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Some Louisiana patients struggle to fill reproductive care prescriptions under new drug law • Louisiana Illuminator

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Some Louisiana patients struggle to fill reproductive care prescriptions under new drug law • Louisiana Illuminator


A Lafayette woman needed to get a uterine polyp removed so that she could get pregnant. A woman from northwest Louisiana and another from New Orleans wanted to take long-term birth control measures

What do these three women have in common? They all need misoprostol to soften their cervix before undergoing routine medical procedures, and they all faced challenges trying to fill their prescriptions.

A new law reclassifying misoprostol and mifepristone as controlled dangerous substances took effect Oct. 1 in Louisiana. The medications were reclassified because they can be used in medication abortions, but they have several other prescribed uses. Misoprostol is often used ahead of medical procedures to soften the cervix and when women bleed profusely after delivery. 

The new designation requires medical facilities and pharmacies to securely store the drugs and closely record their dispensing and use.

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In May, Gov. Jeff Landry approved  a bill from state Sen. Thomas Pressly, a Shreveport Republican,  to reclassify the drugs. Since then, doctors have voiced concerns that the law could lead to delays of care for patients, both in hospital settings and for outpatient procedures. 

Misoprostol has already been pulled off of postpartum hemorrhage carts in Louisiana and locked away in medical cabinets outside of patient rooms.

A New Orleans-area OB-GYN spoke Friday with the Illuminator about an experience she had with a patient earlier in the day that began the night prior. She asked that her name not be used because her employer did not grant her permission to speak with a reporter.

“I had set her up for an office hysteroscopy to remove [a uterine] polyp. But in preparation for that, she needed to take a medication called misoprostol in order to help open her cervix up so that I could do the procedure more safely and more comfortably,” the doctor said.

The patient was traveling from Lafayette for a minimally invasive medical procedure, and the doctor called in a misoprostol prescription a few days ahead of the procedure. But when the patient went to pick it up Thursday night at her local pharmacy, she was informed her prescription couldn’t be filled.

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“She’s just trying to get this procedure done in order to get pregnant,” the doctor said, exasperated. “They told her they do not carry the medication at all anymore. She was very upset.”

An independent pharmacy shifts protocol

Reached for comment Friday, a pharmacist at the Lafayette drug store explained he hasn’t regularly stocked misoprostol for a decade because his small independent drugstore does not see a lot of demand for the drug. When they receive a prescription for misoprostol, they usually get the medication – often just one or two pills – from a larger pharmacy nearby. 

But when the pharmacist went to do that in this case, he was told the drug was a controlled substance, and this was no longer an option because of how the medication needs to be counted. 

The Louisiana Board of Pharmacy, the profession’s state regulatory body, mentioned the new law in their July newsletter, and the state health department sent guidelines on the new law to pharmacies in early September. The Lafayette pharmacist admitted he had not been aware of them until this week.

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The Illuminator is not identifying pharmacists or small businesses in this story for security reasons.

“Sometimes pharmacies may borrow from one another. But it being a controlled substance, you can’t do that,” the Lafayette pharmacist said. “You’d have to replace it with the exact same medication.” 

The pharmacist said this means he will no longer fill misoprostol prescriptions, as it does not make sense for him economically because he rarely gets requests for it.

The OB-GYN sent the prescription Friday morning to a New Orleans-area Walmart pharmacist, suspecting it would be easier to access at a chain pharmacy. But when the patient showed up, she was told the medication was not available.

“She was like, ‘This is ridiculous,’”the doctor said. “She had to drive to all these places — she’s chasing it.” 

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The doctor then called fellow OB-GYNs in the area to find out if there were specific pharmacies they have used recently to fill misoprostol prescriptions. She eventually reached a local CVS that had the medication in stock. The patient’s procedure was delayed until later in the day because the doctor said she was fortunate to have flexibility in her schedule to accommodate the change. 

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However, the doctor said she was frustrated that she, her staff and the patient had to dedicate time to hunting down the medication, which is on the World Health Organization’s core list of essential medicines. 

Louisiana is the only state to designate misoprostol and mifepristone controlled dangerous substances, a designation most often used for highly addictive painkillers. 

