A new bill filed in Texas would make abortion pills controlled substances in an attempt to curb the practice of self-managed abortions in the state.
House Bill 1339 aims to reclassify the medications mifepristone and misoprostol as Schedule IV substances. The bill, which was filed by Republican Rep. Pat Curry of Waco, closely echoes a law passed in Louisiana this year.
OB-GYNs have raised alarms about the impact of the Louisiana law in clinical settings. While mifepristone and misoprostol are known for their use in medication abortions, the drugs are also frequently used for other purposes in gynecologic care, including miscarriage management. Misoprostol is used to treat postpartum hemorrhage, or severe bleeding after childbirth.
When the law went into effect, the Louisiana Department of Health issued guidance about how mifepristone and misoprostol should be securely stored and dispensed now that they are classified as controlled substances — meaning that the medications might not be at arm’s length during emergencies.
In September, the president of the American College of Obstetricians and Gynecologists critiqued the law, saying it created “administrative hurdles” that would lead to delays in care.
“Legislators are creating barriers for clinicians in emergency situations in which a patient’s life or health could be at risk,” said Dr. Stella Dantas, ACOG president, in a statement. “In obstetrics and gynecology, minutes or even seconds can be the difference between life and death.”
Louisiana health care providers have sued the state, challenging the standing of the law.
In statements to The Texas Tribune, Curry said his intent in filing the bill was to make it more difficult for people to order mifepristone and misoprostol online for use in abortions and dismissed concerns raised by doctors.
Since nearly all abortions became illegal in Texas, many women turned to self-managed abortions using pills obtained via mail. A study published in January — authored by a UT Austin professor — found that requests to the UK-based telemedicine service Aid Access surged after the U.S. Supreme Court’s decision overturning Roe v. Wade was leaked.
Texas passed a law in 2021 making it illegal to ship abortion medication by mail in the state. But other states where abortion is legal, like New York and Colorado, have passed “shield laws” aimed at protecting providers who prescribe abortion pills to patients in states with different laws.
Reclassifying mifepristone and misoprostol as Schedule IV substances could introduce new penalties for the illegal possession or distribution of the medications. However, Louisiana's law does not include penalties for women who possess the mifepristone and misoprostol intended for their own use.
Among many doctors and reproductive health advocates, concerns have persisted about how Texas abortion laws may impact the quality of care given to women experiencing miscarriages and other obstetric health emergencies. In recent weeks, ProPublica reported the stories of three women who died after doctors were reluctant to give miscarriage-related care, cautious that it might be classified as abortion under the law. Doctors can face severe penalties if they are found to violate Texas’ Senate Bill 8, which allows an abortion to be performed only if a pregnant woman’s life or a “major bodily function” is at risk.
Dr. Todd Ivey, a Houston-based OBGYN, said Curry’s bill raises the new concern that misoprostol could become less accessible in emergencies. He said he had been anxious about the possibility that Louisiana's law would be duplicated in Texas.
“Every second counts when you're talking about a postpartum hemorrhage,” Ivey said. “I think having it readily accessible, whether it's in the room or quickly available after a request, is incredibly important.”
Drugs classified as controlled substances generally have addictive potential, unlike mifepristone and misoprostol, and must be tracked through Texas’ prescription monitoring system. Ivey said this requirement could be especially burdensome for rural hospitals with limited resources.
“Small hospitals may not want to go through that, because you have to account for everything,” he said. “They may choose not to carry it at all if they don't do obstetrics — but if someone shows up in the emergency room, which may happen in a rural area, and ends up delivering the baby, then even if the physician knows exactly what to do, they're not going to have the tools to do it.”
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