PHOENIX – In the 51 years since the U.S. Supreme Court recognized – and then reversed – federal abortion protections, advocates and opponents have fought constantly over the boundaries of that right.

That fight continues today, but now Arizona finds itself at the forefront of the national battle.

Abortion-rights advocates are hoping to get voters to amend the state constitution this fall to enshrine abortion protections, while opponents are arguing that the proposal goes too far. And both sides are waiting to see if the Arizona Supreme Court will restore a 19-century law, still on the books, that bans almost all abortions.

Dr. Jill Gibson, chief medical officer at Planned Parenthood Arizona, said the past two years have been “a wake-up call” for abortion-rights groups.

“I think it’s been … in some ways, a recognition that we will have to fight for every single part of preserving and expanding abortion services and access to abortion,” Gibson said, since the Supreme Court’s Dobbs decision in 2022 overturned Roe v. Wade, the 1973 ruling that protected abortion nationally.

Reversing Roe – which would have turned 51 on Monday – has energized abortion rights groups across the country. In Arizona, those groups say they are well on their way to collecting the 383,923 signatures needed to put the question of abortion protection to voters this fall.

That proposal, the Arizona Abortion Access Act, would allow abortions up to the point of fetal viability, or the point when a health care professional judges that a fetus has a “significant likelihood” of survival outside the uterus without the use of “extraordinary medical measures.” It would also allow abortions after that point to protect the physical or mental health of the mother.

Critics of the ballot initiative sum up their opposition in the name of their group: It Goes Too Far.

“The amendment is written so broadly that, according to attorney analysis, it allows unlimited abortion up to birth underneath a broad mental health exemption that is frequently abused to and to use to rubber stamp late-term abortion,” said Olivia Escobedo, the political director and spokeswoman for the campaign.

Escobedo also took issue with the fact that the proposed amendment puts decision-making in the hands of a “health care professional” as opposed to a physician. She said the broad language of the proposed amendment “puts the health and safety of girls and women at risk.”

But Darcy Hill, spokesperson for Planned Parenthood Advocates of Arizona, said Esobedo has it backwards.

“We’re really trying to save a pregnant patient’s life and a baby’s life in this whole process,” Hill said. “And I think … that’s what’s missing is that we want to be able to make this essential health care service available and accessible to as many people who need it.”

Hill said the use of “health care professional” was intentional, so that nurse practitioners who are trained in abortion care can provide medication abortions and expand accessibility. She said it would allow Planned Parenthood to provide services “four to five days a week as opposed to the two to three where we’re limited with a physician.”

Current law in Arizona allows abortions up to 15 weeks of pregnancy, with an exception for the life of the mother but no exceptions for victims of rape and incest. That law was passed while Roe was still in effect, but allowed to go into effect after Dobbs.

But abortion opponents said that law is trumped by a near-total abortion ban that has been on the books in Arizona since 1864 and has never been taken off. The Arizona Court of Appeals disagreed, ruling in December 2022 that the 15-week ban is the law of the land.

That ruling was appealed to the Arizona Supreme Court, which heard arguments Dec. 12 but has yet to issue its ruling.

Jake Warner, senior counsel with Alliance Defending Freedom, who argued for the 19th-century ban before the Arizona Supreme Court, said the Court of Appeals misread the 2022 law, which affirmed the 15-week threshold.

“That law expressly said that it was not repealing the older pre-Roe model that fully protected life from the moment of conception,” Warner said. “So the court below really did not honor that text and the legislative intent behind it.”

The looming Supreme Court ruling is why abortion-rights advocates say their ballot initiative is so important.

“We saw the repercussions and the significance that total abortion bans had in states that are even very close to Arizona,” Gibson said. “I do think that there has been a real galvanizing of the community to refuse this reality and to take concrete steps to ensure that we’re fighting as hard as we can to preserve the right to bodily autonomy.”

That was on display over the weekend at the “Bigger than Roe” National Women’s March at the state Capitol, where abortion-rights protesters rallied. The “national” march was held in Phoenix to mark Arizona’s emergence as the next major battleground.

Organizers set up tents and volunteers carried clipboards through the crowd to collect signatures for the ballot petition. Hill said that before the march even started, the initiative had already collected half of the roughly 380,000 signatures that will be needed by July to get on the ballot.

Besides Planned Parenthood, a coalition of advocacy groups is campaigning for the ballot initiative, including the American Civil Liberties Union of Arizona, Healthcare Rising Arizona and others.

Gibson said she feels confident the Court of Appeals decision will be upheld and providers will be allowed to continue under the 15-week law. But she said the idea of criminalizing health care is an uncomfortable feeling for physicians.

“It’s not anything that any of us ever had to kind of wrap our brains around until the Dobbs decision,” she said.

A national survey in 2023 by Gallup found that 69% of Americans support abortion in the first three months of pregnancy, while only 37 percent support allowing abortion up to six months. Thirty-four percent of Americans believe abortion should be legal under any circumstances, the survey found, while 51% support some restrictions.

Hill said the fight has made Arizona a battleground state that “could really swing the election and move reproductive freedom higher up on the priorities of our next president on a federal level but also on a statewide level.”

Gibson said she thinks the overturning of Roe “is actually going to backfire” on abortion opponents.

“What we’re seeing now is that people who were maybe a little bit quieter and a little bit more private about their beliefs supporting access to abortion care now recognize that they need to be loud and proud and make their voices heard,” she said.

For more stories from Cronkite News, visit cronkitenews.azpbs.org.

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Note: This story originally appeared on Cronkite News. It is published via a Creative Commons license. Cronkite News is produced by the Walter Cronkite School of Journalism and Mass Communication at Arizona State University.

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