The legal and political landscape surrounding abortion in the United States continues to evolve rapidly in the wake of the Supreme Court’s 2022 decision overturning Roe v. Wade. Now, a new chapter is unfolding in Louisiana, where authorities have issued a warrant for the arrest of Dr. Remy Coeytaux, a California-based physician accused of mailing abortion pills to a patient in the state in 2023. The case is among the first of its kind since Louisiana enacted some of the nation’s strictest abortion bans, and it is already sparking fierce debate about medical practice, patient safety, and the reach of state laws across borders.
According to Live Action News, the story began when Rosalie Markezich, a Louisiana woman, found herself in a harrowing situation. Markezich’s boyfriend, using her email address and paying $150, ordered abortion pills from Dr. Coeytaux. The pills were mailed to him, and Markezich says she was then coerced into taking them—despite her desire to keep her pregnancy. "Rosalie told her boyfriend that she wanted to keep her baby. But he had other plans. When Rosalie refused the drugs, her boyfriend became angry and shouted at her. Rosalie had suffered domestic abuse before, and she knew the signs of a dangerous man. Her boyfriend had a criminal record. Yet she was alone with him in a car, and her friends were unaware of her whereabouts. She was terrified. To pacify him, Rosalie agreed to take the drugs. And he watched her swallow them. Although she intended to throw them up as soon as she could get away from him, she was unsuccessful, and she lost her baby," court filings recount.
Markezich later joined a lawsuit against the Food and Drug Administration (FDA), arguing that the agency’s approval of mail-order abortions made it possible for her to be victimized in this way. She only learned about the case and the opportunity to seek legal relief in 2025, as noted in the court documents. Her experience, she says, would have been different had she received the drugs in person: "Had she received the drugs in person, she would have told the doctor that she did not want to take the drugs—she would have sought help and support. Rosalie now faces prolonged emotional trauma and mourns the loss of her child."
The case has drawn the attention of Louisiana Attorney General Liz Murrill, who issued a statement saying, "Rosalie is bravely representing many women who are victimized by the illegal, immoral, and unethical conduct of these drug dealers." Murrill’s remarks reflect the state’s determination to hold those involved in mail-order abortion accountable under Louisiana law, even if the alleged perpetrator is located in another state.
Dr. Remy Coeytaux is no stranger to controversy. He is the founder, president, and executive officer of ASafeChoice, a California-based business that provides abortion medication through online orders. According to Live Action News, ASafeChoice uses what is known as a "no-test" protocol, allowing users to obtain abortion pills without seeing a doctor or undergoing any in-person testing. This approach, critics argue, is fraught with risks. Complications associated with the abortion pill regimen can include severe cramping, contractions, heavy bleeding, nausea, vomiting, diarrhea, abdominal pain, and headaches.
Medical experts have raised concerns that the "no-test" protocol makes it impossible to confirm the gestational age of the pregnancy or to rule out an ectopic pregnancy—both vital for patient safety. While proponents of medication abortion often tout its safety, Live Action News reports that chemical abortions are actually four times more dangerous than first-trimester surgical abortions. Citing studies, they note that in Ireland, 12% of women who underwent chemical abortions required emergency room visits, and an analysis of insurance data found that nearly 11% (10.93%) of women experienced sepsis, infection, hemorrhaging, or other serious or life-threatening adverse events within 45 days of taking the abortion pill. This rate is said to be 22 times higher than the "less than 0.5 percent" serious adverse events rate reported by the FDA on the mifepristone label. A peer-reviewed study from the Charlotte Lozier Institute further challenged claims that the abortion pill regimen is "safer than Tylenol."
Dr. Coeytaux’s activities have not been limited to Louisiana. He has reportedly been sued in Texas for the deaths of preborn children and has a record of mailing abortion pills into states with strict anti-abortion laws. This has made him a focal point in the ongoing legal and political battle over "shield laws"—statutes enacted by states like California to protect abortion providers from prosecution when their actions, though legal in their home state, may violate the laws of another.
Louisiana’s criminal case against Dr. Coeytaux is expected to test the limits of these shield laws. If the state is successful in pursuing legal action against an out-of-state provider, it could set a precedent for similar cases across the country. On the other hand, if California’s protections hold, it may embolden other providers to continue offering mail-order abortions to residents of states where the procedure is banned.
For many observers, the case underscores the profound legal uncertainty that now surrounds abortion access in the United States. The Supreme Court’s decision to overturn Roe v. Wade returned the issue to the states, resulting in a patchwork of laws that vary dramatically from one jurisdiction to another. Some states have enacted strict bans, while others have moved to protect or even expand abortion access, including through shield laws and telemedicine services.
For women like Rosalie Markezich, these legal battles are anything but abstract. She describes ongoing emotional trauma from her experience and says she mourns the loss of her child. Her case, and others like it, are likely to play a central role in the national conversation about reproductive rights, patient safety, and the responsibilities of medical professionals.
As the legal proceedings unfold, both sides are watching closely. Supporters of Louisiana’s strict abortion laws argue that holding out-of-state providers accountable is essential to enforcing the state’s will and protecting vulnerable women from coercion and harm. Meanwhile, advocates for abortion rights warn that such prosecutions threaten to undermine access to care, criminalize medical professionals, and pit states against each other in an escalating legal conflict.
With the warrant for Dr. Coeytaux still outstanding and shield laws facing their first major tests, the outcome of this case could reverberate far beyond Louisiana’s borders, shaping the future of abortion access and legal accountability in America for years to come.
