Lorena O'Neil, Louisiana Illuminator

A Louisiana grand jury indicted a New York doctor and a Baton Rouge-area mother Friday on felony charges for allegedly causing a criminal abortion by giving her pregnant teen daughter medication obtained through the mail.

Soon afterward, officials from both states immediately went public with their stances on the case. It is the first criminal case of its kind since the U.S. Supreme Court overturned Roe v. Wade in June 2022.

New York Gov. Kathy Hochul, a Democrat, released a video calling the charges “outrageous,” saying it is why she signed “very tough” shield laws into place protecting telehealth providers.

“I will never, under any circumstances, turn this doctor over to the state of Louisiana under any extradition request,” Hochul said. “Republicans are fighting to have a national abortion ban that will deny reproductive freedom to women, not just in our state, but all across America. We must stand firm and fight this.”

Shortly after the governor’s video was published, The Illuminator spoke with 18th Judicial District Attorney Tony Clayton, a Democrat who is prosecuting the case alongside Republican state Attorney General Liz Murrill. He said he finds it “shocking” that Dr. Margaret Carpenter and representatives from her clinic are not going to come to Louisiana to be arrested and taken into custody.

“You broke the law in the state of Louisiana and you ought to come down here and answer the charges,” Clayton said.

Clayton was among the most ardent supporters of Republican Gov. Jeff Landry’s “tough on crime” legislation, including his successful push to treat 17-year-old violent offenders as adults in the state criminal justice system.

Landry’s office did not respond to the Illuminator’s request for comment, but the governor did reply to Hochul’s social media post. Carpenter provided “illegal abortion pills to a teen who didn’t want them,” Landry said. “This case is about coercion. Plain and simple.” he added.

Fixed it for you, @GovKathyHochul.
News flash, the American people aren’t falling for your lies!
This case is about coercion. Plain and simple. pic.twitter.com/7saVnsPJZh
— Governor Jeff Landry (@LAGovJeffLandry) January 31, 2025

The teenager’s mother posted bond late Friday after being taken into custody at West Baton Rouge Parish Jail. Her bond amount was not listed.

Clayton and Murrill’s prosecution involves a law approved in 2022 that makes it a crime to knowingly cause an abortion with medication. It carries penalties of one to five years in prison and a fine range of $5,000-$50,000. The same measure also made it illegal to obtain such drugs through the mail from out of state.

Clayton claims the prosecution will provide evidence that the teen’s mother filled out an online questionnaire to order the pills from Carpenter’s company, Nightingale Medical. The mother paid $150 for the medication with her credit card and received it in the mail. Clayton alleges the teen’s mother gave her daughter an ultimatum to take the medication or move out of her house.

“The child took the pill and was home by herself,” Clayton said, adding that she later started bleeding, called 911 and was taken to a hospital in an ambulance. A police officer who responded to the call initially thought the teen was experiencing a miscarriage but “found out” she had taken abortion pills provided from an out-of-state clinic, the district attorney said.

Police ultimately brought the case to his office, according to Clayton.

“The mother’s the one who paid for it with a credit card and put the whole deal in action,” he said. “The doctor is being charged because [she] mailed the pill here.”

Louisiana law does not allow a pregnant person to be charged with criminal abortion, and Clayton said he “absolutely” would not charge the minor involved.

When asked if he thought a child under the age of 18 could consent to an abortion, Clayton answered the question by tailoring it to this specific case.

“The evidence will show in this case that the child had planned a gender reveal, and the child wanted to keep her baby,” he said. “This is not a question of her wanting to have the abortion.”

“I’m charging the mother because she ordered the pill, and she paid for the pill with her credit card and she gave the pill to a minor. That’s illegal in the state of Louisiana.” Clayton said.

In a written statement Friday, Murrill implied the teen’s mother compelled her daughter to take the abortion pills.

“The allegations in this case have nothing to do with reproductive health care, this is about coercion,” Murrill said. “This is about forcing somebody to have an abortion who didn’t want one.”

“We investigated this case. District Attorney Tony Clayton brought it to a grand jury. The grand jury unanimously and quickly indicted,” the attorney general added.

When the Illuminator asked the attorney general’s office if she plans to add the crime of coerced abortion to the charges against the teen’s mother, spokesman Lester Duhé responded to the question by referring to her original statement.

