Louisiana Banned Abortion Pills. It Also Faces a Maternal Mortality Crisis. 

Louisiana suffers some of the nation’s highest maternal mortality, infant mortality, and incarceration rates, particularly among Black and Brown people, and people living in rural areas. Instead of addressing these problems by funding public hospitals and clinics, anti-abortion politicians are restricting and even criminalizing reproductive health care.

Last week, Louisiana’s Republican Gov. Jeff Landry became the first governor to sign legislation criminalizing mifepristone and misoprostol. The two medications, commonly called abortion pills, are now used for a majority of abortions. The drugs are considered safe and effective at up to 10 weeks of pregnancy, and are also used to treat ulcers and miscarriages at home.

In Louisiana, lawmakers banned abortion except in life threatening emergencies that are vaguely defined and recently rejected adding exceptions for victims of rape and incest. In Louisiana and other red states, mail-order abortion pills are often the only option besides leaving the state to seek care.

Experts say abortion pills are not addictive drugs and have other medical uses, but the Louisiana law labels them “dangerous controlled substances” on par with drugs such as heroin and methamphetamine. After October 1, anyone who possesses the federally approved medications without a prescription in Louisiana could face up to five years in prison, and any person who distributes the drugs could face up to 10 years.

An amendment to the law provides a narrow carve-out for pregnant women who take the drugs, but not for their friends, family and confidants. It also excludes anyone who might use mifepristone or misoprostol for other medical reasons, whether that be for treating ulcers or inducing labor. Notably, this carve-out also excludes the doctors who would prescribe and potentially administer such drugs in the first place.

“When we look at legislation like this, not only does it take away someone’s right to do what they want with their body in a healthy way, but it’s creating pathways to criminalization, pathways for families to see the destabilization of their lives and possibly in their housing and access to education,” said Pearl Ricks, executive director of the Louisiana Reproductive Justice Action Collective, in an interview.

“This is not just an attack on people who want to make a decision about being pregnant; it’s an attack on people who are looking for relief from symptoms from other illness,” Ricks added.

Louisiana faces a dire shortage of doctors and, unsurprisingly, some of the nation’s highest infant and maternal mortality rates, which significantly exceed the national average. Those rates are even higher among Black women, who represent 37 percent of pregnancies but 62 percent of pregnancy related deaths in the state, according to the Louisiana Department of Health. In 2019, Louisiana health officials reported that “four black mothers die for every white mother and two black babies die for every one white baby.”

However, Louisiana legislators ignored pleas from more than 200 doctors across the state who warned against passing the legislation. In a letter to the legislature, the doctors warned that the legislation “is not scientifically based and produces a barrier to physicians’ ease of prescribing appropriate treatment for patients.”

Supporters say the new law aims to stop men from poisoning pregnant partners in order to induce abortion without consent.

“Requiring an abortion inducing drug to be obtained with a prescription and criminalizing the use of an abortion drug on an unsuspecting mother is nothing short of common sense,” Landry said in a statement last week.

However, opponents say there are already plenty of laws against such a horrendous but rare crime. They also say anti-abortion lawmakers intentionally cast a wide net in order to threaten and confuse doctors, mutual aid activists and people seeking reproductive health care.

“We see a fabrication of a boogeyman every year [in] that capital,” Ricks said. “It’s a willing ignorance, and these folks know it needs perpetuation of misinformation and disinformation to keep people uninformed and unengaged.”

Chasity Wilson, the executive director for the Louisiana Abortion Fund, said the new law is “heartbreaking and terrifying” in a state where Black people are already overrepresented in the criminal legal system and have some of the worst health outcomes in the nation.

“Criminalization is one of white supremacy’s most dangerous weapons, we know that,” Wilson said in an interview. “As an abortion fund headquartered in New Orleans, the most criminalized city in the most criminalized state in the most criminalized country in the world, we are very aware of what this bill means.”

Meanwhile, giving birth in the United States is only becoming more dangerous, with the national maternal mortality rate nearly doubling between 2018 and 2023. The right-wing majority on the Supreme Court overturned Roe v. Wade in 2022, allowing red states to enforce harsh bans on abortion that have tied the hands of doctors and put multiple women with risky pregnancies in extremely dangerous circumstances.

“Instead of working to address the maternal mortality crisis, the infant mortality crisis or the climate crisis (the list of crises goes on), Louisiana’s lawmakers are looking to lock up our neighbors for up to five years for possessing these life-saving drugs,” the New Orleans-based intersectional organizer Deon Haywood recently wrote in Ms. magazine. “The move is pigheaded, embarrassing and downright dangerous — but not surprising.”

Haywood isn’t the only organizer to point out how this new legislation is intertwined with climate change. Wilson said Louisiana is facing an intense hurricane season — the Gulf Coast of Mississippi and Alabama is under threat as well — and people could be in dire need of mifepristone and misoprostol after disaster strikes and access to an already underfunded health care system is limited.

“There are people who miscarry in the state where that medication could help their bodies release the unviable embryo or pregnancy who are not able to access that medication,” Ricks said.

Ricks said frontline activists are now working furiously to educate people about what criminalization of abortion pills means for anyone who can get pregnant. For example, the Louisiana Reproductive Justice Coalition legally distributes Plan B oral contraception, which is often confused with abortion pills but is not a form of abortion.

Ricks said activists are also training community members in personal cyber security so their web searches and communications cannot be used to criminalize them. There is a long history of politicians using restrictions on reproductive care as an excuse for the outright surveillance of woman and their bodies, as well as queer and trans people.

In fact, as Louisiana’s former attorney general, Landry and anti-abortion attorneys general from 16 other states demanded in 2023 that the Biden administration hand over personal information about residents who leave the state in search of abortions or gender-affirming care. With Democrats eager to use abortion as a wedge issue ahead of elections in November, the White House has pledged to defend access to abortion and reproductive health care at the federal level.

“There is a deep, deep fear; there is an anger that we are not even allowed to express because we have to be so crafty in our activism,” Wilson said, adding that activist groups like the Louisiana Abortion Fund only exist in response to state violence. “It is so frustrating and so scary.”

Mississippi, Alabama and Arkansas also see large numbers of pregnancy-related deaths compared to the total population. All three states have the highest rates of incarceration in a nation, which in turn is one of the most incarcerated countries in the world. In Mississippi and Arkansas, anti-abortion politicians are attempting to shut down access to telehealth services that provide access to abortion pills.

The ban on abortion pills comes from the same political elite who embrace austerity. Conservative politicians in Louisiana have long imposed funding cuts in areas ranging from health care and worker pay to public education. Wilson and Ricks said these cuts go hand-in-hand with policies that contribute to the mass incarceration of Black and lower-income people. Given Louisiana’s history, Wilson says it’s obvious who is targeted by the criminalization of abortion pills.

“This will hurt Black people, Brown people and poor people the most, which is intentional,” Wilson said, adding that the same lawmakers who call themselves “pro-life” also cut public spending on education and public health.

“You can’t say this is about life when you continue to chip away from people’s livelihoods.”