Combating the Rampant Abuse of Abortion Pills
Act 246 / SB 276 FAQSenator Thomas Pressly’s Abortion by Fraud Criminalization Act (SB 276) has passed the Louisiana Legislature and has been signed by Governor Landry! SB 276 is an important bill to hold those accountable who use abortion pills to hurt women without their knowledge and takes steps to stop the pills from getting into the hands of predators and minors.
Factsheet on SB 276
LARTL Statement on Passage of SB 276
The illegal distribution of the abortion pills mifepristone and misoprostol is out of control in Louisiana, placing women, girls, and unborn babies in danger. The Louisiana Legislature must take action to protect Louisiana citizens and defend the integrity of Louisiana law.
The story of how Senator Thomas Pressly’s sister, Catherine Herring, was poisoned by her former husband with an abortion pill, clearly shows that these pills are being abused and they are a risk to public health. Louisiana must not only put laws in place that hold men like him accountable, but also must take steps to keep these drugs out of the hands of nefarious individuals.
The abuse of abortion pills is not isolated to Herring’s situation. There are dozens of websites selling abortion pills with little to no safeguards daily. They are blatantly disregarding FDA regulations. They sell these pills without a prescription to minors and beyond the gestational limit set by the FDA. Sadly, President Biden’s Food and Drug Administration (FDA) is doing nothing to stop these companies. Furthermore, these abortion pills are available “on the street” throughout Louisiana by individuals who are stockpiling these pills from illegal sources.
In this report, Louisiana Right to Life will provide information regarding the following:
The elective abortion pill regimen is traditionally comprised of a combination of the drugs mifepristone and misoprostol.
The regimen usually requires a woman to take two medications: mifepristone, which kills the baby by blocking progesterone, a hormone necessary to sustaining pregnancy, and then a second drug, misoprostol (often called Cytotec), to induce early labor and expel the now deceased unborn child.
However, it is becoming increasingly common for the application of high doses of misoprostol to perform an elective abortion without the use of mifepristone. In fact, Planned Parenthood’s website provides instructions on how to perform an abortion with misoprostol alone by taking 12 misoprostol pills.
In January of 2023, the Biden Administration through the FDA removed the “in-person dispensing requirement” that previously required physicians to dispense abortion pills in the presence of their patients. In turn, the FDA required that only “certified” pharmacies could dispense the drugs.
However, the FDA maintained that the gestational limit for the use of these pills is the 10th week of pregnancy. Furthermore, the FDA stated that those prescribing these pills must screen for the presence of ectopic pregnancies, even if in a telemedicine scenario. The guidelines also require that a lawful prescription be provided for these drugs.
The result of these policies was the proverbial opening of Pandora’s box.
Since January of 2023, the internet has seen a proliferation of businesses selling abortion pills. Unfortunately, these companies are taking advantage of the FDA by completely ignoring the guidelines and putting patients at risk.
Companies online are selling abortion pills…
The distribution of these pills is not limited to online companies in other states. There are individuals and groups who are selling them on the street in Louisiana without involvement of a physician, an examination to rule out an ectopic pregnancy, and limited or no guidance on care in case of an emergency.
Other reports have shown that people are accessing abortion pills with ease. In 2022, JAMA published an analysis of overseas abortion pill orders via Aid Access, a telemedicine group. The analysis showed that abortion pill orders increased by 170%.
In 2022, Louisiana came ahead of any other state with 136 pill requests per week, 14.9 per every 100,000. In the two years following the overturn of Roe, posters and stickers for abortion pills with QR codes to websites that hold information for both overseas and local distributors were plastered on street utility boxes and other public places, and these websites are avidly promoted on social media by local Louisiana organizations.
The distribution of these pills is not limited to online companies in other states. There are individuals and groups who are selling them on the street in Louisiana without involvement of a physician, an examination to rule out an ectopic pregnancy, and limited or no guidance on care in case of an emergency. Individuals who are not physicians are stockpiling these pills from illegal sources without a prescription and then selling them.
