Alabama IVF Ruling Imperils Contraception

The idea that fertilized eggs are people, combined with the misunderstanding of how birth control works, opens the door to outright bans on many common and reliable forms of contraception.

Protesters march to denounce the U.S. Supreme Court decision to end federal abortion rights protections on June 26, 2022, in Los Angeles. (David McNew / Getty Images)

The recent Alabama Supreme Court ruling that frozen embryos created by in vitro fertilization (IVF) are children lays the groundwork for banning most forms of contraception. Citing Bible passages and referring to “God” 41 times, the decision put a halt to fertility treatments in Alabama—but it threatens to have a much broader impact on the ability of people to prevent pregnancy by using contraception.

“If a fertilized egg is a person, then you run into all sorts of risks in terms of birth control,” said Sen. Tammy Duckworth (D-Ill.), who had both of her children using IVF.

“They came for abortion first. Now it’s IVF and next it’ll be birth control,” said Hillary Clinton on social media. 

The anti-abortion movement has for years argued—contrary to medical science—that emergency contraception functions by preventing implantation of a fertilized egg in the uterine wall. In fact, hormonal contraceptives block fertilization by preventing ovulation and thickening the cervical mucus so sperm cannot reach the egg. No forms of contraception, including IUDs, interrupt an established pregnancy, which occurs once the fertilized egg implants in the uterine wall.

The idea that fertilized eggs are people, combined with the misunderstanding of how contraception works, opens the door to outright bans on many of the most commonly-used and reliable forms of contraception, including hormonal birth control pills, rings, patches and injections as well as IUDs and emergency contraception.

“I am fearful that other anti-abortion judges and lawyers will be emboldened by this ruling and try to replicate those efforts,” said Candice Gibson, director of state policy at the Guttmacher Institute.

No form of contraception interrupts an established pregnancy, which occurs once the fertilized egg implants in the uterine wall.

Republican lawmakers have already introduced fetal personhood laws in 25 states this year. These laws would require embryos and fetuses to be treated legally the same as a child. Colorado and Iowa, for example, have proposed bills that would define personhood as beginning at fertilization for homicide and wrongful death laws, with no exceptions for IVF. 

To counter anti-abortion misinformation, the U.S. Food and Drug Administration (FDA) changed the labeling of the emergency contraceptive Plan B One-Step in January 2023 to clarify that the medication does not block implantation of a fertilized egg. The American College of Obstetricians and Gynecologists states on their website, “emergency contraception does not cause abortion.”

In January 2023, the FDA finally changed the labeling of the emergency contraceptive Plan B One-Step, removing an inaccurate statement that the medication may function by blocking a fertilized egg from implanting in the womb.  (Jim Watson / AFP via Getty Images)

Emergency Contraception Restrictions on the Rise

Nevertheless:

  • Nine states have adopted restrictions on emergency contraception—including one state excluding emergency contraception from the services to be covered in the state’s family planning program, and two states excluding emergency contraception from their contraceptive coverage mandate.
  • Seven states explicitly allow pharmacists to refuse to dispense contraceptives.
  • Pennsylvania allows hospitals to refuse to provide emergency contraception to sexual assault survivors.
  • Only 13 states protect the right to contraception.

Anti-abortion forces have fought increased access to contraception for over a decade. After the Obama administration instituted a contraceptive mandate under the Affordable Care Act in 2012, conservative groups fought for years to win religious exemptions from having to cover emergency contraception and IUDs in their health insurance plans. In the 2014 ruling in Burwell v. Hobby Lobby Stores, the Supreme Court upheld Hobby Lobby’s religious objection claim. 

In 2017, the Trump administration creative vast “moral and religious” exemptions to the contraception mandate. In 2020, the Supreme Court upheld these exemptions in Little Sisters of the Poor v. Pennsylvania

In June of 2021, during floor debates about a bill to require the Department of Veterans Affairs to cover the cost of all forms of contraception, including emergency contraception, U.S. Rep. Marjorie Taylor Greene (R-Ga.) incorrectly stated, “The Plan B pill kills a baby in the womb once a woman is already pregnant.”

Many prosecutors across the country are already using child abuse and neglect laws to prosecute pregnant women who lose pregnancies or who are suspected of using drugs. They may soon start prosecuting people for using contraception. 

Project 2025, a coalition of conservative groups led by the The Heritage Foundation, has published a detailed agenda for the next Republican president, revealing their plans to attack access to contraception, including emergency contraception and even condoms, and instead promote notoriously unreliable “fertility awareness-based methods and supplies” (see pages 483-485).

Long before Roe fell, feminists have been sounding the alarm about the insidious implications of fetal personhood laws. It’s long past time to heed these warnings.

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About

Carrie N. Baker, J.D., Ph.D., is the Sylvia Dlugasch Bauman professor of American Studies and the chair of the Program for the Study of Women and Gender at Smith College. She is a contributing editor at Ms. magazine. You can contact Dr. Baker at cbaker@msmagazine.com or follow her on Twitter @CarrieNBaker.