After Overturning Roe v. Wade, Will IVF Be America’s Next Culture War?

CHRISTIANE AMANPOUR, CHIEF INTERNATIONAL ANCHOR: Next to the United States, where IVF delivers over 90,000 American babies every year, and is driving a wedge not only between parties, but also within the GOP itself. In her recent piece, Sasha Nauta, The Economist social affairs editor, highlights how Republicans who’ve opposed abortion rights are struggling to back the moral argument to ban IVF. And the journalist joins Hari Sreenivasan now to discuss its potential impact on the upcoming election.

(BEGIN VIDEOTAPE)

HARI SREENIVASAN, CORRESPONDENT: Christiane, thanks. Sacha Nauta of The Economist, thanks so much for joining us. You wrote a piece recently that said, will IVF really be the next frontier and America’s culture wars? Tell us how did we get here? Why is it a culture war? I mean, is responsible for, what, almost 90,000 babies being born every year?

SACHA NAUTA, SOCIAL AFFAIRS EDITOR, THE ECONOMIST: Yes, Hari, I mean, this question was partly raised because it’s a line that you will often hear from Democrats saying Republicans first came for abortion then they came for IVF, and next they’ll come for birth control. And so, we felt it was time to dig into this a bit more. Is there any truth to this statement? And in short, there is. Not because, as you say, you know, 90,000 kids a year are born thanks to this technology. It is widely supported by, you know — it is, I think, nearly nine in 10 Americans are in favor of IVF. So, it would be a hugely unpopular thing for Republicans to go after. But the reason why, you know, it is on the table and it could become America’s next cultural war is because it is a logical — being uncomfortable with IVF is a logical extension from being uncomfortable with abortion. Particularly the sort of most ardent parts of the prolife movement have always believed in this concept that a, basically from the moment of conception, a fetus has the same rights as you and I. And we saw this play out in Alabama earlier this year when the Supreme Court there made a ruling that, in effect, overnight suddenly led to a panic where IVF clinics stopped providing IVF. And so, yes, we think there is something to this statement. We don’t think it’s about to happen tomorrow, but it certainly could be on the table, yes.

SREENIVASAN: Let’s flush out the kind of the moral argument against it here. If you consider life beginning at conception, why is IVF, the process of bringing life out into the world, going to be problematic?

NAUTA: So, the basic biology here is that for IVF, what happens is you take — you tend to fertilize a number of eggs. So, a woman takes medication to stimulate the production of eggs. Hopefully, you’ll have like 10 or a dozen eggs. You’ll fertilize them with sperm and you’ll hopefully produce a number of embryos, more than you would place to try to have a child. And again, if you’re lucky as a woman, say the first embryo takes and you’ve got nine left in the lab you may not — you know, you may not want 10 children in total. Another — so, there’s excess embryos, again, for those who are lucky enough to make enough, but there’s also embryos that perhaps won’t pass, so-called pre-genetic screening. There might be problems with the embryos. And so, the basic process very much tends to involve the destruction or disposal of excess embryos. And that’s the core problem. And you’re right, a lot of Republicans who came out in favor of IVF sort of said, well, there’s nothing more pro-life, you know, than helping families create life, right? But there is a real tension here with the core pro-life argument that life starts at conception.

SREENIVASAN: With the notion of fetal personhood, we’ve seen a number of states implement laws codifying this. What happened in Alabama?

NAUTA: What happened in Alabama was that a number of couples who were going through IVF were very, very unlucky in that their frozen embryos were destroyed by accident. And they sued. And in suing, their case made it all the way to the Alabama Supreme Court, which made an unusual ruling, but actually a ruling which is consistent with what we’ve been talking about. They said, this can be a wrongful death suit because, actually, these frozen embryos, they count as children under Alabama State law. And the consequence of that is that IVF clinics went, whoa, OK, hang on, that could make us criminally liable for wrongful death. Not just in this accidental disruption, but for everybody’s IVF procedure.

SREENIVASAN: So, when the fertility clinics in Alabama decided that this liability was too much and that they needed to close, what was the state’s response?

NAUTA: The state obviously got a lot of phone calls from out of state Republicans and general supporters of IVF and they rushed to get through a stopgap law, essentially a shield law, that was put in place, I think about three weeks or so after. So, there was this pause in treatment. Then the state legislature rushed through the shield law, which essentially gives immunity to both patients as well as clinics. So, it sort of shields the IVF sector, if you will, as well as those using it from the consequences of the personhood of the idea that fetuses have rights. But they didn’t deal with the underlying issue. And that’s a real – – that’s — that thread is going to come back. I think we will hear about Alabama again.

SREENIVASAN: So, what happened in Alabama, I mean, this might be instructive to our audience, is that they didn’t necessarily reverse the idea of fetal personhood, they — you’re saying they just created the shield taking the liability out of the hands or off the shoulders of the IVF clinics and the people who are using them, right?