A separate coerced abortion law approved last year made Louisiana the first state to reclassify mifepristone and misoprostol as controlled dangerous substances. The designation typically applies to highly addictive drugs. Mifepristone and misoprostol are not addictive, and both have multiple uses beyond abortion and are on the World Health Organization’s list of essential medicines.

Murrill also responded to Gov. Hochul’s video post on social media.

“Cheerleading for the alleged coerced abortion of a young girl is sick and barbaric, Governor Hochul,” Murril wrote. “It’s not ‘reproductive health care,’ it’s force.”

When asked if he thought charges of coerced abortion would be added to the case, Clayton said he is focusing on the defendants “dispensing, delivering, aiding and abetting and causing an abortion” through the medication.

New York Attorney General Letitia James, a Democrat best known for winning a civil fraud case against President Donald Trump, released her own statement about the indictment against Carpenter.

“The criminalization of abortion care is a direct and brazen attack on Americans’ bodily autonomy and their right to reproductive freedom,” James said. “This cowardly attempt out of Louisiana to weaponize the law against out-of-state providers is unjust and un-American. Medication abortion is safe, effective, and necessary, and New York will ensure that it remains available to all Americans who need it.”

A West Baton Rouge grand jury indicted a New York doctor and a Louisiana mother Friday, on felony charges for allegedly providing an illegal abortion with drugs obtained through the mail.

It is the first criminal case of its kind in the country since the U.S. Supreme Court overturned Roe v. Wade in 2022, which triggered Louisiana’s strict abortion ban.

Dr. Margaret Carpenter; her company Nightingale Medical; and the mother of the minor in question were all indicted by the District Court for the Parish of West Baton Rouge. The Illuminator is not identifying the mother in order to protect the minor’s identity. The news was first reported by WAFB-TV.

Prosecutors claim the mother ordered abortion medication from Carpenter, who sent it to her in the mail, and the mother reportedly gave it to her pregnant child.

“The minor child was home alone, felt that she had to take the pill because of what her mother told her,” District Attorney Tony Clayton said in an interview with Talk Louisiana. He said he is not planning on prosecuting the minor.

Clayton’s prosecution involves a law approved in 2022, when then state Sen. Sharon Hewitt, a Slidell Republican, authored the proposal that makes it a crime to knowingly cause an abortion through medication. It carries penalties of one to five years in prison and a fine range of $5,000-$50,000. The same measure also made it illegal to obtain such drugs through the mail from out of state.

Louisiana Attorney General Liz Murrill weighed in on the indictments via social media Friday.

“It is illegal to send abortion pills into this State and it’s illegal to coerce another into having an abortion,” Murrill said. “I have said it before and I will say it again: We will hold individuals accountable for breaking the law.”

The crime of “coerced abortion” was not cited in the indictment, but the law involving that crime is what led to Louisiana becoming the first state to reclassify mifepristone and misoprostol as controlled dangerous substances. The designation typically applies to highly addictive drugs. Mifepristone and misoprostol are not addictive, and both have multiple uses beyond abortion and are on the World Health Organization’s list of essential medicines.

In his interview with Talk Louisiana , Clayton referred to the drugs as “poison,” comparing them to fentanyl, and said doctors can’t “hide behind the borders of New York” to ship the medication to Louisiana. [Mifepristone and misoprostol are not related to fentanyl.]

“To put a pill in commerce that ultimately [goes] into the mouth and stomach of a child, I believe that some folks have to answer to that,” Clayton said. “If it’s legal in New York, keep it up there. Don’t do it down here.”

New York has shield laws intended to protect telehealth providers.

Carpenter is also being sued by Texas Attorney General Ken Paxton for allegedly sending pills to the state, but the charges are not criminal.

Carpenter is one of the founders of the Abortion Coalition of Telemedicine (ACT). In a statement to the Illuminator, ACT said it stands behind New York’s shield laws.

“The case out of Louisiana against a licensed New York doctor is the latest in a series of threats that jeopardizes women’s access to reproductive healthcare throughout this country,” reads the statement. “Make no mistake, since Roe v. Wade was overturned, we’ve witnessed a disturbing pattern of interference with women’s rights. It’s no secret the United States has a history of violence and harassment against abortion providers, and this state-sponsored effort to prosecute a doctor providing safe and effective care should alarm everyone.”

