Alabama’s IVF Ruling Proves Abortion Cannot Be Separated From the Rest of Reproductive Healthcare

Focusing on the personhood and rights of a fertilized egg over those of pregnant people limits the ability of all people to build their families as they see fit.

Abortion rights protesters march in Birmingham, Ala., during the March For Reproductive Freedom on May 19, 2019. (Seth Herald / AFP via Getty Images)

As an OB-GYN and abortion provider who cares for patients at all stages of the reproductive life span, I am deeply concerned about the local and national implications of the recent Alabama Supreme Court ruling and its impact on access to fertility care. The court’s opinion that frozen embryos should be considered “extrauterine children” demonstrates why so-called “fetal personhood” arguments are catastrophic not only for abortion access, but for IVF as well.

This court decision—based neither in good science nor good law—exemplifies how the anti-abortion movement negatively affects us all, whether we are seeking to have children or not. It is proof that abortion cannot be siloed separately from the rest of reproductive healthcare, and that the tactics aimed at restricting abortion are the very same ones that had, until this week, brought IVF services in Alabama to a standstill at the state’s three largest providers.

Although Alabama’s governor has now signed into law a bill which purports to offer protection to IVF service providers and recipients, this measure is inadequate, as it fails to address the most problematic aspect of the court ruling—that is, the conflation of frozen embryos with living children. This unresolved false equivalence poses a durable threat to abortion and fertility care alike.

It is therefore essential, now more than ever, that politicians and judges are dedicated to preserving access to full spectrum reproductive healthcare for all.

Abortion providers and advocates warned after Dobbs that the U.S. Supreme Court’s reversal of a constitutional right to abortion would open threats to other reproductive health rights, such as contraception and infertility treatment. By ruling that unimplanted embryos are equivalent to people, the Alabama court has made this threat a reality.

Alabamians are now discovering that the premise of “fetal personhood” is harmful in more ways than one; just as it can be invoked to restrict the right to abortion, so too can it be interpreted in ways that cut off access to fertility care. As a result of the legal Pandora’s Box opened by the court’s decision, Alabama’s major fertility clinics halted IVF services entirely for several weeks, tragically interrupting an untold number of patients’ paths to their desired families. The University of Alabama at Birmingham has stated that their services will remain suspended as they assess the evolving landscape.

What becomes starkly clear is that focusing on the personhood and rights of a fertilized egg over those of pregnant people limits the ability of all people to build their families as they see fit. We are learning in real time that regardless of what one’s reproductive goals are—to become a parent now, later or never—the ability to access comprehensive reproductive health care including abortion is relevant to us all.

We have not yet even begun to fully appreciate the effects that Dobbs will have on the health and well-being of people and families across the country. While this may be the first post-Dobbs ruling to make the case for so-called “fetal personhood” so openly, it is certainly not going to be the last. And although Alabama now has law in place that nominally protects IVF access, the failure of a similar piece of legislation to pass at the federal level just last week demonstrates that this issue is far from resolved.

Yet again, reproductive choice is slated to be a consequential topic during this election season. I implore you to check your voter registration status, to become educated on the policies and people up for election in your jurisdiction, and to think deeply about how limitations on reproductive choice negatively affect each and every one of us. The decision of whether and how to build a family is deeply personal and private, and must be allowed to remain that way.

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Sameera Mokkarala MD MPH is an OB-GYN and a fellow with Physicians for Reproductive Health. She practices in Philadelphia.