Former President Donald Trump, now the presumptive Republican nominee, boasts that he "broke Roe v. Wade." In the aftermath, according to Trump, "states are working very brilliantly" to impose various restrictions on abortion and creating "very beautiful harmony."

Over the last few days, this process has played out in Louisiana. Lawmakers in the Pelican State voted to continue to require child rape victims to carry their pregnancy to term. 

After Roe v. Wade was overturned by the Supreme Court, Louisiana, along with 13 other states, imposed a ban on abortion at all stages of pregnancy. The only exceptions to Louisiana's ban are when an abortion is necessary to save the life of the mother or in cases of "medically futile" pregnancy, when the fetus has a fatal abnormality. Doctors in the state "who perform illegal abortions can face up to 15 years in prison and steep fines of $10,000 to $200,000."

In February, Louisana Representative Delisha Boyd (D) introduced legislation that proposed exceptions for rape and incest to Louisiana's abortion ban. When it became clear that the proposal would fail, Boyd narrowed her bill to allow persons 16 years old and younger to have an abortion if they were the victim of rape or incest. 

The legislation was grounded in Boyd's personal experience. She was born after her mother was raped by a man when she was 15 years old. Boyd said that her mother suffered years of trauma before dying at 30. 

Neelima Sukhavasi, an obstetrician from Baton Rouge, urged the members of the Louisiana House Committee on Criminal Justice to approve Boyd's bill. Sukhavasi said that since Louisiana imposed its abortion ban in 2022, "[s]he and her colleagues have delivered babies for pregnant teenagers, including mothers as young as 13." She told the committee, "[o]ne of these teenagers delivered a baby while clutching a Teddy Bear — and that's an image that once you see that, you can't unsee it." According to Sukhavasi, these girls "can experience health complications that affect them for the rest of their lives."

Nevertheless, the committee rejected Boyd's bill last week on a 7 to 4 vote. All seven Republicans on the committee voted against creating the exception for child rape victims. One legislator who voted against creating the exception, Representative Lauren Ventrella (R), said she believed "teenagers who had consensual sex might feign rape or incest in order to get access to abortion service." Another legislator in opposition, Representative Dodie Horton (R), said rape should be punished, but she "cannot condone killing the innocent." 

Louisiana politics has long been dominated by anti-abortion advocates. But, on this issue, the legislature is out of step with their constituents. A 2023 survey found that 77% of Louisiana voters supported an abortion exception for rape and incest. A survey this year by The Times-Picayune found a majority of Louisiana voters also support allowing abortion for any reason up to 15 weeks of pregnancy. 

Louisiana legislators push to classify abortion pills as controlled dangerous substances

Anti-abortion lawmakers in Louisiana are also pushing a bill that would classify abortion medication as Schedule IV drugs, the same treatment as opioids. If the bill becomes law, Louisiana would be the first state in the country to classify mifepristone and misoprostol as controlled dangerous substances.

Under Senate Bill 276, anyone who possesses mifepristone or misoprostol – the two pills used in a medication abortion – without a valid prescription could face up to “five years in prison and $5,000 in fines.” The bill includes an exemption for pregnant women who use the drugs for their “own consumption.” But it still makes acquiring abortion drugs for future use – a practice known as advanced provision – effectively illegal. 

The proposed law also “appears to target people who might obtain abortion medications in order to distribute them to pregnant people,” WWNO New Orleans Public Radio notes. In Louisiana, distributing or manufacturing controlled substances is a punishable offense “with up to 10 years in prison and $15,000 in fines.” According to the bill’s author, State Senator Thomas Pressly (R), the aim is to take the pills “away from people who are stockpiling these drugs for whatever reason.” The bill, which was written in collaboration with Louisiana Right to Life, also seeks to “create a new crime of ‘coerced criminal abortion by means of fraud,’” Pressly said in a press release. More than 240 Louisiana doctors said the proposed classification is “not scientifically based” and wrote that it could result in “unjustified mistrust by patients and fear of the medication.”

Critics also warn that the new penalties could discourage health providers from prescribing mifepristone and misoprostol and make pharmacies reluctant to fill out those prescriptions. Abortion medication is currently the most popular method of ending a pregnancy. The drugs targeted by Pressly’s bill also have uses outside of abortions: mifepristone is used to treat Cushing’s syndrome, a hormonal disorder, and given for miscarriage treatment. Meanwhile, misoprostol is prescribed to treat ulcers and is sometimes used to help patients give birth. 

The state of maternal care in Louisiana 

Louisiana's limited exceptions for the life of the patient and "medically futile" pregnancies are both extremely narrow and poorly defined. But the state's anti-abortion officials have promised to prosecute doctors for any perceived violations. A recent report by Physicians for Human Rights and other reproductive rights advocates concluded that Louisiana's abortion ban violates "federal law meant to protect patient access to emergency care, disregard[s] evidence-based public health guidance, degrade[s] long-standing medical ethical standards, and, worst of all, den[ies] basic human rights to Louisianans seeking reproductive health care in their state."

Specifically, "initial prenatal care in Louisiana is being pushed deeper into pregnancy, often beyond the first trimester when miscarriage is more common—purposely delayed to avoid the risk of miscarriage care being misconstrued as an abortion in violation of the bans." As a result, pregnant women are "struggling to access time-sensitive, appropriate care for early pregnancy and miscarriages."

Louisiana is already "among the U.S. states with the lowest number of employed obstetricians and gynecologists (OB-GYNs) in the country with the majority of its parishes having less than two per 100,000 residents." This shortage is unlikely to dissipate as obstetricians and gynecologists in the state put themselves at risk of prosecution for providing basic prenatal care. 

Louisiana's House Committee on Criminal Justice also considered legislation last week to "insulate physicians and other health care providers from facing abortion-related charges if they were only trying to treat a pregnant person’s unavoidable miscarriage or troubled pregnancy." At the hearing, Louisiana doctors testified that they were afraid of being thrown in jail for treating pregnant patients. The legislation was rejected by the committee.