A Baton Rouge-area grand jury indicted a New York doctor and a Louisiana mother Friday on felony charges for allegedly providing an illegal abortion with drugs obtained through the mail.

It is the first criminal case of its kind in the country since the U.S. Supreme Court overturned Roe v. Wade in 2022, which triggered Louisiana’s strict abortion ban.

Dr. Margaret Carpenter, her company, Nightingale Medical, and the mother of the minor in question were all indicted in the 18th Judicial District Court. The Illuminator is not identifying the mother in order to protect the minor’s identity. The news was first reported by WAFB-TV.

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District Attorney Tony Clayton said the mother has been taken into custody at West Baton Rouge Parish Jail and had posted bond as of Friday evening. Her bound amount was not immediately available.

Prosecutors claim the mother ordered abortion medication from Carpenter, who sent it to her in the mail, and the mother reportedly gave it to her pregnant child.

“The minor child was home alone, felt that she had to take the pill because of what her mother told her,” Clayton said in an interview with Talk Louisiana.

In an interview with the Illuminator, Clayton said he will be personally trying this case alongside Louisiana Attorney General Liz Murrill. Their prosecution involves a law approved in 2022, when then state Sen. Sharon Hewitt, a Slidell Republican, authored the proposal that makes it a crime to knowingly cause an abortion through medication. The pregnant person cannot be charged with a crime under this law.

It carries penalties of one to five years in prison and a fine range of $5,000-$50,000. The same measure also made it illegal to obtain such drugs through the mail from out of state.

Murrill weighed in on the indictments via social media Friday.

“It is illegal to send abortion pills into this State and it’s illegal to coerce another into having an abortion,” she said. “I have said it before and I will say it again: We will hold individuals accountable for breaking the law.”

The crime of “coerced abortion” was not cited in the indictment, but the law involving that crime is what led to Louisiana becoming the first state to reclassify mifepristone and misoprostol as controlled dangerous substances. The designation typically applies to highly addictive drugs. Mifepristone and misoprostol are not addictive, and both have multiple uses beyond abortion and are on the World Health Organization’s list of essential medicines.

In his interview with Talk Louisiana, Clayton referred to the drugs as “poison,” comparing them to fentanyl, and said doctors can’t “hide behind the borders of New York” to ship the medication to Louisiana. [Mifepristone and misoprostol are not related to fentanyl.]

“To put a pill in commerce that ultimately [goes] into the mouth and stomach of a child, I believe that some folks have to answer to that,” Clayton said. “If it’s legal in New York, keep it up there. Don’t do it down here.”

New York has shield laws intended to protect telehealth providers.

Carpenter is also being sued by Texas Attorney General Ken Paxton for allegedly sending pills to the state, but the charges are not criminal.

Carpenter is one of the founders of the Abortion Coalition of Telemedicine (ACT). In a statement to the Illuminator, ACT said it stands behind New York’s shield laws.

“The case out of Louisiana against a licensed New York doctor is the latest in a series of threats that jeopardizes women’s access to reproductive healthcare throughout this country,” reads the statement. “Make no mistake, since Roe v. Wade was overturned, we’ve witnessed a disturbing pattern of interference with women’s rights. It’s no secret the United States has a history of violence and harassment against abortion providers, and this state-sponsored effort to prosecute a doctor providing safe and effective care should alarm everyone.”

NEW ORLEANS — The New Orleans health department has developed a new online tool to help doctors and patients identify pharmacies that stock misoprostol in Orleans and Jefferson parishes.

The initiative comes after the department was tasked with studying access to the pregnancy care pill after new state law reclassified misoprostol and mifepristone as controlled substances. The drugs were targeted because they can also be used for medication abortion, but both have other medical uses.

Misoprostol in particular is regularly used for reproductive care procedures such as miscarriage, IUD insertion and postpartum hemorrhage.

After the law took effect Oct. 1, city health officials received multiple reports that patients encountered obstacles attempting to fill prescriptions. Similarly, the Illuminator spoke with multiple doctors in October who detailed issues their patients had with obtaining misoprostol from pharmacies.

