Politicians in New Orleans want to repeal pregnancy drug law

NEW ORLEANS (Louisiana Illuminator) – Doctors and officials in New Orleans have vehemently condemned a new Louisiana law that classifies the pregnancy drugs misoprostol and mifepristone as controlled dangerous substances. The law takes effect Oct. 1 and is the first of its kind in the country.

“Women are not safe in Louisiana,” New Orleans City Councilwoman Lesli Harris said at a committee meeting on Wednesday. “Women giving birth are not safe in Louisiana.”

Republican Governor Jeff Landry signed a bill in May to reclassify the two drugs because they are associated with medication abortion, but they have numerous other medical uses. Misoprostol, in particular, is used daily by gynecologists to treat miscarriages, postpartum bleeding and to insert intrauterine devices (IUDs).

The bill, authored by Senator Thomas Pressly (Republican of Shreveport), was originally intended to criminalize forced abortion. But at the last minute and with the support of Louisiana Right to Life, Pressly introduced amendments to reclassify the drugs as Schedule IV drugs, which will impact their storage and prescription.

City Councilman JP Morrell criticized the legislation, which was described by doctors across the state as “confusing” and “unnecessary.”

“The law is so poorly drafted and unclear, and it was really a last-minute concoction,” Morrell said.

Council President Helena Moreno has asked the New Orleans Health Department to study the impact of the legislation, hoping that a data-driven approach will persuade lawmakers to “roll back” these restrictions in the future.

“I have heard many politicians talk about how these restrictions are not a problem, that everything is fine, no big deal, that there will be no problems with access. But from the medical community, from medical professionals, from doctors who treat women there every day, we hear something completely different,” said Moreno.

When Attorney General Liz Murrill learned of Moreno's plans, she told the Illuminator that New Orleans was “creating a problem that doesn't exist.”

In her statement Wednesday to members of the council's Governmental Affairs Committee, Moreno compared Louisiana's new law to a measure that would make pilots' jobs more difficult and potentially lead to crashes.

“I guarantee you we would see quite an outcry from anyone trying to reverse course,” she said. “This is not so different – we hear from the medical community [that] That's a problem. We should listen to them.”

Potential public health crisis

In public comments, Dr. Emily Holt, a New Orleans family physician, said she uses misoprostol in her clinic to help patients with pain before IUD insertion, but as of Oct. 1, she will no longer be able to offer it in her clinic, although it will still be legal to prescribe, she said.

“The hurdle to keep controlled substances in my clinic is too high,” Holt said. She joined a handful of people who testified in person at the committee hearing, and 53 others submitted comments online in support of Moreno's proposal.

Dr. Jennifer Avegno, the city's health director, will lead the investigation into what she called a public health crisis. She explained to council members that adding a drug to the controlled dangerous substances list brings additional, strictly regulated requirements regarding reporting, storage and monitoring of the drugs.

Therefore, doctors are concerned about the impact of the new law on delaying the treatment of postpartum hemorrhage – some hospitals have already removed it from their obstetric care program.

“Doctors are not pursuing politics. Doctors are trying to do their job,” Avegno said. “We're hearing that many doctors are just learning about this, and some probably have no idea.”

The illuminator I previously spoke to a doctor in a rural area of ​​the state who had no idea about the drug reclassification until she spoke to a reporter. She said other doctors in her area were also likely in the dark, having not received any information from their employers or authorities until recently.

Some doctors do not have access to lawyers

Avegno said her investigation was about health care, not politics.

“When we talk about these drugs, every doctor in Louisiana is aware that abortion is highly restricted and no one – no one – has any desire to perform abortions outside of the law,” said Avegno, an emergency room physician.

The city's health department will host a webinar on Thursday to educate healthcare providers on troubleshooting related to the new misoprostol protocols.

Avegno said she has received reports from local health care providers that pharmacies are refusing to hand out prescriptions for misoprostol and mifepristone to treat miscarriages because they fear criminalization, even though the drugs remain legal.

“We are violating the standard of care of hospitals across the country. These are facts,” Avegno said.

Morrell, who served in the Louisiana Legislature before joining the city council, raised concerns about the ideological politicization of medicine.

“Even when legislators say things like, 'Don't worry, if you do the right thing, everything will be fine,' I mean, that's not really true,” Morrell said. “Medical professionals may have people who wish them ill because they don't agree with their politics or their beliefs, and who make frivolous complaints about these things, highly subjective, life-changing decisions.”

And as abortion rights activist Michelle Erenberg of Lift Louisiana testified before the committee, not every doctor has immediate access to an attorney.

“Patients are coming to New Orleans with these health emergencies,” Erenberg says, “because doctors in other parts of the state may not have access to lawyers or are afraid of going to jail.”

Even well-resourced doctors who have easy access to lawyers should not have to constantly seek legal advice when they need to use misoprostol, according to Avegno. She noted that in its recently released guidelines on the new law, the Louisiana Department of Health advised doctors to consult with their hospital's lawyers.

“Most hospital lawyers are not well versed in this,” she said. “This drug is used all day, every day. It's not practical to call the lawyer every time.”

Morrell underscored Avegno's point, saying a hospital lawyer is trained to do what's best for the hospital from a liability perspective. A doctor making a decision at a patient's bedside prioritizes what's best for the patient, he added.

“This is a terrible, terrible, terrible idea”

The debate over prenatal care in Louisiana is now part of the national discussion about the impact of abortion bans after more than two dozen states passed restrictions or outright bans on the procedure. Critics point to the detrimental impact this has on prenatal care overall.

The deaths of two women in Georgia are attributed to the country's abortion ban. Amber Thurman had to expect long delays in treatment because the hospital where she was treated was afraid of surgical intervention. Candi Miller avoided going to the doctor for fear of legal consequences. A team of state doctors considered the deaths of both women to be “preventable.”

At the committee hearing on Wednesday, council members said they did not want to wait until women die in Louisiana for lawmakers to change their decision on the controversial law.

“I don't want to see a woman who is bleeding sacrificed,” Harris said. “Hopefully we can change the minds of people at the state level who think this is a good idea, because it's a terrible, terrible, terrible idea that will cost people's lives, will cost women's lives.”

“If women who miscarry or experience postpartum bleeding don't have easy access to this medication, they become sacrificial lambs whose hearts and minds must be changed, and I don't want to see that happen. No one should have to put themselves in that position to get some state legislator to change their mind on this issue.”

This ongoing coverage of reproductive health issues in Louisiana is made possible with support from the Pulitzer Center.

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