Opinion
ARABIAN, J. In Planned Parenthood Shasta-Diablo, Inc. v. Williams (1994) 7 Cal.4th 860 [30 Cal.Rptr.2d 629, 873 P.2d 1224] (Planned Parenthood I), this court upheld an injunction limiting the protest activities of petitioners, anti-abortion activists, to the sidewalk across the street from a women’s health clinic operated by Planned Parenthood, Shasta-Diablo, Inc. [1012](Planned Parenthood). Thereafter, the United States Supreme Court announced its decision in Madsen v. Women’s Health Center, Inc. (1994) 512 U.S. _ [129 L.Ed.2d 593, 114 S.Ct. 2516] (Madsen), which upheld, under a slightly stricter constitutional standard than we applied in Planned Parenthood I, an injunction creating a buffer zone of 36 feet around a women’s health clinic, thereby effectively restricting the anti-abortion protesters in that case to the other side of the street from the clinic. (512 U.S. at p. _ [129 L.Ed.2d at pp. 609-611, 114 S.Ct. at pp. 2526-2527].)
Petitioners herein petitioned the United States Supreme Court for a writ of certiorari. The Supreme Court granted certioriari, vacated our earlier judgment, and remanded the cause to this court “for further consideration in light of’ Madsen. ((1994) _ U.S. _ [130 L.Ed.2d 329, 115 S.Ct. 413].) We requested and received supplemental briefing from the parties addressed to this topic. Having now reconsidered the matter, we are persuaded that the injunction we upheld in Planned Parenthood I, supra, 1 Cal.4th 860, is equally valid under the new standard set forth in Madsen. We therefore reaffirm the judgment in favor of Planned Parenthood.
I.
The facts are set forth in full in Planned Parenthood I, supra, 1 Cal.4th 860, and will be repeated here only insofar as they are relevant to the remand.
Planned Parenthood operates a family planning clinic in Vallejo. The clinic provides a range of family planning and health services, including abortions. The clinic is located in a one-story building. The entrance to the clinic is on the side of the building adjacent to a parking lot. There is a concrete yard for additional parking immediately in the front of the building, and a narrow public sidewalk between the yard and the street. The sidewalk is punctuated by two driveways into the parking lot. (Planned Parenthood I, supra, 7 Cal.4th at p. 865.)
Beginning in March 1990, petitioners began gathering at the clinic, primarily on Thursdays when abortions were performed, to picket and demonstrate against abortions. Although their numbers varied, there were usually six to eight demonstrators at any given time, and occasionally as many as one hundred. Petitioners picketed on the public sidewalk in front of the clinic as well as in the parking lot. One of the tactics of the sidewalk picketers was to walk slowly across the driveway entrance, thereby delaying cars attempting to turn into the parking lot from the street. Demonstrators would then approach the car and attempt to pass literature through the [1013]windows. Other protesters pursued patients walking from their cars to the clinic entrance, as well as along the sidewalk and across the street to the bus stop, offering “sidewalk counseling.” Such “counseling” consisted of pressing anti-abortion literature and plastic replicas of fetuses on patients attempting to enter the clinic and exhorting them to reconsider their decision to have an abortion. Petitioners also stationed several sidewalk “counselors” directly outside the clinic entrance for the same purpose. (Planned Parenthood I, supra, 1 Cal.4th at pp. 865-866.) A witness for petitioners testified that picketing on the sidewalk in front of the clinic was impractical because the sidewalk crossed both driveways; thus, even a few picketers “would impede traffic on Broadway, being a busy street, [and] would probably cause traffic accidents.”
In response to Planned Parenthood’s complaint for injunctive relief, the trial court initially issued in August 1990 a temporary restraining order enjoining petitioners from harassing any person entering or leaving the building and limiting their picketing to the sidewalk in front of the building. Following a hearing in September, the court granted a preliminary injunction limiting to four the number of pickets that petitioners could maintain on the sidewalk and restricting their proximity to one another. Trial on the complaint for a permanent injunction was held in April 1992. Testimony was received from Janice Schoenfeld, the escort coordinator for the clinic, who stated that the demonstrators had generally complied with the preliminary injunction “except for picketers.” Marsha Anderson, the clinic director, testified that she had been forced to call the police to enforce the preliminary injunction, “ ‘to hand it out to people who were on the sidewalk and were about to break the rules,’” or breaking the rules. (Planned Parenthood I, supra, 1 Cal.4th at pp. 866-867, fn. 2.) The clinic was compelled to employ “escorts” to help patients enter and leave the clinic without being physically accosted by demonstrators.
