路易斯安那州2024年通过的一项法律将米索前列醇和米非司酮重新分类为受控物质，要求医院从应急出血治疗车上移除米索前列醇，并将其存放在受控物质室内 [1]。这一措施改变了医生应对产后出血的方式，从原来直接从治疗车取药改为等待护士至少两分钟时间取药 [1]。
妇产科医生认为这项规定带来严重风险 [1]。新奥尔良妇产科医生Nicole Freehill指出患者在这段时间内可能失血1升或更多 [1]。由于药物获取延迟，患者失血和接受输血的风险随之增加 [1]。
新奥尔良卫生部门2024年9月发布的报告显示，该法律引发了患者用药延迟和药房填写处方困难，但并未产生立法者所声称的效果 [1]。报告称没有证据表明该法律减少了流产数量，仅有伤害的证据 [1]。
与此同时，远程医疗成为相关治疗的替代途径 [1]。2024年超过7,500名路易斯安那州居民通过远程医疗获得药物流产 [1]。至少9个州已提出类似立法，但目前尚无其他州实施该措施 [1]。
Louisiana enacted legislation in 2024 that reclassified misoprostol and mifepristone as controlled substances, requiring hospitals to remove misoprostol from emergency hemorrhage treatment carts and store it in locked controlled substance rooms. [1] This regulatory change has created dangerous delays in accessing a critical medication needed to treat postpartum bleeding.
Under the new rules, physicians can no longer retrieve misoprostol directly from hemorrhage carts as they previously did; instead, they must wait for a nurse to retrieve it from the controlled substance storage area, a process that takes at least two minutes. [1] According to Dr. Nicole Freehill, an obstetrician in New Orleans, patients can lose one liter of blood or more during this delay. [1] The extended access time increases the risk that pregnant patients will experience significant blood loss and require transfusions.
Despite the law's stated intent, a report released by the Louisiana Department of Health in September 2024 found no evidence that the legislation has reduced the number of abortions. [1] The report documented only harmful consequences, with healthcare providers in New Orleans reporting delays in medication administration and difficulties with pharmacy fulfillment of prescriptions. [1]
Meanwhile, over 7,500 Louisiana residents obtained medication abortion through telehealth in 2024, circumventing the state's restrictions. [1] At least nine other states have proposed similar legislation, though Louisiana remains the only state to have implemented such a measure. [1]