavin Newsom over a ban on in-person gatherings amid concerns about the spread of COVID-19.

The church lost its case with the 9th Circuit Court of Appeals, which upheld a lower court ruling that gave Delgado's research "minimal weight" and dismissed it as "likely inadmissible" because of his lack of experience in public health or epidemiology. The Supreme Court ultimately ruled in favor of the church.

As abortion-rights advocates remain concerned about the future despite the Supreme Court decision on mifepristone, Delgado has shown no signs of stopping. In the past year, he has increasingly focused on the political, riling up conservative voters to be as engaged as abortion-rights activists post-Roe.

"We need to be as shrewd as them — as sly as wolves — so we can defeat them on the political battlefield," Delgado told the Catholic Diocese of Lincoln, Neb., at an event this year.

California isn't the only state that has tried to counter Delgado's mission. Colorado became the first state to attempt to ban abortion pill reversal, with Gov. Jared Polis, a Democrat, signing a law last year to discipline doctors who perform it.

A federal judge later ruled that the law probably violates the U.S. Constitution's guarantee of religious freedom. Abortion pill reversal remains legal there.

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