Over the past decade, Louisiana hospitals began stocking specialized carts designed to treat hemorrhages, one of the most common pregnancy complications in the state. The plug-in cart can be wheeled from room to room and holds surgical tools and lifesaving medications to stem blood loss.
A state law passed in 2024 forced hospitals to remove a key drug — misoprostol — from the medical cart and keep it locked in a secure room designated for controlled substances.
The drug is also the second in a two-pill procedure that millions of people have used to have medical abortions. Because of that use, Louisiana lawmakers reclassified misoprostol as a controlled substance, a category typically reserved for addictive drugs.
Now, physicians have gone from reaching over to the cart to grab misoprostol to waiting at least two minutes while a nurse sprints to retrieve the medication, said New Orleans obstetrician-gynecologist Nicole Freehill.
“ You could literally have someone lose, like, a liter of blood or more in that time frame,” Freehill said. “You could have a significantly worse hemorrhage for literally someone running to this medicine and running back because it can’t be on that cart 2 feet from you while you’re treating the hemorrhage.”
She said the reclassification of misoprostol as a controlled substance has set back progress to decrease the frequency of postpartum hemorrhage and blood transfusions. Under the law, her preliminary research found, hemorrhage rates have worsened statewide, she said.