Despite Historic Indictment, Doctors Will Keep Mailing Abortion Pills Across State Lines

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. Since Dobbs, 12 states have enacted near-total abortion bans, and an additional 10 have outlawed the procedure after a certain point in pregnancy, but before a fetus is viable.

The Indictment and Legal Extradition

Carpenter was indicted alongside a Louisiana mother who allegedly received the mailed package and gave the pills prescribed by Carpenter to her minor daughter. On Feb. 11, Louisiana’s Republican governor, Jeff Landry, signed an extradition warrant for Carpenter. He later posted a video 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. The charges carry a possible five-year prison sentence. “Louisiana has changed their laws, but that has no bearing on the laws here in the state of New York,” Hochul said.

State Shield Laws and Protection

Eight states 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. This is the first criminal test of these laws. These states include:

• New York
• Maine
• California
• Colorado
• Massachusetts
• Rhode Island
• Vermont
• Washington

Reactions from the Medical Community

“It’s scary. It’s frustrating,” said Angel Foster, co-founder of the Massachusetts Medication Abortion Access Project, a clinic near Boston that mails mifepristone and misoprostol pills to patients in states with abortion bans. 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. Ever since the Supreme Court overturned Roe v. Wade in 2022, abortion providers like her had been expecting prosecution or another kind of legal challenge from states with abortion bans. “It was unclear when those tests would come, and would it be against an individual provider or a practice or organization?” she said.

The indictment also sparked worry among abortion providers like Kohar Der Simonian, medical director for Maine Family Planning. “It just hit home that this is real, like this could happen to anybody, at any time now, which is scary,” Der Simonian said. Despite these concerns, providers continue to navigate the landscape where it remains unknown whether such challenges would be a criminal indictment, a civil lawsuit, or an attack on licensure.