The reproductive rights amendment passed by Ohio voters in 2023 included protections not only for abortion but also for other health care such as miscarriage care and in vitro fertilization treatments. Doctors specializing in infertility treatment say the amendment has reassured patients, but in the face of ongoing legal and political challenges, these rights should not be taken for granted.
When the U.S. Supreme Court invalidated 50 years of nationwide abortion rights established in the Dobbs ruling in Roe v. Wade in 2022, the issue of abortion and reproductive rights roared to the forefront of American political life. Voters continue to rank this issue as their most significant issue, along with the economy, democracy and immigration.
After 57% of Ohio voters approved the reproductive rights amendment in November 2023, legal challenges emerged against various anti-abortion laws in Ohio, including mandatory 24-hour waiting periods and ultrasounds, and Ohio’s six-week abortion ban in 2019 .no exceptions for rape or incest that occurred several months after the Dobbs decision. The Hamilton County court temporarily blocked the last one in the fall of 2022, then permanently removed it on October 24. The Ohio Attorney General has 30 days to file an appeal.
During the campaign to overhaul Ohio’s reproductive rights laws, in vitro fertilization was raised as a right that supporters of the measure wanted to protect, arguing that any type of reproductive care would interfere with the needs of in vitro fertilization patients.
“Issue 1 has been very reassuring to patients,” said Dr. Rachel Weinerman, a reproductive endocrinologist and infertility doctor in Cleveland who has previously seen patients take fertilized embryos to other states because of regulations and uncertainty about reproductive rights in Ohio.
Abortion bans have been directly linked to fertility care by advocates and physicians because complications that can arise from in vitro fertilization treatment, such as life-threatening ectopic pregnancies and miscarriages, may require care that could be classified as abortion care. Some ectopic pregnancy requires termination of pregnancy because the pregnancy is not viable and may be hazardous for the pregnant woman, whereas miscarriage is considered medically”spontaneous miscarriages.“
“Generally speaking, patients who undergo in vitro fertilization do so because they are desperate to have children,” Weinerman said.
However, in the event of complications, patients must have the freedom to make decisions that may mean terminating one pregnancy in order to preserve the possibility of becoming pregnant in the future. This flexibility is aided by Ohio’s implementation of the Reproduction Amendment.
Weinerman said there remain “everyday concerns” about the implementation and enforcement of last November’s Issue 1 and other challenges to reproductive rights, especially with reports of abortion bans from other states.
Dr. David Hackney, a maternal-fetal medicine specialist in the Cleveland area, also doesn’t see the issue as settled just because Ohio passed the reproductive amendment.
“Reproductive rights are never taken for granted and it is always best to frame everything as an ongoing situation,” Hackney said.
Interest e.g Alabama a court case to determine whether a fertilized embryo can legally be considered a human, and several states have discussed the so-called “personality” bills in the case of proven embryos IVF is still being considered as a warm topic, as well as presidential candidates and Ohio candidates running for a U.S. Senate seat have taken their own position on this issue, including reproductive rights.
“There have been a lot of patient stories since Dobbs,” Hackney said. “It made these issues come to life in a way they hadn’t before.”
IVF as a galvanizing force
Hackney deals with high-risk pregnancies and often has patients who have used IVF during their pregnancy. In an ideal world, these patients could avoid talking about their pregnancies in a political setting, but Hackney said awareness is still significant.
“I think this is a key issue, and even for people who are not directly affected by the pregnancy itself, a lot of the legislation is an attack on autonomy,” Hackney said. “Once the precedent is set for government intrusion into our private lives, what will be the next barrier? And the next barrier after that?”
In the area of reproductive rights, including in vitro fertilization, certain barriers already exist for communities of color. The same complications that are possible for other pregnant women occur for black women, but the effects are often different.
“Black women who do eventually go into labor continue to have higher rates of maternal mortality and complications,” said Linda Goler Blount, president of the D.C.-based Black Women’s Health Imperative. “This starts with when black women complain that something is wrong, their complaints are less likely to be addressed, even with all the extra monitoring and specialists associated with IVF.”
Laws that define personhood, include fertilized embryos and limit abortion services only complicate the situation for patients who have often had difficulty conceiving despite their desires.
“You are actually limiting the ability of people who want to have children to have children and the ability of people to have families,” Weinerman said.
Some election report on in vitro fertilization of the University of California’s Center for Reproductive Health, Law and Policy found that presidential candidates on both sides of the issue “portrayed themselves as protecting this popular reproductive health care.”
Democrats largely supported reproductive rights and Vice President Kamala Harris stated that she would sign a bill establishing a federal right to abortion and provided broad support for in vitro fertilization.
Former President Donald Trump has wavered in his opinion on abortion, but in August he said he would support the federal government’s plan pay for IVF treatments.
“But the Republican Party platform, Republican legislative efforts and Project 2025 “The presidential transition project led by former Trump administration officials reveals the party’s persistent support for ‘personality,'” the UCLA report said.
The UCLA report concluded that personality “is incompatible with the current standard practice of in vitro fertilization, which often involves creating more embryos than are consumed.”
For its part, public opinion is “overwhelmingly” in favor of universal access to in vitro fertilization, survey finds Pew Research Center study conducted earlier this year.
The survey found that 7 in 10 adults believe that access to IVF “is a good thing”, with the majority relating to religious and political issues. Among Republican and Republican independents, 63% support in vitro fertilization, while 79% support Democrats and Democratic-leaning people.
According to Pew, respondents’ position on abortion also did not significantly change their opinion on in vitro fertilization – 60% of people who believe that abortion should be illegal still support in vitro fertilization treatment.
Goler Blount said it’s time for Americans to understand that while medical decisions should be made privately, the government is now part of those decisions.
“We don’t have a choice because it’s not just a decision between the person and their service provider, because the service provider, depending on where they are, has to consider the possibility of filing charges,” Goler Blount told the Capital Journal.
Increased for her women’s participation in elections shows progress in engaging voters based on their needs and opinions about what scrutiny of government should look like.
“I think that after every successful election, we will see more and more women supporting abortion as health care and supporting IVF, as well as a full set of health care,” Goler Blount said.
In Ohio, Democrats in the House of Representatives presented the bill providing “clarity” to doctors working with IVF patients. The measure was raised after the Alabama Legislature passed legislation protecting in vitro fertilization following the state Supreme Court’s decision recognizing fertilized embryos as people.
There has been no action since the bill was introduced in Ohio since it was introduced in April.
IVF protection bills from both sides an attempt was made in the U.S. Congress in September, but both were blocked in the U.S. Senate.
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