Introduction to the Abortion Pill Access Debate
Every month, thousands of women thwart abortion bans in their home states by turning to telehealth clinics willing to prescribe pregnancy-ending drugs online and ship them anywhere in the country.
Whether this is legal, though, is a matter of debate. Two legal cases involving a New York doctor could wind up testing the shield laws some states have passed to protect telehealth providers who ship abortion pills nationwide.
Dr. Margaret Carpenter faces a felony charge in Louisiana for supplying abortion medication through the mail to a pregnant teen in that state. The patient’s mother also faces criminal charges. A Texas judge fined the same physician $100,000 after the state accused her of prescribing abortion medication for a woman near Dallas.
The Role of Shield Laws
So far, the prosecution hasn’t progressed thanks to New York’s shield law, which has protected Carpenter from extradition to Louisiana. But other telehealth centers operating in states with similar legal protections for abortion providers are watching closely.
“We have great legal counsel who have advised us that what we are doing is legal,” said Dr. Angel Foster, co-founder of The Massachusetts Medication Abortion Access Project, which is among a handful of telehealth providers that facilitate abortions from afar in states with bans.
As more states consider enacting shield laws or expanding existing ones, whether one state can shield providers from liability for breaking another state’s laws around abortion is still an unsettled area of law.
Challenges to Shield Laws
Erik Baptist, senior counsel for the Alliance Defending Freedom, which opposes abortion, said shield laws violate a constitutional requirement that states respect the laws and legal judgments of other states.
“What these shield law states are doing are undermining the prerogative of these pro-life states to implement and enforce pro-life laws,” said Baptist, director of the group’s Center for Life. ”And so I think the Supreme Court ultimately will want to take this.”
“That is inherently a challenge with shield laws and telehealth,” said Carmel Shachar, faculty director of the Health Law and Policy Clinic at Harvard Law School. “At a certain point, for the purposes of abortion bans, the courts will need to decide: Do we treat a telehealth abortion as happening within the state of the provider or within the state of the patient?”
Abortion Pills Sent to Your Home
Decades ago, the FDA approved the use of two prescription medicines — mifepristone and misoprostol — to terminate pregnancies.
But it wasn’t until 2023 that telehealth abortions across states became more popular, after the U.S. Supreme Court overturned Roe v. Wade in 2022.
The Society of Family Planning, which supports abortion rights, said that between April and June 2024 there were an average of 7,700 telehealth abortions performed each month in states that either ban abortion totally or after six weeks of pregnancy.
The prescribing process at telehealth clinics varies by provider, but usually takes place entirely online, with the patient answering a series of health-related questions and consent forms.
States with Shield Laws
Twenty-three states and Washington, D.C., currently have shield laws protecting abortion providers.
Of those, eight have specific provisions protecting them from criminal prosecution or civil lawsuits even if the patient is in another state, according to the nonprofit research organization KFF. They include California, Colorado, Maine, Massachusetts, New York, Rhode Island, Vermont, and Washington.
Louisiana’s request to extradite Carpenter hit a roadblock when New York Gov. Kathy Hochul rejected it, citing the state’s shield law. (A county clerk also cited the shield law as he refused to file the civil judgment from Texas.)
“These are not doctors providing health care. They are drug dealers,” Republican Louisiana Attorney General Liz Murrill told state lawmakers as she promoted a bill that would expand who can sue and be sued in abortion medication cases. “They are violating our laws. They are sending illegal medications for purposes of procuring abortions that are illegal in our state.”
Clinics Say They Will Keep Prescribing
Julie Kay, the executive director of the Abortion Coalition for Telemedicine, the nationwide organization co-founded by Carpenter, said providers won’t be “bullied and intimidated” into ceasing operations.
Other telehealth abortion providers said they also won’t be deterred by legal threats.
“I have been working in this field for 25 years and this is part of the work,” said Dr. Rebecca Gomperts, founder and director of Aid Access, an abortion pill supplier. ”It’s something that we all anticipated would happen,” she said of the legal challenges.
A doctor who is part of A Safe Choice, a network of California-based physicians that prescribes abortion pills to women in all 50 states, told The Associated Press he believes he is protected by the state’s shield law, but is also taking precautions.
“I’m not going to be traveling outside of California for a very long time,” said the doctor, who spoke with The Associated Press on condition of anonymity because he wanted to protect his identity for safety reasons.
Conclusion
The debate over abortion pill access and shield laws is a complex and contentious issue. While some states have enacted laws to protect abortion providers, others are challenging these laws and seeking to restrict access to abortion pills. The outcome of these legal challenges will have significant implications for women’s reproductive health and access to abortion services.
FAQs
Q: What are shield laws, and how do they relate to abortion pill access?
A: Shield laws are state laws that protect abortion providers from liability for breaking another state’s laws around abortion. They are being challenged by states that seek to restrict access to abortion pills.
Q: How do telehealth clinics prescribe abortion pills, and what is the process like for patients?
A: Telehealth clinics prescribe abortion pills through an online process, where patients answer health-related questions and consent forms. The pills are then shipped to the patient’s home.
Q: What is the current state of abortion pill access in the US, and how has it changed since the overturning of Roe v. Wade?
A: Abortion pill access has become more restricted in some states since the overturning of Roe v. Wade, but telehealth clinics and shield laws have helped to maintain access to abortion services for many women.
Q: What are the implications of the legal challenges to shield laws, and how may they affect women’s reproductive health?
A: The outcome of the legal challenges to shield laws will have significant implications for women’s reproductive health and access to abortion services. If shield laws are struck down, it could become more difficult for women to access abortion pills, particularly in states with restrictive abortion laws.
