Louisiana moves to criminalize mifepristone, misoprostol

An amendment to the Engrossed Senate Bill No. 276 by Senator Thomas Pressly was proposed by the House Committee on Administration of Criminal Justice in Louisiana, criminalizing the two FDA-approved pills for medication abortions: mifepristone and misoprostol. If approved, the amended bill would make the position of these two medications without a prescription a felony. Those possessing the pills without a valid prescription may be imprisoned for up to five years and fined up to $5,000.

The original Senate bill was written to criminalize and prevent anyone from distributing or administering abortion medications to a patient without their consent. CNN reports that Pressly, the bill’s sponsor, says he proposed the bill after his sister was given misoprostol against her will. However, this amendment to the initially proposed bill goes far beyond protecting patients.

More specifically, the amendment classifies these drugs as controlled dangerous substances, like other drugs with a high potential for abuse, such as narcotics and steroids. According to reporting in CNN, the amendment plans to classify mifepristone and misoprostol as schedule IV drugs.

Medication abortions account for roughly two-thirds of all abortions in the US. The FDA has approved a two-medication regimen for medication abortions in pregnant patients within the first 70 days of gestation. One 200 mg dose of mifepristone is taken orally, followed by an 800 mcg dose of misoprostol within 24–48 hours. Patients are also advised to follow up with a healthcare professional after taking the medications.

According to the Guttmacher Institute, Louisiana’s abortion policies are among the most restrictive of policies across the United States. The state has banned abortions with minimal exceptions, and its constitution “explicitly excludes abortion rights.”

The Washington Post notes that the only abortions approved in Louisiana are for “medically futile” pregnancies or in cases where pregnancy threatens a patient’s life. The state’s lawmakers have declined to add exceptions to the abortion ban for patients under 17 whose pregnancies are a product of rape or incest. Patients who are eligible for an abortion must get an ultrasound and go in for a counseling session 24 hours before they can get an abortion.

Some healthcare professionals are alarmed by the new amendment and what it means for reproductive healthcare in Louisiana. The Washington Post reports that over 240 physicians, providers, and medical students across the state have written a letter opposing this amendment.

“Adding a safe, medically indicated drug for miscarriage management…creates the false perception that these are dangerous drugs that require additional regulation,” they wrote, emphasizing that the amendment is not scientifically based. “Given its historically poor maternal health outcomes, Louisiana should prioritize safe and evidence-based care for pregnant women.”

While mifepristone’s FDA approval has recently been under scrutiny by conservative politicians and political groups, the drug — approved in 2000 — is safe and effective. In fact, the risk of death associated with mifepristone is four times lower than penicillin and ten times lower than Viagra.

Meanwhile, Sarah Zagorski, communications director for the antiabortion organization, said, “As Senator Pressly has stated, the medical community regularly uses controlled substances in a myriad of medical situations, including emergencies. The use of these drugs for legitimate health-care needs will still be available, just like all other controlled substances are still available for legitimate uses.”

Although reproductive health policies across the US have always sparked debate, the criminalization of the two drugs used for medication abortion adds another layer of complexity to the issue.