Doctors Maintain Telehealth Abortion Access 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. 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. 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.
The Legal Clash Over Interstate Medicine
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, according to an NPR and KFF Health News interview with Tony Clayton, the Louisiana local district attorney prosecuting the case. When police responded, they learned about the medication, which carried the prescribing doctor’s name, Clayton said. Consequently, on Feb. 11, Louisiana’s Republican governor, Jeff Landry, signed an extradition warrant for Carpenter. However, 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.
Understanding Shield Laws and State Restrictions
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. But 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, according to research from the Society of Family Planning.
Current Landscape of Abortion Access
| Category | Data and Status |
|---|---|
| States with Shield Laws | New York, Maine, California, Colorado, Massachusetts, Rhode Island, Vermont, and Washington |
| Near-Total Abortion Bans | 12 states have enacted these since the Dobbs decision |
| Partial Abortion Bans | 10 states have outlawed the procedure after a certain point in pregnancy |
The Impact on Healthcare Providers
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. Doctors who prescribe abortion pills across state lines describe facing a new reality in which the criminal risk is no longer hypothetical. 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. Yet, despite these risks, 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.
“It’s scary. It’s frustrating,” said Angel Foster, co-founder of the project. But, Foster added, “it’s not entirely surprising.” 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.