Doctors issue sharp warning as Louisiana reclassifies abortion pills

Two common abortion pills have been classified as “controlled substances” in Louisiana as of Tuesday, under a first-of-its-kind law that medical professionals warn will endanger women’s lives by reducing the medication used for limit cancer treatment. postpartum hemorrhage and other conditions.

Louisiana, which already bans abortion, passed a law reclassifying mifepristone and misoprostol as schedule IV drugs — a designation typically reserved for drugs that carry a risk of abuse or dependence. People caught with the drugs without a valid prescription can face up to five years in prison, although pregnant women who purchase the drugs for their own use are exempt from punishment under the law.

Although the drugs are typically used in medication abortions in the US, they are also regularly used in a range of other conditions, such as to help treat miscarriages, to treat ulcers and to soften the cervix during childbirth and other procedures.

Normally, at the Louisiana hospital where gynecologist Dr. Nicole Freehill works, misoprostol is stored in so-called bleeding carts, which can be easily wheeled to the rooms where patients deliver babies and carry medications normally used to treat bleeding, including misoprostol. It takes about 15 seconds to pull the misoprostol from the cart, Freehill said.

Now, due to safety requirements for schedule IV medications, the hospital must keep misoprostol in stock outside of patient rooms. When the hospital conducted an exercise to see how long it took nurses to get the misoprostol under the new rules, it took nurses two minutes, Freehill said.

“A lot of people might say, ‘Oh, two minutes, that’s really fast.’ And yes, in the longer term that is fast. But if you have someone who is actively bleeding, they can lose hundreds of cc of blood in two minutes,” Freehill said. “So those seconds count. I definitely worry about what’s going to happen to patients who bleed.”

Compared to other wealthy countries, the United States already has a much higher maternal mortality rate, especially among black Americans.

Before the law was passed, more than 200 doctors wrote a letter to the state legislature behind the law, asking that it be reconsidered. “Controlled substances require more complex coordination by pharmacists, patients and healthcare providers, with more documentation and often longer wait times for patients,” they wrote. “Overall, this results in fear and confusion among patients, physicians and pharmacists, which delays care and worsens outcomes.”

In the two years since the U.S. Supreme Court overturned Roe v Wade, more than a dozen states, including Louisiana, have banned nearly all abortions. However, the number of abortions performed in American clinics increased, as did the number of self-induced abortions using pills. (Self-managed abortions are generally safe and effective in the first trimester of pregnancy.) In response, anti-abortion activists have sought to limit access to abortion pills, which are used in two-thirds of all U.S. abortions.

However, there is no medical reason to reclassify mifepristone and misoprostol as schedule IV drugs, Freehill said.

“I may be on this medication five out of seven days of the week, and obviously not for abortion care,” Freehill said. “I don’t see how this will help my patients be safer.”