“We were concerned from the beginning that changing the controlled substances law for misoprostol was going to cause significant barriers,” New Orleans health director Dr. Jennifer Avegno said.

After hearing about these challenges, Avegno said her team began calling all listed pharmacies in Orleans and Jefferson parishes, collecting information for patients and health care professionals so they would know where to fill prescriptions for procedures that are often time-sensitive.

City health workers reached out to 57 pharmacies in New Orleans and 107 in Jefferson Parish.

In New Orleans, 65% said they have the medication in stock and nearly 23% did not. Another 12% did not respond to the city survey.

Only 30% of Jefferson pharmacies reported keeping the drugs on hand, and 45% said they do not carry them. One-fourth of the businesses didn’t respond.

The new health department website provides a map of Orleans Parish searchable by address and location or pharmacy. Pharmacies where misoprostol is available are marked on the map, and there are links to a list for Orleans and Jefferson pharmacies.

Health care professionals and patients can use the new dashboard and map to find pharmacies that stock misoprostol nearby, and the information will be updated regularly based on information from providers, pharmacies and patients, according to Avegno.

In New Orleans, most national chain pharmacies, including CVS and Walgreens, reported having the medication in stock. Avegno said that if some pharmacists said they didn’t currently have it in their pharmacy but could get it if needed, the department counted it as a “yes.”

One of the questions posed to pharmacists was if they used to carry it and now don’t, why was there a change?

Avegno says “several pharmacists” said they stopped carrying the medication after misoprostol became a controlled substance. The respondents were provided anonymity to encourage disclosure.

“It’s too many restrictions, too many hoops to jump through,” Avegno said one pharmacist said.

Some pharmacies in Orleans and Jefferson Parish told city health workers they require additional information from the prescribing physician, even if the prescription is written out correctly with the diagnosis codes for a legally allowed medical use.

“The pharmacist could have it in stock, but there is either an official or unofficial internal policy in that pharmacy that says you better call the physician and make sure it’s not for an abortion or make sure that everything is OK,” Avegno said.

“That’s not part of the controlled substances law,” she added. “They don’t call your doctor every time you get a percocet or valium prescription. There’s this real unease and, I think, lack of trust, and I can’t blame a pharmacist for doing that. I think a lot of people are confused about what their liability might be, so they want to go above and beyond what is required.”

Avegno added that this means a patient going to fill a prescription might still encounter a delay, regardless of whether the medication is in stock. “The fear and confusion are creating barriers, which we’ve been saying all along,” she said.

The city health department plans to broaden its reach to look at what the misoprostol landscape looks like statewide, particularly in maternity care deserts where reproductive care is already challenging to access.

“We want to highlight that so decision makers, policy makers can help mitigate any barriers that may have been caused, intentionally or unintentionally, from the law,” Avegno said.

If you’ve experienced challenges seeking reproductive health care in Louisiana, particularly if you are in a rural area, we’d love to hear from you. Please fill out this secure form or contact our reporter at lorenaoneil.64 on Signal, an encrypted messaging app.

When a woman starts bleeding out after labor, every second matters. But soon, under a new state law, Louisiana doctors might not be able to quickly access one of the most widely used life-saving medications for postpartum hemorrhage.

The Louisiana Illuminator spoke with several doctors across the state that voiced extreme concern about how the rescheduling of misoprostol as a controlled dangerous substance will impact inpatient care at hospitals. Misoprostol is prescribed in a number of medical scenarios — it’s an essential part of reproductive health care that can be used during emergencies, as well as for miscarriage treatment, labor induction, or intrauterine device (IUD) insertion.

But because it is used for abortion, misoprostol has been targeted by conservatives in Louisiana — an unprecedented move for a medication that routinely saves lives. A controlled dangerous substance has extra barriers for access, which can delay care.

“My fear is that someone could eventually die,” said Dr. Tara Morse, an OB-GYN who practices at Touro Infirmary in New Orleans. “And that’s not why we all went into medicine. Our goal is to prevent everything and be able to use every drug at our disposal.”

Every hospital has its own system for obstetric hemorrhage care. Some use rolling carts or kits in birthing rooms with easily accessible medications and equipment in case of hemorrhage after delivery.