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“This has such a huge impact on our practice,” she said. She plans to talk to her employer about whether or not they need to adjust their protocols to store the medication onsite.

a bottle of Misoprostol tablets are displayed at a family planning clinic on April 13, 2023 in Rockville, Maryland.
Misoprostol, used to treat post-delivery hemorrhages, will become a Schedule IV controlled dangerous substance in Louisiana effective Oct. 1 under a new law. The designation means the medicine will have to be securely stored, raising concerns among doctors who say they rely on immediate access to the medication in life-threatening situations. (Anna Moneymaker/Getty Images)

Major pharmacies insist they haven’t changed policy

A pharmacist at the New Orleans-area Walmart where the patient was unable to get her misoprostol prescription filled told the Illuminator late Friday afternoon the medication was not currently in stock but could be ordered and delivered from another pharmacy with the correct diagnosis code — a process that usually takes a day. 

Corporate representatives for Walmart did not respond to requests for comment. 

Amy Thibault, a CVS spokeswoman, said Louisiana’s new regulations haven’t affected how the pharmacy chain handles the targeted drugs.  

There’s been no impact to misoprostol supply or how we stock the medication due to the state law,” Thibault said. 

A Walgreens spokesman said the company has had no issues with the supply of misoprostol to any of its Louisiana stores. 

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“There has been no change in policy” since the new law took effect, Fraser Engerman said. “Stock is based on sales at each of our stores. If there is low volume at a store, it can be ordered for next-day delivery to the store.”

‘Women are not safe in Louisiana’: New Orleans leaders want pregnancy care drug law reversed

Dr. Nicole Freehill, New Orleans OB-GYN, said obtaining misoprostol was challenging immediately after the U.S. Supreme Court overturned Roe v. Wade in June 2022, effectively ending elective abortions in the state of Louisiana. 

We did encounter push back immediately after … but that improved over time and working with pharmacists directly to reassure them we were not prescribing it for ‘illegal’ uses,” Freehill said in a text message. “I am fearful this new law will destroy a lot of that work.”

On Sept. 30, Freehill said she encouraged a patient with an upcoming intrauterine device (IUD) insertion to fill her misoprostol prescription that day — before the new law took effect Oct. 1 — in case of any confusion. But when Freehill sent the prescription to a pharmacy, she said the patient’s insurance provider requested prior authorization.

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“Prior authorization is another level an insurance company puts in place, often due to the cost of a medication or service, it’s usually for brand-name drugs or imaging like MRIs,” Freehill said. “I have never seen one for misoprostol, neither had the pharmacist that I talked to.”

The patient was able to obtain the prescription but had to pay out of pocket for it in order to avoid waiting for the prior authorization, said Freehill, who reported the issue to the New Orleans Health Department. City health director Dr. Jennifer Avegno is conducting an impact study on the new law to determine if it’s leading to care delays or difficulties.

Avegno described the new state law as a “poorly conceived, medically and scientifically baseless law” and said she’s heard from patients and providers across the state about outpatient access to misoprostol being “delayed and denied.” The reasons behind the barriers they face are varied and include pharmacies no longer carrying the medication as well as prolonged waits for prescriptions to be processed, she said.

“As hundreds of health care professionals have warned for months, this has disrupted women’s ability to have routine procedures, manage miscarriages, and even receive fertility treatments,” Avegno said.   

‘It’s really frustrating’

An obstetrician in northwest Louisiana, who requested anonymity because her hospital did not give her permission to speak with a reporter, said she had a patient who faced challenges procuring misoprostol last week.

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“I couldn’t get a single pharmacy in [my area] to dispense misoprostol for an IUD insertion,” the doctor said. 

The OB explained that prior to May, she hadn’t had issues calling in misoprostol prescriptions the day before a procedure. She submitted the prescription in question Tuesday for a procedure the next day.

Doctors criticize misoprostol guidance from Louisiana Department of Health: ‘It’s not helpful’

“Usually the pharmacies would have the medicine the next day or make adjustments pending dosage availability,” she explained, saying that in her experience pharmacists can often get deliveries secured overnight.

The patient was able to fill her accompanying Valium prescription, according to her doctor, but four area pharmacies the patient called told her they did not have misoprostol in stock. One family-owned pharmacy told the patient they were no longer carrying it, her doctor said The patient ended up getting the procedure without misoprostol.

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The doctor said she had her staff follow up with five pharmacies in the area and said none had it readily available. Only two offered to order the medication. 

Now the doctor said she is considering steps to keep misoprostol in her office so that she can dispense it to patients herself, hours ahead of a procedure.

“I counsel these patients on the pain they might experience with IUD insertion and offer them ways to mitigate it. So it’s really frustrating when I can’t hold up my end of the bargain,” the physician said. 

