Defending
second chances.
Defending
second chances.
EVERYTHING YOU NEED TO KNOW
Two state attorneys general are seeking to prevent women from learning about Abortion Pill Reversal, a safe protocol that may counteract the effects of an ongoing chemical abortion and has helped thousands of mothers save their babies after regretting a chemical abortion. California wants more than $20 million in penalties against Heartbeat International and RealOptions—simply for sharing information women voluntarily seek when they change their minds. Thomas More Society is defending Heartbeat and pregnancy centers across the country against these attacks on free speech and women's right to informed choice.
— THE SCIENCE
What is Abortion Pill Reversal?
A chemical abortion typically uses two drugs taken in sequence. The first—mifepristone—blocks progesterone, the hormone that sustains a pregnancy. The second—misoprostol, taken 24 to 48 hours later—causes the body to expel the unborn child.
Abortion Pill Reversal (APR) is the emergency administration of supplemental progesterone after a woman has taken mifepristone but before she takes misoprostol. The progesterone the protocol relies on is a long-established, FDA-approved hormone that physicians have safely prescribed for decades to prevent miscarriage and preterm birth.
1,400+
24/7
Providers, clinics, and hospitals in the Abortion Pill Rescue® Network
Helpline connects women to APR providers (1-877-558-0333)
More than two-thirds of all U.S. abortions are now chemical abortions. For women who change their minds shortly after taking the first pill, APR is often their only option. No woman should ever be forced to complete an abortion she no longer wants.
This baby survived the abortion pill after her mom began Abortion Pill Reversal.
— THE CASES
Two states. Same playbook.
Both California and New York have filed lawsuits seeking to silence Heartbeat International and its network of pregnancy help organizations from telling women that Abortion Pill Reversal exists. The cases differ in procedural posture but raise the same constitutional question: can a state attorney general punish truthful, scientifically backed, and life-affirming speech because he or she disagrees with its viewpoint?
ACTIVE · SUPERIOR COURT OF THE STATE OF CALIFORNIA, COUNTY OF ALAMEDA
The People of the State of California v. Heartbeat International & RealOptions
FILED
September 21, 2023
OPPOSING
COUNSEL
California Attorney General Rob Bonta for the People of the State of California
CLIENTS
Heartbeat International; RealOptions Obria Medical Clinics
DEFENSE
COUNSEL
Thomas More Society
California's attorney general accuses Heartbeat International and RealOptions of "false or misleading statements" for sharing information about APR through the Abortion Pill Rescue® Network. The state seeks a permanent injunction to bar them from telling women that progesterone may counteract the first abortion pill—even though women who received this care have testified under penalty of perjury about their experiences and gratitude for the Abortion Pill Reversal protocol.
ACTIVE · SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF NEW YORK
Letitia James v. Heartbeat International, CompassCare, et al.
FILED
April 30, 2024
OPPOSING
COUNSEL
New York Attorney General Letitia James for the People of the State of New York
CLIENTS
Heartbeat International and a coalition of 12 pregnancy centers
DEFENSE
COUNSEL
Thomas More Society
Like California, New York targets Heartbeat International and pregnancy centers for sharing information about APR—alleging the same "false advertising" theory to punish pro-life speech. After AG James gave a dozen ministries just five business days to defend themselves, Thomas More Society filed a preemptive lawsuit challenging the threatened prosecution as a violation of the First and Fourteenth Amendments, the New York Constitution, and state civil rights law. James then filed her own suit days later; the two actions have since been consolidated and the combined case is now pending before the state trial court.
Federal First Amendment Challenges
Thomas More Society also filed offensive federal lawsuits on behalf of pregnancy help ministries, arguing that the state enforcement actions against Heartbeat International violate the free speech rights of other organizations not party to the direct litigation.
AWAITING DECISION · U.S. COURT OF APPEALS FOR THE NINTH CIRCUIT
Culture of Life Family Services v. Bonta
Federal First Amendment challenge in California, arguing that the AG’s enforcement action against Heartbeat International violates the speech rights of other pregnancy help organizations across the state.
PRELIMINARY VICTORY · AFFIRMED AT U.S. COURT OF APPEALS FOR THE SECOND CIRCUIT
Summit Life Outreach Center & The Evergreen Association v. Letitia James
Federal First Amendment challenge in New York. The district court preliminarily ruled in favor of the pregnancy centers, and that preliminary victory was affirmed by the U.S. Court of Appeals for the Second Circuit. The case remains ongoing.
— CALIFORNIA DEEP DIVE
Inside People v. Heartbeat International & RealOptions
California's attorney general is seeking $20 million in penalties against two nonprofit organizations—for helping women save their babies from a dangerous chemical abortion regimen that the state wants them to complete against their will. Not a single woman has ever complained about the care she received. Here's what's at stake, what the state claims, and how we're fighting back.