Following trial, the court made findings that petitioners had (1) confronted and intimidated women seeking the clinic’s services and forced plastic replicas of fetuses and “counseling” upon the clinic’s patients and staff; (2) interfered with or obstructed entrance to and exit from the clinic; (3) pursued patients to their cars and public transportation to distribute literature and plastic fetuses; and (4) caused some of the women seeking medical services to become emotionally distraught. Based on these findings, the trial court granted a permanent injunction against petitioners. Among other provisions, the injunction restricted their picketing, demonstrating and counseling activities to the public sidewalk across the street from the clinic. (Planned Parenthood I, supra, 7 Cal.4th at pp. 866-867.)
[1014]Although the Court of Appeal invalidated certain other provisions of the injunction, it sustained the place restriction, concluding that it served a substantial governmental interest in safeguarding a woman’s fundamental right to procreative choice under article I, section 1, of the California Constitution, and was narrowly tailored to serve that end. (Planned Parenthood I, supra, 7 Cal.4th at pp. 867-868.)
We granted review and affirmed the judgment of the Court of Appeal, but on slightly different grounds. We applied what was then the settled four-part test to determine the constitutional validity of a time, place, and manner restriction limiting such speech activities as picketing and leafleting in a public forum. (See Ward v. Rock Against Racism (1989) 491 U.S. 781, 791 [105 L.Ed.2d 661, 675, 109 S.Ct. 2746]; Clark v. Community for Creative Non-Violence (1984) 468 U.S. 288, 293 [82 L.Ed.2d 221, 226-227, 104 S.Ct. 3065].) Under that standard, the first issue to be determined is whether the restriction is content neutral, that is, whether it regulates “without reference to the content of the regulated speech.” (Via. Pharmacy Bd. v. Via. Consumer Council (1976) 425 U.S. 748, 771 [48 L.Ed.2d 346, 364, 96 S.Ct. 1817].) We concluded that the place restriction was content neutral, observing that it made no reference to petitioners’ viewpoint, but focused exclusively on the location and manner of their protest activities. (Planned Parenthood I, supra, 7 Cal.4th at pp. 869-871.) Petitioners’ contention that the injunction was content based because it was impelled by, and directed exclusively against, their anti-abortion activities was similarly rejected. As we explained, the injunction was properly confined to petitioners as “they were the only ones found to have harassed clinic patients and staff.” (Id. at p. 870.) It was not their point of view, but their harassing and confrontational conduct that impelled the restriction. “Indeed, a similar injunction might just as readily apply to pro-choice demonstrators or to any other disruptive protest in close . . . proximity to the clinic.” (Id. at p. 871.)
We next considered whether the restriction served a significant governmental interest, and concluded that the buffer zone was amply justified by the significant state interest in preserving the health and safety of patients entering and leaving a medical facility for purposes of receiving treatment, including clinical abortions. As we observed, “the government ‘may properly assert important interests in safeguarding health’ and ‘in maintaining medical standards’ in the performance of abortions. [Citation.] The state has a ‘legitimate interest in seeing to it that an abortion, like any other medical procedure, is performed under circumstances that insure maximum safety for the patient.’ ” (Planned Parenthood I, supra, 7 Cal.4th at p. 873, quoting Roe v. Wade (1973) 410 U.S. 113, 150 [35 L.Ed.2d 147, 175, 93 S.Ct. 705], italics added.)
[1015]In this regard, we noted the substantial line of authority approving the imposition of reasonable buffer zones around family planning clinics to prevent health-threatening physical confrontations with, and intimidation of, patients entering and leaving the facilities. (Planned Parenthood I, supra, 7 Cal.4th at pp. 874-875, 877.) The record and the trial court’s findings plainly indicated that this was one of the primary purposes of the place restriction, “to constrain petitioners’ confrontational tactics and thereby limit the physical intimidation of, and resulting emotional trauma to, the clinic’s patients.” (Id. at p. 875.)
We next examined the injunction to determine whether it was sufficiently narrowly tailored to achieve the expressed governmental interests. We concluded that the buffer zone was necessary to ameliorate the health and safety threat posed by petitioners’ aggressive, confrontational tactics, and that lesser means, such as limiting the number of protesters on the sidewalk, would not have accomplished this end. “[T]he state’s interest in protecting the patients required the preclusion of face-to-face, physical confrontations with the protesters.” (Planned Parenthood I, supra, 7 Cal.4th at p. 879, fn. 10.)
