I am an OB/GYN. I prescribe mifepristone. I have written the prescription, counseled the patient, signed the chart. Under Louisiana law, the conduct that makes me a physician makes Dr. Margaret Carpenter a felon. So I want to be precise about what is happening, because the next warrant has my name on it.
The Act
On January 31, 2025, a West Baton Rouge Parish grand jury indicted Dr. Margaret Daley Carpenter — a New York physician, founder of the Abortion Coalition for Telemedicine — for criminal abortion by means of abortion-inducing drugs. A felony. Five years. The conduct: an April 2024 telehealth consult in which Dr. Carpenter mailed mifepristone and misoprostol to a Louisiana adult who passed the medication to her pregnant minor daughter. On February 11, 2025, Louisiana Governor Jeff Landry signed an extradition warrant. On February 18, New York Governor Kathy Hochul refused it: “I will not be signing an extradition order that came from the governor of Louisiana. Not now, not ever.” Louisiana Attorney General Liz Murrill has since filed federal suit against the FDA over the mail order of mifepristone and is openly preparing constitutional litigation under the Extradition Clause to gut every shield law in the country.
This is the first cross-state criminal prosecution of an abortion provider since Dobbs. It is the template.
The Body It Lands On
Dr. Carpenter, specifically — a board-certified physician practicing telemedicine within the standard of care, prescribing an FDA-approved drug, in a state where the conduct is legal. The Louisiana adult and her minor daughter — charged in the same indictment, which is how the statute requires us to talk about a family in crisis. And, structurally, every physician operating under a shield law in 22 states and the District of Columbia. Every OB/GYN who has ever sent a prescription to a patient who later crossed a state line. Me.
The Data Underneath
Mifepristone was approved by the FDA on September 28, 2000. More than 7.5 million Americans have used it. The mortality rate is approximately 0.27 deaths per 100,000 medication abortions — roughly thirty-three times safer than carrying a pregnancy to term in this country (8.8 maternal deaths per 100,000 live births), and meaningfully safer than acetaminophen. Major complications occur in 0.31% of cases. In 2024, Louisiana classified mifepristone and misoprostol as Schedule IV controlled substances — the same schedule as Valium. The drug Louisiana has criminalized is one of the safest medications the FDA has ever approved.
Meanwhile telehealth abortion is now 27% of all abortions in the United States — up from 5% in early 2022. As of June 2025, 55% of telehealth abortions are provided under shield laws. In states with total bans, nearly every clinician-provided abortion happens this way. The shield-state physician is not a workaround. The shield-state physician is now the system.
The Diagnosis
This is the Fugitive Slave Act of 1850 with a prescription pad. The 1850 act compelled free states to deliver people up to slave states; it conscripted Northern citizens into Southern law and was the constitutional crisis that broke the union. Texas v. Carpenter — Paxton’s parallel civil case, $113,000 default judgment, dismissed in Ulster County on October 31, 2025 — is the same architecture. So is Murrill’s threatened extradition-clause litigation. They want the Supreme Court to read the Full Faith and Credit Clause and the Extradition Clause as forcing shield states to surrender their own physicians for practicing medicine that is legal where it was practiced.
If they win, the Comstock Act of 1873 — quietly cited by Alito in Dobbs — finishes the job federally. Mailed mifepristone becomes a federal crime. Every physician in this country who has ever written a telehealth prescription becomes a defendant.
The 1850 conductors were not abolitionist theorists. They were ordinary people who refused to comply. That is what physicians are now. My tradition has never been clearer.
The Ask
Confirm in writing that your governor will not extradite. New York, Massachusetts, California, Washington, Connecticut, Vermont, Colorado, Illinois — pin them down. Donate to the Abortion Coalition for Telemedicine. Share this receipt. Subscribe at bringtheboltcutters.laboracollective.com. Receipt #5 lands next Friday.
The Roberts Court tied us to the tracks. They forgot we brought bolt cutters. The train is coming. Physicians are not the ones getting hit.
— Yamicia Connor, MD