COURT
Alameda County Superior Court
TRIAL START DATE
June 24, 2026
PENALTIES SOUGHT
$20.5 Million
PATIENTS HARMED
Zero
THE ARGUMENTS GOING TO TRIAL
THE AG CLAIMS
THE TRUTH
THE AG CLAIMS
APR claims are false advertising
The AG alleges defendants' statements about APR violate the False Advertising Law and Unfair Competition Law—requiring no proof of actual harm, intent, or even that anyone was deceived. Under his theory, criticism of the underlying studies is enough.
THE TRUTH
The AG can't prove falsity—because the science supports APR
California law requires the prosecutor to affirmatively prove statements are false. The AG has offered no study showing APR is unsafe or ineffective—only criticisms of defendants' evidence. Multiple peer-reviewed studies, FDA reviews, and professional medical associations (including AAPLOG's 8,000+ members) support APR. Criticizing the other side's research is not the same as proving your own case.
THE AG CLAIMS
This is commercial speech subject to consumer fraud law
The AG argues defendants' speech meets the commercial speech test because their communications are advertisements designed to attract patients and generate revenue for their organizations.
THE TRUTH
A free service by nonprofits is not "commerce"
Heartbeat and RealOptions are nonprofit religious charities. APR is provided completely free of charge. No one is sold anything. No patient pays Heartbeat or RealOptions for APR information or provision. The speech is driven by religious mission, not economic motive—making it protected public-interest speech, not regulable commercial advertising. The U.S. Court of Appeals for the Second Circuit confirmed in NIFLA v. James (2025) that such speech is not commercial.
THE AG CLAIMS
The science behind APR is unproven
The AG's position is that nothing short of a randomized controlled trial counts as evidence of causation—rejecting the mainstream scientific view that case series and other study designs are legitimate evidence. His argument ignores the ethical problem with giving a placebo to a woman who wants to save her unborn child, and wrongly treats anything that cannot definitively prove a causal link as though it tells us nothing at all.
THE TRUTH
The government can't pick winners in a live scientific debate
The U.S. Supreme Court held in Chiles v. Salazar (2026) that government cannot suppress medical speech based on "medical consensus" because consensus evolves and licensed professionals have good-faith disagreements. APR is supported by peer-reviewed studies, standard biochemistry, decades of clinical experience, and the real stories of women who saved their babies. Critics demand a randomized control trial, but there is no ethical way to conduct one—it would require deceiving a woman who wants to save her baby by giving her a placebo instead of treatment. This is a legitimate professional disagreement, not settled science versus fringe claims.
THE AG CLAIMS
$20 million in penalties is justified
The AG counts violations on a per-victim, per-communication basis—every website visit, every consent form, every provider training kit. His math: 3,972 violations for Heartbeat at $5,000 each ($19.86M) and 128 violations for RealOptions ($640K).
THE TRUTH
$20 million to bankrupt charities that helped women for free
The AG's own discovery responses admit he has no evidence of any complaints from APR patients. Not one. No monetary gain. No one harmed. A free service. California courts have imposed penalties as low as $0.10 per violation in analogous cases. The gap between ten cents and five thousand dollars per violation tells its own story about the AG's real motivations. These penalties would force local nonprofits serving their communities into bankruptcy. Moreover, the AG inflates his number by double and triple counting, ignoring the statute of limitations, and ignoring the reach of the state's False Advertising Law.
THE AG CLAIMS
This is consumer protection, not viewpoint discrimination
The AG argues his enforcement action targets false advertising, not protected speech, and allegedly treats pro-life speech fairly.
THE TRUTH
Post-Dobbs retaliation targeting faith-based speech
The AG issued post-Dobbs press releases targeting "crisis pregnancy centers," then launched his Reproductive Rights Task Force, which expressly targeted Heartbeat's APR information. This lawsuit followed. Meanwhile, Planned Parenthood falsely claims abortion pills are "safer than Tylenol" and sells them for profit—the AG does nothing. As the Supreme Court held in NRA v. Vullo, government officials cannot use state power to punish disfavored expression.
THE AG CLAIMS
This case protects women's health
The AG frames the enforcement action as protecting vulnerable women from misinformation about an unproven medical treatment, suggesting defendants put women at risk by giving them false hope.
THE TRUTH
The AG is denying women information they seek out and have a right to receive
California's own Reproductive Privacy Act protects "personal reproductive decisions" about "all matters relating to pregnancy"—including the right to continue a pregnancy. If the AG silences APR information, women who have taken mifepristone but changed their minds lose access to information about a legal medical option. The only people the AG can find are happy mothers with healthy babies. This case doesn't protect women—it takes away their choices.
Key Court Filings
The bench trial before Judge Patrick McKinney begins June 24, 2026. We'll post real-time updates, key filings, and analysis. Bookmark this page.
— LATEST NEWS
Updates
— REAL WORLD TESTIMONIES
Real mothers. Real second chances.
These women filed declarations under penalty of perjury in People v. Heartbeat International & RealOptions. Read their full testimonies to understand what's at stake.