Finally, we concluded that the injunction left petitioners adequate alternative avenues of communication, observing that the site across the street afforded them a vantage from which to picket and leaflet that was “reasonably close to the clinic and, judging from the photographic exhibits in the record, within plain view of their target audience, the clinic patients and staff.” (Planned Parenthood I, supra, 7 Cal.4th at p. 880-881.) Nothing indicated that their signs would not be clearly visible or that their presence and views would not be readily perceived by persons entering and leaving the clinic. (Ibid.)
We thus held that the buffer zone satisfied all of the relevant constitutional criteria, and affirmed the judgment of the Court of Appeal.
II.
To reconsider our decision in light of Madsen, as directed by the high court, necessarily requires a review of the court’s opinion in that case in some detail.
In Madsen, the respondent, an abortion clinic located on a public street called “Dixie Way” in Melbourne, Florida, sought and obtained an injunction against the petitioners, anti-abortion protesters who had picketed and demonstrated outside the clinic. The initial injunction permanently enjoined [1016]petitioners from blocking or interfering with access to the clinic or from physically abusing persons entering or leaving the clinic. Six months later, the trial court issued a broader injunction in response to respondent’s allegations that “access to the clinic [for some women] was still impeded by petitioners’ activities and that such activities . . . had deleterious physical effects on others.” (Madsen, supra, 512 U.S. _ [129 L.Ed.2d at p. 603, 114 S.Ct. at p. 2521].) The number of protesters outside the clinic varied from day to day, ranging from a handful to 400. (Ibid.) The evidence showed, and the trial court found, that as traffic attempted to turn from Dixie Way into the clinic, protesters would force them to slow and attempt to pass antiabortion literature to the occupants; that patients and staff would be followed in a stalking manner, giving such persons a feeling of great apprehension; and that “as a result of having to run such a gauntlet to enter the clinic, the patients ‘manifested a higher level of anxiety and hypertension . . . .’” (Ibid.; see Operation Rescue v. Women’s Health Center (Fla. 1993) 626 So.2d 664, 667-669 [setting forth the full text of the trial court’s findings].)
This and other evidence led the state trial court to conclude that its original injunction was insufficient to “ ‘protect the health, safety and rights of women . . . seeking access to [medical and counseling] services.’” (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at p. 603, 114 S.Ct. at p. 2521].) Accordingly, the trial court expanded the injunction by providing that the protesters were prohibited from entering the clinic’s premises; blocking access to the clinic; congregating, picketing, patrolling, demonstrating or entering within 36 feet of the property line of the clinic, thereby effectively forcing the petitioners to the other side of Dixie Way; singing, chanting, shouting or employing sound amplification equipment or images observable to or within earshot of patients during business hours; approaching physically within 300 feet of the clinic any person seeking the services of the clinic unless such person indicated a desire to communicate by approaching or by inquiring of the petitioners; and physically abusing, intimidating, harassing, crowding or assaulting patients, owners or staff of the clinic. (Id. at pp. _ [129 L.Ed.2d at pp. 603-605, 114 S.Ct. at pp. 2521-2522].) The injunction also included restrictions on similar activities within 300 feet of the residence of any owner, staff member, or employee of the clinic. (Ibid.)
The Supreme Court of Florida upheld all portions of the expanded injunction against a free speech challenge. (Operation Rescue v. Women’s Health Center, supra, 626 So.2d at pp. 675-676.)
After granting certiorari (510 U.S. _ [127 L.Ed.2d 98, 114 S.Ct. 907]), the United States Supreme Court upheld certain provisions of the injunction [1017]and struck down others. First, the high court determined that the injunction was content neutral, rejecting the petitioners’ assertion that because it restricted only the activities of anti-abortion protesters, the injunction was necessarily content based. As the court explained, an injunction “by its very nature, applies only to a particular group (or individuals) and regulates the activities, and perhaps the speech, of that group. . . . [¶] The fact that the injunction in the present case did not prohibit activities of those demonstrating in favor of abortion is justly attributable to the lack of any similar demonstrations by those in favor of abortion . . . There is no suggestion in this record that Florida law would not equally restrain similar conduct directed at a target having nothing to do with abortion; none of the restrictions imposed by the court were directed at the contents of petitioners’ message.” (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at p. 606, 114 S.Ct. at p. 2523].)