Misoprostol is a pill often used in early stages of post-delivery bleeding, especially for patients with hypertension or asthma who might have adverse side effects from using other hemorrhage medications that are usually administered by needles or an IV. Misoprostol is also used as a precautionary measure in case doctors think a patient is at risk for hemorrhaging.

In May, Gov. Jeff Landry signed legislation reclassifying misoprostol and mifepristone as Schedule IV controlled dangerous substances, despite more than 200 doctors signing a letter against the measure. The law goes into effect on Oct. 1, and doctors and pharmacists are scrambling to come up with postpartum hemorrhage policies that will comply with the law while still providing proper medical care for women.

Some hospitals have already preemptively pulled misoprostol from their obstetric hemorrhage carts and kits because controlled dangerous substances need to be stored and accessed differently from other medications.

“It is causing a lot of confusion and angst just not understanding, just not knowing — they’re still trying to figure out what to do,” said an OB-GYN who asked that her name not be used because she had not received clearance from her hospital. She said she’s heard of the medication being pulled off carts at some hospitals.

“The physician community that I work within is certainly anxious about what the changes to the normal process will be,” said Dr. Stacey Holman, division director at Touro’s maternal child services. She added how “frustrating” it is that it’s become routine in Louisiana to have an unclear law attempting to dictate medical practice creating stress on health care providers.

“It’s an unnecessary barrier and really critical to the regular everyday care that we provide to our patients,” she said.

“We’re trying to fix something that is not broken and that is absolutely safe,” Holman said.

Holman said she is not aware of misoprostol being proactively removed from any of Touro’s obstetric hemorrhage carts. But come Oct. 1, “It won’t be in our carts anymore because it [will be] a controlled substance and has to go through the pathways of the pharmacy.”

Alternate drugs are available, but Holman pointed out Touro sees an increased number of hypertensive patients in her community who aren’t able to use one of the primary alternatives. Hypertensive patients are also at increased risk for maternal morbidity and mortality.

“My job is to save the mom’s life, not type out orders on a computer,” Morse said of what the new protocols might look like if doctors have to put in physician’s orders before obtaining the medicine, versus adding the order afterward as is often the case now.

Morse, who occasionally works at rural hospitals in the state, said she’s very worried about how this will impact those facilities — especially ones without in-house pharmacies on nights and weekends.

“I’ve been [at a rural hospital] trying to get a simple headache medication released, and it’s taken 45 minutes,” Morse said. Sometimes doctors have to call a remote pharmacy and leave a voicemail, she said, playing phone tag to get access to vital medication.

“In these [hemorrhage] situations, you don’t have 45 minutes,” Morse said.

While hospitals in New Orleans are attempting to find workarounds for the new law, there are some rural doctors who aren’t even aware the reclassification of misoprostol and mifepristone is happening. One physician in northwest Louisiana who spoke with the Illuminator hadn’t heard that misoprostol was becoming a controlled dangerous substance until a reporter told her about it.

“What? That’s terrifying,” the doctor said. “Take it off the carts? That’s death. That’s a matter of life or death.”

The physician said that if a pregnant patient came into her hospital bleeding out with no IV access, she would automatically use misoprostol as an option. Other medications and tools are not as easily accessible in rural hospitals because they require more resources, whether that’s because they are more expensive or require the use of syringes. Not to mention the more time a patient has to wait for access to medicine, the more blood she loses.

“Blood is always in short supply,” the doctor said of her hospital. “Misoprostol can prevent the need for transfusion.”

The doctor said the pending law likely explains why pharmacists had been “pushing back” when she prescribed misoprostol for outpatient miscarriage management. They’ve been calling her to request clarification on why she prescribed the medication, and one pharmacy refused to fill the prescription. She had to send that patient to a different pharmacy. Her patients often travel hours to see her, and she regularly has to call in misoprostol to help them manage care at home.

On Aug. 22, 50 doctors signed a letter to the Louisiana Department of Health and Surgeon General Ralph Abraham asking for additional guidance on how to safely prescribe and administer misoprostol and mifepristone once the new law goes into effect. They specifically asked for help on the use of misoprostol in the inpatient setting, and “how to ensure it will be readily and quickly available in commonly used obstetric hemorrhage carts.”