01 / Court-Filed Declaration
Elizabeth Barrett
CALIFORNIA
I was lucky and feel I'm living in a fairy tale: tragedy and fear transforming in one moment into joy and bright horizons for the future.
Elizabeth took the first abortion pill at Planned Parenthood under scheduling pressure, then received a text from her boyfriend saying he wanted to keep the baby. Desperate, she and her boyfriend searched online and found information about abortion pill reversal. A doctor from a nearby clinic called her back within fifteen minutes and saw her right away. Her daughter was born healthy in January 2024.
02 / Court-Filed Declaration
Erika Carrillo
SAN MATEO, CALIFORNIA · APR ~9 years ago
I am eternally grateful to RealOptions for the gift of my son's life and for aiding me when I thought all was lost after I had buckled under intense pressure from others to kill my child.
A few years out of high school and feeling intense external pressure to abort, Erika took the first pill—and almost immediately regretted it. She found a website, called the number, and was connected to a RealOptions clinic that saw her the same day. Her son will soon turn nine.
03 / Court-Filed Declaration
Cynthia Michel
SAN DIEGO, CALIFORNIA · APR ~15 years ago
I am now the proud mother of three children, including the son I almost aborted.
At 19 with an unplanned pregnancy, Cynthia took mifepristone at a non-Planned Parenthood facility that wouldn't let her see her ultrasound. After expressing regret to her mother, a priest connected her with Culture of Life Family Services, which led to Dr. George Delgado. The next day, an ultrasound showed a fetal heartbeat. Her son is now 14 years old.
04 / Court-Filed Declaration
Uyen Pham
CALIFORNIA
I was overjoyed when I learned that there was an opportunity to potentially save my unborn child.
In July 2024, Uyen took mifepristone and almost immediately regretted her decision. A close friend stayed up all night researching options and gave her a phone number to call. That call connected her with Heartbeat International, which referred her to RealOptions. A nurse at RealOptions administered progesterone that same day, and her son was born healthy with no complications.
Every day we answer the phone for women who are regretting their decision of taking that first pill of the chemical abortion, looking for an answer… We know our information is good. We know that lives have been saved.
—JOR-EL GODSEY, PRESIDENT OF HEARTBEAT INTERNATIONAL
No woman should ever be forced to complete an abortion she no longer wants. Thomas More Society stands in defense of Heartbeat International's critical work on the frontlines of saving mothers and their unborn children on the cusp of abortion.
— CASE TIMELINE
Two cases, one fight for free speech.
Jun 24, 2026
Trial begins in People v. Heartbeat & RealOptions
Bench trial opens before Judge Patrick McKinney in Alameda County Superior Court.
Apr 15, 2026
New York court hears arguments to end case
Court hears TMS argument on anti-SLAPP motion to dismiss NY AG James' lawsuit. Read More →
May 6, 2024
New York AG files lawsuit to silence pro-life speech
NY AG Letitia James follows through on threats and files suit to censor speech about Abortion Pill Reversal, copying the legal theory from California. Read More →
Apr 30, 2024
Preemptive lawsuit filed to block NY AG
TMS files a verified complaint against James in New York on behalf of Heartbeat International, CompassCare, and a coalition of pregnancy centers. Read More →
Apr 22, 2024
NY AG threatens ministries over pro-life speech
Letitia James' office sends "Notice of Intention to Sue" letters to Heartbeat International and a dozen pregnancy help organizations, giving them five business days to respond.
Feb 6, 2024
California court asked to throw out suit targeting APR speech
TMS files hundreds of pages of argument and evidence asking the court to throw out case against Heartbeat International and RealOptions. Read More →
Oct 24, 2023
Thomas More Society joins the defense
TMS steps in to defend Heartbeat International and RealOptions against the California AG's lawsuit. Read More →
Sep 21, 2023
California AG files lawsuit
Attorney General Rob Bonta sues Heartbeat International and RealOptions Obria Medical Clinics, targeting their promotion of Abortion Pill Reversal.
SPREAD THE WORD
The state wants to keep women in the dark. Don't let the truth be silenced.
Share this page so more people understand what's at stake in California—and why it matters for women everywhere.
— LEGAL DOCUMENTS
Key Documents—People v. Heartbeat Int'l & RealOptions
COURT FILINGS
— FOR PREGNANCY CENTERS
Take proactive steps before the attacks come.
Pro-life pregnancy centers across the country are under fire as the abortion industry and its allies in government seek to discredit, silence, and even shutter the doors of these charitable ministries. While there is no way to avoid attacks completely, there is plenty your center can do to prudently prepare.
Our guide walks through six legal considerations every pro-life pregnancy center should address—from language and licensure to conscience protections and recordkeeping.
— FREE LEGAL HELP
Threatened, sued, or unsure where to start?
Thomas More Society provides free legal advice and representation to pregnancy centers facing constitutional or regulatory threats. If your rights have been violated—or you suspect they soon will be—reach out.
or call 312.782.1680
Help us defend second chances.
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