In a state that has suddenly become a key front in the national fight for reproductive rights, physician Gabrielle Goodrick declared herself ready: “We’re not closing.”

The clinic lobby began to fill with patients in their 20s, 30s and even 40s. Black, White, Latina and Native American. Some were accompanied by husbands and boyfriends. A few cried as they entered, escorted in by volunteers whose umbrellas sought to shield the women from the shouts and signs — “Babies lives matter” — of those abortion opponents.

“We’re just going to keep on keeping on,” staffer Gelsey Normand told one woman as she checked her in.

Goodrick opened the facility in 1999 and seven years later moved it here, near the foot of Camelback Mountain, with a goal of serving as many women as possible in sprawling, booming Phoenix and the surrounding region. Since Roe v. Wade was overturned nationally two years ago, it and other providers in the state have weathered a temporary abortion ban, a prohibition on abortions beyond 15 weeks, restrictions on abortions for fetal anomalies and this week a state Supreme Court ruling that revived a near-total ban dating to 1864 — when Arizona was still only a U.S. territory.

The latest uncertainty, coming seven months before the presidential election, feels punitive. “We’re political pawns,” Goodrick, 58, said Thursday. But she and fellow doctor Barbara Zipkin are resolute. And Zipkin, who began her medical career before abortion was legalized by the Roe decision in 1973, is energized by seeing more and more women engage on the issue.

“Not just White women, women of color,” she noted in between patient appointments. “It’s fabulous. It’s like, get your voice back. Take your power back.”

The clinic expanded shortly before the demise of Roe — when the patient queue at times stretched around the building, some women arriving hours before dawn, from as far as Dallas. The number of patients has only continued to increase, and the seven doctors on staff now do about 4,000 abortions a year. That’s roughly a third of the state’s total.

At one point, to skirt new restrictions, Goodrick arranged for patients to have an ultrasound in Arizona, get a prescription for medication abortion through a California telehealth appointment with Zipkin, who is licensed there, then have the pills mailed to post office boxes where patients could pick them up just over the state line.

The Arizona Supreme Court ruling on Tuesday again ratcheted up emotions; the justices signaled the ban could take effect before the end of the month. The only exception would be an abortion to save the life of the pregnant woman. Patients started calling, confused, alarmed, even frantic.

“It’s like that with every law. No one even knows what’s happening,” one young woman said after she arrived Thursday morning, shaken up by the people shouting outside.

“We’re trying not to panic,” Normand replied from behind protective glass at the front desk, near a “wall of shame” of protester photos and a drawer full of hate mail.

“I was feeling really bad out there,” the woman said. “Like, I love kids. I have kids.”

The clinic had 28 abortions scheduled: 18 surgical and 10 medication. Plus, because Arizona requires patients’ consent 24 hours in advance, 29 additional patients were expected for that. Most of the women live in Arizona, but one had traveled from Texas because abortion is already banned there.

On a counter near the front desk was a copy of the petition for a constitutional amendment that, if passed, would establish a fundamental right to an abortion up to the point of fetal viability. Supporters are still collecting signatures to make sure it goes on the November ballot. About a dozen patients had signed since Monday, prompted by staff and signs in the lobby and exam rooms reminding everyone to vote.

Zipkin greeted a 21-year-old college student from Phoenix, who was still deciding whether to have a medication or surgical abortion.

The student, who asked not to be identified by name, said she was leaning toward pills. Scooter, a Maltese-Yorkie mix that Zipkin calls an “abortion therapy dog,” rested in her lap as the doctor explained both procedures.

“You need to understand what you’re getting into,” Zipkin began.

The young woman, hair pulled back in a ponytail, half a dozen earrings dangling, listened closely. This was her first abortion. She had been taking birth control pills but missed a few. As soon as she missed a period, she called the clinic. She was now just under six weeks pregnant. Having had a teenage mother, she said she “didn’t want to bring a child into the world until I was prepared.”

Scooter hopped down, and the student twisted her fingers, weighing her options. “Nobody in my family knows I’m pregnant or doing this,” she said. After the court ruling, she’d worried that the clinic would cancel her appointment.

“I was a little scared,” she said.

Zipkin reassured her. Then she read aloud a series of warnings intended to ensure that a patient freely consents, understands the potential side effects of abortion and the alternatives that are available. The legislature required the disclaimers for years before Roe was overturned.

“The lawmakers weren’t happy that we were doing abortions in Arizona,” Zipkin said. “They decided if they dragged you in here enough times and made you wait, that maybe you’d get so disgusted with all the waiting and stuff you wouldn’t come back.”

“Just nonsense,” she scoffed.

A recent poll of Arizona voters shows that only 8 percent back the pending total ban — crafted by a man hired to establish law and order in a Wild West territory. Vice President Harris, visiting a Tucson community center on Friday to campaign alongside abortion patients and providers, excoriated the court ruling to allow it.

“Here in Arizona, they have turned the clock back to the 1800s to take away a woman’s most fundamental right — the right to make decisions about her own body,” she told the crowd. “The overturning of Roe was without any question a seismic event. And this ban in Arizona is one of the biggest aftershocks yet.”

At Camelback, doctors acknowledge that creative workarounds likely won’t succeed this time if the 1864 law is not successfully appealed or blocked by the legislature, as some lawmakers have pledged. The state’s newly elected attorney general, a Democrat, says she won’t prosecute abortion providers under the ban. She has informed several that they probably have 60 days before the ban kicks in, while the proposed ballot measure, should it pass, wouldn’t take effect until Nov. 25.

During that window, Goodrick isn’t sure the attorney general will be able to protect clinics from prosecution by conservative county attorneys.

“I don’t know that her reassurances are good enough,” she said. “If it’s illegal to do abortions, we’re not going to do abortions.” The election, she added, “is the future of everything.”

As deadlines loom, clinic staff are focused on the patients they can help — like the single mom with a blonde bob, who asked to be identified only by her first name. Paola, 23, said she had been struggling to find child care and had to quit her cashier job at a Mexican restaurant to stay home and watch her 5-year-old daughter and 3-year-old son.

Nine weeks pregnant, she came to the clinic Thursday with both youngsters. She had just taken the pills for her medication abortion. It was her first. She couldn’t handle a third child, she said: “Two already are a handful. A baby takes a lot of time.”

She had heard about the ban and would consider voting so she could cast a ballot for the abortion amendment this fall. “We should choose what to do with our bodies,” Paola said.

One of the day’s last patients was a Phoenix college student named Jessica, barely five weeks pregnant, who arrived for an abortion because the condom had broken. “I just was not ready to have a child,” she said.

She took the first abortion pill, sipped water from a paper cup and swallowed quickly. She was still jittery, tapping her black Tory Birch sandals, as Zipkin reviewed the additional pills she’d need to take the following day at home. Some bleeding and cramping likely would follow.

“I don’t want you afraid or unsure. You’re safe,” Zipkin said.

Her mother opposed the abortion, but Jessica defended it. She said she didn’t want to face the financial issues her mother had as a young, single parent. “I’m 24 years old. I think I can decide for myself,” she explained. “I’m still in school. I don’t want my kid to remember paycheck to paycheck to paycheck.”

When news of the court ruling broke, she feared her appointment might be canceled. “My heart sank,” she said.

After signing in at the clinic’s front desk, she added her name to the petition for the state constitutional amendment. “I signed it the second I could,” Jessica told Zipkin.

It had been a busy but good day. All medication abortion patients showed. Just four surgical patients didn’t. And unlike when Roe was overturned, those no-shows could be rescheduled. For now, they had time.