Abortion rights at center of fight for Southern Az congressional seat

With just a few days remaining before the November election and many ballots already cast, Arizona Democrats have made abortion rights a central closing argument, arguing Republicans will seek a national ban and try to block IVF and other medical procedures, and pushing for reproductive rights to be codified in the state.

The Proposition 139 abortion amendment, if approved by a majority of voters, would see Arizona swing in just weeks from having a Civil War-era ban on abortion on the books to seeing the right to an abortion enshrined in the state Constitution.

In Southern Arizona, the Democratic push showcases the initiative and the candidacy of Kirsten Engel, who hopes to unseat freshman Republican Congressman Juan Ciscomani.

Engel has described her own issues with reproductive care, telling the public she has “had miscarriages late in pregnancy.”

“Abortion is on the ballot this year,” said Stephanie Stahl-Hamilton,
a Democratic state representative. She called Ciscomani, an “anti-choice
extremist” who supported an Arizona state law that failed to overturn the 1864-era ban. She added Ciscomani has “repeatedly voted for nationwide restrictions on
abortion care, including care for our service members and veterans.” 

“Kirsten
understands the devastating impacts that abortion restrictions have on
women, our families and our health care professionals,” Stahl-Hamilton said during a get-out-the-vote event in Tucson this week.
“Abortion is on the ballot this year. Just five days out, it’s critical
that everyone gets out and votes, so go vote for Kirsten and know that
you are also casting a vote to protect reproductive freedom.”

Dr. Victoria Fewell, a Tucson obstetrician-gynecologist, said under Arizona’s current 15-week ban, women who have either a
medical condition that precludes a safe pregnancy, or a “devastating
fetal anomaly” have to travel out of Arizona for abortion care. She also
worried about the future. Under Arizona Gov. Katie Hobbs and Attorney General Kris Mayes, doctors have some measure of protection if they provide abortion procedures after 15 weeks. 

“That
could change with the next election cycle, and if there is a national
abortion ban, all of this will go away,” Fewell said. “We will not have the
ability to care for patients at all who require abortion care for life
saving reasons.”

Fewell was part of a failed effort to protect abortion rights in 2022 after the U.S. Supreme Court overturned Roe v. Wade and other decisions that protected reproductive rights.

“We need leaders who will protect our ability as healthcare providers to give them the care they need,” Fewell said. She added that the repeat Democratic candidate is “committed to defending the right to choose and understands the devastating consequences of infringing on that fundamental human right and of tying the hands of medical professionals who are trained to perform life saving care.”

Fewell argued Ciscomani supports a “total abortion ban without exceptions for rape, incest or to save the life of the patient.”

She said Ciscomani supported an “archaic 1864 total abortion ban in Arizona and voted for a total national abortion ban with no exceptions.” 

“He has also supported legislation that would threaten IVF and contraception,” she said, adding the freshman GOP lawmaker “consistently and without hesitation, chooses a non-viable fetus over the life of a mother, wife, sister, daughter or friend. If this ideology prevails, there will be nobody spared by these draconian bans.”

She told Tucson Sentinel that she recently provided an emergency abortion for a young woman who “would have died and left her two young children behind” if she went to hospital where physicians were banned from procedure. “These situations are very real, devastating and not at all uncommon.”

Fewell said abortion rights are a public health issue and said when
women have the right to choose, and doctors “have the right and the
freedom to practice evidence-based medicine, families and communities
thrive. They are healthier and stronger.”

“This isn’t about politics. It is about people, people faced with impossible decisions that should not be made by politicians,” Fewell said. “The stakes could not be higher in this election.”

Abortion at center of congressional fight

Democratic challenger Kirsten Engel has made abortion rights central to
her campaign against U.S. Rep. Juan Ciscomani.

Although
Ciscomani has an A-plus rating from the anti-abortion organization
Susan B. Anthony Pro-Life America and a score of 14 out of a 100 from
pro-choice Planned Parenthood Action Fund, he released a television ad
in late September in which he adopted a more moderate tone than he has
in the past.

“I trust women,” Ciscomani said in a direct address to the camera. “I cherish new life. And I reject the extremes on abortion.” 

Ciscomani’s new TV ad represents a softening of his tone on the issue.

While
he said he doesn’t support a national abortion ban and believes the
decisions about abortion rights should be made by individual states,
Ciscomani has consistently voted to restrict abortion while in Congress.

In
2023, while he was working on the agricultural appropriations bill,
Ciscomani voted in favor of a controversial provision that would have
prohibited postal delivery of abortion medication. That provision was
later struck during budget negotiations. 

