This week, Louisiana moved to expand the criminalization of abortion further than any state has since before Roe v Wade was decided. On Thursday, the state legislature passed a bill that would reclassify mifepristone and misoprostol – the two drugs used in a majority of American abortions – as dangerous controlled substances.
Under both state and federal classifications, the category of controlled substances includes those medications known to cause mind-altering effects and create the potential for addictions, such as sedatives and opioids; abortion medications carry none of this potential for physical dependence, habit-forming or abuse. The move from Louisiana lawmakers runs counter to both established medical opinion and federal law. Jeff Landry, the anti-choice Republican governor, is expected to sign the bill. When he does, possession of mifepristone or misoprostol in Louisiana will come to carry large fines and up to 10 years in prison.
Louisiana already has a total abortion ban, with no rape or incest exceptions. But the Louisiana lawmakers are pursuing this new additional criminalization measure because while abortion bans are very good at generating suffering for women, they are not very good at actually preventing abortions. Data from the Guttmacher Institute suggests that the United States saw an 11% increase in abortions between 2020 and 2023 – a possible indication that pregnant people are still managing to obtain abortions in spite of post-Dobbs bans. As was the case in the pre-Roe era, women have continued to seek out ways to end their pregnancies, even in defiance of abortion ban laws.
In the pre-Roe era, illegal abortions were often unsafe, and abortion bans caused a public health crisis: many hospitals had to open septic abortion wards, where women who had had incompetent or careless illegal abortions were treated for frequently life-threatening conditions. But the post-Dobbs reality is that advances in communications technology and medicine mean that illegal abortions need no longer be unsafe ones. Now, women living in states with abortion bans can access safe, effective abortion care in the comfort of their own homes, and often law enforcement and anti-choice zealots are none the wiser. Women can perform their own abortions, safely and effectively, without regard to the law’s opinion on whether they should be free to. They can do this because they can access the pills.
The criminalization measure, then, is part of an expanding horizon of invasive, sadistic and burdensome state interventions meant to do the impossible: to stop women from trying to control their own lives. The Louisiana bill nominally will not apply to pregnant women – they’re exempted from criminal punishments for possession of the medications. But it will take square aims at the vital, heroic efforts of feminists, medical practitioners and mutual aid networks that have been distributing the pills in Louisiana: the people who have adhered to the principles of bodily autonomy and women’s self-determination even amid a hostile climate. These people’s courage and integrity is the greatest threat to the anti-choice regime, and so it is these people whom Louisiana’s new medical criminalization law will be used against first.
But pro-abortion rights and women’s rights activists are not the only ones who will be hurt by the new law. For one thing, the criminalization of possession is likely to scare many Louisiana abortion seekers out of ordering the pills online, even if the bill itself technically excludes them from prosecution. These abortion seekers, dissuaded and threatened out of seeking the most reliable and safe method of self-managed abortion, may then turn to less safe options.
But the new drug classification also has implications for a wide array of healthcare treatments. Mifepristone and misoprostol are not only used in elective abortions. They are also the standard of care for spontaneous miscarriages – the management of which has already become legally fraught for doctors in Louisiana, causing women to suffer needlessly and endanger their health. Misoprostol is used in labor, too, and in the treatment of some ulcers. The drugs’ needless, cruel and medically senseless reclassification as “controlled” substances will make these medical practices more difficult in a state that already has one of the worst rates of maternal mortality in the country. That’s part of why more than 200 Louisiana physicians signed a letter opposing the bill.
The Republican legislators who have pushed the new criminalization do not pretend to actually believe that abortion drugs are habit-forming. Thomas Pressly, the state senator who introduced the bill, frankly said that his aim was to “control the rampant illegal distribution of abortion-inducing drugs”.
But there is something to the notion that abortion access might be “habit-forming”. In the Roe era, after all, women began to conceive of themselves as full persons, able to exercise control over their own destinies – as adults, that is, with all the privileges and entitlements of citizenship. They formed a habit of independence, a habit of imagining themselves as people entitled to freedom, equality, self-determination and respect. It is these habits that the Republican party is trying to break them of.
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Moira Donegan is a Guardian US columnist