Louisiana Hospitals Preemptively Pull Life-Saving Medication Ahead of New Anti-Abortion Law

In 2019, Louisiana’s Health Department ranked the state 47th out of 48 states on maternal mortality for Black women. Despite this, in May, Louisiana became the first state in the country to criminalize mifepristone and misoprostol, a wildly dangerous decision that is reportedly already threatening new mother’s lives. 

Taken together, the two pills are the most common drugs used for medication abortion, which is what led GOP lawmakers in the state to ban and classify them as “controlled dangerous substances.” Separately, the medications are used in a range of medical situations, from miscarriage to IUD insertion. The World Health Organization recognizes misoprostol as an essential medication, particularly to stop life-threatening postpartum hemorrhaging, which is a leading cause of maternal mortality. But, according to journalist Lorena O’Neil, hospitals are preemptively removing the drug from birthing carts out of caution, confusion, and a lack of guidance from the state, ahead of the law taking effect on October 1, 

Reporting for the Louisiana Illuminator, O’Neil spoke with doctors who said they were aware hospitals started removing the medication from carts when Louisiana Gov. Jeff Landry (R) signed the bill in May. These carts typically hold easily accessible, life-saving medications like misoprostol so doctors are prepared to act immediately if someone starts to hemorrhage. But Louisiana’s soon-to-be law would require doctors to obtain it from a pharmacy since it’ll be classified as a “controlled substance,” and, consequently, severely limit their ability to save lives.

One doctor told the outlet they’ve worked at rural hospitals where “trying to get a simple headache medication released” has “taken 45 minutes,” with doctors forced to call pharmacies because their hospital doesn’t have its own pharmacy. “In these [hemorrhage] situations, you don’t have 45 minutes,” the doctor told O’Neil. At least one doctor working at a rural hospital in the state wasn’t even aware that the law was about to take effect until informed by the Illuminator, as the state of Louisiana has yet to issue guidance on how hospitals are now expected to save hemorrhaging postpartum women’s lives. “What? That’s terrifying,” this doctor said when told of the law. “Take it off the carts? That’s death. That’s a matter of life or death.”

Doctors acknowledged that there are alternate medications for postpartum hemorrhage, but hypertensive patients aren’t able to safely use one of the primary alternatives. Patients suffering from hypertension are at greater risk of maternal morbidity and mortality.

Specifically, the law will add medication abortion 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—meaning 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.

Misoprostol is on the World Health Organization’s list of essential medications. It is highly effective at both treating and preventing postpartum hemorrhage—the second most common cause of maternal death after mental health crises https://t.co/9YsxD7Icbw

— Garnet Henderson (@garnethenderson) September 3, 2024

The classification comes as demand for medication abortion has surged across the country post-Roe, prompting a rise in baseless, right-wing narratives equating medication abortion with fentanyl and other deadly narcotics. However, all available data shows that abortion pills are highly safe and rarely result in complications. 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—to the disproportionate detriment of Black women. It further “builds on the blueprint for broader abortion and pregnancy-related criminalization that we’ve been seeing for some time,” Sussman said.

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 consent. In addition to classifying misoprostol and mifepristone as controlled substances, it prohibits anyone from knowingly using abortion medications to cause or attempt to cause an abortion without a pregnant person’s consent, on threat of up to 10 years in prison (or up to 20 years if the pregnant person was three months or more into a pregnancy.) But drugging someone without their consent is already a criminal offense—all this new law does is further endanger women and pregnant people. In May, 250 Louisiana doctors wrote a letter to Pressley urging him to reconsider how his bill treats medication abortion. “Given its historically poor maternal health outcomes, Louisiana should prioritize safe and evidence-based care for pregnant women,” they wrote. 

Just weeks out from the law taking effect, hospitals are left scrambling to figure out how they’ll offer timely, life-saving care to pregnant people without immediate access to misoprostol. As one doctor told the Illuminator, “We’re trying to fix something that is not broken and that is absolutely safe.”