When Mary Leah and Rodney Miller started trying to conceive through IVF, they prayed that the days spent at hospital appointments, the endless expense, the medication and the needles would eventually help them start the family they dreamed of. The couple, both successful lawyers in Alabama, considered themselves pro-life, conservative and devout.
To them, the idea of fertilising an egg in a laboratory wasn’t an easy ethical decision. They believed that life began at conception, and that the embryos they created through IVF were alive. Because of that, they didn’t want to discard their unused embryos — usually a standard part of the IVF process.
Over ten years of pain and disappointment, and six rounds of IVF that cost over $100,000 (£80,000), their faith stayed constant. But some of their views changed. Increasingly, they felt a deep compassion towards people who made choices that were different from theirs, like those forced to seek a late-term abortion or discard unused embryos.
So when, two days before they were about to start their seventh round of IVF, they heard that the Alabama supreme court had ruled that embryos were considered children, they did not join many of their family and friends in celebrating the decision.
“The reality is fewer children will be born, fewer families are going to be started like this,” said Rodney Miller, 46. “We need to put ourselves in the shoes of the people who are actually walking through this. I don’t think there’s a one size fits all solution from a court or from a politician on this issue.”
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Miller was once a committed Republican, although he didn’t vote for Donald Trump. In November, despite his reservations, he’ll vote for the Democratic candidate, Kamala Harris.
“I’m as pro-life as they come. But this is how I’m growing my family. And if you’re attacking this, you’re attacking me, you’re attacking my family, and you’re not getting my vote,” he told The Sunday Times last week in Alabama.
IVF is under attack by groups on the far right, he believes, in an assault that has been planned for some time.
“A lot of these groups, if you look at their end game, it’s to ban IVF. But they’re not going for the touchdown right out of the gate. They’re going to inch their way down the field, and it’s going to take time, but there is a co-ordinated attack against IVF,” he said.
The question of whether IVF is morally permissible has become a new flashpoint in America’s culture wars, and thrown a grenade into the tightly fought politics of reproductive health.
Donald Trump, the former president, having stuffed the US supreme court with highly conservative justices who overturned the Roe vs Wade court decision that protected abortion rights, is now attempting to soften his image on the subject. Last week, he claimed that he’d make IVF treatment free for all Americans — an exercise that would cost an estimated $7 billion a year, require a new government division to run the programme, and essentially create a way within a privatised health system that the government or insurance companies could pay for one specific type of treatment for everyone.
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Donald Trump said he would make IVF free for all Americans
The Republican vice-presidential candidate, JD Vance, has said that he supports IVF, and dismissed questions about the implications of a state court blocking access to treatments as a “ridiculous hypothetical”.
Meanwhile, at the Democratic National Convention in Chicago this summer, speakers relentlessly lambasted the Republicans for what they categorised as their attempts to restrict IVF. Vice-presidential candidate Tim Walz spoke about his infertility struggles with his wife, and vowed to protect access to the treatment.
As the Millers read the judges’ argument on the Alabama supreme court case, they could see within it a framework that they feared would build restrictions on IVF — eventually blocking access to fertility treatments across the country for families desperate to conceive.
The ruling announced that frozen embryos were “extrauterine children” kept in a “cryogenic nursery”. To destroy an unused embryo — as hundreds of thousands of couples across the US and the world do every year — was tantamount to killing a child. In their decision, judges quoted the King James Bible that “whoso sheddeth man’s blood, by man shall his blood be shed: for in the image of God made he man”.
‘It’s a losing issue for the Republicans’
Two years after Roe vs Wade was overturned, ending American women’s federal right to abortions, the debate over IVF has become a new driving force of the Christian right. This summer, the Southern Baptist Church, one of the most significant political and religious forces in the south, announced that it was deeply concerned over the manner in which IVF was being practised, claiming that it results in “destruction of embryonic human life”.
Despite an emergency amendment that protects clinics in Alabama from liability after the state supreme court ruling early this year, some have already shut down IVF programmes and others are quietly moving their frozen embryos out of state.
The decision in Alabama came about because of what appears to be an accident. In December 2020, a patient at a hospital in Mobile, Alabama, wandered through the doors of a fertility clinic on the premises and opened the freezing unit where embryos were being stored. They picked them up and dropped them, destroying them.
In response, three couples brought lawsuits against the fertility centre under Alabama’s Wrongful Death of a Minor Act, seeking damages. A trial court dismissed the charges, on the basis that the embryos were not children. When it was brought to the Alabama supreme court, however, that decision was reversed.
The plaintiffs themselves said that they didn’t want to hinder or impair the right or access to IVF in the state. A source close to one couple insisted that their claim was “not part of a right-wing plot”, that they were “not crazy” and that they simply wanted to get justice after losing their embryos, whether they be deemed humans or property by the court.