“Our experience at our center in Monroe is that misoprostol is sold on the street without mifepristone for elective abortion. A client even told us that abortion pills were being advertised for sale on SnapChat.” – Lyndsey Sikes, Life Choices Monroe
The FDA has stated that “the use of mifepristone, in a regimen with misoprostol, for the medical termination of pregnancy through ten weeks gestation is contraindicated in patients with confirmed or suspected ectopic pregnancy.” Furthermore, the FDA states that those providers who would like to prescribe these pills “must have the ability to date pregnancies accurately and the ability to diagnose ectopic pregnancies.”
As Dr. Shemwell states above, she understands the risk presented to women who have not been screened for these dangers. The current pattern of abuse of these drugs puts the health of women at risk since there is no screening being done online or on the streets.
Simple research online shows the vast collection of businesses illegally selling abortion pills to Louisiana. The following is a sampling of 26 online distributors that ship abortion pills to Louisiana citizens without a prescription. We can provide the list of distributors upon request to law enforcement or Louisiana Legislators.
Here is a brief review of documentation compiled from May 6-13 2024 showing the following five different companies were willing to sell abortion drugs to minors in the state past the 10-week threshold the Food and Drug Administration requirement.
Alicia Collins: Abortion-Inducing Drugs Provided Online for Free Without Any Health Screening for Late Abortion
On December 5, 2023, it was brought to the attention of Louisiana Right to Life that a Louisiana woman under the pseudonym “Alicia Collins” obtained abortion-inducing drugs from an online abortion-pill distributor that provides abortion services at no cost. Collins states that her intention in obtaining the drugs was to show how dangerously easy it was to obtain these drugs.
According to Collins, she engaged in an email conversation with a representative from the distributor Collins was required to provide her name and address. Collins was never asked to provide her age, though she did state that she was a “kid living with her parents.”
She disclosed to the distributor that she had an Emergency Room visit due to leg cramps and learned then that she was 25-weeks pregnant. The distributor representative then said the process for termination at 25-weeks could be “distressing.” The distributor then asked Collins if she could tell her parents she was “going on a sleepover” and instead seek out-of-state abortion services. But Collins insisted that she would have local support, and the distributor proceeded to send Collins the pills in the mail as requested, even though the FDA has only approved the chemical abortion regimen to be utilized during the first 10-weeks of pregnancy.
At no point in the email conversation did the online-abortion pill distributor screen Collins for medical concerns or for a potential ectopic pregnancy.
They provided her with a PDF document for instructions.
*The pills came in an unmarked bag and the pills had no identification marks on them, which is unlike standard prescription drugs. The package also had no instructions.
Samantha Jennings: Abortion Pills Provided in the Mail without Disclosing Pregnancy Information
A second woman under the pseudonym “Samantha Jennings” obtained abortion-inducing drugs through the mail from an online-abortion pill distributor. They provided four options for getting pills in Louisiana. They also provided tips for protecting privacy and potential legal risks. Jennings states that her intention in obtaining the drugs was to show how dangerous it was to obtain these drugs without disclosing pregnancy information.
Jennings chose “Mifepristone 200mg (1 tablet) + Misoprostol 800 mcg (4 tablets)” which was priced at $55. There were options to order multiple kits, and this particular site had an affiliate program to earn 7% commission successful referrals.
Jennings did not have to enter any information regarding pregnancy confirmation, gestation, last menstrual period, etc. for this particular transaction.
The payment options they accepted were through Zelle or Bitcoin (with 20% off.) The package was then shipped by USPS to the address she provided. The package was left at Jennings’ doorstep with no signature required.
The aforementioned concerns compelled Louisiana Right to Life to join Sen. Thomas Pressly in advancing SB 276 at the Louisiana Legislature. SB 276 creates a new crime of “coerced criminal abortion by means of fraud” to give law enforcement proper means to prosecute those who use deceit and manipulation to harm pregnant women and their unborn children.
SB 276 was also amended in committee to add Mifepristone and Misoprostol to Schedule IV of the Uniform Controlled Dangerous Substances Law in Louisiana.
Sen. Pressly was motivated to introduce SB 276 after his sister, Catherine Herring, was poisoned by her former husband. He crushed up abortion-inducing drugs seven times and put them in her drinks. Unfortunately, her former husband was only sentenced 180 days after his abusive action’s deadly intent.