The high court then observed that if the underlying action had involved a generally applicable statute, instead of an injunction, it would proceed to assess its constitutionality under the standard set forth Ward v. Rock Against Racism, supra, 491 U.S. 781, 791 [105 L.Ed.2d 661, 675], to wit, whether the time, place and manner regulation “ ‘was narrowly tailored to serve a significant governmental interest.’ ” (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at p. 607, 114 S.Ct. at p. 2524].) However, citing certain differences between injunctions and generally applicable statutes, the court concluded that a different standard was required. Injunctions, the court observed, “carry greater risks of censorship and discriminatory application than do general ordinances” and represent judicial remedies tailored to specific circumstances rather than “a legislative choice regarding the promotion of particular societal interests.” (Ibid.) These differences, the Madsen court determined, “require a somewhat more stringent application of general First Amendment principles . . . .” (Ibid.) Accordingly, the court held that the test to be applied in evaluating a content neutral injunction should be “whether the challenged provisions of the injunction burden no more speech than necessary to serve a significant government interest.” (Id. at p. _ [129 L.Ed.2d at p. 608, 114 S.Ct. at p. 2525].)
Applying this test to the Florida clinic restrictions, the high court agreed with the Florida Supreme Court’s conclusion that the state’s “strong interest in protecting a woman’s freedom to seek lawful medical or counseling services in connection with her pregnancy,” ensuring “safety and order,” and “promoting the free flow of traffic on public streets and sidewalks” was more than sufficient to justify an appropriately tailored injunction. (512 U.S. at p. _ [129 L.Ed.2d at pp. 609-610, 114 S.Ct. at p. 2526].) The court then [1018]turned to whether the specific restrictions imposed on the petitioners’ activities burdened no more speech than necessary to achieve those goals.
The high court first held that the 36-foot buffer zone represented a valid means of “protecting unfettered access to and egress from the clinic, and ensuring that petitioners do not block traffic on Dixie Way.” (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at p. 610, 114 S.Ct. at p. 2527].) The court found significant in this regard the fact that the protesters were involved in highly “focused” picketing “directed primarily at patients and staff of the clinic.” (Ibid.) The court noted that it had long distinguished “between the type of focused picketing banned from the buffer zone and the type of generally disseminated communication that cannot be completely banned in public places, such as handbilling and solicitation.” (Ibid.)
The Supreme Court also recognized that the trial court appeared to have had few other practical options “given the narrow confines around the clinic” (512 U.S. at p. _ [129 L.Ed.2d at pp. 610-611, 114 S.Ct. at p. 2527]), and noted that the trial court “was convinced that allowing the petitioners to remain on the clinic’s sidewalk was not a viable option in view of the failure of the first injunction to protect access.” (Ibid.) Although the high court acknowledged that the need for a complete buffer zone might be “debatable,” it held that “some deference must be given to the state court’s familiarity with the facts and the background of the dispute between the parties even under our heightened review.” (Ibid.) The court also noted that the buffer zone was narrow enough that protesters across the street could still “be seen and heard from the clinic parking lots.” (Ibid.) Thus, the high court concluded that the buffer zone burdened “no more speech than necessary to accomplish the governmental interest at stake.” (Ibid.)
The Madsen court also upheld the limited noise restrictions around the clinic, citing the state’s strong interest in maintaining a relatively tranquil environment outside a medical facility “during surgery and recovery periods.” (512 U.S. at p. _ [129 L.Ed.2d at p. 612, 114 S.Ct. at p. 2528].) As the court observed, the “First Amendment does not demand that patients at a medical facility undertake Herculean efforts to escape the cacophony of political protests.” (Ibid.) Thus, the court held that the restrictions burdened no more speech than necessary to “ensure the health and well-being of the patients at the clinic.” (Ibid.)
The high court then proceeded to strike down several other provisions of the injunction, notably that portion of the 36-foot buffer zone that included certain private property abutting the clinic, and the ban on all “images [1019]observable” to patients inside the clinic. The court concluded that neither restriction appeared necessary to protect either access to the clinic or patient health and safety. (512 U.S. at p. _ [129 L.Ed.2d at pp. 611-613, 114 S.Ct at pp. 2528-2529].) The court also found impermissible the ban on all uninvited approaches to patients within 100 yards of the clinic, observing that it was broader “than is necessary to prevent intimidation and to ensure access to the clinic.” (Id. at p. _ [129 L.Ed.2d at p. 613, 114 S.Ct. at p. 2529].) Similarly, the high court found that the 100-yard buffer zone around the residences of clinic owners and staff was unnecessarily large, and observed that a “smaller zone could have accomplished the desired result.” (Id. at p. _ [129 L.Ed.2d at p. 614, 114 S.Ct. at p. 2530].)
