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The Louisiana attorney general also tried to extradite the physician for sending medication abortion pills to a patient in the state.
Republican-controlled states' testing of abortion rights "shield laws" that have been passed in eight states in recent years ramped up on Thursday as a judge in Texas ordered a New York doctor to pay more than $100,000 in fines and fees for prescribing medication abortion pills to a 20-year-old woman in the Dallas area last year.
On the same day, the physician, Dr. Margaret Daley Carpenter of the Abortion Coalition for Telemedicine (ACT), was subject to a demand for extradition to Louisiana after a state grand jury last month indicted her for mailing misoprostol and mifepristone, pills that are used in a majority of abortions in the U.S., to the state.
The charges in Louisiana are the first criminal charges filed against an abortion provider in a state with a shield law, which bar officials and agencies from cooperating with lawsuits and prosecutions against healthcare professionals who send abortion pills to patients in states that ban abortion care. The laws have been passed as advocates in states where abortion care remains legal fight to ensure Americans across the country can still obtain care after the U.S. Supreme Court's overturning of Roe v. Wade in 2022.
Texas Attorney General Ken Paxton did not file criminal charges against Carpenter, but accused her in a lawsuit of violating the state's near-total abortion ban by providing the medication to a resident through the mail.
In the country's first ruling on a case involving a shield law, State District Judge Bryan Gantt ordered Carpenter to pay $100,000 in fines and $13,000 in attorneys' and other fees. He also ruled that Carpenter, who did not attend Thursday's court proceedings, "is permanently enjoined from prescribing abortion-inducing drugs to Texas residents."
Violating the ruling could result in a jail sentence for Carpenter.
Despite the ruling, ACT executive director Julie Kay toldThe Associated Press on Thursday that "patients can access medication abortion from licensed providers no matter where they live."
"ACT has and continues to stand behind New York and other shield laws across the country that enable the distribution of safe and effective telemedicine abortion care."
In December, ACT said medication abortion pills, which have been approved by the Food and Drug Administration since 2000 and have "been proven safe and effective globally for decades," are "an essential part of women's healthcare."
The Texas case is expected to eventually reach the U.S. Supreme Court, where the right-wing majority could rule against legal protections for abortion providers who provide telemedicine for out-of-state patients—even as Republicans including President Donald Trump claim they believe abortion law should be left up to the states.
In Louisiana, Carpenter was indicted for allegedly violating the state's near-total abortion ban by sending pills for a girl who reportedly then experienced a medical emergency. The patient's mother has also been charged. If convicted, Carpenter could face up to 15 years in prison.
Republican state Attorney General Jeff Landry demanded her extradition to Louisiana, but New York Gov. Kathy Hochul, a Democrat, said Thursday that she "will not be signing an extradition order that came from the governor of Louisiana. Not now, not ever."
ACT said Thursday that "ongoing attempts by anti-abortion state officials to restrict access to abortion care are inconsistent with New York state law."
"ACT has and continues to stand behind New York and other shield laws across the country that enable the distribution of safe and effective telemedicine abortion care," said the group.
The Texas case also reflects a dynamic that could lead to new prosecutions against abortion providers: those resulting from legal challenges filed by men whose partners receive abortion care.
In the case of the 20-year-old Texas resident, the patient was taken to a hospital in July by a man identified in legal filings as the "biological father of her unborn child."
After the man "started to suspect" the patient had used abortion pills and found the medications that had been prescribed by Carpenter and ACT, he "filed a complaint with the Texas attorney general's office."
The New York Timesreported that with Texas Right to Life, several men plan to file wrongful death lawsuits in the coming weeks against doctors and others who assisted their female partners in obtaining abortion care.
"We must remain vigilant," one expert warned. "The anti-abortion movement is ruthlessly pursuing its end goal of banning abortion nationwide."
While welcoming the U.S. Supreme Court's unanimous decision to preserve access to mifepristone, a medication commonly used for abortion care, rights advocates on Thursday also stressed that the six conservative justices who reversed Roe v. Wade are no allies to reproductive freedom.
"We are relieved by this outcome, but we are not celebrating," said Destiny Lopez, acting co-CEO of the Guttmacher Institute. "From the start, this case was rooted in bad faith and lacking any basis in facts or science. This case never should have reached our nation's top court in the first place and the Supreme Court made the only reasonable decision by leaving access to medication abortion using mifepristone unchanged."
"Mifepristone is safe, effective, and essential."
"Mifepristone is safe, effective, and essential," Lopez continued, citing Guttmacher data that two-thirds of known U.S. abortion patients last year used medication to end their pregnancies. "Even with this baseless challenge defeated, we must remain vigilant. The anti-abortion movement is ruthlessly pursuing its end goal of banning abortion nationwide."
