DETROIT — A trial has begun in a case that challenges Michigan abortion-related laws, including a 24-hour waiting period, with testimony focused on whether they place an undue burden on women seeking the procedure in the state.

The bench trial is taking place in Michigan's Court of Claims in Detroit, where Northland Family Planning Center is asking Judge Sima Patel to rule unconstitutional three abortion regulations in state law — a mandatory 24-hour waiting period to terminate a pregnancy; requiring those seeking an abortion to obtain counseling and read information from the state before getting the procedure; and a ban on advanced-practice clinicians like physicians assistants and nurses performing an abortion.

The legality of the regulations came under scrutiny after Michigan voters approved a constitutional amendment in November 2022 creating a state-level right to have an abortion.

"Because I worked with lobbying legislators in Lansing, my understanding was (these regulations were) to make it more difficult for women to get abortions (and) to delay abortions," said Renee Chelian, the executive director of Northland Family Planning Center. "My observation was (their intent was that) it would deter women and when they read the materials it would change their mind."

The state, represented by fire-walled attorneys within Attorney General Dana Nessel's office, said it intervened in the lawsuit after Nessel, the Michigan Department of Health and Human Services and the Department of Licensing and Regulatory Affairs signaled they would not defend the law against the challenge brought by Northland.

"The challenged statutory provisions do not unconstitutionally deny, burden, or infringe on an individual’s right to reproductive freedom under Michigan’s Constitution ... and they do not discriminate in the protection or enforcement of this fundamental right," the state's attorneys said in their motion to intervene in the lawsuit.

Northland sued Nessel, LARA Director Marlon Brown and MDHHS Director Elizabeth Hertel. Nessel, Brown and Hertel said they would not defend the constitutionality of the laws.

Hertel said MDHHS did not have the legal authority to enforce the challenged laws, which is why the state intervened on behalf of the people of Michigan. Hertel said adding the state as a party was the only way for meaningful and complete relief for Northland.

The Reproductive Freedom For All Amendment requires the state not to "deny, burden, or infringe upon this freedom barring a compelling state interest to protect the health of the individual seeking care," Patel wrote in her order granting a preliminary injunction in June.

"Additionally, any statute or regulation that does deny, burden, or infringe upon reproductive freedom must only do so in order to protect the patient’s health, achieve this goal by the least restrictive means, be consistent with accepted clinical standards of practice and evidence-based medicine, and not infringe upon an individual’s autonomous decision making."

It appeared the laws Northland challenges, Patel wrote in her order, "are likely unconstitutional." She will rule on the case after the trial, which is scheduled through Feb. 21.

Two people testified Thursday at the first day of the trial: Chelian and Dr. Charisse Loder, who works at the University of Michigan's Women's Clinic. None of the parties gave opening statements.

The law before the June preliminary injunction was granted required those pregnant to wait 24 hours to get an abortion after they received state-mandated informational materials. They either had to go to the clinic to get the materials or print them out themselves, both of which can cause hardship to people seeking an abortion, Chelian and Loder said.

Chelian and Loder said patients were often annoyed when they learned they could not have an abortion the day they made their appointment and would have to wait at least 24 hours for a new appointment.

"I observed people being frustrated, angry and upset that they had gotten a babysitter or a ride or taken a day off school or work, only to be turned away," Chelian said. "They sometimes weren't sure when they could come back, pushing them into another gestational limit or making it so they couldn't get a medication abortion. ... They couldn't understand why the state had anything to do with this."

The state argued that the 24-hour waiting period does not unduly burden access to abortion; instead it ensures people can exercise their right in an "informed, voluntary, and reflective manner." Its attorneys asked Patel to affirm the laws and leave the question about any policy changes to the Legislature.

Appellate courts found that laws like the ones challenged by Northland did not constitute an undue burden on a woman's right to reproductive freedom, the state wrote in its motion to intervene. The Michigan Court of Appeals found in 1992 that the objective of the laws was to ensure “a woman’s decision to obtain an abortion is informed, voluntary, and reflective."

After the injunction, Chelian said employees at Northland spent less time on the phone talking about the state's website with patients and can reduce waiting times for those who come in.

"It makes it much easier for them to get an appointment they want and have already made up their mind about," Chelian said. "There's no other medical procedure in this state where the patient is required to look at alternatives to the procedure they're going to have.

"It's biased, its unnecessary, it burdens the patient, there’s no reason for it. ... It is not fair to make an assumption that they want something because you think it's not a burden or someone else happens to think it's not a burden."

The delay and mandatory counseling were designed to pressure people into choosing to continue a pregnancy instead of having an abortion, the lawsuit said.

The lawsuit contended the law also forces patients to read irrelevant, misleading or stigmatizing information that may not apply to their circumstances for ending a pregnancy. Loder said the materials provided by the state are misleading, overplaying the risks of abortion and downplaying the risks of pregnancy.

"I don’t believe (the materials) help my patient make an autonomous decision,” Loder said.

The state argued that the informational materials also do not put an undue burden on abortion care, and is in keeping with the state's interest to protect a patient's health, as does the law limiting abortion providers to licensed physicians.

“Providing a patient with medically accurate information is not a burden to that patient, is it?” Assistant Attorney General Kendell Asbenson asked Loder.

“I don’t agree with that statement,” Loder said.

“It’s a burden to provide medically accurate information to a patient?” Asbenson said.

“I think it’s a burden to provide medically accurate information that is not relevant to the patient,” Loder said, saying it would not be helpful to provide Asbenson, a man, information about female reproductive health.

The trial continues Friday.

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