Arizona reinstated a near-total ban on abortions. Providers are surprisingly optimistic

The waiting room of the Acacia Women’s Center in Phoenix, Arizona, was calm and quiet on Friday. Patients sat with their mothers, friends or partners, paying no mind to the slapstick Tyler Perry movie on the TV and an arrangement of Vogue magazines resting on a table.

It had been three days since the state’s highest court reinstated an 1864 law that would ban almost all abortions and send abortion providers to prison for up to five years.

Related: Republicans divided over Arizona near-total abortion ban, poll shows

The revival of the 160-year-old statute has kickstarted deep uncertainty over the fate of clinics like Acacia, one of the few medical centers left providing abortions in the state.

Some of the women awaiting the procedure that day said they were deeply worried by the state supreme court’s decision. Others didn’t want to talk about it.

Dr Ronald Yunis, the obstetrician and gynecologist who owns the women’s center was nervous yet hopeful. Yes, the 1864 law is jeopardizing abortion access in his state. But he, like some other providers, believe it will eventually lead to abortion being enshrined in the state’s constitution. And if that happens, abortion rights in Arizona will be stronger than ever.

For now, Yunis is determined to keep performing abortions, which take up about half of his practice – at least until June, when the law is slated to take effect. In the meantime, abortions up to 15 weeks can be performed in accordance with a restrictive 2022 state law passed by conservative Republican lawmakers.

A conservative himself, Yunis once supported Republicans in the statehouse.

Now he calls them “idiots” who refuse to “shut their mouths about abortion”.

He’s sure Republican lawmakers will reverse course and vote to repeal the law despite having blocked an effort by Democrats to undo it last week. It’s “their only political play”, Yunis says, given the blowback from Arizona voters and weakened GOP candidates facing tight races in November.

It would take only a few Republicans to join forces with Democrats to knock the ancient statute down, the Arizona Republic reports, and lawmakers could start the process to repeal the law as early as Wednesday.

Even if the law is stricken from the books, abortion providers in Arizona face deep uncertainty. There is nothing preventing the passage of more anti-abortion measures in the future. And in a statehouse where an election-denying GOP lawmaker recently spoke in tongues with his anti-abortion “prayer team” in the senate chamber, anything is possible.

Arizona’s attorney general, Kris Mayes, a Democrat, has assured providers they will not be prosecuted for performing abortions as long as she is in office. But providers nevertheless fear that a subsequent attorney general might prosecute them for practicing abortion under Mayes’s watch if far-right leaders in the legislature either preserve the 1864 law or criminalize abortion with further legislation. There’s a seven-year statute of limitations for many crimes in Arizona.

Meanwhile, Republican leaders are flip-flopping on the issue. Kari Lake, the Arizona senate candidate, once ballyhooed the 1864 law. Now trailing her Democratic rival in the race, the congressman Ruben Gallego, in a US Senate race, she maintains the law is “out of step” with Arizonans. It might be an acknowledgment made too late. When polled in 2022, only 28% of voters in Arizona approved of the 1864 law.

Amid the uncertainty, providers say they are hanging their hopes on what’s become an increasingly effective way to undo bills passed by Republican legislators – relying on voters to enshrine abortion rights in state constitutions via ballot measures.

In the wake of the decision to reinstate the 1864 law, a popular proposed ballot measure giving Arizona voters the chance to add abortion rights to the state constitution in November is gaining momentum – even as Republicans strategize the measure’s defeat.

“This whole episode is so emblematic of how broken our political system is,” says Dr Paul Isaacson, of Family Planning Associates Medical Group in Phoenix.

Isaacson, 65, a longtime abortion provider, says his medical group will continue offering services “until we can’t”.

Amid the uncertainty, Isaacson worries he might have to shut down for several months before the election brings more clarity about his future. If he shuts down, he will still have to pay rent and bills for leased equipment in his office. Worse, there may be painful layoffs of a small staff he calls a “second family”.

“It’s a very, very big deal,” he says.

Last week was nerve-racking, abortion providers say, but now they are taking a step back from the chaos and trying to figure out the best way to move forward in the short term.

Dr Gabrielle Goodrick, a physician who owns Camelback Family Practice, a clinic that provides one-third of the state’s abortions, says she was holding fostered kittens in her lap when she learned of the court’s decision to revive the 1864 law. Her initial reaction, she says, was “grief and shock”.

Setting aside her emotions, Goodrick began researching ways for her practice to stay open. She vows the clinic will not close its doors. In the worst-case scenario, she envisions it staying open to help women go to other states for abortions and to provide legal reproductive and healthcare needs to women in Arizona.

She’s looking for grants and funding possibilities that would help any staffers that might be let go, which would be the hardest part of any partial shutdown. Her 15 staffers, she says, “are fighters and I love all of them”.

Layoffs will not be necessary if Arizona voters cement abortion rights in the state constitution in November. And Goodrick has high hopes for the passage of the measure.

“I can feel the blue wave coming,” she says. “It’s very reassuring.”

That optimism is echoed by Dr Jill Gibson, chief medical officer at a Phoenix-based Planned Parenthood Arizona. The non-profit recently resumed providing abortions in Flagstaff, a city in northern Arizona’s “abortion care desert”.

It’s been two years since Planned Parenthood provided abortions in Flagstaff, and given the firestorm precipitated by the 1864 law, it could be risky to resume services. But Gibson is hanging her hopes on voters giving abortion constitutional protection in November.

“I am absolutely certain it will pass,” she says, noting that “when abortion is on the ballot it wins.”

Yunis, the abortion provider who owns the Acacia Women’s Center, likes a good fight. He’s fought for women’s rights for years, he says, and he’s not about to stop.

Several years ago, he allegedly pointed a gun at an anti-abortion protester “with a history of violence” blocking his car. Yunis claims self-defense. Still, the incident led to a misdemeanor conviction, scrutiny by the Arizona Board of Medical Examiners and getting dropped by Medicare. But it didn’t dampen his spirit.

Now, even amid the chaos caused by Arizona’s abortion ban machinations, he senses victory.

“We are going to see abortion as a constitutional amendment in Arizona,” he says. “There is no doubt now.”