Louisiana has initiated a high-stakes legal battle by formally requesting the extradition of a California-based physician accused of mailing abortion pills into the state. The move, announced on Tuesday 13 January 2026, directly challenges protective 'shield laws' enacted in several US states to safeguard telehealth providers who serve patients in regions with abortion bans.
A Direct Challenge to Protective Legislation
This marks the second instance where Louisiana authorities have pursued an out-of-state medical practitioner under the state's stringent abortion restrictions. Republican Governor Jeff Landry publicly declared his intent to bring the provider "to justice" in a social media post, confirming that extradition paperwork had been dispatched.
The case pits Louisiana, which enforces one of the nation's most restrictive abortion regimes, against jurisdictions like California that have passed laws specifically designed to protect healthcare professionals who facilitate abortions for patients in banned states via telehealth services.
The Accusations and Potential Penalties
The physician at the centre of the case is Dr Remy Coeytaux, who practises in the San Francisco Bay Area. Louisiana Attorney General Liz Murrill announced that Coeytaux faces a criminal charge of 'abortion by means of abortion-inducing drugs'.
According to court documents, the doctor is alleged to have mailed the medications mifepristone and misoprostol in 2023 to a Louisiana woman who obtained them through Aid Access, a European online telemedicine service. Investigators state the woman used the pills to terminate her pregnancy and that authorities confirmed Coeytaux as the sender.
If convicted, the doctor could face a staggering sentence of up to 50 years in jail alongside substantial fines. Attorney General Murrill told The Associated Press she believes this was not an isolated incident and further indictments may follow.
Broader Legal and Political Context
The case unfolds against a backdrop of intensifying conflict over abortion access post-Roe v. Wade. Louisiana law bans abortion at all stages of pregnancy, with no exceptions for rape or incest. Last year, state lawmakers further tightened restrictions by targeting out-of-state prescribers and reclassifying abortion pills as controlled dangerous substances.
Dr Coeytaux is also involved in a separate federal lawsuit filed in Texas, where a man alleges the doctor illegally provided abortion medication to his girlfriend.
In a similar previous case, Louisiana sought the extradition of a New York doctor accused of mailing pills to a pregnant minor. That request was refused by New York Governor Kathy Hochul, who cited her state's shield laws. California Governor Gavin Newsom's office, which now faces an extradition request, has not yet commented.
Legal advocacy groups have condemned Louisiana's actions. The Center for Reproductive Rights, which is representing Coeytaux in related civil matters, criticised the state for targeting doctors while its own abortion ban "puts women’s lives at risk every day."
This escalating confrontation is set to become a significant test case for the limits and reach of state shield laws, determining whether providers in protective states can be held criminally liable under the laws of states where their patients reside.