In committee, Herring testified that “in 2022, I endured assault specifically aimed to abort and kill the baby I was carrying. The pills obtained by my husband were clearly not prescribed to him by a doctor.” Herring then explained that she felt uneasy when he became impatient when she would not finish a glass of water. He said, “chug faster.”
Herring then experienced abnormal bleeding and utilized progesterone she had at home after speaking with a nurse from the Abortion Pill Reversal Hotline. Her daughter is alive today because of her swift action but has developmental delays caused by the drugs. She was delivered 10-weeks early and attends therapy 8-times a week.
The fact that Herring’s former husband could get a hold of Misoprostol underlines the need to take action to put these abortion pills under control.
Statement from Woman’s New Life Clinic, New Orleans:
We have received numerous calls from women seeking post-abortion care as a result of what they report is “prolonged bleeding.” Many are actively bleeding and some have been bleeding for weeks. When we ask callers if they received instructions with their mail-order pills or pills obtained in a clinic regarding care during and after the process, callers answer no. Clients who have had experience with abortion pills report little to no discharge instruction from the source. One client reported that she received an email from the abortion pill provider telling her to take a pregnancy test 5 weeks after taking the abortion pill, with no further instructions. Some have reported that the clinic they visited told them to go to the ER if they feel the need to but to lie and tell them they are having a miscarriage. Many clients report this being the worst experience of their lives. Another client reported that when she went through the abortion pill experience she was not first tested for STI’s before the process was initiated. She had a severe STI which resulted in an ICU stay.
Statement from Mary’s House, Shreveport:
A patient came to us who had vaginally taken pills she had ordered online. She inserted 4 pills but was still pregnant and went to the Emergency Room. After, the ER sent her to us so we could help her get a doctor. We walked her over to the hospital across the street. She had no idea how to take the pill, how many, or who to call when there was a problem.
In another incidence, a minor came to our clinic to find out if she was pregnant. Since the client was underage, the Director talked to her parents to let them know what our process was for an appointment: pregnancy test, talk to a peer counselor, and have an ultrasound if she was far enough along.
The minor told the nurse her last period was more than eight weeks prior and she had a positive pregnancy test. We then were able to do an ultrasound to determine exactly how far along she was. When the sonographer did the ultrasound there was no visible presence of a baby.
In the meantime, the parents told the Director that a family member had ordered the abortion pill online and had given it to the girl. The only reason they came to the pregnancy center was to find out for sure that she was no longer pregnant.
Statement from Pregnancy Center and Clinic, Lafayette:
Over the past year, our pregnancy center has been contacted by women who were experiencing complications from taking the abortion pills. The women stated they had taken the abortion pills and wanted ultrasounds because they were not sure if the abortion was complete. One client came to our clinic after taking the abortion pills she received through the mail. The client stated nothing happened after taking these pills. The client stated after she contacted the online supplier to let them know she did not have an abortion, the supplier sent her another set of pills to take. The client stated after the second dose of pills she did bleed a little but did not experience an abortion. The client came to our center to confirm her pregnancy and an ultrasound was provided by one of our volunteer OB/GYNs. The client was 18-weeks pregnant with a healthy baby. The client chose to parent her baby.
Statement from Life Choices, Ruston:
Life Choices of North Central Louisiana works with women nearly every day who are accessing the abortion pill by mail. Due to the unregulated nature of this method of distribution, the women receiving pills are being sent a wide variety of instructions, or sometimes no instructions, for taking the pills. Many do not know exactly how far along they are or have even had their pregnancy confirmed via ultrasound, ruling out a potentially deadly ectopic pregnancy. Furthermore, women are being left with little to no options for follow up care and are not told what to expect following the regimen. The following statements have been shared with Life Choices’ staff in regards to taking abortion pills obtained through the mail:
“I started bleeding and bleeding and bleeding. The instructions with the pill told me that I could go to the ER for excessive bleeding but that I should tell them that I was having a miscarriage. You are the first person that I’ve told about having an abortion. My boyfriend doesn’t even know.”
“It was the worst decision I ever made. I would never tell anyone to do it. It was horrible to be alone and not really know what was happening.”
-“I kept passing clots all weekend long. I didn’t know if this was okay or not. How do I know if the abortion is complete or not? Am I okay?”
