Louisiana has already experienced problems with criminalizing medication abortion
Since the Supreme Court’s Dobbs V. Jackson Women’s Health Organization decision, abortions, including medication-abortion, are completely prohibited in Louisiana, except in very limited circumstances. But anti-abortion lawmakers took things one step further: On October 1, Louisiana became the first state in the country to classify mifepristone and misoprostol, the two drugs used in medication abortion, as “controlled, dangerous substances.” Possession without a prescription is a crime punishable by steep fines and up to ten years in prison.
However, both drugs are not only used for abortion care. Health-care providers use mifepristone and misoprostol to treat a variety of other reproductive and nonreproductive conditions, including for intrauterine device insertion and postpartum hemorrhage, an emergency condition where any delays in treatment are dangerous and potentially life-threatening.
Dr. Anitra Beasley, medical director at Planned Parenthood Gulf Coast–which operates in Louisiana and Texas–explained that unlike mifepristone and misoprostol, most medicines that are classified as “controlled, dangerous” substances have the potential to be abused.
“Classifying these drugs in the same category as opioids means that hospitals, health care facilities and doctors’ offices will now have to figure out new protocols for securing
or whether or not they can even have [them] drugs in their offices,” Beasley said. “We know these medications are safe and there is absolutely no reason to restrict their use, and any extra stipulations that you put on them will only make getting them and using them harder.”[these]Although it’s only been in effect for a little over two months, the new law is already causing problems for providers and patients alike.
“Even in the first few weeks what we’ve seen, particularly on the out-patient side, are delays and/or significant confusion about obtaining misoprostol for medically needed legal procedures,” said Dr. Jennifer Avegno, an emergency medicine doctor and director of the New Orleans Health Department who is overseeing an investigation into the impact of the new law.
Avegno added that this confusion has included pharmacies telling patients that they no longer carry misoprostol, or checking with their doctor to ensure that they’re not being used for an abortion even when they have a prescription showing it’s for another condition.
“On our in-patient side, I know that our physicians and in-patient pharmacists had to work really hard to develop new protocols that allow for misoprostol to be somewhat close at hand
, but still there have been delays,” Avegno said. This is happening in an urbanized area with all the resources available. There is concern over what’s happening in facilities without the same resources and awareness as ours. The suit also challenges the process by which the law was passed–added at the last minute as an amendment to another bill, without any public hearing, NBC News reported. The suit also challenges the process by which the law was passed–tacked on at the last minute as an amendment to another bill, without any public hearing, NBC News reported.[for emergency use]Louisiana has one of the country’s highest maternal mortality rates, and advocates and health-care providers are concerned that the new law will only worsen the situation.
“It’s a crisis, but doesn’t make us unique among states that have banned abortion,” Lift Louisiana Executive Director Michelle Erenberg said. We have seen the impact of Louisiana’s nearly total abortion ban. Any additional laws that restrict access to treat pregnancy complications like miscarriages or postpartum hemorrhage will further exacerbate the maternal health crisis already in our state. Chasity Wilson, executive director of the Louisiana Abortion Fund, said misinformation affects the level of conversation they are able to have with their clients.
“Having to add in the layer of education on top of all our other work is such an unfortunate part of our jobs and creates such a huge burden,” Wilson said. “We just wish that people who are voted in to protect us actually had our best interest.”
Beasley said that since medication abortion was already illegal in the state, there was no need for the law.
“By placing it in the same category as medication with abuse potential absolutely makes it seem dangerous when it’s not,” Beasley said. People already have trouble accessing health care. Health-care providers and certified nurse midwives who used to be able to prescribe and dispense misoprostol will now need a controlled substance license, which is tracked by law enforcement. Health-care providers and certified nurse midwives who used to be able to prescribe and dispense misoprostol, will now need a controlled substance license, which is tracked by law enforcement.
This could prove onerous for providers working in private practices or small, community-based hospitals or clinics.
“If they don’t have a giant team of lawyers, they may just decide not to use this medication at all rather than risk being surveilled or investigated,” Erenberg said.
Although there have yet to be reports of anyone dying as a direct result of the law, “I hope I don’t hear about a tragic consequence of someone bleeding out because of it,” Avegno said.
Advocates are also concerned about copycat legislation in other states and are already preparing toolkits and talking points for providers and organizers to fight similar legislation. Dr. Daniel Grossman of the University of California at San Francisco Advancing New Standards in Reproductive Health Research Program said he expects to see a “range of assaults” on medication-abortion, even in states that have a near-total prohibition. They may be scared to order the pills, and instead resort to other dangerous methods.