Ciscomani also voted in
favor of different provisions in legislation to block the Defense
Department from paying for or reimbursing expenses for members of
the U.S. military who have to travel to different states to seek
abortion care if they cannot access those services in the state where
they are stationed. He voted to prevent people on the Affordable Care
Act from being able to acquire health insurance plans that include
abortion coverage. Under ACA current law, plans can offer abortion
coverage but the cost of that benefit is ineligible for federal
subsidies and must be paid for entirely by the person buying insurance. 

The
legislation would have also prohibited abortions in federal healthcare
facilities or by a federal employee, according to the congressional
summary of the bill.

Engel has been hammering Ciscomani on the issue since she launched her campaign last year.

“The contrast between myself and my opponent could not be more stark,” Engel said at a 2023 roundtable on abortion. “In Congress, I will protect our freedom to make our own reproductive health care decisions. My opponent will not. He will give it away to politicians to make these decisions for us.”

The Susan B. Anthony Pro-Life America
organization wrote on their website: “Rep. Ciscomani has stood up
against the ever-growing pro-abortion agenda of the Biden-Harris
administration and the radical bureaucrats who are actively working to
expand abortion access, resources and funding. Rep. Ciscomani has voted
consistently to defend the lives of the unborn and infants.” 

“This
includes stopping hard-earned tax dollars from paying for abortion,
including abortion travel expenses, whether domestically or
internationally, and pushing back on the Biden-Harris administration’s
extreme executive actions on abortion,” the group said.

In 2020, U.S. Rep. Ann Kirkpatrick, a Democrat, won Congressional District 2 in Southeast Arizona with 55.1
percent of the vote. However, the district was redrawn and some heavily
Democratic parts such as the border city of Douglas and nearby Bisbee were
shifted into CD7. The new CD6 in the southeastern part of the state wraps around
Tucson’s northeast side toward Casa Grande and reaches east to New
Mexico.

In 2022, Ciscomani won the race for an open seat by just 1.4 percent of the vote, garnering about 5,000 votes more than Engel in a tight race.

On Thursday, Engel linked Ciscomani to Trump and his nominees for the U.S. Supreme Court who helped overturn Dobbs.

“By stripping away that federal protection—that right of privacy—we are now left with what we’re seeing across the country and here in Arizona, these abortion bans,” she said.

“I myself have had miscarriages late in pregnancy,” she said, adding that with bans in place, procedures to make sure a woman has a safe miscarriage is “now off the table.”

“That is what the Supreme Court has left us with, and we know that my opponent is perfectly fine with that,” Engel said.

Medical experts have emphasized that most abortion procedures late in a pregnancy — what anti-abortion politicians tag as “late-term abortions” — are necessary to save a woman’s life or health, due to miscarriage, infection or other complication. They are not purely voluntary procedures.

In August, the Democratic Congressional Campaign Committee launched a series of ads linking Ciscomani to the Patriot Academy, an organization that dubs itself an “elite leadership training program” that applies a “Biblical, historical, & Constitutional Foundation.”

The organization hosts “Capitol Boot Camps” designed to train future leaders to “understand and influence government policy with a biblical worldview.” And, the group noted Ciscomani is one of its board of directors and a “3-time alumnus.”

“He’s actually part of a group in Washington, DC, that advocates for a nationwide abortion ban,” said Engel. She said Ciscomani cheered the repeal of Roe v. Wade and she had “no reason to hope he would stand up for women and their rights.” 

“He will just fall in line with the Republicans,” she said. Ciscomani,
she said “has shown no interest in really being an independent voice for Southern Arizona on these issues.”

“These are our rights. We want them back, and we need change in Congress in order to put them back,” Engel said.

“I’m ashamed to say that my daughter has fewer rights today than I did when I was her age,” Engel said. “I’m ashamed that our state hasn’t protected women’s fundamental rights, and I’m ashamed that our current U.S. Representative—and my opponent—is part of the problem.”

Engel said Republicans could also target contraception, but said she could protect these rights in the U.S. House. “We can do it by flipping the House and winning these majorities in Congress to protect women’s health care,” Engel said.

Prop. 139 fueled by court fights

The U.S. Supreme Court’s decision to overturn Roe v. Wade, the
landmark 1973 decision that made abortion legal in the U.S., over the
summer of 2022 threw reproductive rights into chaos in Arizona. Weeks
after the Supreme Court’s decision, then-Arizona Attorney General Mark
Brnovich sought to enforce the near-total ban on abortion first added
to Arizona’s territorial statutes in 1864.

