By Rebekah Sager for the Michigan Independent.
Broadcast version by Chrystal Blair for Michigan News Connection reporting for the Michigan Independent-Public News Service Collaboration

The AP reported on Jan. 31 that a grand jury had indicted a doctor in New York on felony charges of criminal abortion for prescribing an abortion medication online for a patient in Louisiana.

The indictment was issued by a grand jury of the Louisiana 18th Judicial District Court for the Parish of West Baton Rouge against Dr. Margaret Carpenter, her New Paltz-based company Nightingale Medical, and the mother of the teen patient, who obtained and administered the medication. Arrest warrants were issued on Jan. 31 for Carpenter and the mother; the mother turned herself in to the police that day.

Louisiana law outlaws abortion completely, with exceptions for the life and health of the pregnant patient.

While 18th Judicial District Attorney Tony Clayton told the AP, "We expect Dr. Carpenter to come to Louisiana and answer to these charges, and if 12 people (a jury) think she's innocent then, let it go," New York's so-called shield law protects Carpenter from extradition, said Rachel Rebouché, the dean of Temple University Law School.

What are shield laws?

Eighteen states, including New York, have laws that protect medical providers from investigation, subpoenas, warrants, and demands for extradition from another state. New York's law says that the governor will not recognize such demands from another state as long as the provider was not physically located in that state when the procedure was carried out.

The law in eight of the 18 states - California, Colorado, Maine, Massachusetts, New York, Rhode Island, Vermont, and Washington - specifically protects reproductive health care, regardless of the patient's location.

What happens when a state's shield law is challenged?

Rebouché, who has worked closely with legislators and shield law advocates, said, "I think the long game is to stop mailed medication abortion, which is approved by the FDA as well."

"I think the consequences are, for the providers, I think there is a chilling effect," Rebouché continued. "No one wants to be indicted for a crime. No one wants to be sued for $100,000 and for Dr Carpenter, she can't go to Texas or Louisiana, she can't go to a state that might extradite her to one of those states."

Rebouché explained that in such cases of interstate conflict, each side has the right to pass its own laws. "Typically, states do cooperate," she said. "That's the baseline. But states have rights to also defend people in their jurisdictions."

"Maggie Carpenter is not breaking the law," Rebouché said. "She is complying entirely with New York law. Now, Texas and New York can disagree about what that means, but she, as a doctor, is not breaking the law. ... Almost half the country has got this through its legislature to protect people who are providing reproductive health care."

On Feb. 3, New York Democratic Gov. Kathy Hochul signed a law that gives doctors who prescribe abortion medication the right to ask that pharmacies only print the name of their medical practice on the prescription label and not the doctor's name.

"The intent of shield laws is to try to deflect attacks from out of state for providers in state through different levels, criminal, civil, professional discipline, insurance hikes," Rebouché said.

Officials in Louisiana continue to insist that they will prosecute Carpenter. "It is illegal to send abortion pills into this State and it's illegal to coerce another into having an abortion. I have said it before and I will say it again: We will hold individuals accountable for breaking the law," Louisiana Attorney General Liz Murrill said on the social media platform X.

Rebouché noted: "Louisiana can and has arrested her for what it claims is a violation of its abortion ban. It has to prove that in a criminal court. ... If Louisiana has prosecutors who are going to go after anybody who's helped somebody, that could have a significant chilling effect."


Rebekah Sager wrote this article for the Michigan Independent.


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Illinois serves as a crucial access point for abortion services and sees the most out-of-state patients in the country.

Since Roe v. Wade was overturned in June 2022, Planned Parenthood of Illinois has seen the largest increase in abortion services than any other state. About 25% of its patients are from out-of-state.

Julie Uhal, program manager of strategic initiatives and impact measurement for Planned Parenthood of Illinois, said they planned for an initial surge but sustained high patient volume has strained their resources. She explained they saw up to a dozen out-of-state patients per month before Roe was overturned.

"We're seeing 800, 900, 1,000 out-of-state patients every single month," Uhal reported. "That hasn't changed. That's remained constant for three years now because abortion bans don't stop the need for abortion care. They just make it more difficult for people to access."

Uhal pointed out many out-of-state patients are uninsured or have insurance in other states which cannot be used in Illinois. Combined with rising health care costs, lower reimbursement rates and threats to Medicaid, she said Planned Parenthood faces financial difficulties, which have already forced them to close four clinics this year.

