PHOENIX — A group of Arizona advanced practice nurses filed a lawsuit yesterday challenging the state’s ban on the provision of abortion by trained advanced practice clinicians (APCs) such as nurse practitioners and certified nurse midwives. The lawsuit, brought on behalf of the nurses by the American Civil Liberties Union (ACLU), the ACLU of Arizona, and the law firm Papetti Samuels Weiss McKirgan LLP, argues that the APC ban violates Arizonans' constitutional right to abortion access, established by voters in 2024, by arbitrarily restricting their choice of provider and, more broadly, making abortion less available in the state.
The APC ban bears no relationship to patient safety, clinical standards, or medical evidence. APCs are already allowed to provide abortion in roughly half the states, and clinical studies and experience show that they do so just as safely as their physician peers. APCs are crucial in ensuring timely access for patients who, in addition to state restrictions, face other barriers to care such as transportation limitations, inflexible work schedules, childcare needs, and controlling partners. Leading medical authorities, including the American College of Obstetricians and Gynecologists and the American College of Nurse Midwives, have called on states to repeal these bans so that these highly qualified health care professionals can serve patients seeking abortion.
Arizona’s APC ban has severely limited the pool of available abortion providers in the state. Arizona already has a shortage of physicians, particularly in rural and tribal areas, and many Arizonans see APCs as their primary or reproductive health care provider. When these patients face an unwanted pregnancy or a pregnancy complication, many of them must travel long distances to seek abortion care from a new provider. Because of how few abortion providers there are in the state, some of these patients face delays. They may be forced to have a procedure because they miss the narrow window to end their pregnancy with medications. Some are even forced to carry to term. Being prevented, or even delayed, from accessing abortion raises risks to a patient’s physical and mental health.
“Arizonans should be free to access abortion care in their communities, including from qualified, trained advanced practice clinicians,” said Alice Clapman, senior counsel with the ACLU’s Reproductive Freedom Project. “Overturning the state’s APC ban would not only bring its healthcare policy in line with the medical science but also make good on the state constitution’s promise to protect abortion access as a fundamental right. The ACLU will do everything in our power to make sure that Arizonans can get abortion care from providers they trust, including advanced practice clinicians.”
“I became a midwife because I felt called to care for my patients as whole people with a range of medical, social, and emotional needs throughout the span of their lives,” said plaintiff Janna Stefanek, a certified nurse midwife. “For some patients, this includes abortion care. The APC ban forces me to turn those patients away at a vulnerable time when they need me — that is just wrong. I am honored to fight to ensure Arizonans have access to the care they deserve from trusted and qualified providers in their own communities.”
“As a physician, I work closely with advanced practice clinicians,” said Dr. Laura Mercer, legislative chair of the Arizona Section of the American College of Obstetricians and Gynecologists. “Preventing these dedicated professionals from providing abortion care within their scope of practice is harmful and out of step with modern medicine. The evidence is clear: advanced practice clinicians can be trained to provide many types of uncomplicated abortion care as safely as physicians. Furthermore, allowing them to do so has numerous benefits for their patients. Lifting this unjustified ban will mean more Arizonans can access the health care they need, and sooner.”
“The fundamental right to abortion means little when Arizonans cannot get care from trusted and skilled providers in their own community,” said Lauren Beall, staff attorney at the ACLU of Arizona. “Overturning senseless restrictions that tie the hands of advanced practice clinicians is the next important step to fulfill the promise of the Arizona Abortion Access Act. Allowing APCs to provide abortion care is essential to ensure all Arizonans can access this health care, especially those who have faced systemic barriers across our state for far too long.”
Arizona’s APC ban overrode the state Board of Nursing’s decision that, with appropriate training, advanced practice nurses were qualified to provide abortion care. Before this ban, Arizona APCs specializing in reproductive health care safely performed abortions and cared for abortion patients in the state as part of their regular scope of practice. APCs trained in reproductive health care also routinely provide care that is significantly more complex than medication and procedural abortion, including for patients in labor and who are experiencing miscarriages or postpartum complications. The APC ban has prevented these extremely skilled health care providers from giving their patients critical and time-sensitive abortion care, including in medically urgent situations.
The lawsuit, Gill et al. v. State of Arizona, was filed in the Arizona Superior Court for Maricopa County by the ACLU, the ACLU of Arizona, and local counsel Papetti Samuels Weiss McKirgan LLP.
Background on the case is available here.
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