After the first reproductive rights measure failed to gather enough
signatures by a July 2022 deadline for the ballot that year, activists
regrouped and launched Arizona for Abortion Access.

Arizona’s GOP lawmakers had passed a 15-week abortion ban in early 2022 — with then-Gov. Doug Ducey, a Republican, signing the measure — which had a clause that the older ban would take effect if Roe v. Wade was overturned. The determination of which law held sway ultimately went to the state Supreme Court, which found in April 2024 that the 19th century law was still in place.

In response to the year-long initiative campaign finding renewed vigor with the court ruling, the Legislature narrowly repealed the 1865 ban, with five Republicans crossing the aisle of the GOP-dominated House and Senate to join with the Democratic minority in April. But that repeal wouldn’t take effect until 90 days after the lawmakers’ session ended, with the territorial law finally lifted on Sept. 14.

The shifting landscape of abortion
had supercharged supporters of the Arizona Abortion Access Act, who gathered
a record-breaking number of signatures to qualify for November’s
ballot.

Listed on the ballot as Prop. 139, the measure puts a pivotal choice before Arizona’s 4.1 million voters: pass the initiative and put abortion rights in the state’s Constitution, or vote it down, leaving the current 15-week ban in place. If approved by voters, Prop. 139 would allow women to terminate their pregnancy until the point at which a fetus could survive outside the womb. The measure includes additional provisions that would allow women to seek abortions past that point if their health or life would be in jeopardy if they did not terminate their pregnancy.

The proposed constitutional amendment would establish a “fundamental right” to abortion in Arizona and prohibit “denying, restricting or interfering with that right before fetal viability unless justified by a compelling state interest.”“Fetal viability” is defined as “the point in the pregnancy when, in the good faith judgment of a treating health care professional and based on the particular facts of the case, there is a significant likelihood of the fetus’ sustained survival outside of the uterus without the application of extraordinary medical measures.”

The group pulled together nearly 824,000 signatures, and
of those around 578,000 were validated by Arizona officials—far beyond
the 383,923 signatures needed for a proposal amending the state
Constitution. A previous version of the measure had failed to gather enough
signatures, however, the effort gained momentum after a state court ruled
the 160-year ban was state law—a consequence of the U.S. Supreme
Court’s decision to undo Roe v. Wade.

“This is the most signatures ever gathered for a ballot measure in Arizona history, which is a testament to the broad support among Arizona voters for restoring and protecting abortion access in Arizona,” said Cheryl Bruce, campaign manager for the initiative group.

The signatures were gathered by more than 7,000 volunteers across Arizona’s 15 counties. 

“After spending several months talking to voters across the political spectrum, from age 18 to 80, I have no doubt that Arizona voters will overwhelmingly pass the Arizona Abortion Access Act. Arizonans will finally be able to trust that our reproductive freedoms are restored and protected in our state Constitution,” said Susan Ashley, a volunteer signature collector who began collecting signatures in January. 

The campaign said it was backed by “robust fundraising” including donations from more than 13,000 donors. Arizona for Abortion Access said they would launch a $15 million bilingual television and radio ad campaign targeting voters in Phoenix and Tucson.

‘Goes to far’

Prop. 139 faces opposition from right-wing groups, including the Center for Arizona Policy Action. 

“When the U.S. Supreme Court overturned Roe v Wade two years ago, the people, through their elected representatives, grappled with the critical issue of abortion – a serious and consequential topic worthy of rigorous debate. About half the states, including Arizona, now have laws protecting the lives of unborn babies at 15-weeks or earlier,” wrote Cathi Herrod, the organization’s president. She said the Dobbs ruling and changes to abortion law “reflect the American system of government at work; the judiciary interpreting law, and the legislative branch making policy reflective of the people represented.”

“Democrats in Arizona have joined the abortion industry in opposing even the most reasonable limits on abortion,” she wrote. “Now, they are working overtime to amend the state Constitution legalizing unlimited and unregulated abortion on demand.” 

“Most voters oppose such extreme abortion laws, and support limits like Arizona’s current 15-week limit with exceptions of the life of the mother or medical emergencies – which is defined as a serious risk of substantial and irreversible impairment of a major bodily function,” Herrod said.

Campaign spending reports show backers of the abortion-rights amendment have raised more than $17 million, while opponents have raised less than $500,000 to campaign against it.

The legal machinations and
political rhetoric have created whiplash and confusion for Arizona
medical providers and their patients. But proponents of the
measure now have a clear picture of what strict limits
on the procedure would mean for pregnant Arizona women in crisis.

