Louisiana has become the first US state where the two pills used for medical abortion are designated as controlled substances. A bill signed into law by Republican governor Jeff Landry in May puts the pills in the same category as opiates and criminalises unprescribed possession. But in a state where abortion has already been almost entirely banned since 2022, doctors say the real impact of the law has further – potentially dangerous – implications. Misoprostol, the pill typically taken second in a medical abortion, is also used for treating miscarriages and postpartum haemorrhages. In preparation for the new law, staff in some Louisiana hospitals have been running drills for when nurses need to retrieve the drugs from a locked medicine cupboard, where they now must be kept. Meanwhile in Georgia, a judge struck down a law banning abortions after six weeks. Pending appeal, abortions there are legal again up to 22 weeks.