A new bill introduced in Texas would make abortion pills a controlled substance in an effort to curb the practice of self-administered abortions in the state.
House Bill 1339 aims to reclassify the drugs mifepristone and misoprostol as Schedule IV substances. The bill, introduced by Republican Rep. Pat Curry of Waco, is similar to legislation passed in Louisiana this year.
Obstetricians and gynecologists are sounding the alarm about the impact of Louisiana’s law on clinical practice. Mifepristone and misoprostol are known to be used for medication abortion, but these drugs are also frequently used for other purposes in gynecological care, including the management of miscarriage. Misoprostol is used to treat postpartum hemorrhage or severe bleeding after childbirth.
When this law took effect, the Louisiana Department of Health issued guidance on how to safely store and dispense mifepristone and misoprostol because they are classified as controlled substances. This means that you should never leave your medication within reach in case of an emergency.
In September, the president of the American College of Obstetricians and Gynecologists criticized the law, saying it creates “administrative hurdles” that lead to delays in treatment.
“Lawmakers are putting up barriers for clinicians in emergency situations where a patient’s life or health may be at risk,” ACOG President Dr. Stella Dantas said in a statement. “In obstetrics and gynecology, minutes or even seconds can mean the difference between life and death.”
Louisiana health care providers challenged the law’s position and sued the state.
In a statement to The Texas Tribune, Curry said the intent of the bill is to make it more difficult for people to order mifepristone and misoprostol, which are used for abortions, online, and to discourage doctors from using the bill. He dismissed the concerns.
With nearly all abortions now illegal in Texas, many women have turned to self-administered abortions using drugs obtained by mail. A study published in January, authored by a professor at the University of Texas at Austin, found that applications to UK-based telemedicine service Aid Access after the US Supreme Court’s decision overturning Roe v. Wade was leaked. was found to have increased rapidly.
In 2021, Texas passed a law making it illegal to mail abortion pills within the state. But other states where abortion is legal, such as New York and Colorado, have passed “shield laws” aimed at protecting health care providers who prescribe abortion drugs to patients in states with different laws.
Reclassifying mifepristone and misoprostol as Schedule IV substances could introduce new penalties for illegal possession or distribution of drugs. However, Louisiana law does not include penalties for women who possess mifepristone and misoprostol for their own use.
Many doctors and reproductive health advocates are wondering how Texas’ abortion law will affect the quality of care given to women experiencing miscarriage or other obstetric medical emergencies. Concerns about whether this is possible remain. In recent weeks, ProPublica has reported the stories of three women who died because their doctors were reluctant to provide miscarriage-related treatment, wary of the possibility of it being classified as a legal abortion. Doctors could face severe penalties if found to have violated Texas Senate Bill 8, which allows abortions to be performed only if a pregnant woman’s life or “major bodily functions” are at risk. .
Dr. Todd Ivey, a Houston-based obstetrician-gynecologist, said Curry’s bill raises new concerns that misoprostol could be harder to obtain in emergencies. He said he was concerned that Louisiana’s law could apply in Texas as well.
“When you’re talking about postpartum hemorrhage, every second counts,” Ivey says. “I think it’s really important to have immediate access, whether it’s in the room or immediately available upon request.”
Unlike mifepristone and misoprostol, drugs classified as controlled substances are generally addictive and must be tracked through Texas’ prescription monitoring system. Ivey said the requirement could be especially burdensome for rural hospitals with limited resources.
“Small hospitals may not want to go through that because they have to explain everything,” he said. “If you don’t do obstetrics, you might have the option of not having a baby at all, but if someone shows up in the emergency room, and that might happen in a rural setting, you end up delivering a baby.” Even if doctors knew exactly what to do, they wouldn’t have the tools to do it.”
