Planned Parenthood, the state's largest abortion provider, announced a sweeping cutback of abortion services in Arizona on Thursday, saying it will no longer offer the procedure in communities outside metro Phoenix and Tucson.

The organization had been offering abortions at 10 of its 13 Arizona locations. Starting today, that will drop to three.

Planned Parenthood eliminated the services after an Arizona appellate court last week upheld a 2009 state law that placed new restrictions on abortions in the state, including authorizing only physicians to perform surgical abortions.

Previously, nurse practitioners and midwives could perform the procedure. A shortage of doctors in the state trained or willing to perform abortions has forced Planned Parenthood to reduce the number of locations where it can offer the service.

The impact, its officials say, will be felt statewide, but women living in rural communities, including Flagstaff, Prescott Valley and Yuma, will be hit the hardest.

Planned Parenthood was the only provider offering the procedure in those areas. Now, those women will need to travel to the Valley or Tucson or go out of state.

Planned Parenthood also fears the reduction in services could lead to longer waiting times because an onslaught of patients will now seek medical care from just a handful of doctors.

Abortions also will no longer be offered at Planned Parenthood's Goodyear, northeast Phoenix and Chandler locations.

"This morning, Arizona women will wake up with fewer health-care options," said Bryan Howard, president and CEO of Planned Parenthood Arizona.

Social-conservative groups who pushed for the changes in law disagree. They say new restrictions will benefit women by ensuring they are well-informed and receive proper medical care.

The newly upheld law also:

Requires women to have an in-person "informed consent" consultation at least 24 hours in advance with the physician who will be performing the procedure. Under previous rules, qualified staff members were able to provide women with the information over the phone.

Requires that minors get a notarized statement of parental consent before getting an abortion. Parental consent was previously required, but the statement didn't have to be notarized.

Allows pharmacists and other health-care professionals to refuse to provide emergency contraception for religious or moral reasons.

Cathi Herrod, president for the Center for Arizona Policy, a socially conservative organization that helped author the 2009 law, said the new requirements are about safety and raising "the standard of care" for women.

"The real story here is that Planned Parenthood has chosen to end their services rather than raise that standard of care to be at the same level as other medical care in the state," Herrod said. "The real story here is that they can't find doctors to perform these services. I think that's telling."

Planned Parenthood countered that medical professionals who perform abortions often face harassment and threats and that the state's shortage of physicians was exacerbated by the Legislature in the 1970s barring the University of Arizona from teaching the procedure at its College of Medicine.

"A lot of people don't want to stick their neck out to do this," said Beth Otterstein, a nurse practitioner who works at Planned Parenthood's Flagstaff location. "I've had (abortion opponents) come to my house. People don't want to put their families and themselves in jeopardy."

Otterstein, who practiced medicine for 30 years, said she doesn't accept the argument that the new abortion requirements are about women's health.

"We are highly regulated by the state," Otterstein said. "I don't know what these health risks are that they are referring to."

Planned Parenthood estimates that one in five of the women it sees is seeking an abortion.

The agency performs slightly fewer than 10,000 abortions each year in Arizona, and roughly 10 percent of those procedures are performed on women living in rural communities.

Otterstein said her Flagstaff clinic drew patients from as far away as the Four Corners area, where Arizona borders Utah, New Mexico and Colorado.

"It's more than just an inconvenience for these people," Otterstein said.

"We are a source of legal and safe health care. They are leaving families and communities to come to Flagstaff, and now, they have to go even farther."

But JoAnn Everitt, founder and services director at the Crisis Pregnancy Centers of Greater Phoenix, disagreed.

She said the court's ruling will help ensure that women are aware of all their options and receive both quality care and needed emotional support.

Everitt said her agency, which serves women with unplanned pregnancies, sees many women in their centers who have long-term emotional trauma as a result of their abortions.

"It does effect women," Everitt said, "and there is never any aftercare. It's just 'OK, get on with your life and forget about it.' But they are struggling."

Planned Parenthood said Thursday that it decided to implement the service reductions immediately because it feared the appellate court's ruling was "expansive" enough to also impact other pending litigation over additional abortion restrictions passed by state lawmakers earlier this year.

Those include a new requirement that would prohibit nurse practitioners from providing the abortion pill and rules that allow only physicians to perform many other services typically done by nurse practitioners before a medical abortion, including pelvic exams.

About half of the abortions in the state are abortion by pill, and Planned Parenthood routinely relies on nurse practitioners to perform the service.

Howard said that his group will likely appeal the court's decision but that, in the meantime, his agency has no choice but to comply with the law.

"Some politicians are determined to make private health-care decisions a political and public issue," he said, adding that women will now "face unnecessary delays, travel long distances and be forced to take time away from their families and jobs."

Despite the new service reductions, all 13 Planned Parenthood locations will stay open, Howard said. But most will provide only family planning and other health services.

Effective today, abortion services will be offered only in the Valley at the agency's Glendale and Tempe locations and at its Sanger Health Center in Tucson.