New restrictions on abortion are set to take Tuesday after Planned Parenthood Arizona announced Monday it would not appeal a ruling declaring them legal.
But a court fight remains.
Bryan Howard, president of the organization, said it makes no financial sense to ask the Supreme Court to overturn last month’s decision by the Court of Appeals to allow some limits enacted by the Legislature in 2009 to take effect. The appellate panel, in voiding an injunction against the provisions, issued a point-by-point ruling explaining why lawmakers are empowered to impose the restrictions.
The result is that abortions, once available at all 10 Planned Parenthood sites around the state, now are being offered only in Glendale, Tempe and one of the organization’s two Tucson locations.
More to the point, Howard said the changes mean that women likely will have to wait longer before they can have an abortion. And if that data shows a significant delay for many, that could provide ammunition for a new court fight.
Central to that issue are the new restrictions.
One spells out that women must first have a face-to-face consultation with a doctor at least 24 hours before an abortion.
Until now, that information could be provided by specially trained nurse practitioners. And it could be done by phone.
Howard said the new restriction means women will have to arrange to take time off from work, and potentially child care, for two trips rather than one. He said that presents particular hurdles for women in rural areas who will have to make two separate trips to the Phoenix or Tucson areas or arrange to stay overnight.
He also said Planned Parenthood does not have enough doctors on staff to do the pre-abortion counseling.
Howard figured that this counseling takes 20 to 30 minutes. With Planned Parenthood performing about 10,000 abortions a year, that translates out to up to 3,000 hours a year.
The other big change in the 2009 law makes it illegal for specially training nurse practitioners to perform early-term surgical abortions.
On top of that, legislators approved yet another restriction earlier this year, making even medical abortions off limits to nurse practitioners. That change also takes effect today.
Now, with all abortions having to be performed by a limited number of available doctors, Howard said that will create waiting lines.
“They should be able to choose between an early surgical abortion or medication abortion, which is involves nothing more than taking a pill on Day 1 and another pill on Day. 2,’’ Howard continued. “But if this package of restrictions ends up pushing women beyond the ninth week, they’re then forced to have a surgical abortion.’’
That information, in turn, then could give Planned Parenthood the ability new ammunition for a separate challenge they are making to this year’s law on medical abortions.
Howard said the key here is the cumulative effect of the delays. He said a court might conclude all the restrictions are unconstitutional because they harm women by denying them the right to a less risky procedure.
But Deborah Sheasby, attorney for the Center for Arizona Policy, which crafted the restrictions, said those arguments won’t work.
She said the U.S. Supreme Court in 1992 upheld the right of states to enact restrictions on abortions even if they did result in longer waiting periods before some women could exercise their constitutional right to terminate a pregnancy.
“It has to be a large fraction of the women who are affected by that” before a restriction would be considered improper, Sheasby said. And she doubted that whatever Howard’s data shows will be enough to meet that standard.
Legal issues aside, Howard said Planned Parenthood is looking for ways to minimize the impact of the new restrictions.
He said while there is no way around that 24-hour waiting period or having the pre-procedure session be performed by a doctor, nothing in the law requires that session to be with the physician who actually will be performing the abortion. In fact, the law does not even require that the doctor know how to perform an abortion.
Howard said several sympathetic doctors already have contacted Planned Parenthood offering to do the pre-procedure counseling. He said while some specialize in obstetrics and gynecology and others are family practitioners, some of the volunteers have other specialties.
Under the terms of the law now allowed to take effect, the doctor must discuss the risks and alternatives to the procedure, as well as the probable “anatomical and physiological characteristics of the unborn child at the time the abortion is to be performed.” Howard said that does not require an abortionist.
“They’re still going to have to be knowledgeable,” Howard said, especially since women are likely to ask questions.
“We’re still going to have to train them in basic aspects of delivering abortion care,” he continued. “It would be unprofessional not to.”
The 2009 law also contained another provision that now also will take effect: Doctors and pharmacists will no longer need to dispense the “morning after” pill if that violates their personal beliefs.
Some contend the pill, essentially a large dose of hormones, simply prevents a women from ovulating. But other say it causes an abortion by preventing a fertilized egg from implanting in the uterus.
Medical professionals have for years been allowed to opt out of performing or aiding abortions.
Howard said the best way for women to avoid being affected by the new restrictions is to focus on prevention.
“Women are only affected by these laws if they experience an unintended pregnancy,” he said.