By Suzanne Bowdey

“Leaving it to the states” sounded good in theory, but in practice? The abortion debate has never been more volatile. That’s because the war over destroying unborn children isn’t just being waged in one of the most unusual places, but also one of the least regulated: the mail. Unlike past decades, when women had to actually visit a Planned Parenthood to end their pregnancies, abortion is just a postage stamp away. And incredibly, living in a pro-life state doesn’t change that.

While the Supreme Court was right — and years overdue — in overturning the flawed Roe v. Wade ruling, the biggest mistake people made after 2022 was thinking the abortion question was solved. Far from it. If anything, Dobbs only inflamed the tensions boiling under the surface. For the last several months, it’s only exposed the very dangerous divides between red and blue states — divides that may very well land the issue back in the lap of the highest court.

The problem facing pro-life states is spelled out in a first-of-its-kind lawsuit that Texas Attorney General Ken Paxton (R) filed on Friday when a New York doctor mailed a mother in the Lone Star State abortion pills — in direct defiance of Texas law. For months, liberal states have been secretly (and not-so-secretly) exporting these drugs to their conservative neighbors, brazenly violating state sovereignty.

The New York Times went behind the curtain of one of these pill pop-ups in Boston, where the patients “do not have to travel here to terminate their pregnancies, and they do not have to wait weeks to receive abortion medication from overseas. Instead, they are obtaining abortion pills prescribed by licensed Massachusetts providers, packaged in the little room and mailed from a nearby post office, arriving days later in Texas, Missouri and other states where abortion is largely outlawed.” Blue states have tried to get around it by passing what they’ve dubbed “shield laws” that supposedly protect anyone shipping abortion drugs to pro-life states from prosecution or investigation. Whether those shields hold up in court is another question — one that Paxton plans to test.

In this latest case, a New York doctor mailed mifepristone to a 20-year-old Texan, who started bleeding so profusely in July that she asked the father of the baby — who had no idea she was pregnant — to take her to the hospital. “In this case, an out-of-state doctor violated the law and caused serious harm to this patient,” Paxton insisted in a statement. “This doctor prescribed abortion-inducing drugs — unauthorized, over telemedicine — causing her patient to end up in the hospital with serious complications.” In Texas, Paxton underscored, “We treasure the health and lives of mothers and babies, and this is why out-of-state doctors may not illegally and dangerously prescribe abortion-inducing drugs to Texas residents.”

Dr. Margaret Daley Carpenter is not a licensed Texas physician, the complaint explains, nor is she authorized to practice telemedicine in Texas, where abortion is severely restricted. Under the Lone Star law, doctors and medical suppliers are forbidden from sending these drugs into the state.

“Carpenter’s conduct violates the Texas Health and Safety Code’s prohibition on prescribing abortion-inducing drugs via telemedicine,” the lawsuit reads. “Carpenter’s knowing and continuing violations of Texas law places women and unborn children in Texas at risk. Carpenter sees Texas patients via telehealth and prescribes them abortion inducing medication.”

Her home state of New York, on the other hand, passed a shield law promising to protect her from legal action. In other words, the case pits one democratically-passed state law against another. And the Left isn’t about to back down. The Empire State’s AG, Letitia James (D), fired back at Paxton, “We will always protect our providers from unjust attempts to punish them for doing their job and we will never cower in the face of intimidation or threats.” She vowed to “continue to defend reproductive freedom and justice for New Yorkers, including from out-of-state anti-choice attacks.”

Just to put the current debate in perspective, almost 10,000 abortions were carried out by telehealth under these shield laws in the second quarter of 2024, according to the Society of Family Planning. That’s a 5% increase over the first quarter of 2024, Axios notes.

Will Scharf, who was just tapped by Donald Trump to be White House staff secretary, is appalled that leaders in New York and elsewhere would ignore Texas’s duly passed policies. “When you have states actively seeking to circumvent each other’s laws, that raises a very real legal problem that will stretch far beyond just the abortion sphere,” he argued in February.

In essence, Texas Right to Life’s John Seago pointed out, “You have states not just picking their own strategy but really trying to completely sabotage the governing efforts of their neighboring states. It can’t stand,” he reiterated, “and we can’t be content with this new development.”

While Trump has been cagey about whether he’ll restrict mifepristone, many argue this goes well beyond the merits of the drug into the Wild West of interstate commerce and distribution. If states can dodge other legislatures’ pro-life laws, imagine what they could do with transgender hormones or other “health care.”

That’s why this suit is so necessary, FRC’s Mary Szoch insisted to The Washington Stand. “Once again, take a moment and thank God for Texas. While states like New York work to prevent abortionists from being held accountable for the harm they do, Texas is working to protect both moms and babies. Abortionists from out of state are mailing women the deadly abortion drug, mifepristone, knowing that that drug sends one in 25 women to the emergency room and that if their patient should need emergency assistance, they won’t be able to administer it because they are thousands of miles away.”

“Texans have had enough,” Szoch emphasized. “They won’t stand idly by as the abortion industry targets and exploits vulnerable women in their state. Roe v. Wade originated in Texas. And since the day that horrific decision came down in 1973, Texans have done everything in their power to bring back a time when the dignity of every woman, every man, and every child — born and unborn — is acknowledged and respected by all. Let’s pray for another victory for life.”

Suzanne Bowdey serves as editorial director and senior writer at The Washington Stand.