Attacks on IVF are not only happening in Alabama. This year, according to the Centre for Reproductive Rights, a legal advocacy organisation, 21 states tried to introduce legislation that grants “personhood” to embryos — which are usually frozen when they have developed to a clump of around 100 cells about the size of a tenth of a millimetre — meaning that they could be legally treated as children. Alabama introduced “personhood” legislation through a constitutional amendment in 2022.
At a time when more people than ever are choosing to have children through IVF, states across America are weighing whether to pass legislation that could effectively render the practice illegal.
“What we’re looking at is the possibility of losing IVF for everybody,” said AshLeigh Dunham, an Alabama lawyer working on fertility issues.
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AshLeigh Dunham fears that restrictions on IVF may spread across the US
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Last week, a Republican US congresswoman from California, Michelle Steel, released a video telling the story of how she used IVF to get pregnant with her two daughters, and vowing to protect access to the treatment.
Yet in practice the Republican Party has consistently backed faith and political groups who want to restrict access to IVF. Steel twice co-sponsored a bill that would grant “personhood” to embryos; she later withdrew over “confusion” about the bill’s intent on IVF.
Emily Capilouto, 36, from Alabama, whose own IVF procedures were delayed for months because of the supreme court ruling, told The Sunday Times: “If it wasn’t for the Republican Party I’d be pregnant by now.”
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Emily Capilouto has seen her IVF treatment delayed
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Supporting restrictions on IVF may prove to be a stunning political miscalculation for the Republicans. Just as the fight to overturn Roe vs Wade created a class of single issue voters who cast their ballots for Republicans because they considered them their allies in the battle against abortion, so could the struggle to ban IVF create a group of people who vote Democrat to support them in their battle to maintain access to fertility treatments.
Polling shows that banning IVF is enormously unpopular. In a June survey by Gallup, 82 per cent of respondents said they were broadly comfortable with IVF. Ten per cent said it was morally wrong. About half said they believed that destroying frozen embryos was morally acceptable.
“It’s a winning issue for the Democrats, and it’s a losing issue for the Republicans. And it’s almost like no one on the GOP [Republican] side is asking why that is,” said Miller, later adding: “I think after Roe vs Wade, they needed another culture war issue to keep people engaged, to keep people going to the polls and supporting them.”
For many deeply religious couples who struggle with infertility, IVF is a way for them to follow the Bible’s commandment to “be fruitful and multiply”, and start the family they’ve dreamed of.
Since IVF was invented in the 1970s, opposition to it has existed on the edges of ultra-conservative Christian groups. In 1981, Elizabeth Carr was the first baby born from the treatment in the United States. When she first saw the news from the Alabama supreme court this year, she was devastated — but not surprised. When Roe vs Wade was overturned, she and other activists had suspected that IVF would be next.
“The stage had been set for something like this to happen in many states, not just Alabama,” she told The Sunday Times. “There are folks who want to put IVF back in the box because they argue we shouldn’t have it in the first place. But there are millions of children on earth because of IVF. We can’t go back.”
‘My children are a gift from God’
Democrats are taking note. This spring, Marilyn Lands, a Democrat member of the Alabama House of Representatives, flipped a Republican congressional district in the state after campaigning on access to abortion and fertility treatments. She believes that this message can sway undecided and Republican women.
Marilyn Lands believes the IVF issue can persuade undecided voters to back the Democrats
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“When the IVF ruling happened, it just totally stunned us,” Lands said at her home near Huntsville, Alabama. “There was a real sense that at one point that we’ve gone too far … And we see over and over, what starts in Alabama spreads to other states.”
Sitting at her kitchen table in Alabama, her four children — three born from IVF — running riot around her, Kristia Rumbley, a former school counsellor, mulled over the implications of the state supreme court ruling. She still had frozen embryos in storage in the state. Since they were considered human beings, could they be taken into care? What if she miscarried? Could she be charged with murder?
The legislators who produced the Alabama supreme court ruling, she said: “Just don’t educate themselves. I have no idea. It blows my mind how they don’t know what they’re doing or what the consequences are.”
Kristia Rumbley had three children via IVF
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After a decade of heartbreak, over 100 negative pregnancy tests and six rounds of IVF, Mary Leah Miller finally gave birth to their twins, Mary Elizabeth and Dalton, two years ago, from embryos donated by another family. Today, at 42, she is eight months pregnant, again with twins from donor embryos implanted through IVF.
“There is nothing bad about my children,” she said. “They are a gift from God. They were created in His image. And for somebody that doesn’t know anything about the process that we went through, to say that something is wrong with my children, or the way that I went about having my children is wrong … They were put on this Earth for a purpose, and I’m looking forward to seeing what that is.”