Democrats
hope to use the issue to once again win the state’s 11 Electoral College votes. Late polling shows a hairsbreadth difference between GOP
candidate Donald Trump and Democratic candidate Kamala Harris.

One poll by Noble Predictive Insights showed Trump leading Harris by a single point, however, around 57 percent of voters told the pollster they supported Prop. 139, with only 7 percent undecided.

Doctors worry

Dr. Jill Gibson, chief medical director for Planned Parenthood Arizona, said the fallout from the court decisions has has created staffing challenges because of the changing laws and the stigma abortion care carries. Gibson said PPAZ has already been working under the 15-week ban, which requires the organization to “make a lot of adjustments to ensure that patients are able to get care that they need.”

“We recognize that any abortion ban is, is absolutely antithetical to our ability to, you know, accurately and effectively take care of our patients,” Gibson said. 

“And for so many reasons, patients are needing to seek abortion care after 15 weeks, not the least of which is that we don’t have sufficient access to abortion services in this state.” Gibson said also called the 15-week ban a “double trap” for some patients. 

Some women won’t recognize they’re pregnant during their first trimester, even at 7-8-9 or 10 weeks, she said. And, then they might have to wait several weeks before their initial pregnancy confirmation visit, followed by an abortion counseling visit required by the state. “And, then may have additional weeks that they have to wait before they can actually schedule their abortion,” she said. 

“So the actual reality is because of so many of the regulations and restrictions that have been put in place by the Arizona State Legislature, patients don’t have the access that they need and that delays their ability to get care under 15 weeks,” Gibson said.  

Planned Parenthood has established a patient navigator system to refer patients out-of-state, but that takes additional funding and time, she said. PPAZ works with affiliate organizations in California, Colorado, New Mexico and even New York to help patients, but she also worried about limitations for people in rural areas of Arizona. For those women, the state’s limit on providing medication for abortion using tele-health networks requires women to travel to the cities of Tucson, Phoenix or Flagstaff.

“All of this ultimately leads to poorer outcomes,” Gibson said. 

“The only thing that should be guiding healthcare decisions is medical science and the standard of care and the decision should be made between a woman and her health care provider,” she said.

However, physicians and nurses, along with their patients, Gibson said “are worried about what this will mean legally under the law because of the (Supreme Court) and because of our state Legislature. It really is just hampering folks ability to get the care they need in a timely manner.”

“There is no other area of medicine that is restricted by a Supreme Court ruling or random legislators,” Gibson said. “Medicine should be guided by medical practices and science and data driven research.”

Dr. Hiral Tipirneni said following the Supreme Court’s decision and a state court’s decision to enforce the territorial ban providers found themselves on uncertain ground. 

A former congressional candidate in Arizona, Tipirneni spoke about the uncertainty providers face due to the changing regulations.”

“They’re worried about legal ramifications and how this will impact their practices because there is a degree of confusion and uncertainty,” she said.  “I think until this issue is more settled and clear, health care providers are working under this cloud of misconception and uncertainty.” 

“They will always render the best care, but they’re hesitant sometimes to be available for some kinds of abortion care because there’s some uncertainty,” Tipirneni said. 

Since the Supreme Court’s decision, Pro-Choice AZ and the Abortion Fund of AZ spent $596,000 to help dozens of women travel for an abortion, said Eliosa Lopez, executive director of Pro-Choice Arizona and the Abortion Fund of Arizona. Lopez said the state’s limits means women travel long distances.

“There are so many restrictions because abortion is an out-of-pocket expense,” she said, adding while some clinics offer financial support, others do not nor do they have payment plans. “They need the full amount up front,” Lopez said. This means women might find themselves choosing between rent or groceries, or getting an abortion.

Those restrictions have made it impossible for Arizonans to get an abortion without traveling to Pima or Maricopa counties.

Jodi Liggett, the founder of the Arizona Center for Women’s Advancement and a chief organizer with the initiative effort, said supporters did not set a limit based on a specific number of weeks into a pregnancy because they wanted to take into account future advances in medical science and leave that decision to doctors. Current fetal viability in the United States is roughly 24 weeks although there is a significant risk of birth defects for anyone born at that age.

“We are not talking about weeks in the language,” Liggett said. “It will be a medical determination on an individual basis. It’s returning decision-making to individuals and their medical professionals.”

The initiative includes input from reproductive-rights organizations and polling had shown strong support for the measure, according to Liggett.

