A looming near-total abortion ban spurs advocates into action

When the Arizona Supreme Court reinstated an 1864 territorial-era restriction on abortion last month, Ronald Yunis, a gynecologist at Acacia Women’s Center in Phoenix, said the clinic received a flurry of calls from patients. Many had the same question: What comes next?

The law banning abortion—which mandates a sentence of two to five years for anyone who assists with an abortion—could take effect June 8, but Attorney General Kris Mayes said in a statement that “no woman or doctor will be prosecuted under this draconian law” during her term.

The Arizona House of Representatives approved a bill on April 24 to undo the ruling, sending it on to the state Senate. But even if the governor signs the bill into law, it still wouldn’t necessarily kick in before June 8, reproductive rights coalition Arizona for Abortion Access spokesperson Dawn Penich told Healthcare Brew.

Reproductive care activists have been quick to mobilize, seeking to get abortion rights on the ballot this fall via a constitutional amendment process.

Penich, whose organization is behind the effort to enshrine abortion rights into the state constitution, said a ballot initiative is the best path forward for Arizona residents.

She noted that the proposed amendment restores abortion access in Arizona to the point of fetal viability, which varies by patient but typically falls within 20 to 25 weeks, rather than the current abortion law’s more restrictive 15-week limit.

The amendment has already garnered more than 500,000 signatures, NBC News reported, crossing the legal threshold of the necessary 383,923 signatures.

“People are watching this and realizing: The only way to ever stop this is to get it in the constitution and be done with it,” Penich said, adding that her organization is still pushing for more signatures before the amendment gets submitted to the secretary of state on July 3.

In the meantime, doctors must prepare for a restrictive ban.

“For me, I just go back to gynecology, and in November, [abortion access] comes back,” Yunis said, seemingly confident that the law would be overturned. “What we’re seeing here is a pendulum.”

Planned Parenthood Arizona said it will also continue providing care for a “short period of time,” according to the organization’s website. The reproductive and sexual healthcare provider didn’t return Healthcare Brew’s request for comment.

At larger hospitals in Arizona, providing abortion care could become more complicated.

Though the vast majority (over 99%) of the 11,407 abortions performed in the state in 2022 were conducted through clinics, according to the Arizona Department of Health Services, about two dozen were performed at large health systems in the state.

Lorna Romero Ferguson, spokesperson for the nonprofit Health System Alliance of Arizona—which represents Banner Health along with six other large healthcare systems in the state—said in a statement that patients will have access to “care in compliance with the law.”

Tori Fewell, an ob-gyn with Banner–University Medical Center and reproductive care advocate in Tucson, told Healthcare Brew she can’t provide elective abortions in her day-to-day work at the hospital but occasionally cares for patients who “are in need of abortions for medical reasons.” The fate of these procedures is now up in the air, she said.

“It’s very vague. [The 1864 law] just states that the only exception is to save a mother’s life—a patient’s life—so it could be interpreted many different ways,” she said. “Who’s interpretation do we rely on for that?”

The uncertainty around the law and its limitations, she said, is enough for some providers to feel “very, very fearful” of performing procedures that could result in prosecution.

Fewell said that even at Banner–University, one of the state’s largest hospitals, the legal ambiguity makes it difficult for providers to move forward.

“Many have brought up the subject of legal counsel,” she said. “And that’s going to be very costly.”

The repeal of the 1864 ban is headed to the Arizona Senate, where Republicans hold a slim majority.

Despite the uncertainty, healthcare providers said they are still working to support patients in the interim.

“As a gynecologist—I’ve been doing this for over 30 years—it’s difficult. It’s difficult to go into the office. It breaks my heart,” Yunis said. “This isn’t a medical issue; it’s a political issue right now. The medical issue is a done deal.”