Misoprostol, used in postpartum care and medication abortion, now locked in secure rooms
A 2024 Louisiana law that reclassified the drug misoprostol as a controlled substance has forced hospitals to remove it from emergency hemorrhage carts, delaying access to a medication doctors describe as the go-to treatment for life-threatening postpartum bleeding, according to a report by the Associated Press.
Over the past decade, Louisiana hospitals began stocking specialized carts designed to treat hemorrhages. The plug-in carts, which can be wheeled from room to room, contain surgical tools and lifesaving medications to stem blood loss. After the law took effect, misoprostol was removed from those carts and relocated to a locked, secure room reserved for controlled substances.
For physicians like New Orleans obstetrician-gynecologist Nicole Freehill, misoprostol is the first-line drug for managing hemorrhages. “The drug is uniquely cheap, safe and shelf-stable,” she said.
The reclassification stems from misoprostol’s role as the second pill in a two-drug regimen used for medication abortion. Because of that use, Louisiana lawmakers reclassified misoprostol as a controlled substance, a category typically reserved for addictive drugs. The restriction has placed a logistical barrier in front of the rapid hemorrhage treatment that the carts were designed to provide, raising the risks for pregnant patients in a state where hemorrhage remains a leading pregnancy complication.