The complaint, filed in Louisiana in late September, alleges that advertising, prescribing and shipping abortion medication to patients in the three states amounts to a public nuisance that threatens residents’ health and safety. Abortion is banned in Louisiana, Arkansas and Alabama, with limited exceptions.

The Massachusetts groups named are the Massachusetts Medication Abortion Access Project, known as The MAP, Ishani Village and Abuzz. Louisiana Attorney General Liz Murrill said statements by the organizations and others indicate they collectively send at least 1,600 packages of abortion pills each month to addresses in the three states. That figure was not independently confirmed in the complaint details provided.

Murrill described the providers as drug traffickers at a news conference after the filing and said their work violates Louisiana law. The Massachusetts providers’ attorneys either declined requests for comment or did not respond. They must file a response in federal court.

The lawsuit is the first legal challenge against the Massachusetts providers since the U.S. Supreme Court overturned the nationwide constitutional right to abortion in 2022. Medication abortion is legal in Massachusetts, and federal policy allows abortion medications to be prescribed through telehealth and mailed to patients.

Massachusetts’ shield law protects providers who issue legal prescriptions in the state from certain out-of-state legal actions. But Nicole Huberfeld, co-director of Boston University’s Program on Reproductive Justice, said the law applies in state courts, not federal court, and cannot protect providers outside Massachusetts.

State officials may still use the shield law to refuse to assist with records requests from the Louisiana federal case if it proceeds, Huberfeld said. She also called the public-nuisance claim an unusual approach, noting that such claims are more commonly used in disputes involving environmental harm.

The three attorneys general are pursuing a separate challenge to shield laws in Massachusetts, New York and California. They have asked the U.S. Supreme Court to rule on whether those laws are constitutional. The court is expected to decide early in 2027 whether to take up the challenge or send it to a lower court first.

Massachusetts Attorney General Andrea Campbell defended the state’s law, saying it protects the privacy of patients and providers and bars the use of state resources to punish health care decisions protected under Massachusetts law. Alabama Attorney General Steve Marshall argued that shield laws undermine state sovereignty.

Louisiana has also filed a separate lawsuit seeking to end telehealth prescribing of mifepristone, one of the two medications commonly used in medication abortions. That case argues the Food and Drug Administration was wrong to allow the drug to be prescribed without an in-person appointment.