By Elissa Cleland, AMSA Gender & Sexuality Chair and rising M3 at Eastern Virginia Medical School
On February 20th, the Alabama Supreme Court made the decision to limit a birthing person’s choice of when and how to have children. Many Alabama politicians seem painfully unaware of the ramifications of this decision; however, we have already seen the fallout begin to manifest. In a reversal of a ruling from 2018, the Alabama Supreme Court has held a fertility clinic liable for the “death” of frozen embryos under the Wrongful Death of a Minor Act, defining extrauterine embryos as people. This decision was influenced by Chief Justice Parker’s religious fanaticism and Alabama’s extreme post-Roe political landscape. In his concurring majority opinion, Chief Justice Parker claimed that “even before birth, all human beings bear the image of God and their lives cannot be destroyed without effacing his glory.” Referencing texts from the Christian Bible to support his decision, he has forced his theocratic ideology onto the people of Alabama.
Alabama Senator Tommy Tuberville’s interview with NBC News following the ruling starkly revealed the policymaker’s profound lack of medical knowledge, underscoring the pressing need for informed decision-making in healthcare policy. Repeatedly declaring “we need to have more kids,” Senator Tuberville was embarrassingly uninformed about IVF services in his state or apparently what they are used for. When the interviewer countered that IVF services have been suspended in response to this decision, actively preventing families from having children, the senator had no response. The University of Alabama at Birmingham, Alabama Fertility, and the Center for Reproductive Medicine at Mobile Infirmary have all suspended their services, halting several families’ journey to parenthood.
As a future physician, it’s infuriating and deeply unsettling to witness laughably uninformed legislators dictating the practice of medicine. Reproductive, Endocrinology, and Infertility (REI) Specialists are concerned about being held liable for unsuccessful embryo implantation and the practicality of storing unused embryos. Will physicians be held financially liable if an embryo does not result in pregnancy or even criminally liable for homicide? If embryos are considered people, are physicians expected to store embryos indefinitely? Unused embryos would have to be stored even after patients have passed away or even patients’ children and grandchildren have passed away. The logistical nightmare that has ensued after this decision has influenced IVF clinics’ decision to halt their work and has many future physicians like myself apprehensive about practicing reproductive medicine in this political climate.
I attend Eastern Virginia Medical School, home of the very first successful pregnancy using in vitro fertilization in the United States. In 1981, the Jones Institute at Eastern Virginia Medical School announced the birth of Elizabeth Carr, the second baby in the world to be born using in vitro fertilization and the first in the US. Now, over 8 million babies have been born in the US utilizing IVF. Huge strides have been made since Elizabeth Carr, helping birthing people who have medical conditions that prevent them from carrying their own children or screening for devastating genetic mutations prior to implantation. IVF gives the power of when and how to start a family to many women and people with ovaries. For female physicians who are usually in extremely demanding residencies during their prime reproductive years, IVF has allowed them to choose both a career and a family. 20% of female physicians have utilized IVF and 11.5% have cryopreserved their oocytes. As a rising third year medical student, I am currently in the process of egg retrieval and will freeze my eggs until my partner and I are emotionally and financially stable enough to pursue children. Therefore, this decision will impact physicians both as providers as well as their experience as patients.
The events unfolding in Alabama are extremely upsetting but not surprising. This decision is yet another example of the irreparable damage a rightwing, theocratic, fascist ideology has had on our society by exacerbating reproductive injustice. As these politicians claim to care about protecting the sanctity of life, they are actively barring prospective parents from having children. This ruling is nothing but an exertion of theocratic, patriarchal control over femme people, pregnancy-capable individuals, and their bodies under the guise of protecting children. Ironically, this decision was announced in the same week that Alabama rejected federal funding for providing free meals for low-income school-age children over their summer break. Alabama legislators expound upon protecting unborn children while refusing to feed the ones who are already starving in their school system. The hypocrisy is staggering. Alabama legislators are scrambling to introduce a bipartisan bill to protect IVF following the decision. Alabama residents can reach out to their local representatives in support of this clarifying legislation so that IVF services can resume for the people of the state.
It is also imperative that physicians exert our social and political power to influence and shape policy. As we navigate the ever-changing and increasingly authoritarian reproductive health policies gripping our nation, physicians can use their voices to advocate for our patients and combat injustice and ignorance. Medical professionals can get involved by calling local representatives and being vocal in healthcare professional-specific political organizations. Future physicians – medical and premedical students – can get involved in advocacy for policies that align with the principles of justice, compassion, and evidence-based care by joining organizations such as the American Medical Student Association. We invite future physicians who are driven by their passion for equity and hungry for collective liberation to attend the upcoming AMSA annual meeting, Future Physician For Change, which will be held on May 30th-June 1st, 2024 in Washington, D.C.
