Stung by last week's appellate court ruling, Planned Parenthood is no longer offering abortions at seven of the 10 Arizona locations.
Bryan Howard, president of the organization, said the change, effective Friday, involves more than just complying with the court's ruling that a variety of restrictions placed on abortion providers by lawmakers in 2009 are legal. That includes a 24-hour waiting period on abortions and a requirement that surgical abortions be performed only by a doctor.
He said the ruling, if upheld, undermines efforts by Planned Parenthood to fight an even broader curb on the practice enacted just this year: a ban on specially trained nurse practitioners from offering even non-surgical abortions. So Planned Parenthood is dropping its legal bid to bar the state from enforcing that law.
The net result, Howard said Thursday, is both surgical and medical abortions from Planned Parenthood will be available only at its locations in Glendale, Tempe and one of its Tucson sites.
There will be no more abortions in Yuma, Flagstaff, Prescott Valley, Goodyear, Chandler, Phoenix and the other Tucson location. He said, though, all the sites will remain open for other services, including family planning, which Howard said becomes more important than ever with the curbs.
The basic problem, Howard said, is the requirements of both the 2009 and 2011 laws leave Planned Parenthood with just six full- and part-time doctors to handle nearly 10,000 abortions a year, including that mandate for the face-to-face meeting with patients ahead of time.
"The real challenge is the shortage of physicians who are trained and who, I might also add, are willing to ensure the risk of protests from opponents of abortion," he said.
But Cathi Herrod, president of the anti-abortion Center for Arizona Policy, said Planned Parenthood was simply making "a business decision" in ending abortions at the seven sites.
"They will end their services rather than raising the standard of care to meet the law's requirement," she said. "All Planned Parenthood had to do was to find doctors to work at their clinics to continue providing the abortion services."
Herrod also brushed aside Howard's contention that medical practitioners who perform abortions face harassment or possibly worse.
"It's been years since you've seen any protests outside of a doctor's house in this state," she said. And while acknowledging the threats on doctors elsewhere, "we haven't had hardly any of that in this state."
Those protests, Howard countered, are real.
He said a nurse practitioner in Flagstaff who has been providing non-surgical abortions - using medications instead of instruments - has had protestors in the driveway of her home.
"When word gets around, as it does in the health care community, about facing that kind of risk for yourself and your family, I think some medical professionals think twice," he said.
Complicating matters from Howard's perspective is the fact that state law bans the teaching of abortion at the University of Arizona College of Medicine. Howard said that limits the number of new doctors who can be hired.
Herrod, however, said that's only partly true, saying emergency training at the school includes dilation and curettage, essentially a scraping of the uterine lining.
"A doctor who is trained to do a D-and-C following a miscarriage of a pregnancy is trained to do an abortion," she said. "So it's not an issue of training. It's an issue of doctors not being willing to participate in a procedure that hurts women and takes the lives of (unborn) children."
Howard said attorneys for Planned Parenthood are still reviewing last week's appellate court ruling. He said a final decision of whether to seek review by the Arizona Supreme Court will come by mid September.
He acknowledged that federal courts have rejected arguments that similar restrictions enacted by other states, including the waiting period and physician-only abortions, are unconstitutional. But Howard noted that the Arizona Constitution has protections beyond its federal counterpart.
"The state Constitution actually says the government shall not interfere in the private affairs of its citizens," he said. "And there are (court) precedents where that definition of ‘private affairs' has included medical decision making.
Howard brushed aside the fact that abortions were not legal in Arizona in 1912 when that provision was adopted.
"Well, we didn't bring the claim in 1912; we brought it in 2011," he said. "We stand by our analysis and we will be moving up to the Supreme Court unless something about our analysis changes."