A federal appeals court has struck down a key component of a North Carolina abortion law that has been deemed one of the strictest in the country.

Under the 2011 law, abortion providers were required to show the ultrasound and describe the fetus in detail even if the woman “actively averts her eyes and refuses to hear,” which the judge ruled is against the First Amendment.

“This compelled speech, even though it is a regulation of the medical profession, is ideological in intent and in kind,” 4th Circuit Appeals Court Judge J. Harvie Wilkinson wrote in the decision.

“Abortion may well be a special case because of the undeniable gravity of all that is involved, but it cannot be so special a case that all other professional rights and medical norms go out the window,” he wrote.

The abortion law was passed in 2011 over a veto by then-Gov. Bev Perdue (D). It was first blocked in court in fall 2011, and again by a federal district court in January 2014 in a challenge filed by groups including the Center for Reproductive Rights, the American Civil Liberties Union and Planned Parenthood.

The law is one of the strictest in the country, with a 24-hour waiting period and state-mandated counseling. The ruling upholds most other pieces of the law.

Abortion rights groups praised the decision.

“Exam rooms are no place for propaganda and doctors should never be forced to serve as mouthpieces for politicians who wish to shame and demean women,” Nancy Northup, president of the Center for Reproductive Rights, wrote in a statement.