Judge tosses Arizona abortion restrictions, says state can’t second-guess a woman’s decision

The Maricopa County Superior Court ruled last week that several long-standing Arizona abortion restrictions are unconstitutional, striking down laws that limited women’s ability to make private medical decisions with their doctors.

Judge Greg Como’s ruling found that the laws, which make getting an abortion far more difficult for certain women in Arizona, violated the constitutional right to abortion that Arizona voters approved through Proposition 139 in 2024. Together, these laws operated on the assumption that women needed additional oversight and time to reconsider their medical choices—an approach the court found inconsistent with the rights guaranteed under the new amendment

When over 60% of Arizona voters backed Prop 139, they affirmed that decisions about whether and when to continue a pregnancy belong to patients in consultation with their health care providers, not the state. But a number of pre-Prop 139 restrictions created confusion about whether lawmakers could still limit how and under what circumstances abortion care could be provided.

The constitutional amendment explicitly bars the state from “implementing or enforcing any policy that interferes with a person’s right to abortion before fetal viability.” Como’s decision reinforces that intent, making clear that Arizona voters did not just protect the procedure itself—they protected the presumption that women are capable of making informed, rational choices about their own reproductive health.

Under the constitutional framework established by Prop 139, restrictions on abortion can only stand if they do not interfere with a woman’s autonomous decision-making, are based on evidence-based medical standards, and demonstrably protect or maintain the woman’s health. Even in those narrow circumstances, they must be implemented in the least restrictive way possible.

The case was brought to Judge Como’s court by Dr. Paul Isaacson, a Phoenix OB-GYN and abortion provider who argued that several outdated laws replaced medical judgement with political mandates. Arizona Attorney General Kris Mayes had the opportunity to defend the state’s pre-Prop 139 laws. However, citing the 2024 constitutional amendment, she declined.

Instead, attorneys representing Republican politicians in the state Legislature—Sen. Warren Petersen and Rep. Steve Montenegro— defended the laws in court.

The court ultimately rejected their arguments, striking down three major restrictions:

• A 24-hour waiting period between a patient’s consultation and the abortion.
• A ban on performing abortions if the reason involved a fetal genetic or health diagnosis.
• A ban on using telemedicine to prescribe or provide abortion medication.

EXPLAINED: Why AZ doctors are fighting these abortion rules in court right now

Como wrote that the laws imposed a “universal suppression of medical judgement and choice,” finding that they substituted state control for the expertise of doctors and the autonomy of patients.

In his decision, he stated that the restrictions “infringe on a woman’s autonomous decision-making by mandating medical procedures and disclosure of information regardless of the patient’s needs or wishes.”

Mayes supported Como’s decision, praising it as a reaffirmation of the protections voters intended to establish through Prop 139.

“Today’s ruling is a major victory for Arizona women, families, and their doctors,” Mayes said in a statement. “The court has affirmed what we’ve known all along: the abortion restrictions challenged in this case are unconstitutional.”

The ruling can still be appealed, but for now, it represents a decisive affirmation that Arizona law cannot treat women’s decisions about their health care as suspect.