Statement from Life Choices, Monroe:
“We had an exchange with a minor who had a medication abortion while sitting on the couch next to her mom who had no idea. Also the abortion pills she took she purchased off the street and not through a provider.”
“Our center averages 50 women a week and those who are considering taking abortion pills would buy off the street before ordering online. One client purchased 4 pills for $250 and another told us she got 12 pills for an undisclosed amount. Both of these were not prescribed through a provider.”
“Our experience at our center in Monroe is that misoprostol is sold on the street without mifepristone. Both being considered controlled substances would help law enforcement stop the illegal spread of the pills throughout our state.”
The information above shows that the distribution of abortion pills are out of control. They are a danger to women’s health and the pattern of distribution violates the laws of Louisiana.
Senator Thomas Pressly has elected to add the abortion-inducing drugs Mifepristone and Misoprostol to Schedule IV of the Uniform Controlled Dangerous Substances Law in Louisiana. As he has stated, it is his goal to keep these pills out of the hands of predators such as his sister’s former husband. While the details cannot be shared, he is also aware of situations in Louisiana of men obtaining the pills to pressure women to have an abortion.
Can a substance that is not addictive be added to a schedule of controlled substances?
Yes. In Louisiana, Revised Statute (RS) 40:961 provides definitions regarding controlled substances. RS 962 and RS 963 then outlines the criteria for determining if a drug should be classified as a controlled substance under, specifically, Schedule IV of the Uniform Controlled Dangerous Substances list. The schedules of controlled substances are organized by their potential for abuse, accepted medical usage, and potential for dependency. Nothing in Louisiana law states that controlled substances must be addictive. Some of the factors to be considered when adding a substance to the controlled schedules include:
As this report has outlined, the high potential for abuse, its restricted medical use in Louisiana, and the risk to public health justify these drugs’ inclusion within the schedules of controlled substances.
Will doctors and pharmacists still be able to legitimately administer or dispense mifepristone or misoprostol
Yes. Doctors and pharmacists have established protocols for dealing with controlled substances that have legitimate medical uses. Furthermore, Louisiana abortion law is clear that if an abortion inducing drug can be used for a legitimate purpose other than elective abortion, it is legal. This includes doctors using misoprostol in miscarriage situations or to induce labor.
“From my experience in Northeast Louisiana, medications such as mifepristone and misoprostol are recklessly available online and on the street without a prescription or a physician’s exam. Without proper physician screening for ectopic and molar pregnancies, these medications have the potential to be dangerous. For these reasons, I support categorizing both of these medications as controlled substances. Physicians commonly use controlled substances, and I’m confident that my care for women will not be harmed by this legislation, even as it applies to the appropriate use of misoprostol in my practice.” – Dr. Amber Shemwell, OBGYN in Monroe
Cytotec is commonly used in hospitals. Can hospitals still use Cytotec?
Yes. As stated above, SB 276 permits Cytotec to be used in legitimate health care purposes other than elective abortion.
Is It Already Illegal to Possess Abortion Pills Without a Prescription?
Yes. It is currently illegal for a person to possess any legend drug, also known as a prescription drug, without a lawful script from a physician. Misoprostol and mifepristone are currently prescription drugs. Therefore, those individuals “stockpiling” abortion pills without a prescription are already in violation of Louisiana law. SB 276 enhances penalties in order to keep these drugs out of the hands of predators and minors without parental consent.
Why Schedule IV?
Schedule IV provides additional penalties when a Schedule IV controlled substance is used to commit a crime of violence and is administered to a person without their knowledge. Senator Pressly felt this situation appropriates fits the crime perpetrated on his sister.
Can a woman who is in possession of or has taken abortion pills be punished under Louisiana’s Uniform Controlled Substances Act?
No. SB 276 expressly provides that possession by a woman for her own use is not a violation of act. Furthermore, Louisiana current law consistently states that a woman shall not be prosecuted for possession or use of abortion-inducing drugs.
Will SB 276 somehow “scare” patients from using Misoprostol?
No. Many controlled substances, including opioids, are used regularly in the course of legitimate medical case. These include opioids that are commonly discussed in the national opioid abuse epidemic. Health care providers discuss the use of these opioids in health care on a regular basis.
