JACKSON, Miss.—Criminalizing providers for mailing abortion drugs to patients could mean doctors are less willing to prescribe certain drugs to pregnant women, an expert on reproductive health law and history told the Mississippi Free Press after the Mississippi Legislature approved the bill.
Mary Ziegler, a Martin Luther King Jr. professor of law at the University of California Davis School of Law, pointed to concerns over how House Bill 1613 could affect the willingness of physicians to prescribe the drugs for other medically necessary purposes.
Mailing abortion drugs to patients would be a crime under the legislation, which defines the practice as felony drug trafficking in the law. Doctors or providers who prescribe or distribute abortion-inducing drugs, like mifepristone and misoprostol, without an in-person visit with a patient could face imprisonment and civil penalties. The Legislature sent the bill for Gov. Reeves to sign into law last week.
“I think the concern some had with the bill was that physicians would be afraid to use drugs counterindicated during pregnancy because even if they were prescribing those drugs for non-abortion purposes, a zealous prosecutor, a confused law enforcement officer or something like that could be like, ‘Oh, you know, it was an adverse pregnancy outcome in this drug that can cause adverse pregnancy outcome and so clearly this was an abortion’ even if that’s not what was happening,’” Ziegler told the Mississippi Free Press on April 2.
Abortion drugs have other medical uses, too; doctors prescribe misoprostol to treat gastric ulcers, for example, and women who suffer incomplete miscarriages use it to help pass tissue and avoid the need for surgery.
Mississippi House Rep. Zakiya Summers, D-Jackson, said women, law enforcement, county boards of supervisors and medical professionals “should be outraged by this bill.”
H.B. 1613 will also cause unnecessary burdens on already overwhelmed law enforcement officers, Summers said. The legislation does not name the abortion-inducing drugs that would be criminalized under the bill for providers to prescribe to patients without seeing the patient in person.
“What the Legislature did in regards to that bill was to force our law enforcement officers to now become medical practitioners and physicians to determine which drugs, because the medication name is not included in the bill,” she told the Mississippi Free Press on April 2. “So now they’re putting the burden upon our law enforcement officers, who are already strapped of precious resources, to determine whether or not a pill or a medication that has been prescribed by their physician or their doctor is an abortion-inducting medicine.”
Ziegler: Criminalizing Abortions Won’t Stop People from Having Them
The most common use of abortion-inducing drugs is for pregnant people who are going through a miscarriage. Doctors prescribe the drug and supervise the process. Rep. Celeste Hurst, R-Sandhill, told the Mississippi Free Press that the intention of her provision in H.B. 1613 is to ensure patient safety by clarifying that it is illegal under state law for doctors to prescribe those medications without an in-person visit from a patient.
“Right now, it’s being mailed out without any doctor oversight and without any age verification whatsoever—they’re not even verifying if the person they’re communicating with via form is a woman,” she told the Mississippi Free Press on Feb. 16.
Hurst clarified that her provision would not punish people who receive the abortion-inducing drugs illicitly from doctors; it would only affect the doctors or prescribers.
Violators could face imprisonment at the Mississippi Department of Corrections for one to 10 years under the legislation. The Mississippi attorney general could also enforce civil penalties for the offender “to obtain declaratory or injunctive relief, and to recover civil penalties and costs,” the provision explains.
Ziegler said it would be challenging to prosecute out-of-state abortion drug providers for sending the drugs to Mississippians because the other states’ governments may not comply with Mississippi’s investigation and extradition requests because there is only “clear extradition rights” for fugitives.
“What’s happening is California or New York look at that and say, ‘Well, the doctor didn’t go to Mississippi and they stayed in New York or California. And based on what we think, all the relevant conduct happened in New York or California where abortion is legal,’” she said. “And Mississippi looks at that and says, ‘No, no, you sent pills into Mississippi, so the relevant stuff happened in Mississippi where abortion is a crime.’ And those are complicated arguments.”
She said while Mississippi Republicans had hoped Trump would “crack down on abortions,” his administration has not enacted any new provisions so far to further restrict abortion access in the U.S.
Abortions have increased by 21% since 2020, Guttmacher reports. From 2017 to 2020, Guttmacher data show the average rate was about 14 abortions per 1,000 women aged 15 to 44 in the U.S., while the rate for 2025 was 16.7 abortions per 1,000 women.
“That suggests that when people have abortions, it’s being driven by lots of stuff that isn’t the law,” Ziegler said. “Right? Like, the economy, affordability, how their other kids are doing, what their health looks like—there’s just a ton of other things.”
Mississippi enacting laws to criminalize abortions will not stop people from obtaining them, the professor said, noting the most common ways to lower abortion rates is by having a stable economy and providing access to birth control.
“I think one of the challenges Mississippi has confronted is that it’s a lot easier to criminalize abortion that it is to actually stop people from getting abortions,” Ziegler said
H.B. 1613 Originally Didn’t Mention Abortion
H.B. 1613 originally said that a person possessing 200 or more grams of illegal drugs would constitute an aggravated drug trafficking charge, Mississippi House Judiciary B Chairman Rep. Kevin Horan, R-Grenada, said on the House floor on Feb. 11.
Mississippi House Rep. Celeste Hurst, R-Sandhill, introduced an amendment to add “abortion-inducing drugs” to the list of illegal substances under the drug trafficking statutes in Mississippi Code Section 41-29-139.
When the House bill came over to the Senate, Sen. Joey Fillingane, R-Sumrall, amended the legislation to say that a person possessing 267 grams or more of illegal drugs would constitute an aggravated drug trafficking charge, which was noted in a similar Senate bill. The Senate approved the amendment.
The House passed H.B. 1613 by a 77-39 vote on Feb. 11, and the Senate passed it by a 24-7 vote on March 6. Nine senators voting against the bill paired their votes with nine senators who voted in favor of the bill. The paired votes are not part of the vote total. Both chambers approved the conference report on March 31. The Legislature will send the bill to Gov. Tate Reeves soon for him to decide whether to sign it into law.
