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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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.

Perinatal experts said postpartum depression is more common than most people think and those covered by Medicaid are at higher risk.

Two of every five mothers who give birth in Wisconsin are covered by BadgerCare. Federal data show up to 50% of postpartum depression cases are undiagnosed because of the stigma surrounding symptoms.

Jennifer Davis, chapters and international affiliates director for the nonprofit Postpartum Support International, said the condition presented differently for her after both of her pregnancies with symptoms of overwhelming worry and anxiety after her daughter's birth and depression after having her son.

"Crying at night, almost all the time, regretting this decision, feeling emotionally disconnected, but still outwardly smiling," Davis recounted. "Now I really am back in this place of 'I can't share this. I cannot share that I questioned why I had my son.'"

Federal data show the prevalence of postpartum depression is higher among those on Medicaid with an increased likelihood for treatment in Medicaid expansion states. Wisconsin is one of only two states yet to expand Medicaid coverage, although it recently passed legislation to extend Medicaid postpartum coverage from 60 days to a full year.

Even though up to 85% of women experience mood changes in the first few days to weeks after delivery, postpartum depression and anxiety can take months to emerge and involve symptoms lasting longer than two weeks that interfere with daily life.

Jennifer Davis noted she suffered alone after both of her pregnancies but found hope in connecting with like-minded people though Postpartum Support International.

"The weight that lifted off of me first, just knowing that other people are going through this and I am not alone," Davis explained. "Even though we don't talk about it a lot, this is very normal, and that there are so many ways and strategies that you can seek help and support when you are in the midst of it."

Wendy Davis, president and CEO of Postpartum Support International, said even if people are not comfortable speaking with their family, friends or providers, they can utilize resources such as the nonprofit's helpline to get connected with volunteers and resources in their community.

"One thing we know for sure is that families and even health care providers don't know enough about the resources," Davis observed. "That doesn't help a new mom who doesn't even know she has something called postpartum depression or that she could reach out and get support for free."

Common signs of postpartum depression include anxiety, sadness, anger and irritability, difficulty sleeping, and intrusive thoughts, which can include thoughts of harming your baby. Research shows a 98% recovery rate with treatment.


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