Doctors Challenge Arizona Abortion Laws as Unconstitutional Burden on Patients

Arizona abortion providers urged a Maricopa Superior Court judge on Nov. 5, 2025 to block a series of anti-abortion laws they claim unreasonably burden patients and violate the Arizona Constitution.

Last year, Arizona voters overwhelmingly agreed to make abortion a fundamental right by adding it to the state constitution. But dozens of restrictions crafted by anti-abortion groups remain enshrined in state statute. To remedy that, reproductive rights groups have turned to the courts to nullify those laws.

In May, the Center for Reproductive Rights and the Arizona branch of the American Civil Liberties Union filed a lawsuit on behalf of two local abortion providers and the Arizona Medical Association seeking to do just that. The legal challenge argues that multiple Arizona laws should be struck down as unconstitutional. Among the challenged statutes are those banning the prescription of abortion pills via telemedicine and sending them through the mail; prohibiting abortions sought because of a fetal genetic anomaly; and requiring an ultrasound, the recitation of state-mandated information, and a 24-hour waiting period before an abortion can be performed.

In the first of three hearings debating the relevance of the laws in the wake of Arizona Proposition 139’s passage, which made abortion a constitutional right and explicitly bars the enforcement of laws that unduly infringe on a woman’s access to the procedure, doctors testified that the laws make it harder to provide care—and often create insurmountable barriers for their patients.

Maricopa Superior Court Judge Gregory Como didn’t come to a conclusion on Nov. 5. And it’s likely that the debate won’t end in the trial court. The case is expected to continue with additional hearings on Nov. 6 and 7, and Como said he hopes to issue a ruling soon to allow the case to move through the court system for a quicker resolution.

“I recognize that these issues are likely to be decided by the appellate courts, and I think that, to the extent that we can get a ruling and get it up on appeal, that’s to the benefit of all parties,” he said.

Abortion providers: Laws hurt relationship with patients, quality of care

Dr. Paul Isaacson, an OB-GYN and the co-founder of Family Planning Associates Medical Group, one of a handful of private abortion clinics in Phoenix, said that state laws limiting who he can offer abortions to and how he does so negatively impact the quality of care he is able to give women who visit his clinic. He criticized the law prohibiting abortion based on fetal genetic abnormality, referred to as the “Reason Ban,” saying that it has the potential to result in inadequate care because women have increasingly been advised by their doctors not to reveal the fact to abortion providers, and referring doctors themselves have limited the amount of information shared with abortion clinics.

“It closes a door of communication that existed,” Isaacson said. “I get far less information from the referring physicians.”

The law was previously frozen under the auspices of Roe v. Wade, in part because of a lawsuit joined by Isaacson, but a federal judge ruled it could be enforced once again in 2022 because the U.S. Supreme Court overturned the constitutional right to abortion in Dobbs v. Jackson Women’s Health Organization. Since then, abortion providers in Arizona have repeatedly said that the law acts as a sort of gag rule, preventing them from freely counseling their patients for fear of being forced to deny them an abortion.

The law includes exceptions for lethal fetal abnormalities and medical emergencies, but Isaacson and other abortion providers have said that the law’s definition of what falls under the former category is too vague.

Isaacson also denounced the state-mandated requirements that providers must fulfill before patients can receive even a medication abortion. Arizona law requires a 24-hour waiting period between an initial consultation and the actual procedure.

During that first appointment, providers are legally required to conduct an ultrasound—even if one isn’t medically necessary or has already been carried out by another doctor. They also must recite information to the patient about fetal development, alternatives to an abortion like adoption, the financial responsibility of the father, and the existence of public and private services available to help if she chooses to continue her pregnancy. And the providers are required to direct patients to a state-created website and pamphlet which providers say contains biased and inaccurate information.

Isaacson said his patients have sometimes reacted emotionally or with frustration to the information and said it hurts the patient-doctor relationship.

“It puts me in a position of having to provide information that the patients are finding harmful,” he said. “It puts me in a position of appearing to dissuade them from having an abortion.”

Abortion foes: Laws don’t impact ability to provide abortions

Republican legislative leaders in Arizona have taken up the defense of the abortion restrictions. State Attorney General Kris Mayes is charged with backing state laws in court, but the Democrat, who ran on a promise to protect abortion access, refused to do so in this case and filed a motion early on agreeing with reproductive rights groups that the challenged laws violate the Arizona Constitution. In light of that, Arizona Senate President Warren Petersen and House Speaker Stephen Montenegro intervened in the lawsuit to convince the court to keep the laws in place, arguing that they can coexist with the state’s newly adopted constitutional right to abortion and that the complaint filed by the abortion providers is invalid because they haven’t actually faced any harm from them.

Attorney Justin Smith, representing the GOP leaders, pressed Isaacson on Nov. 5 about his assertions that the laws should be thrown out because they sometimes prevent women from seeking care. In his testimony, Isaacson said that the 24-hour delay often leads to women foregoing their second appointment, and noted that it’s difficult for women from rural areas, or with limited income, to make multi-day travel, lodging, or child-care arrangements.