Planned Parenthood is the largest provider of sexual and reproductive health care in the state. More than 40% of local patients use Medicaid to cover the cost of services, which in addition to abortion care includes birth control, cancer screenings, STI treatment and prenatal and gender-affirming care. Without Medicaid funding, Planned Parenthood of Illinois said it would need about $16 million a year to continue providing services at its current rate.

"A lot of people don't realize that many Planned Parenthood clinics are in areas that are otherwise health care provider deserts for access," Uhal emphasized. "For a lot of people, going in for a birth control appointment might be the only time they see a doctor that year."

Uhal stressed the burden of accessing common health care continues to be placed on the patient since states banned abortion services. The recent Supreme Court ruling which set a precedent to allow states to exclude Planned Parenthood from Medicaid will only worsen the burden. She added helping patients to navigate emotional and logistic barriers to care has been just as important as providing them with care.

"One in four people that can get pregnant will have an abortion at some point in their lifetime," Uhal explained. "So it's really important for people to know that they're not alone. There shouldn't be as much shame and stigma surrounding this as there is."

Planned Parenthood of Illinois opened the Carbondale Health Center in 2023 to help meet the increased demand for services, particularly for patients traveling from the South. About 90% of patients there come from out-of-state.


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Abortion rights advocates in Kentucky are concerned as the Department of Health and Human Services has revoked a policy requiring hospitals to provide abortion care in emergency situations.

Known as the Emergency Medical Treatment and Labor Act, the rule offered federal protection for the procedure, particularly in Kentucky and other red states with near total abortion bans.

Tamarra Wieder, Kentucky state director for Planned Parenthood Alliance Advocates, said stripping away protection will be catastrophic for women in rural counties who already face barriers to care.

"We know in a state like Kentucky that people have already turned up at emergency rooms because of our abortion restrictions," Wieder pointed out. "Doctors have been forced to wait until patients were at life-threatening situations, sepsis, hemorrhage, before they are able to provide care."

According to the National Institutes of Health, pregnancy complications are the fifth-most common reason women of reproductive age visit the emergency room.

Weider added rural communities across the Commonwealth suffer the nation's worst family planning and sexual health outcomes and continue to struggle with access to safe and convenient obstetric and reproductive health care.

"I think it's really important to note that 57% of Kentucky's rural hospitals no longer offer obstetric services, 57%," Weider emphasized.

Kentucky's Human Life Protection Act, passed by lawmakers in 2019, banned all abortions except to save the life of the mother and it went into effect immediately after the Supreme Court overturned Roe v. Wade in 2022. The same year, voters in the Commonwealth rejected a ballot measure which would have amended the state constitution to explicitly deny the right to an abortion.

Arizona doctors have filed a lawsuit to overturn a set of restrictions which they argue interfere with access to abortion care. Arizona voters last year passed Proposition 139 which enshrined the fundamental right to an abortion, up until fetal viability, in the state's constitution.

Gail Deady, senior attorney, Center for Reproductive Rights, which is representing some of the plaintiffs in the case, explained that the abortion rights that were secured because of the measure do not go into effect automatically, and existing laws that limit access must be challenged before they can be struck down under Prop 139.

"This lawsuit is intended to honor the will of the voters and it looks to strike down the most onerous abortion restrictions that are currently on the books in Arizona," she said. "The theory behind this case is that these restrictions do not have any medical basis, they do not make abortions safer."

Deady explained that some of the restrictions include forcing doctors to turn away patients if they suspect a fetal genetic diagnosis is the reason for a patient seeking care, requiring patients to wait at least 24 hours before obtaining abortion care, and banning the use of telehealth for abortion. Mailing abortion pills - like mifepristone - is also prohibited. Conservative, anti-abortion advocates have expressed support for the restrictions, its's unclear if they'll oppose the lawsuit.

Deady argues many Arizonans are facing negative consequences as a result of the laws. She adds that it also means a delay in receiving the care most Arizonans supported last year, and added that Arizona has what she calls a "two-trip" law which requires patients make two separate visits to a clinic.

"Just to hear mandatory, state-scripted information about abortion that often is not medically correct, it spreads misinformation and is designed to make people feel ashamed of the decision that they've made which has now been recognized as a constitutional right in Arizona," she explained.

Deady said her organization is currently advocating for the restrictions to be blocked during litigation. The state attorney generals' office is currently examining the complaint.