Claiming the rights of women are being violated, Planned Parenthood filed a broad-based legal attack on a host of Arizona laws and regulations governing abortion.
The lawsuit filed Thursday in federal court lists restrictions that have been imposed over multiple years by the Arizona Legislature on who can perform what abortion-related services, requiring women to make two trips to a clinic and forbidding doctors from prescribing abortion medications via telemedicine. Each of those, according to attorney Catalina Vergara, infringes on the constitutional right of women to terminate a pregnancy.
But the legal papers also ask a federal judge to look not just at the individual hurdles being placed in the path of women but what they say is the cumulative effect.
That has resulted in closure of Planned Parenthood clinics in Yuma, Goodyear, Prescott Valley and Chandler. And the Flagstaff clinic can provide abortion services only one day a week.
Bryan Howard, president of Planned Parenthood Arizona, said the result is borne out in the fact that the number of abortions performed has dropped from between 9,000 and 10,000 a year a dozen years ago to fewer than 6,500 now.
Some of these same laws have been challenged in the past. That includes the mandate for patients to visit a clinic at least 24 hours ahead of an abortion and a prohibition against anyone but a licensed physician from surgically terminating a pregnancy.
In a 2011 ruling, state appellate court Judge Peter Swann rejected arguments that the restrictions impose undue restrictions on a woman’s constitutional right to choose. And he said that it is legally irrelevant that nurse practitioners, who are more available in rural areas than abortion-trained doctors, have a comparable safety record.
But attorney Alice Clapman pointed out Thursday that the U.S. Supreme Court ruled in 2016 that abortion restrictions need to be judged on whether they create an “undue burden” on women. What that means, she said, is that courts look at the statutes “to determine if the benefits of the restriction outweigh the burdens.”
“When states restrict abortion under the guise of women’s health they have to actually produce evidence that the restrictions enhance patient safety,” Clapman said. She said several of the challenged statutes are “sham public safety laws where there’s no evidence of benefit.”
“The court is going to take a hard look at that evidence and really ask the state to justify these restrictions when they’re imposing a burden,” Clapman said.
But Cathi Herrod, whose Center for Arizona Policy has been behind crafting many of the statutes at issue, said they’re all justified and justifiable.
“Abortion is different than other medical procedures,” she told Capitol Media Services.
“It involves taking of a life, it involves risk to the woman’s health,” Herrod said. “So the state is completely justified in requiring only doctors perform abortions.”
She also defended the other challenged restrictions like a requirement for a personal consultation with a doctor 24 hours before terminating a pregnancy and forbidding doctors from prescribing the pills for a medication abortion unless there is a face-to-face visit.
“Women who are considering abortion deserve a chance to be one-on-one with a doctor before they take the abortion pill,” Herrod said.
The lawsuit surrounds three basic areas.
First are what are known as “physician-only” rules, spelling out that abortions, both medical and surgical, and abortion-related procedures can be performed only by someone who is a doctor.
Challengers point out that other medical professions, including nurse practitioners and physicians assistants, are legally entitled to perform “substantially identical procedures” involving women.
“They are only prohibited from doing so if the procedure is done to terminate a pregnancy,” the lawsuit states. “There is no medical or health-related reason for this distinction.”
One effect, according to the lawsuit, is that it keeps doctors busy doing chores that others can do, reducing the time they have available to actually perform abortions and causing delays for other patients.
Challengers also say there’s no medical reason to require women to visit a clinic and having an ultrasound at least 24 hours ahead of terminating a pregnancy for a consult with the physician.
They say it presents a particular hardship to women from rural areas who have to travel to one of the metro areas either two days in a row or stay overnight. And that, the lawsuit says, forces women to juggle work and school schedules, childcare needs and transportation availability.
And the lawsuit says Arizona not only allows but encourages the use of telemedicine, allowing medical advice to be given and prescriptions to be written after a video conference with patients. But the lone exception is when an abortion is involved.