The measure would end enforcement of Arizona’s current 15-week ban, passed by the Arizona Legislature in 2022. It would also provide abortion advocates with a legal pathway to blocking enforcement of other laws restricting abortion, such as waiting periods, mandatory ultrasounds and restrictions on the use of medication abortion, that have become law over the last few decades in Arizona, according to Liggett. 

Groups in support of the initiative include Planned Parenthood Advocates of Arizona, NARAL Arizona, Affirm Sexual and Reproductive Health, Arizona List and Healthcare Rising Arizona.

As U.S. hardens on abortion rights, a warning from Latin America

For Rosa Hernández, an abortion ban in the Dominican Republic led to the death of her 16-year-old daughter. For Cristina Quintanilla, anti-abortion laws in El Salvador meant after suffering a stillbirth she faced another nightmare when she was convicted of aggravated murder and sentenced to 30 years in prison. For Margarita Acosta, her abortion decades ago still resonates because she faced “weeks of anguish”  in Columbia. 

The women were part of the Latinx Storytelling Tour, and Sept. 28 in Tucson, they shared their experiences in the face of decades-long abortion bans in their home countries. The tour was presented in partnership with the Green Wave, a Latin American-based movement pushing for reproductive rights, along with Arizona for Abortion Access and Arizona List.

Since the reversal of Roe v. Wade, Arizonans find themselves in a legal landscape marked by uncertainty and instability. And, as the group noted, this often falls on Latinas.

Around 6.7 million women live in states with abortion restrictions, including Arizona. As the Green Wave said, abortion restrictions fall on women, including women in the country without legal authorization, who also endure language barriers, inadequate insurance, provider shortages, cultural stigma, and deportation threats. This is all compound by “the challenges of accessing abortion care, increasing health risks and disparities.”

In the room, green bandanas were draped across the chairs, and an audience of around 60 people listened as the women offered a warning—what do abortion bans mean for women. 

The green bandana has been the symbol of abortion movements for decades, beginning with the Green Wave movement in Argentina, when women fought for abortion rights because they were dying—either because they had an unsafe abortion or because they arrived at the hospital and were denied healthcare, said Paula Avila-Guillen, executive director from the Women’s Equality Center. 

She noted white handkerchiefs became a symbol of resistance for women who lost children during Argentina’s dictatorship, but during this new fight women chose the color green as a symbol for life, health and hope. “And, abortion is all of them,” Avila-Guillen said.

“Standing alongside our Latin American allies, we’re inspired by their determination to overcome abortion bans. Arizona’s reproductive freedom fighters are crucial to protecting autonomy, health, and well-being, especially for Latinx people facing the worst of the abortion restrictions in our state,” said Dr. Catherine Nichols, executive director of Arizona List. 

“Together, we’ll push forward, honoring the resilience of our storytellers and the tireless efforts of Arizonans defending reproductive justice.”

“By sharing our stories, we hope the people of Florida, Nevada and Arizona understand the devastating impact of abortion bans and the profound difference their activism makes,” said Morena Herrera, an activist who spoke about her experiences helping women imprisoned in El Salvador for having an abortion. 

“By sharing our stories, we hope the people of Florida, Nevada and Arizona understand the devastating impact of abortion bans and the profound difference their activism makes. They are the guardians of reproductive justice, and their tireless efforts are the backbone of a movement that protects the autonomy, health, and well-being of entire families and communities,” Herrera said. 

Two of the women who spoke are among the first major abortion-related cases being reviewed by the Inter-American Commission of Human Rights, the group said, “marking a significant milestone in the fight for reproductive justice in Latin America, with potential far-reaching implications for the region.”

After storytellers, women in Tucson tell their own

Claire Knipe, political director for Arizona List, said the storyteller event was important for women in part because conversations about abortion and other reproductive needs are taboo. “This sometimes leads us to not think about the realities of what an abortion ban can lead to,” she said. 

“That inability to talk about something uncomfortable leads us into really dangerous and dire circumstances. The importance of an event like this is to talk to folks about what the reality is if Arizona is under an abortion ban.” 

“These stark reminders are really important,” Knipe said. 

Darrell Bakeman, 78, retired nonprofit executive and member of Arizona List, decided to tell her own story, describing herself as an “OG” who experienced an abortion before Roe v. Wade.  

As a 22-year-old college student in Houston, she needed an abortion, but had to travel to Washington D.C. 

After the procedure, she needed emergency care at a hospital. Bakeman said she didn’t talk about the procedure much, but sometimes told members of her church.

 “It wasn’t legal then, and that reality before Roe was women had dangerous procedures,” she said. “Without these protections, women face coat-hangers and pain.”