In Dobbs v. Jackson Women’s Health Organization, the Supreme Court overturned Roe v. Wade’s purported right to abortion and returned the abortion issue to the people and their elected representatives.[1] However, the promise to restore the abortion question to the democratic process rang hollow, as twenty-two states plus the District of Columbia enacted novel laws, known as shield laws, to interfere with the pro-life laws of other states.[2] These laws go well beyond establishing a so-called abortion right. Instead of focusing on a woman seeking abortion, they instead protect the abortionist himself, “shielding” him from criminal, civil, and professional liability for sending mail-order abortion drugs into a pro-life state in violation of that state’s abortion code. It protects the abortionist even if he is practicing without a medical license in the pro-life state, and even if the woman suffers complications or a coerced abortion.

 

Shield laws raise important questions about federalism, comity, and states’ traditional police powers over the practice of medicine. Moreover, by enabling an abortionist to prescribe and distribute chemical abortion drugs into a sister state, shield laws violate the Tenth Amendment’s reservation of powers to the states respectively.

 

How Shield Laws Work

Shield laws are a patchwork of provisions scattered throughout a state’s public health, business, and criminal codes. In some states, the governor’s executive order establishes the shield law. Shield laws essentially authorize the practice of mail-order abortion from shield law states to pro-life states by:

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• Refusing to recognize final judgments in abortion cases decided out of state;[3]

• Prohibiting extradition of abortionists for sending mail-order chemical abortion drugs into a pro-life state;[4]

• Authorizing a retaliatory lawsuit against an individual that “interferes” with abortion, so that the abortionist may recover damages against an individual or entity that sues him for providing an abortion;[5]

• Directing state officials to not cooperate with out-of-state investigations and legal proceedings;[6]

• Limiting professional consequences for abortionists, such as professional discipline, revocation of a medical license, or adverse actions by a medical malpractice insurer;[7]

• Allowing chemical abortion prescribers to omit their names from the drug label and instead list the name of the abortion clinic or other health care practice.[8]

 

These laws not only prevent pro-life states from effectively enforcing their abortion laws, but they also hurt the woman who underwent a chemical abortion. Without the provider’s name on the drug label, the woman loses a critical piece of evidence in a medical malpractice lawsuit. If a woman who suffers complications during a chemical abortion brings a lawsuit against an abortionist, the shield law’s plain language permits the abortionist to bring a retaliatory lawsuit against the woman for interfering with abortion access. Ultimately, shield laws permit an abortionist to violate basic public health laws, preventing extradition of an abortionist who is practicing without a medical license in the pro-life state.[9]

 

Police Powers and Public Health Law

States have broad police powers over the practice of medicine. The Supreme Court reaffirmed in Medina v. Planned Parenthood South Atlantic that “States have traditionally exercised primary responsibility over ‘matters of health and safety,’ including the regulation of the practice of medicine.”[10] This principle has long been settled. It includes the recognition that states may require medical licensing to uphold patient safety, which as the Supreme Court said in Watson v. Maryland, ensures providers “possess the necessary qualifications of learning, skill, and character essential to their calling.”[11]

 

Shield laws, however, enable an abortionist to disregard standard-of-care regulations enacted under the state’s valid police powers to protect public safety. Medical licensing laws require that any individual that practices medicine within a state must hold a medical license.[12] The health code may restrict abortion after a certain gestational age to protect public safety,[13] especially considering “[t]he frequency of complications increases with gestational age due to the greater degree of anatomic and physiologic changes later in pregnancy.”[14] It may mandate informed consent safeguards and health and safety requirements as part of the standard of care for pregnant women.[15] The health code also may recognize that when a pregnant woman presents to a medical professional, there are two patients: the mother and the unborn child.[16] These protections are critical because of mifepristone’s significant risks. As the U.S. Food and Drug Administration (FDA) cautions in the black box warning on mifepristone’s drug label, a woman may experience “serious and sometimes fatal infections or bleeding” from taking chemical abortion drugs.[17] Yet under shield laws, an abortionist may blatantly violate a state’s medical standard of care, which endangers patient safety. However, an abortionist faces no consequences simply because he resides in another state, stripping the women he has harmed of justice.

 

Shield Laws Infringe upon the Tenth Amendment

A state may not exercise the police powers of a sister state. The Tenth Amendment of the Constitution recognizes, “[t]he powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively . . . .”‍[18] In The Federalist No. 45, James Madison echoed this language, affirming that “[t]he State government will have . . . the powers respectively vested in them . . . .”‍[19] Under the Constitution, states have the “status as coequal sovereigns in a federal system,”‍[20] and each state may exercise its police powers within its jurisdiction.