Two years after Dobbs v. Jackson Women's Health OrganizationoverturnedRoe, "abortion is banned in 14 states and severely restricted in many more," she noted. "In the face of relentless attacks, policymakers at all levels need to keep pushing forward expansive and protective policies that ensure everyone can access abortion care using the method that best suits their needs.
The court agreed to take Food and Drug Administration v. Alliance for Hippocratic Medicine in December and heard arguments in March. The new opinion, written by Justice Brett Kavanaugh, concludes that the anti-choice groups that were trying to cut off access to the abortion pill across the country lacked "standing to challenge FDA's actions regarding the regulation of mifepristone."
Justice Clarence Thomas penned a concurring opinion—as he did for Dobbs, when he suggested the court should also reconsider rulings that affirmed the right to use contraceptives, overturned a state law that criminalized consensual sexual activity between adults of the same sex, and enabled LGBTQ+ couples to legally marry nationwide.
The dismissal on standing "is a powerful affirmation of what we have always known: mifepristone is a safe and essential medication, and there is no legitimate medical or scientific reason why access to mifepristone should be limited," said Dr. Jamila Perritt, a Washington, D.C.-based OB-GYN who leads Physicians for Reproductive Health.
"We fought tirelessly to ensure access to mifepristone because of its critical role in reproductive healthcare and its importance in expanding abortion access for our community members, especially those living at the intersections of systemic oppression disproportionately harmed by abortion bans and restrictions," Perritt explained.
However, that fight is far from over. Like Lopez, ACLU Reproductive Freedom Project director Jennifer Dalven emphasized that "we are relieved the Supreme Court didn't take this bait, but unfortunately we know that this is far from the end of the line."
"Although the court refused to allow these particular people to bring this case, anti-abortion politicians are waiting in the wings to attempt to continue pushing this case before an extremist judge in Texas in an effort to deny people access to medication abortion care," she said, calling out District Judge Matthew Kacsmaryk, an appointee of former President Donald Trump, the presumed Republican nominee for November.
While Trump has bragged about his role in reversing Roe—he appointed three of the court's six right-wing justices—Democratic President Joe Biden has campaigned on his support for reproductive rights. Like the advocates, he welcomed Thursday's ruling but also warned of "Republican elected officials' extreme and dangerous agenda to ban abortion nationwide."
With the mifepristone case settled—for now—rights defenders are shifting their focus to another forthcoming decision.
"Today, the Supreme Court did the bare minimum by rejecting this case on standing and allowing mifepristone to remain FDA-approved and without new restrictions. However, with the case returning to the district court, the fight is not over," said Planned Parenthood Federation of America president and CEO Alexis McGill Johnson. "As we breathe a sigh of relief for now, we cannot forget that the court is deciding another case about abortion this term."
That case, Dalven noted, "will determine whether politicians can force doctors to withhold emergency room care from their patients while they suffer severe, life-altering pregnancy complications."
"These cases show the extreme lengths politicians will go," she added, "to prevent people from getting the reproductive healthcare they need."
Sen. Patty Murray described the event as "a close accounting of the trauma Republicans are inflicting on women and families across our country, and the damage they are doing to basic reproductive healthcare."
Abortion rights advocates in the U.S. Senate held a Tuesday hearing highlighting the impacts of healthcare bans imposed by the GOP, particularly since the Supreme Court's June 2022 ruling in Dobbs v. Jackson Women's Health Organization, which reversed Roe v. Wade.
The hearing—titled, "The Assault on Women's Freedoms: How Abortion Bans Have Created a Healthcare Nightmare Across America"—was officially hosted by Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Bernie Sanders (I-Vt.), but he kicked it off by explaining why he was turning things over to Sen. Patty Murray (D-Wash.), the panel's former leader.
"Given the subject matter I think it's appropriate for a woman to chair this important hearing and this is an issue that Sen. Murray has been deeply and passionately involved in for many, many years," Sanders said, connecting the fight for abortion access to women's battles for other basic rights, including equal pay and political representation. "Sen. Murray, the gavel is yours."
Murray described the hearing as "a close accounting of the trauma Republicans are inflicting on women and families across our country, and the damage they are doing to basic reproductive healthcare through their horrific anti-abortion crusade."
With Republican politicians' recently implemented abortion bans and restrictions, "they have told women on no uncertain terms, 'You don't control your body, we do.' That is horrifying," she said. "The consequences of the post-Dobbs abortion bans are so much broader and so much more devastating than any one story or hearing can ever do justice."
