NEW ORLEANS — Louisiana’s new law reclassifying pregnancy care pills as controlled dangerous substances took effect Tuesday, creating an outcry from the state’s medical community as doctors, pharmacists and hospital lawyers try to determine how to navigate new protocols. The drugs are being targeted because they can be used to induce abortion.

The law, which Republican Gov. Jeff Landry signed in May, makes misoprostol and mifepristone Schedule IV drugs, adding the requirement that they be locked, securely stored and their use closely documented. Health care providers have shared worries that any delays in access to misoprostol, which has multiple other uses beyond medication abortions, could create life-threatening delays for patients bleeding post delivery. 

The New Orleans health department hosted a learning session for physicians and pharmacists Sept. 19 about the law, Act 246. After the session, city health director Dr. Jennifer Avegno sent a letter to Louisiana Surgeon General Dr. Ralph Abraham and Health Secretary Michael Harrington compiling some of the most pressing questions and seeking guidance. 

“We believe it is imperative that these questions are submitted to LDH for any necessary clarification, guidance, or additional rule-making, so that providers have legally accurate and medically appropriate tools,” Avegno wrote in the letter, a copy of which The Illuminator obtained. 

Avegno is also in charge of an investigation into the law’s impact and whether it leads to any delay of care issues. The city’s health department created a reporting form health care workers and patients can complete to submit confidential information about any challenges.

Questions from last month’s webinar included asking for photographs of and specific instructions for officially approved and legal “secured areas” where the drugs can be stored for immediate access. The Louisiana Department of Health issued a memo in early September suggesting hospitals store the drugs in a “locked or secured area of an obstetric hemorrhage cart.”

So far, hospitals have not found this to be a feasible option because of the logistics involved with tracking and storing controlled substances. Instead, they are storing misoprostol in passcode-protected storage lockers made by Pyxis Corp. and named after the company. They are located outside of patient rooms.

Another question dealt with the word “abortion.” Medically-speaking and outside of political context, abortion can mean a miscarriage and pregnancy loss. There are several common, legal and medically appropriate diagnosis words that include the word abortion, including missed abortion, incomplete abortion and spontaneous abortion. 

While elective abortions are almost entirely illegal in Louisiana, misoprostol is still safe and legal for use in miscarriage management. But providers are worried that pharmacists, particularly those in rural areas, might be fearful of filling any prescriptions with the word “abortion” in it. 

The webinar panel encouraged additional education and outreach to make sure pharmacists and patients understood the distinction, and they asked the state health department for additional clarification.

Act 246 has gained nationwide attention, with Louisiana becoming the first state to make these medications controlled substances.

Maternal fetal medicine specialist Dr. Jane Martin of New Orleans wrote a commentary for StatNews, a health and medicine periodical, criticizing the reclassification of the drugs.

“A pregnant uterus receives 700 milliliters of blood per minute leading up to delivery, and the same amount can be lost each minute if a postpartum hemorrhage is not adequately treated immediately after being recognized,” Martin wrote. She describes how the original version of the bill criminalized coerced abortion and had wide support, but it took “an unprecedented turn” when amendments were added to reclassify pregnancy care pills as controlled dangerous substances. 

“I didn’t choose this profession to navigate legal obstacles, but to provide compassionate care during some of the most pivotal and vulnerable moments in someone’s life,” Martin added, saying that restricting access to misoprostol puts her patients in “unnecessary danger.’ 

“The delivery room is a place of healing, not hesitation,” she wrote “The last thing I need to be asking myself during an emergency, while running through my mental checklist that I’ve used in every postpartum hemorrhage I’ve ever attended, is ‘Could I go to jail for this?”

Martin isn’t the only one speaking out forcefully. Dr. Veronica Gillispie-Bell, the state health department’s leading expert on maternal mortality, penned a column for  MSNBC voicing her opposition. She practices medicine in the New Orleans area.

“As an OB-GYN whose patients expect me to give the best care to them (and their babies), I’m convinced that this new law endangers them,” Gillispie-Bell wrote.  “Lawmakers must engage with physicians to craft evidence-based policies that protect our patients, not increase their risk of death.

Republican Attorney General Liz Murrill and anti-abortion group Louisiana Right to Life have accused the news media of fear-mongering and spreading ”disinformation” about the controversial law.

“The appropriate and professional way to obtain answers to questions about the law is to ask them, not to create and perpetuate confusion,” Murrill said Tuesday, when the law took effect, in a video address. 

Avegno sent the letter with doctors’ questions Sept. 26 but has yet to hear back, she said.

This report was published in partnership with the Pulitzer Center’s StoryReach U.S. fellowship. Read more of our coverage.

