Doctors Will Keep Mailing Abortion Pills Across State Lines Despite Historic Indictment
When the news broke on Jan. 31 that a New York physician had been indicted for shipping abortion medications to a woman in Louisiana, it stoked fear across the network of doctors and medical clinics who engage in similar work. On Jan. 31, Margaret Carpenter became the first U.S. doctor criminally charged for providing abortion pills across state lines — a medical practice that grew after the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision on June 24, 2022, which overturned Roe. Ever since the Supreme Court overturned Roe v. Wade in 2022, abortion providers like Angel Foster had been expecting prosecution or another kind of legal challenge from states with abortion bans.
The Legal Conflict and State Shield Laws
Eight states — New York, Maine, California, Colorado, Massachusetts, Rhode Island, Vermont, and Washington — have passed laws since 2022 to protect doctors who mail abortion pills out of state, and thereby block or “shield” them from extradition in such cases. However, this is the first criminal test of these relatively new “shield laws.” The telemedicine practice of consulting with remote patients and prescribing them medication abortion via the mail has grown in recent years — and is now playing a critical role in keeping abortion somewhat accessible in states with strict abortion laws. The following data highlights the current legal environment surrounding these procedures:
| Category of State Law | Number of States or Details |
|---|---|
| Near-total abortion bans | 12 states |
| Outlawed after a certain point in pregnancy | 10 states |
| States with protective "Shield Laws" | New York, Maine, California, Colorado, Massachusetts, Rhode Island, Vermont, Washington |
The Extradition Battle Between New York and Louisiana
Carpenter was indicted alongside a Louisiana mother who allegedly received the mailed package and gave the pills prescribed by Carpenter to her minor daughter. The teen wanted to keep the pregnancy and called 911 after taking the pills, and when police responded, they learned about the medication, which carried the prescribing doctor’s name. On Feb. 11, Louisiana’s Republican governor, Jeff Landry, signed an extradition warrant for Carpenter, arguing she “must face extradition to Louisiana, where she can stand trial and justice will be served.”
New York’s Democratic governor, Kathy Hochul, countered by releasing her own video, confirming she was refusing to extradite Carpenter. “Louisiana has changed their laws, but that has no bearing on the laws here in the state of New York,” Hochul said. The charges carry a possible five-year prison sentence, and the doctors could end up in the crosshairs of a legal clash over the interstate practice of medicine when two states disagree on whether people have a right to end a pregnancy.
Impact on Healthcare Providers and Patient Access
At the Massachusetts Medication Abortion Access Project, physicians use telehealth to prescribe and mail pills to people who live in states that ban or restrict abortion. The doctors say that if they stop, tens of thousands of patients would no longer be able to end early pregnancies safely at home, under the care of a U.S. physician. Despite the fact that the criminal risk is no longer hypothetical, many clinics remain dedicated to their mission.
As Kohar Der Simonian, medical director for Maine Family Planning, noted: “It just hit home that this is real, like this could happen to anybody, at any time now, which is scary.” Yet, for organizations like the Massachusetts Medication Abortion Access Project, the work continues because, as Foster added, “it’s not entirely surprising” that these legal tests have finally arrived.