Finally, the high court summarily rejected vagueness, overbreadth, and ffeedom-of-association challenges to the injunction. (512 U.S. at p. _ [129 L.Ed.2d at pp. 614-615, 114 S.Ct. at p. 2530].)1
III.
We turn now to the question whether the injunction that we upheld in Planned Parenthood I, supra, 1 Cal.4th 860, remains valid under Madsen, supra, 512 U.S. _ [129 L.Ed.2d 593, 114 S.Ct. 2516].
A. The Place Restrictions Are Content Neutral
As to the threshold issue of content neutrality, we note that our analysis in Planned Parenthood I, supra, 7 Cal.4th 860, is entirely consistent with the high court’s reasoning and conclusion in Madsen, supra, 512 U.S. _ [129 L.Ed.2d 593, 114 S.Ct. 2516]. There, as here, the injunction was issued in response to petitioners’ physical harassment and intimidation of clinic patients. There, as here, the injunction was impelled solely by the petitioners’ course of conduct, not by the content of their speech. Neither injunction made any reference whatsoever to petitioners’ anti-abortion viewpoint. Thus, the Madsen court’s conclusion that the buffer zone was content neutral fully comports with our like conclusion in Planned Parenthood I, supra, 7 Cal.4th at page 871. The petitioners’ assertion that an injunction directed exclusively against a particular ideological group is necessarily content based was [1020]rejected as spurious in each case. (Madsen, supra, 512 U.S. at p._[129 L.Ed.2d at pp. 606-607, 114 S.Ct. at p. 2524]; Planned Parenthood I, supra, 7 Cal.4th at p. 870.)
Petitioners also reassert the argument, raised and rejected in Planned Parenthood I, supra, 7 Cal.4th 860, that a buffer zone justified in part on sheltering patients from the “emotional impact” of anti-abortion speech is necessarily content based. Once again, petitioners misapprehend the basis of the place restriction at issue. The purpose of the injunction, as the trial court made plain, was to ameliorate the confrontational tactics of petitioners and to prevent the physical intimidation that resulted in higher stress and anxiety. The target was thus petitioners’ physical tactics, not their anti-abortion message. As we explained, “a similar injunction might just as readily apply to pro-choice demonstrations or to any other disruptive protest in close physical proximity to the clinic.” (Planned Parenthood I, supra, 7 Cal.4th at p. 871.)
B. Significant State Interests Support a Limited Buffer Zone
As to the nature and purpose of the place restrictions themselves, the holdings in Planned Parenthood I, supra, 1 Cal.4th 860, and Madsen, supra, 512 U.S. _ [129 L.Ed.2d 593, 114 S.Ct. 2516], are also consistent. Madsen conclusively affirmed the principle which many lower courts—including our own—had previously endorsed, that a narrowly drawn “buffer zone” around a family planning clinic may be justified if it advances significant state interests. The factual parallels between Madsen and the case at bar are indeed striking. In both cases, petitioners engaged in highly focused picketing and sidewalk “counseling” directed to patients and staff in various areas in front of the clinic, including the sidewalk and the driveways providing access to the parking lot. (Madsen, supra, 512 U.S. _ [129 L.Ed.2d at pp. 603-604, 114 S. Ct. at p. 2521]; Planned Parenthood I, supra, 1 Cal.4th at p. 866.) In both cases, petitioners impeded access to the clinic and blocked traffic by marching across the driveways, causing traffic to slow so that petitioners could approach vehicles and hand literature to the occupants. (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 603-604, 114 S.Ct. at p. 2521]; Planned Parenthood I, supra, 7 Cal.4th at p. 866.) In both cases, petitioners physically stalked patients attempting to enter the clinic, causing higher levels of stress and anxiety. (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 603-604, 114 S.Ct. at p. 2521]; Planned Parenthood I, supra, 7 Cal.4th at pp. 866-867.) In both cases, evidence concerning the petitioners’ activities following issuance of the original injunction led the trial court to conclude that a broader restriction was necessary to accomplish its goals. [1021](Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 603-604, 114 S.Ct. at p. 2521]; Planned Parenthood I, supra, 1 Cal.4th at pp. 866-867.) In both cases, the trial court limited the petitioners’ activities to the opposite side of the street from the clinic; in Madsen, the buffer zone prohibited petitioners from picketing, patrolling, demonstrating or entering within 36 feet of the property line of the clinic, effectively forcing petitioners to “move to the other side of Dixie Way . . .” (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 609-610, 114 S.Ct. at pp. 2526]); here, the buffer zone limited petitioners’ protest activities to the public sidewalk on the opposite side of Broadway. (Planned Parenthood I, supra, 7 Cal.4th at p. 867.) Although the record provided by the parties does not disclose the precise parameters of the buffer zone thus created, we have taken judicial notice of official maps maintained by the Public Works Department of the City of Vallejo which show the distance across Broadway to be 60 feet.2 Thus, the 2 restrictions were essentially equivalent in size and function, the disparity between 36 and 60 feet—or approximately 8 yards—representing a relatively small difference in degree, attributable solely to the differing widths of the streets in question.3
Thus, Madsen strongly supports the conclusion that the buffer zone in this case was amply justified by at least two significant governmental interests. First, as we previously held in Planned Parenthood I, supra, 7 Cal.4th 860, the buffer zone was necessary to ensure “safety and order” in the relatively restricted physical area surrounding the clinic, an interest expressly recognized by the high court as supportive of the place restriction in Madsen. (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 609-610, 114 S.Ct. at p. 2526].) Indeed, in upholding the corollary noise restriction imposed by the Florida trial court, the high court observed that the state has a strong interest in maintaining a relatively tranquil environment for patients “during surgery and recovery periods.” (Id. at p. _ [129 L.Ed.2d at pp. 611-612, 114 S.Ct. at p. 2528].) The First Amendment does not, in the high court’s words, “demand that patients at a medical facility undertake Herculean efforts to escape the cacophony of political protests.” (Ibid.)
[1022]As the high court further recognized, a buffer zone may also be justified as a means of “protecting unfettered access to and egress from the clinic, and ensuring that petitioners do not block traffic . . . (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 610, 114 S.Ct. at p. 2527].) Although this was not cited as a basis for upholding the injunction in Planned Parenthood I, supra, 7 Cal.4th 860, since the state’s interest in protecting the patients’ health and safety was deemed to be a sufficient interest to uphold the place restriction, the parallels with Madsen in this regard cannot be overlooked. There, as here, the close physical confines of the area surrounding the clinic limited the trial court’s options. The evidence here disclosed that the sidewalk in front of the clinic is quite short and punctuated by two driveways, so that even one or two picketers could effectively block pedestrian or vehicular traffic. Indeed, there was evidence that the more limited preliminary injunction had not been complied with, and the trial court found that petitioners had, in fact, interfered with and obstructed entrance to and exit from the clinic. (Planned Parenthood I, supra, 1 Cal.4th at p. 867.) The buffer zone was thus the only practicable means of ensuring unfettered access.
In sum, therefore, we find that Madsen provides compelling reinforcement of our earlier conclusion that the buffer zone in this case was amply warranted by the facts and the governmental interests at stake.
Petitioners’ arguments to the contrary are unpersuasive. They would have us read Madsen for the proposition that a limited buffer zone is permissible only where the record reveals that patients have been physically prevented from gaining access to a medical facility. Since nothing in the record here reveals that any woman was ever physically denied access, petitioners contend that Madsen is critically distinguishable from the case at bar, and affirmatively invalidates the instant injunction.
Petitioners misread Madsen in several respects. First, petitioners are incorrect in asserting that Madsen requires proof that patients have been denied access to medical attention. The Florida trial court in Madsen determined that the petitioners had significantly “interfered” with access to and egress from the clinic by means of a number of harassing tactics, and that several women had initially turned away, only to return at a later date. There was no finding, however, that any woman had been physically denied access to the clinic or medical attention. (Operation Rescue v. Women’s Health Center, supra, 626 So.2d at pp. 666-669.) The United States Supreme Court held, in turn, that the 36-foot buffer zone was necessary to protect “unfettered” access to and egress from the clinic. (512 U.S. at p. _ [129 L.Ed.2d at p. 610, 114 S.Ct. at p. 2527].)