In February, a prosecutor from a rural area outside Baton Rouge asked members of Louisiana’s Senate judiciary committee to imagine a frightening scene: You are home with your wife at 4 a.m. when suddenly a 17-year-old with a gun appears. The teenager won’t hesitate, District Attorney Tony Clayton said. “He will kill you and your wife.”

According to Clayton, teenagers were terrorizing the state without fear of consequences. The only way to stop them was to prosecute all 17-year-olds in adult court, regardless of the offense, and lock them up in prison. Law enforcement officials from around the state made similar arguments. Legislators quickly passed a bill that lowered the age at which the justice system must treat defendants as adults from 18 to 17.

But according to a review of arrests in the five months since the law took effect, most of the 17-year-olds booked in three of the state’s largest parishes have not been accused of violent crimes. Verite News and ProPublica identified 203 17-year-olds who were arrested in Orleans, Jefferson and East Baton Rouge parishes between April and September. A total of 141, or 69%, were arrested for offenses that are not listed as violent crimes in Louisiana law, according to our analysis of jail rosters, court records and district attorney data.

Just 13% of the defendants — a little over two dozen — have been accused of the sort of violent crimes that lawmakers cited when arguing for the legislation, such as rape, armed robbery and murder. Prosecutors were able to move such cases to adult court even before the law was changed.

The larger group of lesser offenses includes damaging property, trespassing, theft under $1,000, disturbing the peace, marijuana possession, illegal carrying of weapons and burglary. They also include offenses that involve the use of force, such as simple battery, but those are not listed in state law as violent crimes either, and they can be prosecuted as misdemeanors depending on the circumstances.

In one case in New Orleans, a boy took a car belonging to his mother’s boyfriend without permission so he could check out flooding during Hurricane Francine last month, according to a police report. When the teen returned the car, the front bumper was damaged. The boyfriend called police and the teen was arrested for unauthorized use of a vehicle. In another case, a boy was charged with battery after he got into a fight with his brother about missing a school bus.

In July, a 17-year-old girl was charged with resisting arrest and interfering with a law enforcement investigation. She had shoved a police officer as he was taking her older sister into custody for a minor charge resulting from a fight with another girl. None of those defendants have had an opportunity to enter a plea so far; convictions could result in jail or prison time of up to two years.

In juvenile court, teenagers facing charges such as these could be sentenced to a detention facility, but the juvenile system is mandated to focus on rehabilitation and sentences are generally shorter than in adult court, juvenile justice advocates said. And in the juvenile system, only arrests for violent crimes and repeat offenses are public record. But because these 17-year-olds are in the adult system, they all have public arrest records that can prevent them from getting jobs or housing.

Rachel Gassert, the former policy director for the Louisiana Center for Children’s Rights, said there was one word to describe what she felt when Verite News and ProPublica shared their findings: “Despair.”

Eight years ago, Gassert and other criminal justice advocates convinced lawmakers to raise the age for adult prosecution from 17 to 18 years old, pointing to research that shows that the human brain does not fully develop until early adulthood and that youth are more likely to reoffend when they are prosecuted as adults. The law enacted this spring was the culmination of a two-year effort to reverse that.

“The whole push to repeal Raise the Age was entirely political and all about throwing children under the bus,” Gassert said. “And now we are seeing the tire treads on their backs.”

Gov. Jeff Landry’s office, Clayton and state Sen. Heather Cloud, R-Turkey Creek, who sponsored the bill to roll back Raise the Age, did not respond to requests for comment. The Louisiana District Attorneys Association, which supported the bill, declined to comment.

Louisiana is the only state to have passed and then fully reversed Raise the Age legislation. It’s one of four states, along with Georgia, Texas and Wisconsin, that automatically prosecute all 17-year-olds as adults. In other states, 17-year-olds can be prosecuted as adults only in special circumstances, such as when they are charged with a serious, violent crime like murder.

Landry and his Republican allies argued that Raise the Age and other liberal policies were responsible for a pandemic-era uptick in violent offenses committed by juveniles in Louisiana. They said juvenile courts, where a sentence can’t extend past a defendant’s 21st birthday, are too lenient.

Juvenile justice advocates argued that the law would cause teenagers to be prosecuted as adults for behaviors that are typical for immature adolescents. These 17-year-olds would face long-lasting consequences, including arrest records and prison time. And the harm would fall largely on Black children. Nearly 9 out of every 10 of the 17-year-olds arrested in Orleans and East Baton Rouge parishes are Black, Verite News and ProPublica found. (A similar figure couldn’t be calculated for Jefferson Parish because some court records weren’t available.)

Opponents of the law also pointed out that the data didn’t show a link between enacting the Raise the Age legislation and a surge in violent crime. In 2022, when then-Attorney General Landry and others first tried to repeal the law, crime data analyst Jeff Asher said in a legislative hearing that Louisiana’s increase in homicides during the pandemic was part of a national trend that began before Raise the Age was passed.

