US women are defying abortion bans by getting pregnancy-ending drugs online. That could change
Every month, thousands of American women thwart abortion bans in their home states by turning to telehealth clinics willing to prescribe abortion medicines online and ship them anywhere in the country.
Whether this is legal, though, is a matter of debate. And two legal cases involving a New York doctor could test the shield laws that some states have passed to protect doctors who ship abortion pills to states where they are illegal.
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At the centre of the debate is Dr Margaret Carpenter, who faces a felony charge in Louisiana for supplying abortion medication through the mail to a pregnant teen there. A Texas judge also fined Carpenter $100,000 (€88,000) after the state accused her of prescribing abortion medication for a woman near Dallas.
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 centres that offer abortion pills are watching closely, and some legal experts say the issue will likely make its way to the US Supreme Court.
Decades ago, the US Food and Drug Administration (FDA) approved the use of two prescription medicines – mifepristone and misoprostol – to terminate pregnancies. This is the most common method for abortion in the US.
But telehealth abortions that cross state lines have become more popular since the US Supreme Court overturned Roe v. Wade, a 1973 ruling that established national abortion rights, in 2022.
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That ruling prompted some states to restrict abortion access. Currently, 19 states have abortion bans or limits that are tighter than those set by Roe v. Wade.
In return, more women have been seeking abortion medication via telehealth clinics.
The prescribing process usually takes place entirely online, with the patient answering a series of health-related questions and consent forms. Pills can arrive in less than a week.
'This has been the safety net… of allowing people who don't have the ability to travel out of state to get abortion care,' said Greer Donley, a University of Pittsburgh law professor and abortion law expert.
When dealing with medications not related to abortion, doctors are often able to write prescriptions for patients in other states – but usually they must have a license to practice medicine there, according to Mei Wa Kwong, executive director of the The Center for Connected Health Policy.
About half of US states have shield laws, which aim to protect doctors and patients in states where abortion is legal from civil or criminal lawsuits in states with abortion bans or restrictions.
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Through New York's shield law, the state has blocked Louisiana and Texas' efforts to punish Carpenter. But Louisiana and other restrictive states are now taking a closer look.
"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," Murrill said. "They are sending illegal medications for purposes of procuring abortions that are illegal in our state".
Julie Kay, who works with 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.
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"I have been working in this field for 25 years and this is part of the work," said Dr Rebecca Gomperts, a Dutch physician and founder of Aid Access, an abortion pill supplier.
"It's something that we all anticipated would happen," she said of the legal challenges.
Another California-based physician who prescribes abortion pills to women in all 50 states told The Associated Press on condition of anonymity that 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," the doctor said.
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