Moving forward from Alabama’s mindblowing setback to women’s health 



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Women’s health in America can’t catch a break. 

In the same week that First Lady Jill Biden announced $100 million in federal funding for women’s health research and development, the Alabama Supreme Court ruled that embryos are children, effectively freezing access to fertility treatment for women in that state. 

While the federal investment in women’s health research took women’s health one important step forward, Alabama’s court has taken women’s health two steps back.

At issue is in vitro fertilization (IVF), a complex process that can lead to pregnancy in those facing infertility. IVF typically involves hormone injections and procedures to retrieve eggs, fertilize them and implant one or more of the resulting embryos into a woman’s uterus. 

The process usually generates more embryos than can be or are implanted. From a broader pool of embryos, health care providers may choose the healthiest, most viable ones to implant. What clinics can do with those “extra” embryos is the crux of the issue. Typically, unimplanted embryos are stored for a time and then ultimately disposed of. 

If those embryos are considered people, then how can they be disposed of without the threat of legal consequences? Clinics facing potential criminal prosecution for what has up till now been standard practice in IVF treatment are pausing those services. In turn, women are losing access to vital fertility services. 

Whatever your political or religious beliefs, limiting access to safe, effective and essential medical care is bad for women. But Alabama has made a hard situation — infertility and the struggle to have children — more complicated, stressful and difficult.

Pregnancy is already a dicey proposition. American women die during pregnancy or just after childbirth at twice the rate of the nearest high-income country. Black and Hispanic women have two to three times higher maternal mortality rates compared with white women.

Yet still, millions of women go to extraordinary lengths to become pregnant. According to the Pew Research Center, just 2 percent of women in the United States have had IVF, but nearly half have used some kind of fertility care or know someone who has. The Pew data show that fertility treatment is more common among higher-income people, likely due to the cost and lack of insurance coverage, although infertility cuts across demographic and political lines. 

Achieving a viable pregnancy is difficult enough for women or couples with infertility. While safe, the IVF process can be lengthy, uncomfortable and stressful. And ultimately, there’s no guarantee of success. 

IVF is not only physically and emotionally taxing, but it can also be costly. Most states do not require insurance companies to cover IVF or other fertility treatments, leaving many women and their families to pay out-of-pocket for these procedures. One IVF cycle can cost between $15,000 and $30,000, and it’s common to need multiple cycles. 

Now, even this difficult, expensive process may evaporate, and women who can’t conceive a baby without intervention could be left with few if any options. Health care providers uncertain of their ability to do no harm and simply practice medicine according to scientific standards will be forced to turn away from the patients they serve.

Women and their doctors need to be able to use all the available medical advancements to manage their care as they wish for a healthy, successful pregnancy. In a trusted doctor-patient relationship, there should be no room for outside parties or criminal reprisals. 

For women trying to have a baby in the face of infertility, the absolute last thing they need is added stress and anxiety. Instead, we should be aiming to create a safe environment for every woman who wants to become pregnant to do so. 

While the Biden administration has the right idea to invest in research to improve women’s health, it’s essential that we, as a nation, not step backward in how we treat the issue, especially for those who are seeking to be pregnant. The health care community and policymakers who regulate them should do everything possible to support these efforts and choose forward progress to ensure the highest quality in women’s health.

Martha Nolan is a senior policy advisor at Healthy Women.



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