Postpartum Care in Louisiana Threatened After State Officially Criminalizes Abortion Pills

A new law in Louisiana criminalizing medication abortion—and, consequently, rendering the life-saving medication for postpartum hemorrhage much more difficult for doctors to access in the state’s hospitals—took effect on Tuesday. 

The law, which Gov. Jeff Landry (R) signed in May, adds the most common medication abortion pills (mifepristone and misoprostol) to the state’s controlled dangerous substances list as a Schedule IV drug—even though a substance must be addictive to be classified as such. Anyone in possession of the drug without a prescription could face prison time. The law offers a supposed exception for pregnant people who are imminently about to use the pills to terminate a pregnancy, but Pregnancy Justice warned Jezebel in May that it’s unclear how law enforcement would determine this.

But abortion pills are used in a range of medical situations, from treating miscarriages to aiding IUD insertions. The World Health Organization classifies misoprostol as an essential medication to stop life-threatening postpartum hemorrhaging, which is a leading cause of maternal mortality. "This is not about medicine. This is not about science. This is not about safety. Attempts by states like Louisiana... are intended to punish and control those seeking reproductive health care services," Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health, told Jezebel. "Access to medications used in abortion care, like mifepristone and misoprostol, should be expanded, not restricted."

Now, Louisiana hospitals will no longer be able to carry the medication on birthing carts to ensure that patients can receive it as quickly as possible. Instead, at least one major Louisiana hospital system—Ochsner Health—specified last week that all health care providers will need to detail why they’re prescribing or seeking misoprostol and, in cases of emergency, they’ll have to follow an override system to allow misoprostol to be released from the locked cabinet.

Dr. Jennifer Avegno, an emergency physician and director of the New Orleans Health Department, told CNN on Tuesday that fellow health providers in her state have been doing drills to practice obtaining misoprostol from locked cabinets in emergencies. “It adds several minutes to that process,” she said. “If you’ve ever watched someone bleed out after childbirth, as I have, you know that minutes can make a difference.” She told NBC News that “in the setting of a life-threatening hemorrhage, minutes are really important.” 

“We already have a maternal health crisis in Louisiana, as we do in the rest of America," Avegno said. "This will not make it better."

Kaitlyn Joshua, a Louisiana resident who was denied an emergency abortion for her miscarriage in 2022, told NBC the law “literally keeps me up at night.” In remarks given at the Democratic National Convention in August, Joshua recounted, “I was in pain, bleeding so much my husband feared for my life. No woman should experience what I endured. But too many have.” She continued, “They write to me, saying, ‘What happened to you happened to me.’ Sometimes they’re miscarrying, scared to tell anyone, even their doctors.”

Today, a Louisiana law goes into effect that classifies abortion pills as controlled substances.

While it doesn't make it a crime for a pregnant person to have for their own use, cops and prosecutors misinterpret laws to target abortion seekers and those who support them. pic.twitter.com/ITIpyVY213

— If/When/How: Lawyering for Reproductive Justice (@ifwhenhow) October 1, 2024

To Joshua’s point, Tamika Thomas-Magee, a nurse and the director of clinical services at Planned Parenthood Gulf Coast, told NBC the new Louisiana law is a “scare tactic” to dissuade health care providers from ever prescribing or offering the pills. Under this law, a state program called the Prescription Drug Monitoring Program will track the medications patients receive. “Every time one of our physicians writes a misoprostol prescription, that’s going to be documented,” Avegno told CNN, adding that “there is a real fear” among OBGYNs that they could be suspected of “secretly doing abortions” for prescribing or providing the medications.

It can’t be emphasized enough that patients experiencing a wide range of medical situations and needs will all be harmed by this law. Dr. Honor MacNaughton, a family physician in Massachusetts, told CNN the law could especially harm individuals experiencing miscarriage, who often take the pills to “put the process behind them as soon as possible”—otherwise, a miscarriage “can take days or sometimes even weeks” to end.

And, again, the law simply doesn’t make sense: Medication abortion pills aren’t addictive. Dr. Smita Prasad, president of the Louisiana Society of Addiction Medicine and an assistant professor at Tulane, described the law as a “[misuse of] the schedule system,” and said it “really deflects from a real problem that we have in the United States: other substances like fentanyl and synthetic fentanyl, that are killing people.”

This law is part of a rising, baseless right-wing narrative equating medication abortion with fentanyl and other deadly narcotics. All available data shows that abortion pills are highly safe. In May, Dana Sussman, senior vice president of Pregnancy Justice, told Jezebel that with “no medical or scientific justification whatsoever,” the Louisiana bill relies on the same racist framework of the War on Drugs, and further “builds on the blueprint for broader abortion and pregnancy-related criminalization that we’ve been seeing for some time."

Louisiana state Sen. Thomas Pressly (R) introduced this bill in February on behalf of his sister, whose husband added abortion pills to her drink without her knowledge. But drugging someone without their consent is already a criminal offense, meaning all this new law does is endanger women and pregnant people. Nevertheless, last month, Landry wrote off doctors’ warnings about this law as a mere “kerfuffle,” and said it’s “absolutely not true” that Louisiana’s abortion laws bar people from being able to get essential care. Great to see the governor taking his state’s well-documented maternal health crisis seriously!