“It happened in red states. It happened in blue states. It happened in big cities, small towns, suburbs, metro parishes,” Asher told lawmakers. Starting in 2023, data has shown a significant drop in homicides in Louisiana and nationwide.

Conservative lawmakers dismissed Asher’s numbers and instead cited horrific crimes committed by teenagers, such as the brutal killing of 73-year-old Linda Frickey amid a surge in carjackings in New Orleans in 2022. In that incident, four teenagers between 15 and 17 years old stole Frickey’s SUV in broad daylight. One of them kicked, punched and pepper-sprayed her as he pulled her out of the vehicle, according to court testimony. Frickey, who had become tangled in her seat belt, was dragged alongside the vehicle. Landry argued that teenagers who commit such heinous crimes must be punished as adults.

Opponents said the Frickey case instead showed why the law wasn’t needed: District attorneys in Louisiana have long had the discretion to move cases involving the most serious crimes out of juvenile court, which is what Orleans Parish District Attorney Jason Williams did. Three girls who took part in the carjacking pleaded guilty to manslaughter and were each sentenced to 20 years in prison; the 17-year-old who attacked Frickey and drove her car was found guilty of second-degree murder and sentenced to life in prison.

After the attempt to repeal the Raise the Age law failed in 2022, lawmakers passed a bill in 2023. It was vetoed by Democratic Gov. John Bel Edwards. “Housing seventeen year olds with adults is dangerous and reckless,” Edwards said in a written statement at the time. “They often come out as seasoned criminals after being victimized.”

This year, with Landry in lockstep with the Republican supermajority in the Legislature, the law sailed through. For Landry, who was elected on an anti-crime platform, the law’s passage fulfilled a campaign pledge. When the law took effect, he declared, “No more will 17-year-olds who commit home invasions, carjack, and rob the great people of our State be treated as children in court.”

Now these teenagers are treated as adults from arrest to sentencing. In New Orleans, that means that when a 17-year-old is arrested, police no longer alert their parents, a step that department policy requires for juveniles, according to a department spokesperson. It’s not clear if law enforcement agencies elsewhere in the state have made a similar change.

All 17-year-olds arrested in New Orleans are now booked into the Orleans Parish jail, where those charged with crimes not classified as violent have spent up to 15 days before being released pending trial. Though the jail separates teens from adults, it has been under a court-ordered reform plan since 2013 after the Department of Justice found routine use of excessive force by guards and rampant inmate-on-inmate violence. Federal monitors said in May that violence remains a significant problem, although they acknowledged conditions have improved somewhat. The sheriff has agreed with this assessment, blaming understaffing.

Most of the cases involving 17-year-olds in Orleans, Jefferson and East Baton Rouge parishes are pending, according to court records and officials in those offices. Several defendants have pleaded guilty. Prosecutors have declined to file charges in a handful of cases. Many defendants are first-time offenders who should be eligible for diversion programs in which charges will eventually be dropped if they abide by conditions set by the court, according to officials with the Orleans and Jefferson Parish district attorneys.

None of the DAs in Orleans, Jefferson or East Baton Rouge parishes took a position on the law, according to officials in those offices and news reports. Williams, the Orleans Parish DA, responded to Verite News and ProPublica’s findings by saying his office is holding “violent offenders accountable” while providing alternatives to prison for those teenagers “willing to heed discipline and make a real course correction.”

Margaret Hay, first assistant district attorney with Jefferson Parish, declined to comment on Verite and ProPublica’s findings except to say, “We’re constitutionally mandated to uphold and enforce the laws of the state of Louisiana.” East Baton Rouge District Attorney Hillar Moore declined to comment.

Even those who avoid prison face the long-term consequences of going through the adult court system. Background checks can reveal arrests and convictions, which could prevent them from obtaining a job, housing, professional licenses, loans, government assistance such as student aid or food stamps, or custody of their children.

“Having a felony arrest or conviction on your record,” said Aaron Clark-Rizzio, legal director for the Louisiana Center for Children’s Rights, “is like wearing a heavy yoke around your neck.”

Marsha Levick, chief legal officer with the Juvenile Law Center, a nonprofit law firm based in Philadelphia, said that what’s happening in Louisiana reminds her of the late 1990s, when states toughened punishments for juveniles after a noted criminologist warned of a generation of “super predators.” That theory was eventually debunked — but not before tens of thousands of children had been locked up and saddled with criminal records.

Mariam Elba contributed reporting and Jeff Frankl contributed research to this article.

Do you have a story to share regarding a 17-year-old facing criminal charges in Louisiana? Contact Richard Webster at [email protected].

This article first appeared on Verite News and is republished here under a Creative Commons license.

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