Murray mentioned a story shared by Dr. Neelima Sukhavasi last month when Louisiana lawmakers were considering whether to add rape and incest exceptions to the state's strict abortion ban (they didn't). Recalling a rape survivor giving birth, the OB-GYN said, "One of these teenagers delivered a baby while clutching a Teddy Bear—and that's an image that once you see that, you can't unsee it."
The senator stressed that "these nightmares are happening across our country and there are so many other stories that go untold."
"It is harrowing to think that we live in a reality where forced pregnancy has become so widespread and so rampant that only the most dystopian stories get national attention—but the stories of all the other women who are confronted by these bans, their pain, their heartbreak, their anger and fear, are also horrific, valid, and an important part of the conversation," she continued. "A forced pregnancy does not have to make headlines to make someone's life a living hell."
The committee heard from two Physicians for Reproductive Health fellows who provide abortion care—Drs. Nisha Verma of Georgia and Allison Linton, chief medical officer at Planned Parenthood of Wisconsin—as well as Guttmacher Institute acting co-CEO Destiny Lopez and Madysyn Anderson, a patient who had to leave her home in Houston, Texas to end a pregnancy.
The panel also heard from two witnesses called by Ranking Member Bill Cassidy (R-La.), a gastroenterologist who calls himself "unapologetically pro-life": Indiana-based Dr. Christina Francis, CEO of the American Association of Pro-Life Obstetricians and Gynecologists, and Melissa Ohden, founder and CEO of the Abortion Survivors Network.
Anderson was the first to provide testimony. She spoke about finding out she was pregnant during her senior year at the University of Houston, shortly after a breakup. She made an appointment at a nearby Planned Parenthood clinic, where she found out she was 11 weeks pregnant—too far along to get an abortion in Texas, even before the Dobbs decision.
"I called 20 different clinics after my first visit. Yes, 20. I called surrounding states and even as far as the Dakotas. No one could see me right away. The earliest I could be seen was two weeks later at Jackson Women's Health Organization in Mississippi," she said. "My dad took off work and we drove 720 miles and spent 13 hours on the road. We spent five hours in a hotel trying to sleep before my first appointment just to turn right around and go back home."
Because of Mississippi laws at the time, she had to make another trip for the procedure. In addition to missing hours of work and an internship—and having to disclose the reason to her boss and professors—Anderson had to pay $2,850 for her appointments and travel. She said that "there is no dollar value I can put on the stress of managing everything."
As of May 1, 14 U.S. states had total abortion bans and 27 states had prohibitions based on gestational duration, according to Lopez's group, which tracks reproductive rights policies. Some states are going even further. Louisiana, for example, recently passed a law to classify two drugs used in medication abortions—mifepristone and misoprostol—as controlled dangerous substances, a move opposed by hundreds of healthcare providers.
Lopez emphasized that the drugs are "safe and effective," and framed the Louisiana law as "simply an effort to make abortion more difficult to attain," which she said will impact "folks who are already marginalized" by our healthcare system.
Verma similarly stressed that "medication abortion is incredibly safe and effective" and warned of misinformation shared by people including Cassidy's witnesses about topics such as so-called "abortion reversal," recalling one study that had to be stopped early because participants were experiencing dangerous bleeding.
The doctors talked about a range of other related issues including difficulties treating patients post-Dobbs; the fact that, as Linton put it, "we already have maternity care deserts" and they are expected to increase, as doctors flee states with restrictions; and, Verma noted, the distances that people are forced to travel for abortion care are "getting further and further."
The Supreme Court—whose makeup remains the same as when the Dobbs decision was handed down—is currently weighing two cases that could further restrict abortion care nationwide: one involving mifepristone and another regarding whether abortions are considered "necessary stabilizing treatment" for patients experiencing emergencies.
In Congress, Republicans continue to push for restrictions on abortion—and advocates warn that in vitro fertilization and contraception are also at risk. Reproductive rights are also dominating the contest for the White House, with former GOP President Donald Trump bragging about the role he played in reversing Roe.
Democratic President Joe Biden, meanwhile, continues to emphasize that he supports abortion rights. Murray made clear during Tuesday's hearing that party members are determined to keep fighting for reproductive freedom.
The divided Senate is set to vote Wednesday on the Right to Contraception Act. Speaking after the hearing, Murray said that "the message here is a simple one: Do you support the right to contraception, or not? The vast majority of Americans absolutely do. Overwhelmingly! But what about Republicans?"
"One of the Republican witnesses at our hearing this morning—someone Republicans chose to bring in to represent their arguments—is actively working to ban basic forms of contraception," she noted. "That should tell you a lot."