Alabama Attorney General Steve Marshall: Protecting life after Roe v. Wade remains an uphill battle

Every pro-life advocate will forever be indebted to President Donald Trump whose Supreme Court nominees helped overturn Roe v. Wade on that monumental day nearly four years ago. Since then, the pro-life movement has been reignited, countless babies have been saved in states that passed bans, and mothers have been given the informed opportunity to choose life. However, much work remains to protect unborn children and ensure the safety of women’s health.

Still, the story across the country remains very concerning. More abortions are occurring now than in the years before Roe was overturned because abortion drugs, like mifepristone, can be delivered through telehealth services, allowing someone to terminate a pregnancy without ever stepping foot inside a doctor’s office. This is because the Food and Drug Administration (FDA) under President Biden weakened regulations on abortion, eliminating in-person dispensing requirements and ultimately expanding access to abortion drugs by mail.

Some conservative leaders are rightfully holding the line on the issue of life. Sen. Josh Hawley (R-Mo.) introduced the Safeguarding Women from Chemical Abortion Act last week, with companion legislation in the House to be introduced soon. The bill would ban the use of mifepristone and allow women to sue the manufacturers that are making billions of dollars off these unsafe products.

Despite repeated insistence from abortion advocates that mifepristone is some harmless pharmaceutical akin to an over-the-counter pain reliever, there is significant scientific evidence that women who take it face serious health risks. In fact, 11% percent of women who consume this abortifacient “experience sepsis, infection, hemorrhaging, or another serious or life-threatening adverse event,” according to a 2025 study published by the Ethics and Public Policy Center.

If any other drug on the market produced such dramatic and deadly side effects even a fraction of the time mifepristone does, it would be banned immediately. But because it so easily advances the cause of abortion, bureaucrats and politicians see no problem making it readily available, even when doing so violates the law.

We’ve already seen doctors in liberal states illegally mailing abortion pills to patients in states that have adopted abortion restrictions. In one such case, a California doctor unlawfully mailed abortion drugs across state lines to a Louisiana man coercing his resistant girlfriend to end the life of a baby she longed to keep.

When Louisiana requested California extradite this law-breaking doctor for his crimes, Democratic Gov. Gavin Newsom flatly refused, taking to social media to tell Louisiana Attorney General Liz Murrill to “go f*** yourself,” declaring that “California will never help you criminalize healthcare.” Newsom justified his refusal by invoking California’s so-called “shield laws” and a 2022 executive order barring his state from cooperating with any extradition request tied to abortion procedures that are legal in California but may be illegal elsewhere.

That woman, Rosalie Markezich, is now the lead plaintiff in a landmark federal lawsuit, State of Louisiana v. U.S. Food and Drug Administration, challenging the Biden FDA’s 2023 decision to eliminate the in-person dispensing requirement for mifepristone. Louisiana Attorney General Murrill and Alliance Defending Freedom filed the suit alongside Markezich, arguing the Biden administration’s rule intentionally enabled out-of-state doctors to flood pro-life states with mail-order abortion drugs.

I am proud to have joined 21 fellow state attorneys general in filing a friend-of-the-court brief in support of Louisiana and Markezich in this critical case. Alabama stands firmly with those fighting to restore common sense safeguards for women’s health and to protect the sovereignty of pro-life states to maintain and strengthen our culture of life.

But this lawsuit is only part of the solution. Today, 27% of all abortions occur after someone has merely had an online doctor’s visit. As in so many instances where he corrected course from dangerous or foolish Biden era policy, here, too, Trump has the opportunity to right a grave wrong.

He should direct U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. to reinstate federal policies requiring abortion drugs to be prescribed during an in-person appointment with a doctor and ensure the medication is provided directly by the physician. This would greatly reduce the number of mail-order abortion drugs, ensuring these dangerous drugs are handled with discretion and care.

Alabama has led the pro-life movement since its founding, understanding that the right to life applies to all of us. In 2019, Gov. Kay Ivey signed the Human Life Protection Act, a near-total protection of life in the womb, although at the time it couldn’t be implemented due to federal abortion laws. When the U.S. Supreme Court made the historic decision to overturn Roe v. Wade on June 24, 2022, Alabama fully implemented the bill within hours of the decision.

I have spent nearly a decade as Alabama’s attorney general fighting for the unborn in courtrooms, in briefs, and in battles with radical governors like Newsom who believe they can override the will of pro-life states. That work matters, but it has its limits. Real, lasting protection for unborn children requires federal action.

Steve Marshall has served as Alabama Attorney General since 2017 and is a Republican candidate for the U.S. Senate in 2026.