The majority of abortion clinics are centered in Phoenix. Planned Parenthood, the state’s largest abortion provider, offers the procedure at only four of its clinics with half of those located in the Phoenix metro area. Only one is located in Flagstaff and one in Tucson.

Smith dismissed Isaacson’s argument, pointing out that plenty of abortions have been carried out since the 2009 law establishing a 24-hour waiting period was passed.

“Since that law went into effect in 2009, you have abided by the 24-hour waiting period, haven’t you?” he asked. “And yet you’ve still been able to perform abortions since 2009. The 24-hour waiting period law does not prevent women in Arizona from having abortions, does it?”

Isaacson responded that, for some women, the delay does result in them being forced to miss their second appointment, but he wasn’t able to provide exact estimates when Smith questioned his claim. Smith posited that the no-shows simply decided not to go through with an abortion. He added that Arizona’s own data collection showed that the overall rate of abortions spiked after 2009 and consistently increased in the following years, proving that the 24-hour law has had no impact on women. In 2009, 10,045 abortions in Arizona were recorded. That number rose to 11,059 in 2010.

But that increase wasn’t unprecedented: In 2004, the number of abortions reached 12,301 before falling to below 11,000 until the increase in 2010. Arizona health department officials at the time of the ostensibly sudden increase attributed the jump to improved reporting mechanisms. It’s difficult to say whether the lingering effects of the Great Recession, population growth, or other factors contributed to the increase.

The number of abortions in Arizona increased again afterwards to 13,606 in 2011 and has consistently hovered between 12,000 and 13,000 since then. According to census data, Arizona’s population has grown by about 75 percent since 2011—from about 4.2 million people to nearly 7.3 million—meaning the rate at which women receive abortions has fallen dramatically.

Smith grilled Isaacson on his willingness to provide abortions to women seeking the procedure because of a fetal genetic abnormality. In an aggressive back-and-forth exchange, Smith questioned whether Isaacson would be comfortable providing a race-based or sex-selection abortion. The law that prohibits abortions based on a fetal genetic abnormality also bans abortions because of the fetus’ race or sex, but reproductive rights advocates are only challenging the genetic abnormality provision. Isaacson said he wouldn’t be willing to provide race- or sex-based abortions, but said he didn’t agree that state laws should exist to ban them, saying that “there may be some circumstances which could be compelling.”

Smith sought to compare abortions based on a fetal genetic abnormality to discrimination, and questioned Isaacson about whether he would perform an abortion if a woman said it was because of a Down Syndrome prognosis or if he would regard such a procedure as unethical. Isaacson responded that he wouldn’t be uncomfortable performing an abortion in that situation because he believes in a “woman’s right to choose” and doesn’t view it as unethical.

In a bid to justify the ultrasound mandate, Smith singled out Isaacson’s claim that sometimes a physical examination and the patient’s own estimate is sufficient to determine a fetus’ gestational age. The doctor had testified that some patients have regular menstrual cycles, others are able to pinpoint exactly when conception may have occurred, and pregnancies conceived through IVF have clear implantation dates. Opponents of the ultrasound mandate argue that the law should be nullified because a one-size-fits-all approach is wrong and takes away the ability of doctors to tailor their treatment. But Smith was skeptical, saying that medical tests like ultrasounds are more reliable than a patient’s memory.

“Sometimes the information women give you is not as accurate as an ultrasound,” he said.

Smith also questioned whether Isaacson has faced any enforcement actions or prosecution threats from Arizona Gov. Katie Hobbs, Mayes, or the state medical board. Isaacson said that he had not. A key argument advanced by Petersen and Montenegro has been that the lawsuit is premature because doctors haven’t yet endured any consequences from the laws that could be challenged under the new reality of a post-Prop. 139 Arizona. Mayes has vowed not to take any provider to court over abortion law violations.

Can informed consent exist through a screen? What about in mandated speech?

Dr. Laura Mercer, an OB-GYN who also provides abortions, spoke in favor of lifting the ban on telemedicine, saying there is no reason to mandate in-person consultations. Allowing doctors to conduct abortion appointments over the phone or via a video call would be beneficial for patients who live in rural areas or can’t afford to take multiple days off of work, she said. And because the same law that prohibits telemedicine consultations also forbids mailing abortion pills, blocking it would vastly improve access to the procedure.

Mercer added that ensuring patients are aware about what an abortion entails is as easy to do through telemedicine as it is during an in-person meeting.

“Informed consent is largely education. It’s making sure my patient has as much information and education as she needs to make the decisions that are right for her, and actually lends itself really well to a telehealth setting, where a patient is able to be in her own environment with whatever support people—family members or friends—that they want to be present in order to talk about what is going on and make sure they have their questions answered,” she said. “I don’t have to touch a patient to have those discussions with her.”

