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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.
"It is important to remember that Dr. Carpenter did nothing wrong," said one legal expert. "Texas is trying to apply its laws extraterritorially."
"Time for shield laws to hold strong," said one reproductive rights expert on Friday as Texas Attorney General Ken Paxton announced a first-of-its-kind lawsuit against an abortion provider in New York.
Paxton is suing Dr. Margaret Daley Carpenter, co-founder of the Abortion Coalition for Telemedicine (ACT), for providing mifepristone and misoprostol to a 20-year-old resident of Collin County, Texas earlier this year.
ACT was established after the U.S. Supreme Court overturned Roe v. Wade in 2022, with the intent of helping providers in "shielded states"—those with laws that provide legal protection to doctors who send abortion pills to patients in states that ban abortion, as Carpenter did.
New York passed a law in 2023 stipulating that state courts and officials will not cooperate if a state with an abortion ban like Texas' tries to prosecute a doctor who provides abortion care via telemedicine in that state, as long as the provider complies with New York law.
Legal experts have been divided over whether shield laws or state-level abortion bans should prevail in a case like the one filed by Paxton.
"What will it mean to say for the GOP to say abortion should be left to the states now?"
"It is important to remember that Dr. Carpenter did nothing wrong," said Greer Donley, a legal expert and University of Pittsburgh law professor who specializes in reproductive rights. "She followed her home state's laws."
The Food and Drug Administration also allows telehealth abortion care, "finding it safe and effective," Donley added. "Texas is trying to apply its laws extraterritorially."
In the Texas case, the patient was prescribed the pills at nine weeks pregnant. Mifepristone and misoprostol are approved for use through the 10th week of pregnancy and are more than 95% effective.
The patient experienced heavy bleeding after taking the pills and asked the man who had impregnated her to take her to the hospital. The lawsuit suggests that the man notified the authorities:
The biological father of the unborn child was told that the mother of the unborn child was experiencing a hemorrhage or severe bleeding as she "had been" nine weeks pregnant before losing the child. The biological father of the unborn child, upon learning this information, concluded that the biological mother of the unborn child had intentionally withheld information from him regarding her pregnancy, and he further suspected that the biological mother had in fact done something to contribute to the miscarriage or abortion of the unborn child. The biological father, upon returning to the residence in Collin County, discovered the two above-referenced medications from Carpenter.
In the lawsuit, Paxton is asking a Collin County court to block Carpenter from violating Texas law and order her to pay $100,000 for each violation of Texas' near-total abortion ban.
Carpenter and ACT did not immediately respond to a request for comment on the case.
Caroline Kitchener, who has covered abortion rights for The Washington Post, noted that lawsuits challenging abortion provider shield laws were "widely expected after the 2024 election."
President-elect Donald Trump has said abortion rights should be left up to the states, but advocates have warned that the Republican Party, with control of the White House and both chambers of Congress, is likely to push a national abortion ban.
"The truce over interstate abortion fights is over," said legal scholar Mary Ziegler, an expert on the history of abortion in the U.S. "Texas has sued a New York doctor for mailing pills into the state; New York has a shield law that allows physicians to sue anyone who sues them in this way. What will it mean for the GOP to say abortion should be left to the states now?"
"This is what potentially winning right-wing legal cases read like these days," said one progressive activist. "Dark stuff."
Opinion polls have repeatedly made clear that U.S. voters are turned off by the Republican Party's fixation on banning abortion care and controlling Americans' reproductive choices—but that didn't stop three GOP officials from writing in a court filing this month that they want to restrict abortion pill access because it would reduce teen pregnancy rates in their state.
"In my expert legal opinion, this is deeply gross and weird," wrote attorney and writer Madiba K. Dennie on Monday at Balls & Strikes, a news outlet focused on the judiciary.
Dennie was referring to a legal filing by Republican Attorneys General Andrew Bailey of Missouri, Kris Kobach of Kansas, and Raúl Labrador of Idaho in a case regarding mifepristone, one of two pills commonly used in medication abortions—which account for more than half of abortions in the United States.
As S.P. Rogers wrote at the newsletter Repro-Truth, attorneys general filed an amended complaint earlier this month in an effort to revive Alliance for Hippocratic Medicine v. Food and Drug Administration (FDA), a case in which the plaintiffs argued in favor of severely restricting mifepristone access nationwide.
The three states had joined the case earlier this year, before the U.S. Supreme Court rejected the case based on the plaintiffs' lack of standing.
Because the high court didn't outright dismiss the case, the three attorneys general were able to file a complaint on October 11 seeking to prohibit mifepristone use for anyone under the age of 18 and overturn eased restrictions for the drug.
Bailey, Kobach, and Labrador argued that mifepristone access would could cause "injuries" to their states because it is "depressing expected birth rates for teenaged mothers."
"A loss of potential population causes further injuries as well: The [states'] subsequent 'diminishment of political representation' and 'loss of federal funds,' such as potentially 'losing a seat in Congress or qualifying for less federal funding if their populations are' reduced or their increase diminished," reads the court filing.
In other words, wrote Rogers, in the view of the Republican state officials, "teenage girls, which the states refer to as 'teenaged mothers,' exist for the purposes of churning out new citizens for the states."
"Idaho, Kansas, and Missouri are claiming to have a legitimate, sovereign state interest in forced birth—in teenage girls and women as breeders. It's an argument that positions everyone capable of birthing as brood mares—a scenario in which the state does not exist for the people, but the people for the state—and augurs a future claim for the prohibition of contraception," added Rogers.
Republicans including GOP presidential nominee Donald Trump have signaled their desire to roll back the right to contraception.
At Balls & Strikes, Dennie wrote that the GOP officials made clear that they believe "uteri are state slush funds, and girls owe the state reproduction once they are capable of it."
"A personal dislike of somebody else taking medicine is not a legitimate grievance," wrote Dennie. "So the states are trying to show that they are entitled to the population growth and accompanying funds that pregnant minors would produce, and the FDA is getting in the way of that."
While the argument is "shocking in its brazenness," added Dennie, it shouldn't come as a surprise in a country where the Republican Party has shown no sign of backing down from its goal of banning abortion, even as news reports mount about children who have been forced to give birth and pregnant patients who have died or become gravely ill because healthcare providers have refused to treat them for fear of prosecution.
The legal complaint, said Dennie, "is a natural outgrowth of the conservative legal movement's efforts to subordinate women."