HELENA, Mont. (AP) — The Montana Supreme Court has upheld a ruling that allows two advanced practice nurses to provide abortions in the early stages of pregnancy while they challenge a law saying only doctors and physician assistants can perform the procedures.

District Court Judge Mike Menahan a year ago blocked the Montana Abortion Control Act as it applied to nurse practitioner Helen Weems and an unidentified nurse midwife. The state appealed on several grounds, including arguing that the nurses did not have standing to challenge the law.

The Montana Supreme Court, in a 4-3 decision Friday, upheld the lower court’s ruling, saying medical providers have standing to challenge laws that affect their patients.

It cited a 1999 ruling in favor of a physician’s assistant who sought to overturn a Montana law that said only doctors could provide abortions. The state’s highest court had ruled that the right to privacy in the Montana Constitution protects a woman’s autonomy over her reproductive health and that the physician-only abortion law violated her ability to obtain a legal medical procedure from a health care provider of her choice.

The dissenting justices argued the lower court blocked a law that had not been challenged for a decade and that the Montana Board of Nursing has not determined advanced practice nurses can provide abortions.

“The court lacks both the authority and the proper medical training and knowledge to make such a determination,” Justice Jim Rice wrote in his dissent.

Major medical organizations, including the American College of Obstetricians and Gynecologists, the American Public Health Association and the World Health Organization say laws prohibiting advanced practice nurses from providing abortions in early stages of pregnancy are medically unfounded, the American Civil Liberties Union of Montana said.

Montana rules say advanced practice nurses may only practice in areas in which they have current national certification.

“There is simply no reason to prohibit qualified clinicians like our clients from providing abortion care,” said Hillary Schneller, staff attorney at the Center for Reproductive Rights. “This law only further restricts abortion access in a state where it is already limited.”

The Center for Reproductive Rights and the ACLU of Montana will next ask the lower court for a permanent injunction allowing all advanced practice nurses to perform abortions in the early stages of pregnancy as the groups keep fighting the law, Schneller said Monday.

Weems has been providing abortion care at her clinic in Whitefish while the nurse midwife has not yet received such training, Schneller said.

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