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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.
"If you think it's absurd to regulate men, then you should think it's equally absurd to regulate women," said the author of an Ohio bill, who is also an OB-GYN.
Faced with relentless Republican attacks on reproductive freedom including efforts to give embryos and fetuses legal rights from the moment of conception, Democratic lawmakers in two states have recently introduced legislation that would ban men from ejaculating for purposes other than making babies, with some exceptions.
Last month, Mississippi state Sen. Bradford Blackmon (D-21) introduced S.B. 2319, the Contraception Begins at Erection Act, which would "make it unlawful for a person to discharge genetic material (sperm) without the intent to fertilize an embryo, effectively criminalizing certain male reproductive behaviors," according to an official artificial intelligence summary of the proposal. The bill—which died in committee last week—contains exceptions for "genetic material donated or sold to a facility for future embryo fertilization, and genetic material discharged using a contraceptive method intended to prevent fertilization."
"If you're going to penalize someone for an unwanted pregnancy, why not penalize the person who is also responsible for the pregnancy?"
"All across the country, especially here in Mississippi, the vast majority of bills relating to contraception and/or abortion focus on the woman's role when men are 50% of the equation," Blackmon explained, according toNBC News. "This bill highlights that fact and brings the man's role into the conversation. People can get up in arms and call it absurd but I can't say that bothers me."
Meanwhile in Ohio, state Reps. Dr. Anita Somani (D-11) and Tristan Rader (D-13) have introduced their own Contraception Begins at Erection Act, which would fine violators $10,000 per unauthorized discharge, with exceptions for when contraception is used during sex, or in cases of masturbation, and sex between members of the LGBTQ+ community.
"If you're going to penalize someone for an unwanted pregnancy, why not penalize the person who is also responsible for the pregnancy?" Somani, who is also a licensed OB-GYN, asked in an Ohio Capital Journal article published Sunday. "You don't get pregnant on your own."
Every Sperm is sacred! #equalrights #reproductiverights
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— Anita Somani District 8 OH ( @anitamd.bsky.social) February 4, 2025 at 5:19 PM
Responding to Republicans who have called her bill "absurd," Somani said, "If you think it's absurd to regulate men, then you should think it's equally absurd to regulate women."
While observers have questioned the seriousness of these bills—and with Somani and others giving nods to a famous number in Monty Python's 1983 black comedy The Meaning of Life—they come at a nadir for reproductive freedom in the United States.
Since the right-wing U.S. Supreme Court canceled half a century of federal abortion rights in the 2022 Dobbs v. Jackson Women's Health Organization ruling, a dozen states including Mississippi have also passed near-total abortion bans, while numerous other states have enacted restrictions on the procedure.
Eight states have also enacted or proposed restrictions on access to contraception, according to the Guttmacher Institute. Last year, Senate Republicans blocked consideration of the Right to Contraception Act. Republican President Donald Trump has signaled support for federal restrictions on contraception, and far-right U.S. Supreme Court Justice Clarence Thomas has suggested that the tribunal "should reconsider" past rulings upholding the right to birth control.
In Ohio, voters decisively enshrined abortion rights in the state constitution via a 2023 ballot measure. Nevertheless, anti-abortion activists haven't given up—Republican activist Austin Beigel told the Capital Journal that GOP lawmakers are preparing to introduce legislation for a total abortion ban in the coming weeks.
"It just says human life begins at conception," he explained. "Therefore, all the protections that are offered to other people under the state law are also offered to the pre-born."
This isn't the first time that semi-satirical legislation has been introduced to highlight the hypocrisy of banning women from controlling their bodies. In 2019, a Democratic state lawmaker in Georgia introduced a "Testicular Bill of Rights" that would, among other things, have required men to get permission from their sexual partners before obtaining erectile dysfunction medication and enacted a 24-hour "waiting period" for men who want to buy porn or sex toys.
"People worldwide will have fewer points of service," said Doctors Without Borders. "It means fewer safe places to talk about their health options, and fewer providers to go to for help during medical emergencies."
Reproductive rights and medical experts on Monday continued to warn that U.S. President Donald Trump's highly anticipated reinstatement of the Mexico City Policy, which bans nongovernmental organizations that perform or promote abortion from receiving federal funding, will cause "devastating damage" for people around the world.