“This is a nationally recognized guideline to emergently treat life-threatening postpartum hemorrhage and it is critical that providers are aware and have access to medication without delay,” the doctors wrote, requesting Abraham’s advice be communicated well in advance of Oct. 1.

They had not heard back as of Monday.

OB-GYN questions Louisiana’s ‘dangerous’ classification of abortion, miscarriage drugs

The Louisiana Department of Health, the state Board of Pharmacy and Attorney General Liz Murrill did not return requests to explain how they plan to educate health care providers and assist them in making sure care for Louisiana women is not disrupted. A provision in the new law calls for doctors to be educated on how to comply.

“This is a bad drug to be a controlled substance,” says Dr. Jennifer Avegno, director of the City of New Orleans health department and an emergency room physician. “We are putting women’s lives at risk by denying them immediate access to a life-saving drug.”

Avegno adds, “The OB providers that I’ve spoken to are very concerned and very upset about the way this will change their practice, and I don’t blame them.” She likened the situation to delaying a patient in anaphylaxis access to an EpiPen or removing medicine from a crash cart in an emergency room.

“When you need to give blood to a crashing patient, do you want it right there or do you want to have to call somebody to have them walk it down from the blood bank?” said Avegno, who thinks the new law could lead patients to lose more blood.

“Ultimately it will be OK. But for some people, having that delay or being forced to take a drug that is not the best indication for them will worsen outcomes,” she said.

Louisiana is among the worst states in terms of maternal mortality and morbidity, and Black women are disproportionately at risk of dying due to complications with pregnancy or childbirth. But the state has successfully been reducing death rates due to postpartum hemorrhage.

“The state has done really good work on reducing maternal mortality through hemorrhage over the last several years by very deliberate mechanisms,” Avegno said. “And [with this new law] we run the risk of backsliding.“

Dr. Jane Martin, a maternal fetal medicine specialist in New Orleans, agrees.

“The frequency of severe maternal morbidity and mortality related to postpartum hemorrhage (PPH) has decreased when you look at the last few decades,” Martin said. “What has changed is the push for hospitals and systems to have protocols in place, which I think is what’s brought these bad PPH outcomes down.”

Martin points to a report that shows, from 2016 to 2019, severe maternal morbidity due to hypertension and postpartum hemorrhage decreased by almost 40% in Louisiana, solely due to standardization of processes.

“But it’s literally taken years, if not decades for hospitals to have these protocols function as well-oiled machines,” Martin said. “When we change these protocols that work so well, we are introducing a significant opportunity for errors, lapses and delays in care, and worse maternal outcomes solely because we are messing with a process that works well and now has to be re-learned.”

As public health becomes political, state surgeons general play delicate role

When asked about the status of misoprostol at its hospitals, Ochsner Health System said it is “working to get more information about the postpartum hemorrhage carts and additional impacts of the new regulation.” A spokesperson said communications about the impacts of the new state law will be shared with their physicians in the weeks ahead, and that Ochsner will provide official comment once that has occurred.

Ochsner did not disclose whether the medication has been preemptively removed from carts and kits at their hospitals. The health system owns or operates 46 hospitals in Louisiana.

LCMC Health runs eight acute care hospitals in the New Orleans area that the new law would impact. Dr. John Heaton, its president and chief medical officer, provided this statement:

“Maternal health is a top priority for our community of patients. We are dedicated to fostering collaborations with physician leaders, nursing leaders, and pharmacy leaders to develop innovative solutions that comply with all legal standards. We are committed to safe care of the highest quality in our birthing hospitals.”

Holman, director of maternal child services at Touro, said that as the largest birthing hospital in the LCMC system, her hospital is working to support others in the system to determine their protocols.

“We don’t want to scare the patients, but we certainly want to make sure people understand that this is a big deal,” Holman said. “Our goal is to minimize how much we impact the logistics of each hospital, but every hospital will be impacted in some way.

“We are not going to put patients in harm’s way. We are going to figure out solutions to this, but we’re going through a lot of steps and figuring out a lot of things for a medication that is actually safe.”

Louisiana Illuminator is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Louisiana Illuminator maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com. Follow Louisiana Illuminator on Facebook and X.