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If you’ve experienced challenges seeking reproductive health care in Louisiana, particularly if you are in a rural area, we’d love to hear from you. Please fill out this secure form or contact our reporter at lorenaoneil.64 on Signal, an encrypted messaging app.



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Louisiana’s oldest death row inmate dies less than month before execution date

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Louisiana’s oldest death row inmate dies less than month before execution date


A terminally ill man who spent over 30 years on death row in Louisiana for the killing of his stepson died days after a March date was scheduled for his execution by nitrogen gas.

Christopher Sepulvado, 81, died Saturday at the Louisiana State Penitentiary in Angola, Louisiana, “from natural causes as a result of complications arising from his pre-existing medical conditions,” according to the Louisiana Department of Public Safety and Corrections.

He was the oldest of the 57 inmates on death row as the state weighed resuming executions after a 15-year pause, CBS affiliate WWL-TV reported.

Sepulvado was charged with the 1992 killing of his 6-year-old stepson after the boy came home from school with soiled underwear. Sepulvado was accused of hitting him on the head with a screwdriver and immersing him in scalding water. He was convicted of murder and sentenced to death in 1993.

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His attorney, federal public defender Shawn Nolan, said in a statement Sunday that doctors recently determined Sepulvado was terminally ill and recommended hospice care. Nolan described his client’s “significant” physical and cognitive decline in recent years.

“Christopher Sepulvado’s death overnight in the prison infirmary is a sad comment on the state of the death penalty in Louisiana,” Nolan said. “The idea that the state was planning to strap this tiny, frail, dying old man to a chair and force him to breathe toxic gas into his failing lungs is simply barbaric.”

According to Nolan, Sepulvado had been sent to New Orleans for surgery earlier in the week but was returned to the prison Friday night. According to WWL-TV, Sepulvado’s health had sharply declined, and COPD and gangrene led to a recent leg amputation.

Louisiana officials decided to resume carrying out death sentences earlier this month after a 15 year pause driven by a lack of political interest and the inability to secure legal injection drugs. Republican Gov. Jeff Landry pushed to proceed with a new nitrogen gas execution protocol after the state’s GOP-dominated Legislature last year expanded death row execution methods to include electrocution and nitrogen gas.

Louisiana Attorney General Liz Murrill said in a statement that “justice should have been delivered long ago for the heinous act of brutally beating then scalding to death a defenseless six-year-old boy.”

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Louisiana Nitrogen Death Penalty
Death Row building at the Louisiana State Penitentiary Friday, Sept. 18, 2009, in Angola, La.

Judi Bottoni / AP


Murrill added that Louisiana failed to deliver justice in his lifetime “but Christopher Sepulvado now faces ultimate judgment before God in the hereafter.”

Sepulvado’s execution was scheduled for March 17. Another man, Jessie Hoffman, was convicted of first-degree murder in 1996 and slated for execution on March 18. Hoffman initially challenged Louisiana’s lethal injection protocol in 2012 on the grounds that the method was cruel and unusual punishment. A federal judge on Friday reopened that lawsuit after it was dismissed in 2022 because the state had no executions planned.

The country’s first execution using nitrogen gas was carried out last year in Alabama, which has now executed four people using the method.

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Louisiana man with execution date next month dies at Angola

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Louisiana man with execution date next month dies at Angola


A federal appellate court this week refused to throw out a ban on housing incarcerated youth at Angola. (Photo credit: Jarvis DeBerry/Louisiana Illuminator)

Christopher Sepulvado, the 81-year-old man who was facing execution next month for the 1992 murder of his stepson, died overnight at Louisiana State Penitentiary in Angola, according to his attorney.

Shawn Nolan, who had represented Sepulvado, said was sent to a New Orleans hospital last week for a leg amputation. Doctors instead sent him back to Angola, and it is believed the infection ultimately claimed Sepulvado’s life, according to Cecelia Kappel, another attorney representing death row clients.

Doctors had previously determined Sepulvado, who had multiple serious ailments, was terminally ill and recommended hospice care at the time a judge set his execution date for March 17, according to Nolan.

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“Christopher Sepulvado’s death overnight in the prison infirmary is a sad comment on the state of the death penalty in Louisiana,” Nolan said in a statement. “The idea that the State was planning to strap this tiny, frail, dying old man to a chair and force him to breathe toxic gas into his failing lungs is simply barbaric.”

