Bearded, unkempt and cuffed at the legs and arms, Mr. Dear frequently disrupted the proceedings in state court here, shouting out declarations of anger and defiance.

“I’m guilty. There’s no trial. I’m a warrior for the babies,” he yelled at one point. “Let it all come out. The truth!” he yelled at another.

As Judge Gilbert A. Martinez discussed a pretrial publicity order, Mr. Dear shouted: “Could you add the babies that were supposed to be aborted that day? Could you add that to the list?”

It was the first in-person appearance in court for Mr. Dear since his arrest on Nov. 27 after the attack on the clinic, which left three people dead and nine wounded. He was arrested by the police after a tense, hourslong, nationally televised standoff.