Nearly six months after letting the case go dormant so a trio of regulatory bodies could evaluate the practice, a federal judge heard arguments on Tuesday over whether to block Colorado from enforcing an effective ban on “abortion reversal” treatment against a Catholic health clinic.

Bella Health and Wellness, a faith-based healthcare provider with locations in Englewood and Denver, is claiming a recent state law violates its First Amendment right to religious exercise. Either its providers must refrain from acting on their Christian beliefs and no longer facilitate treatment to reverse the effects of medication abortion, or else they will continue to treat patients and risk professional discipline, Bella Health argued.

Lawyers for Bella Health pointed out the law, Senate Bill 190, came amid a national fight over reproductive rights in the wake of the U.S. Supreme Court’s conservative majority overturning longstanding federal protections for abortion. They argued the Democratic sponsors of SB 190 denigrated faith-based clinics, calling them “fake” and “deceptive,” and the law should receive the highest degree of scrutiny from the courts.

U.S. District Court Judge Daniel D. Domenico observed the law against abortion reversal treatment might be neutral toward religion and broadly within the regulatory powers of the state. However, evidence also suggested the sponsors intended to target faith-based providers in particular.

“I don’t necessarily think a majority or even very many of the supporters of this law thought, ‘We dislike Catholics and let us ban something that Catholics want to do’,” he said. “But they saw something that was engaged in by members of a religious group … and banned that.”

With medication abortion, a pregnant patient typically takes the drug mifepristone, followed by a dose of misoprostol. Although a pregnancy may survive even in the absence of the follow-up dose, administration of progesterone can dramatically boost the chances of maintaining the pregnancy – according to proponents of abortion reversal – even after a person has taken mifepristone.

Bella Health and the state disputed the accuracy of the science underlying the practice of abortion reversal. Bella Health indicated its employees successfully provided progesterone to thousands of patients over the years, but Domenico questioned whether he needed to become a “scientific arbiter” to resolve the clinic’s First Amendment claims.

SB 190, enacted as part of a package to bolster reproductive rights in Colorado, contained several components Bella Health found problematic. The preamble to the bill labeled the provision of abortion reversal services a “deceptive trade practice,” with misleading claims about abortion and contraception being subject to penalties under the Colorado Consumer Protection Act.

The legislature also proactively labeled as “unprofessional conduct” the provision of abortion reversal treatment. However, if the state’s boards of pharmacy, nursing and medicine all decided abortion reversal is a generally accepted practice, the prohibition would fall by the wayside.

In April, Domenico originally declined to block SB 190 from taking effect based on the state’s representation that it would not take action against Bella Health until the three boards completed their review. Recently, each board concluded its rulemaking. The pharmacy and nursing boards declined to categorize the treatment as professional or unprofessional, instead opting for a “case-by-case” approach. The board of medicine opted to label the use of progesterone in combination with mifepristone as unprofessional conduct.

The state announced it would not enforce SB 190 through Oct. 23, prompting Bella Health to return to Domenico and ask for a preliminary injunction. The clinic’s lawyers argued the state had chosen to ban the administration of progesterone only in one context, suggesting any concern about safety was minimal or non-existent.

“Here, they’re allowing every other use of progesterone,” said lawyer Mark L. Rienzi of The Becket Fund for Religious Liberty. He added that some pregnant patients may be tricked or coerced into taking mifepristone to induce an abortion, making abortion reversal treatment essential for those who want to keep their pregnancies.

“This is life and death to the women who knock on our door,” he said. “All they’re asking for is, ‘Hey, if there’s something you know of that might help, give it a shot.'”

The state countered by calling abortion reversal “unscientific” and “dangerous,” with few pregnant patients changing their minds after taking mifepristone.

“What is the interest that’s being served by this law?” asked Domenico, a Donald Trump appointee.

“Protecting patients from a procedure that all science says, at best, doesn’t work,” responded Assistant Attorney General Brian Urankar.

Domenico appeared torn about the merits of Bella Health’s claims. On the one hand, he noted the state would not automatically impose stiff penalties on Bella Health for continuing to provide the treatment, nor is the provision of progesterone an inherently religious practice.

“Say this were the reverse. Say they passed a statute banning medication abortion,” Domenico said to the clinic’s lawyers. “A state in general could do that, right?”

On the other hand, Domenico noted the legislature had taken the unusual step of declaring a specific medical practice unprofessional, then ordered three bodies of experts to decide whether they disagreed.

“Before this case the state of Colorado let you just sort of figure it out as you went. Now you have a statute that applies to this one use of this drug,” Domenico said. “The plaintiff’s argument is that this one use is mostly done by religious people and the state knew that. And they banned it. And that’s a constitutional problem.”

Mifepristone itself is the subject of litigation elsewhere, and a Trump-appointed judge in Texas received criticism, including from scientists, for the way he applied science to suspend mifepristone’s longstanding federal drug approval this year. Domenico acknowledged the unsettled science surrounding progesterone administration, and suggested he would defer to the judgment of Colorado’s medical board, which is a defendant in the lawsuit.

Domenico will issue a ruling before the state’s non-enforcement period expires on Tuesday.

The case is Bella Health and Wellness et al. v. Weiser et al.