(Bloomberg) -- Louisiana plans to make it a crime to possess either of the two main US abortion pills without a prescription, expanding restrictions in a state that already has a near-total ban on ending unwanted pregnancies.

The state Senate passed a bill by a 29 to 7 vote on Thursday, adding mifepristone and misoprostol to the list of controlled substances that includes highly addictive narcotics. The measure now goes before Governor Jeff Landry, a Republican who opposes abortion access and is expected to sign the bill into law.

Louisiana’s move to criminalize the abortion pills could open the door for other GOP-led states that already limit access to the procedure. Louisiana ranks 47th out of 48 states in maternal mortality rates, US Centers for Disease Control and Prevention data show from 2018 to 2021. Other states with strict abortion laws also ranked low in the list including Mississippi, Georgia and Alabama.

In May, the Republican-led Louisiana legislature rejected adding an exception to rape and incest in its abortion ban. Landry, when he was state attorney general, joined other GOP states in asking the federal government to release information about people who receive out-of-state abortion care.

“Anti-abortion advocates are so set on their radical agenda that they will manipulate any and every opportunity in pursuit of blocking people from care, and attempting to reclassify medication abortion would be another example of such manipulation,” Nimra Chowdhry, the senior state legislative counsel at the advocacy group Center for Reproductive Rights, said in an emailed statement.

Supreme Court

The future for mifepristone has been uncertain ever since a Texas federal judge moved last year to rescind US Food and Drug Administration approval of the drug. An appeals court scaled back that order with a decision that would let mifepristone stay on the market, but with more restrictions. The US Supreme Court is expected to make a ruling in June.  

Despite mounting evidence over the years that the medication is safe and effective, mifepristone has been subject to tight regulations. For years, doctors, medical groups and researchers have argued that the rules are unnecessary and pressured the FDA to loosen them.

“These drugs are safe and classifying them as anything other than safe and effective is unfounded in scientific evidence,” said Caitlin Gerdts, the vice president of research at Ibis Reproductive Health, an advocacy group. “This is politics driving policy at the expense of people’s health.”

The oral drug mifepristone was first approved for use to facilitate an abortion in France in 1988, and is now approved in more than 90 countries. Misoprostol, meanwhile, is commonly used to treat stomach ulcers. It can be used to terminate a pregnancy on its own, but requires a different dosage than the more common regimen that combines misoprostol and mifepristone.

Side effects are often more acute with a misoprostol-only regimen, and the drug has a slightly lower success rate.

Criminalizing possession of the pills will hurt women trying to obtain abortion care and those looking to use misoprostol for treatment of stomach ulcers, Chowdhry said.

Abortion has been banned in Louisiana since the US Supreme Court handed down its decision in Dobbs v. Jackson Women’s Health Organization in June 2022. The court repealed the landmark ruling Roe v. Wade and reverted laws about abortion to the state level. 

In Louisiana, voters in November 2020 ratified a ballot initiative that added language to the state constitution that abortion is not a right.

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