 

This is true for the practice of medicine. In Gonzales v. Raich, the Supreme Court recognized that “[t]he States’ core police powers have always included authority to define criminal law and to protect the health, safety, and welfare of their citizens.”[21] The Court also noted in Hillsborough County, Florida v. Automated Medical Laboratories, Inc., that “the regulation of health and safety matters is primarily, and historically, a matter of local concern.”[22] Accordingly, each “state constitutionally may prescribe conditions to [the] practice [of medicine], considered by it to be necessary or useful to secure competence in those who follow it,”‍[23] but may not go so far as to define the laws of sister states.‍[24]

 

Shield laws change the practice of medicine in pro-life states. They enable an abortionist to practice without a medical license in a sister state and authorize the prescription of drugs that are illegal under that sister state’s law. Thus, by altering the practice of medicine in a sister state, a shield law state is usurping its sister state’s police powers. This violates the Tenth Amendment’s reservation of powers to states respectively.

 

As the pro-life movement looks ahead, states must prioritize combatting shield laws to the greatest extent possible, such as through prosecuting an abortionist for practicing without a medical license, strengthening a private right of action in an abortion law, or issuing a public advisory about the dangers of mail-order abortion drugs. These actions may reaffirm pro-life states’ police powers and help restore a standard of care that protects mothers and unborn children.

 

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[1] 597 U.S. 215, 231–32 (2022).

[2] Mia Steupert, An Overview of Online Abortion Drug Access in Post-Dobbs America, Charlotte Lozier Inst. 1, 18 (May 26, 2026), https://lozierinstitute.org/an-overview-of-online-abortion-drug-access-in-post-dobbs-america.

[3] E.g., Mass. Gen. Laws Ann. ch. 218, § 4A(c) (West 2022).

[4] E.g., Me. Rev. Stat. Ann. tit. 15, § 203(5) (West 2024).

[5] E.g., N.Y. Civ. Rights Law § 70-b (McKinney 2025).

[6] E.g., Del. Code Ann. tit. 29 § 611 (West 2025).

[7] E.g., Cal. Bus. & Prof. Code § 852 (West 2024).

[8] E.g., Colo. Rev. Stat. Ann. § 12-280-124(2)(b) (West 2025).

[9] See, e.g., Governor Newsom Rejects Louisiana’s Attempt to Extradite California Doctor for Providing Abortion Care, Governor Gavin Newsom (Jan. 14, 2026), https://www.gov.ca.gov/2026/01/14/governor-newsom-rejects-louisianas-attempt-to-extradite-california-doctor-for-providing-abortion-care/.

[10] 606 U.S. 357, 364 (2025) (citing De Buono v. NYSA-ILA Med. &Clinical Servs. Fund, 520 U.S. 806, 814 (1997)).

[11] 218 U.S. 173, 176 (1910).

[12] E.g., Tex. Occ. Code Ann. § 155.001 (West 1999); Tex. Occ. Code Ann. § 165.159 (West 1999).

[13] E.g., S.C. Code Ann. §§ 44-41-610 to -740 (2023) (prohibiting abortion after detection of “the unborn child’s fetal heartbeat”).

[14] Rsch. Comm., Am. Ass’n of Pro-Life Obstetricians & Gynecologists, State Restrictions on Abortion: Evidence-Based Guidance for Policymakers, Comm. Op. No. 10, at 12 (2022).

[15] E.g., Fla. Stat. Ann. § 390.0111(3) (West 2023) (establishing informed consent safeguards, including a twenty-four-hour reflection period).

[16] See, e.g., Idaho Code Ann. § 18-622 (West 2023) (requiring a physician separating the mother and unborn child to “provide[] the best opportunity for the unborn child to survive”).

[17] See Mifeprex Prescribing Information, U.S. Food & Drug Admin. 1, 1 (Jan. 2023), https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/020687Orig1s025Lbl.pdf.

[18] (emphasis added).

[19] (emphasis added).

[20] World-Wide Volkswagen Corp. v. Woodson, 444 U.S. 286, 292 (1980).

[21] 545 U.S. 1, 42 (2005) (emphasis added) (citations omitted).

[22] 471 U.S. 707, 719 (1985).

[23] Collins v. Texas, 223 U.S. 288, 296 (1912).

[24] Huntington v. Attrill, 146 U.S. 657, 669 (1892).

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