Shielding providers: The legality and impact of abortion protection laws

Since the U.S. Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, abortion pills like mifepristone have become the focal point of intense political and legal battles across the country. Despite abortion pills being banned in 18 states and restricted in 10, the national monthly number of abortions has only continued to rise. Notably, in the second quarter of 2024, telehealth services alone facilitated more than 9,700 abortions per month. This increase has been largely supported by “shield laws,” which protect healthcare professionals and enable them to deliver essential reproductive care to patients in under-resourced areas nationwide.

Shield laws have been enacted in eight states, including New York, but they do not guarantee full legal protection for medical providers. Under such laws, if a state with an abortion ban issues an arrest warrant for a physician residing in a state where abortion remains legal, that state—such as Connecticut—can refuse to extradite the physician. However, under federal law, a doctor who has previously prescribed abortion pills across state lines could still face criminal charges if they travel to an anti-abortion state. The practical and legal limits of these shield laws have yet to be fully tested—until now.

In January 2025, Dr. Margaret Carpenter, a New York physician and founder of Nightingale Medical, was indicted by a Louisiana grand jury on charges of Criminal Abortion after prescribing mifepristone to a pregnant teenager in Louisiana. If convicted, Dr. Carpenter faces one to five years in prison and fines ranging from $5,000 to $50,000. Louisiana Governor Jeff Landry has signed an extradition warrant for Dr. Carpenter, but New York Governor Kathy Hochul has adamantly held that she will not comply with such a request.

During a recent visit to New Orleans, newly confirmed Attorney General Pam Bondi told Tony Clayton, the prosecutor leading Dr. Carpenter’s case, that she would “love to work with him” to help create legal consistency and prevent states from harboring individuals accused of violating Louisiana’s abortion laws. While Bondi did not specify how she plans to address the issue, any federal legislation would need to pass through a narrowly Republican-controlled Congress—an uncertain prospect. Another potential avenue for the Trump administration is to revive the enforcement of the Comstock Act of 1873, which could be interpreted as prohibiting the mailing of abortion medications. However, courts may reject that interpretation, and it remains unclear whether the current administration is willing to take that step.

Shield laws have drawn scrutiny from legal experts on both sides of the abortion debate, as they challenge the traditional framework of interstate cooperation. After all, the U.S. Constitution requires that states extradite individuals who commit crimes in one state and then flee to another. However, it also mandates that states recognize and respect each other’s legal decisions under the Full Faith and Credit Clause. An exception to this principle—the “penal exception”—has led some legal scholars to argue that it could apply to cases involving anti-abortion laws.

By enacting shield laws, states that support abortion rights effectively disrupt the enforcement power of states with abortion bans, making it harder to prosecute out-of-state providers. At the heart of this legal battle is an unresolved constitutional question: Does the authority of anti-abortion states to prosecute providers outside their borders supersede the right of pro-choice states to protect those providers from prosecution?

For over a century, the Supreme Court consistently held that federal courts lack the authority to enforce the Extradition Clause. This stance changed in 1987 with Puerto Rico v. Branstad, when the Court unanimously ruled that federal courts can compel states to comply with extradition requests under Article IV of the Constitution. With New York Governor Kathy Hochul refusing to extradite Dr. Carpenter, it is likely that the Louisiana’s Attorney General will soon file a federal lawsuit to enforce the extradition.

In the meantime, medical practitioners who provide—or have provided—abortion pills in states where abortion is banned or restricted must avoid traveling to or through these states to minimize the risk of prosecution. While this severely limits their constitutional right to interstate travel, it remains the best option to avoid legal jeopardy.

The Dobbs decision aimed to remove judges from the national abortion debate, leaving state legislatures to determine their own policies. However, this ruling has sparked even more contentious legal questions—particularly how to resolve disputes between states over whether abortion laws can be enforced beyond their borders. This presents a novel and unpredictable legal challenge. As Mary Ziegler, a professor at the University of California, Davis Law School, recently stated: “[T]he Supreme Court…has a penchant for reconsidering precedent.” This Louisiana case, along with other similar cases likely to arise, could bring the abortion issue back before the Supreme Court sooner than anticipated, requiring the Justices to address whether states can be compelled to enforce another state’s anti-abortion laws.