On Tuesday, the New Orleans Health Department debuted its online misoprostol map locator and access report form, which shows the exact locations of pharmacies in Orleans and Jefferson Parishes that stock the now-controlled substance.
The map comes shortly after the Louisiana legislature passed Act 246, the law that reclassified misoprostol and mifepristone, two medications commonly used together, to trigger medical abortions. As the law moved closer to taking effect on October 1, 2025, the New Orleans City Council tasked the Health Department with investigating and studying any delay in care because of Act 246. The department also created an anonymous online report form, so that physicians and patients could report any problems encountered when filling, prescribing, or accessing misoprostol.
In 26 states across the country, there are reports of pharmacies refusing to fill prescriptions associated with emergency contraceptives and abortion, including here in Louisiana, according to the National Women’s Law Center. In New Orleans, shortly after the law went into effect, Dr. Jennifer Avegno, the Health Department’s director, got many similar reports of problems ranging from reasonable to fear based on legal repercussions.
A portion of the complaints weren’t political, Avegno said. “In some cases it made total sense: they’re a specialty pharmacy and only carry certain drugs, like for skin conditions or cancer.”
But the new law played a role. “A lot of what we’ve heard is, ‘Well, we just decided it was too much trouble because of the new law, and so we stopped carrying it,’” she said.
Beyond the complaints, the Health Department’s staff set out to find who carried misoprostol. They found that 65% of all pharmacies in Orleans and 30% in Jefferson had misoprostol currently in stock and available.
The map released this week only shows 33 pharmacies: the Health Department wanted to take a “conservative approach” by only listing locations that they were able to confirm with additional layers of verification.“We only listed the ones that we had spoken to and someone confirmed they had it there and available,” Avegno said.
Pharmacies not on the map either said that they didn’t carry misoprostol – the Health Department called and they said, “Nope, we don’t have it” – or they simply may have been unreachable by phone.
When looking at the list overall, patterns emerge. For instance, smaller pharmacies in New Orleans were more likely to not carry misoprostol, when compared with chain pharmacies.
When misoprostol prescriptions cannot be filled at a pharmacy, that could be due to a corporate or personal decision. In 2022, after the U.S. Supreme Court overturned Roe v. Wade, which guaranteed a woman’s right to abortion, CBS News reported that CVS Health had asked its pharmacists in some states to verify with doctors whether the prescribed use was to assist in medical abortions.
Misoprostol has a number of uses that don’t relate to abortion. It’s often used to soften the cervix before doctors insert an IUD, treat and prevent ulcers, and it’s a key, life-saving medication used in emergency rooms to stop postpartum hemorrhaging.
In at least one case, misoprostol was not available because of a pharmacist’s personal beliefs, which prompted that clinician to stay away from anything that could be related to abortion. The person said, “Oh no, I’m not carrying anymore. I don’t fool with abortion drugs,“ Avegno said, noting that
Under current Louisiana law, misoprostol cannot be legally prescribed for abortions.
Raising other concerns
Family doctor Emily Holt, owner of Poppy Direct Care, provides primary care including reproductive healthcare to young adults. Though she often writes prescriptions for misoprostol for patients who have scheduled IUD insertions, she no longer dispenses medication at her practice because of Act 246. As someone affected adversely by the medication’s relabeling, Holt became a plaintiff in a lawsuit filed against the state of Louisiana.
Like the Health Department, Holt had been making phone calls and trying to compile a list of misoprostol-stocked pharmacies, so that her patients didn’t have to drive around town searching for it.
“I think it’s great that they’re trying to alleviate some of the administrative burden of finding which pharmacies even stock misoprostol,” Dr. Holt said. “But from my perspective, I’m still going to be doing the same work that I’ve done before. Like this is just for Orleans and Jefferson Parish. So what about the rest of Louisiana?”
Reproductive-health access has long been much more difficult in rural areas, with underprivileged populations, and with critical patients in often-unpredictable situations such as postpartum hemorrhaging.
“It sounds like the New Orleans Health Department is doing everything that they can do to alleviate the really enormous administrative burden that falls on patients and practitioners, to get patients misoprostol when they need it,” Holt said. “But we wouldn’t even need them to be doing this work if the legislature had the best interest of patients in mind and overturned this law or didn’t pass this law in the first place.”
Future expansion plans
Knowing those stark health inequities, Avegno and her Health Department staff plan to expand the map to include pharmacies across Louisiana. The Health Department plans to focus first on metropolitan areas and regions with high concentrations of obstetrician and gynecologists.
But about 25% of Louisiana parishes do not have a single OB-GYN provider.
For anyone working in women’s reproductive health, misoprostol is an essential tool, Avegno said. “As one of my OB friends says, if you have a uterus, at some point you’re going to use misoprostol for something,” she said. “Whether it’s miscarriage, IUD, when you’re in labor – a wide variety of things.”
As a result, the relabeling has affected a large number of people, she said. And that matters even more in Louisiana, because of its poor health indicators.
That’s what prompted the need for a map of misoprostol availability, she said. “We need to always keep in mind that Louisiana has some of the worst women’s health outcomes in America. And even little barriers add up.”