Alex Saquella, another attorney for Petersen and Montenegro, questioned Mercer about her commitment to securing informed consent from her patients. Saquella argued that the Arizona laws which require providers to recite state-mandated information don’t impede them from sharing information they themselves consider important, but instead just set a minimum threshold on which they can build. She pointed out that providers don’t have to adhere to a specific script, and nothing in the law forbids them from expressing their opinions about that state-mandated information or correcting out-of-date information afterwards.

To prove that the recitation of the state-mandated information isn’t as cumbersome as providers claim it is, Saquella referenced a video activists with the anti-abortion Live Action group recorded of Mercer during a deceitful patient consultation in 2013. During that consultation, Mercer told the patient, who was faking an interest in an abortion, that the state-mandated information was “politically motivated stuff” intended to scare her away from the procedure and that she would go through it quickly.

“You weren’t just complying with the law here, you were actively editorializing and undermining the informed consent materials while speaking to a patient,” Saquella accused.

Mercer disagreed, saying that, while she was sharing her own opinions, she wasn’t undermining the informed consent process. She added that her criticism of the state-mandated information comes from her belief that much of the information she is forced to recite isn’t appropriate for every patient, and isn’t information doctors would, in their professional opinion, choose to share.

Opponents: Arizona’s abortion restrictions are just preventative safeguards

Toward the end of the over five-hour hearing, the legal team for Petersen and Montenegro and reproductive rights attorneys sparred over the veracity of the testimony from abortion providers.

Attorney Andrew Gould, representing the Arizona GOP leaders, argued that claims that the 24-hour waiting period negatively affects low-income patients are directly contradicted by the existence of abortion aid funds. Because some reproductive rights groups have set up funds to financially support struggling women, the argument that Arizona’s laws are burdensome falls flat, Gould claimed.

To make that point, he used funding documents of a local pro-choice group that runs a financial aid program for abortion patients. But abortion rights attorneys pointed out that the witness on the stand at the time had no connection to the organization being used to refute his testimony.

“At issue here is the burden supposedly on these patients that they can’t make it to these medical clinics,” Gould said. “This evidence impeaches the testimony of this witness that [patients] can’t pay for the cost, and in a facial challenge all we have to show is that some of these patients can go and they’re receiving medical support.”

But Como sided with attorneys for the abortion providers, who said that the documents didn’t add to the conversation or refute comments made by witness Dr. William Richardson. Richardson, an abortion provider in Tucson, Arizona had shared that multiple patients told him or his staff they couldn’t attend a second appointment because of financial issues.

“He hasn’t testified that I heard that there’s no funding available for patients,” Como said. “He just testified about the impact of these statutes on his own practice and his patients.”

Gould insisted that the financial assistance funds undermine Richardson’s claims, but Como remained unconvinced.

“It’s quite possible that there’s a burden to his patients and to his practice despite these funding sources,” Como said.

Gould also sought to establish that Arizona’s mandated-information laws are necessary by questioning the commitment of abortion providers to adhere to adequate informed consent procedures on their own. Gould pressed Richardson about the procedures Planned Parenthood abided by in 1998 and 1999, when he served as the medical director for the organization’s Southern Arizona chapter.

Gould interrogated Richardson on whether he was aware that Planned Parenthood clinics, before Arizona’s 24-hour waiting period was passed, were encouraged to perform up to 55 abortions a day, or that patients were at times given informed consent forms to fill out by themselves or spoken to in groups to fulfill informed consent requirements. Richardson said he was not aware of any of those procedures. Gould asserted that those procedures clearly show that the state needs to step in to regulate how abortion providers carry out their jobs to ensure patients have all the information they need to make an informed decision.

“This goes to the standards of care throughout the state of Arizona,” he said. “This impeaches the experts that these standards are unnecessary and what this testimony goes to is that these clinics don’t even follow the standards that their own experts say they follow in their own practice.”

To defend the need for the state’s 24-hour waiting period, referred to as the two-trip scheme, Gould compared it to Richardson’s personal protocols employed when a patient appears to be unsure about an abortion.

“When you think they are unsure, you send them home, isn’t that correct?” Gould asked. “And you send them home so they can think about it, so that if they do decide to come back, they’re sure?”

Richardson responded that he did. But the Tucson, Arizona doctor disagreed about the continued need for a compulsory 24-hour delay for every patient, telling Laura Bakst, an attorney for the Center for Reproductive Rights at the beginning of his testimony that he strongly opposes the laws because they infringe on his practice, and his patients’ medical needs and rights.

“I find that the laws that we are challenging are preventing me from providing the sort of care that I think my patients want and that they deserve, and that now that they’re constitutionally entitled to,” he said.

This story was originally reported by Gloria Rebecca Gomez for Arizona Mirror. Arizona Mirror is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Arizona Mirror maintains editorial independence. Contact Editor Jim Small for questions: info@azmirror.com.

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