Arizona abortion providers challenge pre-Dobbs limits in state court
Nearly a year after Arizona voters enshrined the right to abortion in the state constitution, leading obstetricians and gynecologists are still challenging a series of pre-existing laws they say hinder access to care.
Dr. Paul Isaacson, a prominent supporter of the 2024 Proposition 139, testified Wednesday that laws requiring a 24-hour waiting period and multiple clinic visits create barriers for women seeking abortion care and, in some cases, push them past the legal limits for medication or procedural abortions. He also said a ban on abortions for certain reasons, such as fetal abnormalities, discourages open communication between patients and providers.
“They’ve advised their patients not to say anything when they come to us,” Isaacson said. “I can’t say what I want to say to them.”
Attorney Justin Smith, representing intervenors seeking to maintain the laws, argued that the rising number of abortions in Arizona — nearly 17,000 in 2025 compared with 10,000 in 2009 — shows the restrictions do not prevent access. The state’s population has grown by more than 1.3 million during that time.
Isaacson’s lawsuit targets three groups of laws: the “reason ban,” which bars abortions based on fetal abnormalities, non-lethal fetal diagnoses, gender, or race; the two-visit requirement, mandating a second clinic visit before an abortion; and the 24-hour delay, requiring a pre-procedure visit and ultrasound. Isaacson is represented by the American Civil Liberties Union and filed the suit in May after voluntarily dropping a federal challenge over the reason ban in April.
With Democratic Attorney General Kris Mayes declining to pursue abortion-related prosecutions, state officials have sided with Isaacson. However, Arizona House and Senate leaders, Steve Montenegro and Warren Petersen, intervened to defend the statutes.
Wednesday marked the first day of a three-day evidentiary hearing on Isaacson’s motion for a preliminary injunction. Maricopa County Judge Greg Como said arguments this week could inform a permanent injunction ruling without the need for a separate trial.
Two-visit requirement
Under the two-visit law, patients must receive an ultrasound and a state-mandated informational pamphlet covering abortion procedures, gestational development, and risks of abortion and pregnancy continuation. Isaacson said the pamphlet contains inaccuracies, including references to federally banned procedures and medications not used in routine care. He also criticized the inclusion of crisis pregnancy centers, which he described as “unlicensed, unregulated facilities” promoting alternatives to abortion.
“The law puts me in a position to dissuade them from having an abortion,” he said. Isaacson also noted that first-trimester medication abortions often do not require ultrasounds if patients have accurately tracked their menstrual cycles. Smith argued that physicians can provide additional guidance and that ultrasounds offer more precise gestational measurements than patient recollection.
24-hour waiting period
Isaacson and Dr. Laura Mercer testified that the 24-hour waiting period has no medical basis and can worsen symptoms like pain or bleeding, add travel and childcare burdens, and compromise patient confidentiality. Sexual assault survivors, in particular, may face added stress from the delay. The requirement has occasionally pushed patients beyond the legal window for both medication and procedural abortions.
Reason ban
Isaacson said the reason ban has caused patients to withhold critical medical information, especially when adverse fetal diagnoses are involved. While Isaacson would not perform an abortion solely for reasons of gender or race, he said the state law itself is unnecessary and that he would perform abortions for conditions like Down syndrome.
The hearing will continue Thursday at 9:30 a.m., with no indication yet from Judge Como on how he may rule.
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