Louisiana has ignited a new front in the national battle over abortion access by issuing a warrant for the arrest of Dr. Remy Coeytaux, a California physician accused of mailing abortion pills to a patient in the state. The move, revealed in court documents filed on September 19, 2025, marks one of the rare instances where a state has sought to criminally charge an out-of-state doctor under its abortion ban since the U.S. Supreme Court overturned Roe v. Wade in 2022. The case highlights the intensifying legal conflict between states with restrictive abortion laws and those with so-called "shield laws" protecting providers who offer telehealth and mail-order abortion services.
According to Associated Press and SAN, Louisiana authorities allege that Dr. Coeytaux provided abortion pills to Rosalie Markezich, a Louisiana woman, in 2023. Markezich claims her boyfriend at the time used her email address to order the medication and sent her $150, which she then forwarded to Coeytaux. She told officials that she felt coerced into taking the pills and said, "the trauma of my chemical abortion still haunts me"—a statement that has become a rallying cry for anti-abortion advocates in the state.
Markezich's situation has quickly become a focal point in the broader debate over whether states can restrict or block the mailing of abortion pills across state lines. She and Louisiana Attorney General Liz Murrill have joined a lawsuit seeking to order federal drug regulators to bar telehealth prescriptions for mifepristone, one of the two drugs most commonly used for medication abortions. In court filings, Markezich asserted that she would have carried her pregnancy to term if it weren’t for the mail-order pills, and that being able to access abortion medication remotely enabled her boyfriend’s coercion.
"Rosalie is bravely representing many women who are victimized by the illegal, immoral, and unethical conduct of these drug dealers," Attorney General Murrill said in a statement, according to Associated Press. Murrill’s office has not specified the exact charges Dr. Coeytaux faces or when the warrant was issued, but under Louisiana’s abortion ban, physicians convicted of providing abortions can face up to 15 years in prison and $200,000 in fines. The law also allows patients who receive abortions to sue providers and others involved, a provision that has emboldened anti-abortion activists to pursue legal action beyond criminal prosecution.
Dr. Coeytaux is also facing a civil lawsuit in Texas, where a man alleges the doctor illegally provided abortion pills to his girlfriend. This combination of criminal and civil actions—spanning multiple states—underscores the patchwork of abortion laws now in effect across the country. A similar scenario is playing out with Dr. Margaret Carpenter, a New York physician who faces charges in both Louisiana and Texas for allegedly mailing abortion pills to a Louisiana minor who later required hospitalization. New York authorities, however, have refused to extradite Carpenter, citing state laws designed to shield medical providers from out-of-state investigations related to abortion care.
Eight states, including California and New York, have enacted such shield laws, according to the Guttmacher Institute. These measures are meant to protect providers who prescribe and mail abortion medications to patients in states with abortion bans. California Governor Gavin Newsom, a Democrat, signed AB 260 into law on September 26, 2025, further strengthening these protections. The Abortion Coalition of Telemedicine, which represents providers like Coeytaux and Carpenter, said in a statement to Associated Press that they "fully expect" Governor Newsom to uphold the shield law in this latest case.
"The medication is safe and an essential part of women's healthcare," the coalition insisted, calling Louisiana’s legal actions "extreme" and describing them as an attempt to "intimidate healthcare providers." The group, co-founded by Dr. Carpenter, has expressed concern that aggressive legal tactics could discourage doctors from offering abortion care to patients in restrictive states, potentially leaving vulnerable women without access to safe options.
Louisiana, for its part, has doubled down on enforcement since Roe v. Wade was overturned. The state criminalizes anyone who intentionally causes an abortion by providing or distributing abortion-inducing drugs. The penalties range from one to five years in prison and up to $50,000 in fines, with harsher punishments possible if the abortion results in serious injury, death, or involves a minor. The law specifically targets those who knowingly provide or mail abortion-inducing drugs outside of narrow legal exceptions, which is why out-of-state providers can be prosecuted.
These legal battles are not limited to individual cases. Louisiana, along with Florida and Texas, is seeking to join a lawsuit led by Republican attorneys general from Idaho, Kansas, and Missouri that aims to roll back federal approval for mifepristone. This multi-state effort reflects a growing push among conservative states to restrict not just in-person but also telehealth access to abortion medication, which has become the most common method of abortion in the U.S. According to reports cited by Associated Press, the availability of abortion pills by mail is a major reason why abortion numbers have risen in recent years, even as bans have proliferated.
On the other side of the debate, a group of 19 Democratic state attorneys general issued a statement on September 29, 2025, affirming that mifepristone is safe and expressing concern over a federal review of the drug’s safety and effectiveness—a review initiated by Health Secretary Robert F. Kennedy Jr. and Food and Drug Administration Commissioner Marty Makary earlier this year. The Democratic attorneys general warned that efforts to restrict access to mifepristone could undermine reproductive healthcare nationwide.
The legal landscape is further complicated by the differing penalties and civil remedies available under state laws. In Texas, anyone can sue those who prescribe abortion pills, not just the patient. Meanwhile, Louisiana’s law allows only patients to bring civil suits. These provisions create a climate of legal uncertainty for both providers and patients, with the threat of lawsuits and criminal charges looming over every telehealth prescription.
As this legal tug-of-war continues, both sides are preparing for a protracted fight. Attorney General Murrill has vowed to use "any legal means available" to hold accountable those who violate Louisiana’s abortion laws, and has threatened to sue governors whose shield laws "purport to protect these individuals from criminal conduct" in Louisiana. Meanwhile, advocates for abortion access insist that telehealth and mail-order abortion pills are critical for ensuring that women in restrictive states can still obtain care.
The outcome of these cases could have far-reaching implications, not only for the doctors and patients directly involved but for the future of reproductive healthcare across the nation. As states with opposing laws clash in courtrooms and legislatures, the patchwork of abortion access in America grows ever more complex—and the stakes for women, providers, and policymakers alike have never been higher.