Sepulvado would have the first person Louisiana put to death using nitrogen hypoxia, a method state lawmakers and Gov. Jeff Landry approved last year. The death penalty hasn’t been carried out in Louisiana since 2010, when Gerald Bordelon, 47, received a lethal injection for the kidnapping and murder of his 12-year-old stepdaughter, Courtney LeBlanc, in Livingston Parish.

Next on Louisiana’s execution calendar is Jessie Hoffman, 46, who was sentenced to die for the 1996 rape and murder of 28-year-old Mary “Molly” Elliot. Authorities said Hoffman abducted Elliot in downtown New Orleans and brought her to St. Tammany Parish, where he raped and murdered her, leaving her body in a remote area near the Pearl River.   

Hoffman is scheduled to die March 18, though attorneys are challenging Louisiana’s new execution method in court on behalf of 10 death row inmates. There are currently 57 people facing the death penalty in the state.

DeSoto Parish Judge Amy Burford McCartney issued a death warrant Feb. 12 for Sepulvado for the killing of  6-year-old Wesley Allen Mercer. Police said the boy was beaten and scalded to death. His mother, Yvonne Jones, was convicted of manslaughter and served more than seven years in prison. 

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Sepulvado was previously scheduled to die by lethal injection in 2013, but his attorney successfully argued that Louisiana officials could not provide enough information on the drugs being used to execute him. The lack of those details constituted cruel and unusual punishment, a federal judge ruled.

Multiple execution dates for Sepulvado have since been handed down and subsequently suspended as lawyers for him and other death row inmates have challenged the use of lethal injection.

Sepulvado’s motion for reconsideration was denied in November 2022, but U.S. District Judge Shelley Dick, an appointee of former President Barack Obama, agreed Friday to reopen the case. 

This is a developing story.

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Nicholls to host Louisiana’s Restoration Generation Coastal Summit

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Nicholls to host Louisiana’s Restoration Generation Coastal Summit


Nicholls State University is going to host a big first in the continued fight to raise awareness in our state’s continued fight against coastal erosion.

Nicholls will host the inaugural Louisiana’s Restoration Generation Coastal Summit on March 12, 2025 in the Cotillion Ballroom.

The event will be hosted from 9 a.m. – 3 p.m. and it is sponsored by Restore the Mississippi River Delta and the Nicholls Mass Communication Department. The event aims to explore issues related to conservation in Coastal Louisiana while inspiring the next generation of coastal advocates.

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During the day, there will be presentations, panel discussions, coastal and cultural vendors, live Cajun music and more.

Bren Haase is the executive director of the Barataria-Terrebonne National Estuary Program. Haase will deliver a keynote presentation on ‘Restoration in the Barataria and Terrebonne Estuaries.’

The panels will include ‘The People of our Coast,’ ‘Careers in Coastal Restoration,’ and ‘Louisiana’s Restoration Generation: Students Making an Impact.’

“We are thrilled to partner with Nicholls State University for the first Coastal Summit. This event is a fantastic opportunity for students to learn about Louisiana’s land loss crisis and discover solutions they can directly plug into to help, while also exploring careers in coastal restoration. By engaging in these critical discussions, these students are standing up for their coast— helping to drive meaningful discussions that can help shape the future of Louisiana’s coast,” said Emily Guidry Schatzel, senior communications manager for Restore the Mississippi River Delta.

Attendees can register and secure their spot at the event at Nicholls.edu/maco/coastal-summit.

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Registration is not required, but it is encouraged. Registrants will receive a conference bag, discounted Louisiana-themed lunch in the Vernon F. Galliano Dining Hall and entry into a raffle drawing.

The summit is free and the public is invited to attend. Pre-registration at the above-listed website closes on March 6.

The inaugural Summit is part of a service learning project for students who are studying Environmental Communication, Global Communication and Public Relations.

Louisiana’s Restoration Generation is a movement of college students who aim to engage the college student population on issues of concern in Coastal Louisiana, while encouraging students to explore career paths in restoration industries. They also aim to inspire students to become conservation advocates for Coastal Louisiana.

It is part of the Nancy Sanderson Matherne Institute for Global Communication in the Nicholls Department of Mass Communication

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“Communication on coastal issues is something important to us in the Department of Mass Communication. We see this as an opportunity to give our students important real-world experience while making an impactful difference for our community and our state,” said Nicki Boudreaux, assistant professor of Mass Communication and director of the NSM Institute for Global Communication. “This is our opportunity to create a movement.”

For more information, contact nicki.boudreaux@nicholls.edu.



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