[1023]Thus, contrary to petitioners’ assertion, Madsen does not require evidence that patients have been physically barred from obtaining medical treatment as a precondition to the establishment of a limited buffer zone. It is sufficient, as the trial court found here, that petitioners had significantly blocked driveways, surrounded patients’ cars, and stalked and obstructed patients walking to and from their cars and public transportation, and had thereby significantly “interfered” with clinic access. (Planned Parenthood I, supra, 1 Cal.4th at p. 867.)
Nor, as petitioners urge, does Madsen undermine this court’s conclusion in Planned Parenthood I, supra, 7 Cal.4th 860, that the buffer zone was justified by the state’s interest in protecting the health and safety of medical patients, particularly those about to undergo surgery with all the physical and emotional strains and medical risks attendant thereto. Indeed, in upholding the noise provisions of the injunction in Madsen, the high court relied on the same precedents that we cited in Planned Parenthood I, supra, 7 Cal.4th at page 873 (Groyned v. City of Rockford (1972) 408 U.S. 104, 116 [33 L.Ed.2d 222, 232, 92 S.Ct. 2294]; Beth Israel Hospital v. NLRB (1978) 437 U.S. 483, 509 [57 L.Ed.2d 370, 390-391, 98 S.Ct. 2463] (conc. opn. of Blackmun, J.); NLRB v. Baptist Hospital, Inc. (1979) 442 U.S. 773 [61 L.Ed.2d 251, 99 S.Ct. 2598]) for the principle that “[t]he nature of a place, ‘the pattern of its normal activities, dictate the kinds of regulations . . . that are reasonable.’ ” (Groyned v. City of Rockford, supra, 408 U.S. at p. 116 [33 L.Ed.2d at p. 232], fn. omitted; Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 611-612, 114 S.Ct. at p. 2528].) Recognizing the “emotional strain and worry” that naturally afflict patients entering and leaving medical facilities, particularly “during surgery and recovery periods” (512 U.S. at p. _ [129 L.Ed.2d at pp. 611-612, 114 S.Ct. at p. 2528]), the Madsen court held that the restriction was necessary “to ensure the health and well-being of the patients at the clinic.” (Ibid.)
The high court’s reasoning applies with equal force here, where physical confrontations with protesters moments before receiving medical treatment, including surgical procedures, subjected patients to heightened stress and anxiety. The state’s recognized interest in protecting the “health and well being of the patients” at the clinic (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 611-612, 114 S.Ct. at p. 2528]) represents a sufficiently important interest to justify the limited buffer zone imposed by the trial court in this case.
C. The Buffer Zone Burdened No More Speech Than Necessary
Finally, we consider whether the buffer zone satisfies the “somewhat more stringent” (512 U.S. at p. _ [129 L.Ed.2d at pp. 606-607, 114 S.Ct. at p. [102425]24]) test articulated by the high court in Madsen, i.e., did it “burden no more speech than necessary” to accomplish the state’s interests? (Id. at p. _ [129 L.Ed.2d at pp. 607-608, 114 S.Ct. at p. 2525].) We conclude, on balance, that the restriction more than meets this heightened standard.
The physical layout of the clinic and its environs included relatively short narrow sidewalks in front of the clinic, punctuated by two driveways into the clinic parking lot. The evidence established that one or two pickets could effectively block passage along the sidewalk and impede traffic. In its preliminary injunction the trial court had allowed four interspersed picketers to remain on the sidewalk in front of the clinic. However, the evidence at trial indicated that picketers had not followed the preliminary injunction and the clinic director stated that police had been called “to issue the injunction a couple of times ... to people who were on the sidewalk and were about to break the rules, or breaking the rules.” (Planned Parenthood I, supra, 7 Cal.4th at pp. 866-867, fn. 2.) The court also heard testimony that petitioners had physically followed and surrounded patients, interfered with clinic access, and caused heightened stress and anxiety in clinic patients.
The trial court was thus required to craft an injunction that more effectively protected the state’s interests in protecting unimpeded access to the clinic and the well-being of clinic patients, while simultaneously preserving petitioners’ right to communicate their message to clinic patients and staff. A less restrictive alternative had been tried and found wanting. A minimal buffer zone was clearly a reasonable and necessary means of ameliorating the confrontational tactics of petitioners. The site across the street was in plain view of persons entering and leaving the clinic and afforded petitioners a reasonable vantage from which to communicate their viewpoint without subjecting patients to physical intimidation. On balance, therefore, we hold that the buffer zone burdened no more speech than necessary to accomplish the governmental interests at stake. (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 610-611, 114 S.Ct. at p. 2527].)