The global gag rule (GGR), as it is called by critics, has been imposed by every Republican president for decades, including Trump during his first term. After returning to office a week ago, Trump on Friday signed an executive order "to end the use of federal taxpayer dollars to fund or promote elective abortion" and revived the controversial rule with a presidential memorandum.
"As the single largest funder of international aid, the U.S. plays a powerful role in shaping the global health landscape—and women's and girls' lives are being used as pawns in this political game," Dr. Carole Sekimpi wrote Monday for the British journal The BMJ. "My work overseeing reproductive health programs in Africa for MSI Reproductive Choices gives me an understanding of the profound consequences that this will have on communities that Trump will never set foot in."
"It's prudent to first understand that the U.S. government never funds abortions," Sekimpi stressed, noting the rule punishes groups that participate in anything abortion-related with separate funding. "Last time Trump was in power, MSI was among those that refused to accept the terms of this policy. The U.S. funding we lost would have allowed us to serve 8 million women, preventing 6 million unintended pregnancies, 1.8 million unsafe abortions, and 20,000 maternal deaths. And that was just one organization."
Ibis Reproductive Health president Kelly Blanchard and Evelyne Opondo, an Ibis board member and the International Center for Research on Women's Africa director, also emphasized in a Monday Medium post that the rule's impact "is felt keenly by organizations that provide comprehensive sexual and reproductive healthcare—including contraception and abortion care—around the world," such as MSI and International Planned Parenthood Federation, "who refuse to abide by the terms because they support the human rights of all people and will not withhold information or critical reproductive healthcare from individuals who need it."
"The GGR flies in the face of both human rights and evidence-based public health," the pair asserted. "The GGR does not prevent abortion from happening but rather increases barriers to abortion access, reduces access to contraception increasing risk of unintended pregnancy, and could actually increase unsafe abortion, a key driver of maternal deaths around the world."
Melanie Nezer, vice president for advocacy and external relations at the Women's Refugee Commission, similarly declared in a Monday statement denouncing the GGR, "Let us be clear: this policy will not protect lives—it will endanger them."
"The goal of the global gag rule is to curtail access to safe sexual and reproductive healthcare, including access to safe abortion," she said. "The result is more suffering from the consequences of conflict-related sexual violence, more unintended pregnancies, more unsafe abortions, and more maternal death that would otherwise be entirely preventable."
Reproductive rights groups worldwide were similarly critical of the decision on Friday and throughout the weekend, with Planned Parenthood Federation of America president and CEO Alexis McGill Johnson calling it "dangerous" and arguing that "elected officials should not be interfering in personal medical decisions, in this country or anywhere in the world."
Like the critics on Monday, Rachana Desai Martin, chief government and external relations officer at the Center for Reproductive Rights, pointed to the fallout from GGR during the Republican's first term and said that "the reinstatement and expansion of President Trump's global gag rule is a direct assault on the health and human rights of millions of people around the world."
Also recalling the first Trump administration, Guttmacher Institute acting co-CEO Destiny Lopez highlighted how her group's "research has documented its severe ripple effects, including stalling and even reversing progress in expanding access to modern contraception in countries like Ethiopia and Uganda."
"Now history will sadly and shamefully repeat itself, and people in many countries will find it harder to access safe abortion, contraception, and other critical health services," she said, vowing to track the impacts and work to repeal the harmful policy.
Reproductive Freedom for All president and CEO Mini Timmaraju also pledged to battle the GGR and other Republican attacks on choice, saying that "these policies inflict harm on those who need access to reproductive healthcare, including abortion, in our country, and around the world—and we will fight back."
Previewing the fight ahead, National Abortion Federation president and CEO Brittany Fonteno warned that the GGR "will not be the last" attack on reproductive healthcare, adding that "for nearly a decade now, Donald Trump has shown us just how dangerous he is for abortion access, and it is clear that over the next four years, the anti-abortion movement will take every opportunity to strip away our fundamental right to reproductive freedom—both here and abroad."
RealClearPolitics, the first to report the rule's revival, noted that "the president timed the release of his executive actions to coincide with the annual March for Life on Friday when some of his most ardent supporters rallied on the National Mall. Vice President JD Vance addressed the march in person, while Trump recorded a video message Thursday to be played at the Friday rally."
Although Trump said on the campaign trail that he thinks abortion policies should be decided at the state level, rights advocates have cited his extensive record of dishonesty and bragging about the role he played in overturningRoe v. Wade, and expressed fear that the Republican-controlled Congress will send a national abortion ban to his desk.