Although petitioners contend otherwise, Madsen fully supports this conclusion. There, as here, the trial court was confronted with a relatively restricted geographic area in front of the family planning clinic, physical harassment of patients occurring within these narrow confines, and an earlier injunction that had not proved to be successful. The high court held that, in these circumstances, a 36-foot buffer zone ensuring unimpeded access to the clinic by restricting petitioners to the opposite side of the street was amply justified. As summarized above, the facts here similarly justified a limited buffer zone to ensure patient access and prevent intimidation.
[1025]Petitioners also contend that the buffer zone cannot be upheld as necessary to preclude health-threatening physical confrontations between patients and protesters without running afoul of Madsen's separate holding that the 100-yard “no approach” zone in that case was invalid. To recall, the Florida court, in addition to prohibiting protesters from entering anywhere within 36-feet of the clinic, also ordered petitioners to refrain from physically approaching any patient within 100 yards of the clinic unless such person indicated a desire to communicate. (Madsen, supra, 512 U.S. at p. _ [129 L.Ed.2d at pp. 604-605, 114 S.Ct. at p. 2522].) The high court held that this “no approach zone” was overbroad, since it appeared to forbid contact within an exceptionally large geographic area without sufficient evidence of its necessity. As the high court observed, “it burdens more speech than is necessary to prevent intimidation and to ensure access to the clinic.” (Id. at p. _ [129 L.Ed.2d at p. 613, 114 S.Ct. at p. 2529].) In contrast, the evidence here amply supported the conclusion that a buffer zone of some 60 feet, like the analogous 36-foot zone in Madsen, was necessary to “prevent intimidation and to ensure access to the clinic.” (Ibid.) Nothing in Madsen undermines this conclusion.
Finally, our conclusion in Planned Parenthood I, supra, 7 Cal.4th at pages 880-881, that the injunction leaves petitioners adequate alternative means of reaching their target audience remains unchanged in light of Madsen. From their vantage across the street petitioners may convey their anti-abortion message to clinic patients and staff, without obstructing access to the clinic or physically intimidating patients in the process.4
Conclusion
The place restriction upheld by this court in Planned Parenthood I, supra, 7 Cal.4th 860, fully comports with the holding of the United States Supreme Court in Madsen, supra, 512 U.S. _ [129 L.Ed.2d 593, 114 S.Ct. 2516]. Accordingly, we reaffirm the judgment of the Court of Appeal.
Lucas, C. J., Mosk, J., Baxter, J., George, J., and Strankman, J.,* concurred.
We note that three Justices would have found the injunction to be content based and thus would have applied a strict-scrutiny standard to determine its constitutional validity. (512 U.S. at pp. _, _ [129 L.Ed.2d at pp. 622-627, 114 S.Ct. at pp. 2537-2540] (conc. & dis. opn. of Scalia, J., joined by Kennedy and Thomas, JJ.) Another justice would have adopted a less, rather than a more, stringent standard for assessing whether an injunction survives a free speech challenge. (Id. at pp. _ [129 L.Ed.2d at pp. 615-616, 114 S.Ct. at pp. 2531-2534] (conc. & dis. opn. of Stevens, J.).)
In accordance with Evidence Code section 459, subdivisions (c) and (d), the parties have been given notice and an opportunity to be heard on the issue of judicial notice of the map in question. We find the law to be well settled that trial or reviewing courts may properly notice government maps and surveys. (Evid. Code, §§ 452, subd. (h), 459; Merritt v. Barta (1910) 158 Cal. 377, 381 [111 P. 259]; People v. Southern Pacific Co. (1918) 177 Cal. 555, 558 [171 P. 294]; South Shore Land Co. v. Petersen (1964) 226 Cal.App.2d 725, 745 [38 Cal.Rptr. 392].)
The relevant distance is the 60 feet between the sidewalk in front of the clinic and the sidewalk across the street. As the record and the trial court’s findings make clear, the sidewalk in front of the clinic is the site where most of petitioners’ target audience—the clinic patients and staff—had been approached as they entered and left the clinic either on foot or in their vehicles.
Petitioners also rely on a recent federal decision, Pro-Choice Network v. Schenck (2d Cir. 1994) 34 F.3d 130, in which the court held that the record evidence did not support imposition of a buffer zone outside a woman’s health clinic. That decision has been withdrawn, however, pending rehearing in bank.
Presiding Justice, Court of Appeal, First District, Division One, assigned by the Acting Chairperson of the Judicial Council.