NAUTA: That’s right. And what’s happening now is that two of the couples who were involved in the initial suit are actually saying that the shield law is unconstitutional. And so, they’d like the shield law actually to — they say, you know, it’s unconstitutional. It should be gotten rid of. So, again, that shield law is going to be challenged. So, this is why I think it might come back. Because, as you’ve pointed out, the underlying basic principle that an embryo has the same rights as a child has not been dealt with.

SREENIVASAN: When it comes to the Republicans that are staunchly pro-life, you know, are they a bit into a corner here? On the one hand, they do agree with the idea of fetal personhood. But on the other hand, I’m sure they have constituents who are died (ph) in the war Republican who want to have a baby and want to use this technology.

NAUTA: Yes, they are backed in a corner. And we saw — you know, back in February, we saw them struggling with this saying, I am pro-life. I’m also pro-IVF. This should be impossible. We know — actually Gallup did some good polling on this, we know that over eight in 10 Americans think IVF is morally acceptable, but only about half of Americans are thinking it is morally acceptable to destroy these excess embryos. So, that’s an inconsistent view, right? You can’t really have both. And yet, so far, people have been able to hold both views, but as this issue becomes more and more political and, you know, as both parties push each other on being clearer on what their consistent position is, the harder it becomes for Republicans to hold — to try to continue to hold both views.

SREENIVASAN: Now, this is an election year. Former President Donald Trump has said, look, this should basically be a state’s right issue, sort of just like he has with abortion. But what happens to the national Republican Party, the party platform, the planks, if you will, when it comes to the convention? Does this create enough of a rift in the pro-life community saying, you know what, this is inconsistent with this?

NAUTA: I mean, the pro-life community has actually been quite vocal about their problems with IVF. We saw the Southern Baptist convention last month overwhelmingly adopt a resolution in which they opposed IVF as currently practice and called it dehumanizing the U.S. Conference of Bishops, similar, the Heritage Foundation. So, there’s a lot of pressure from the pro-life side on Republicans to have a more morally consistent position on this. I don’t think IVF will be enough to break this coalition, but I think this underlying issue of personhood will come back again and again. And in fact, you know, you mentioned the party platform as we get ready for the Republican Convention, the party platform have adopted the new language on abortion, which I know has been presented in the press as sort of a softening of Donald Trump’s position on abortion. And the reality is, it’s very hazy language. I’ve talked to several legal scholars, all of whom say he’s, you know — they’re trying to shear horn all sorts of — they’re trying to square this circle that we’ve been talking about. Over time, I find it very hard to see how the Republican Party can continue to stay in sync with the direction that the pro-life movement is going.

SREENIVASAN: As we have this conversation about IVF laws, there do seem to be parallels in how different state legislatures are dealing with access to abortion. If it is left to be a state’s right issue, are there parallels here between how IVF as a technology will be treated, how abortions, how access to contraception will be treated as well?

NAUTA: There are definitely parallels. And those who work in the IVF field, right from the moment that Roe versus Wade was overturned two years ago now, said, you know, lobbying abortion back to the states also will put IVF on the table. So, by removing the protections of Roe, it has been left up to every state to start dealing with these questions of where does life begin? What does that mean for the medical practices in our state? So, there is a direct connection with abortion. I think that the big parallel that you hear IVF providers talk about a lot is that they worry that in conservative states or states that are anti- abortion, pro-life you will start to see — you won’t see many ban bans, but you’ll see an eroding of access. And we saw that during the protections of Roe. You’ll remember, you know, in theory, abortion was legal everywhere in America, but in practice, there were many states where it became harder and harder for women to access abortion, all sorts of extra regulations were put in place that made it harder and harder to access. And the big fear is that you’ll see a similar chipping away of access to IVF, perhaps even to contraception in some of these similar states. And yes, that is the big fear. So, whether that’s by regulation, by being stricter about how embryos can be treated, perhaps, how many embryos you might be allowed to create for IVF, whether you can freeze them, whether you can destroy them but — whether you can genetically test them. But there’s also — you know, there’s also the kind of knock-on consequences of the chilling environment that’s been created due to abortion bans. So, we’ve heard from states with strict abortion bans that they are struggling more and more with getting OB/GYNs. Again, you can see a knock- on for fertility doctors. So, it’s not that hard to see how, in some of these states, even if as we expect, IVF will broadly remain legal or become harder and harder to access in a country where, by the way, it is already very expensive to access IVF.

SREENIVASAN: Heading into this election cycle, is this going to be enough of an issue where — I mean, we have seen Democrats definitely mobilize around abortion access and reproductive rights, right, and I wonder — I mean, you spent some time in Arizona for this story. What were you seeing on the ground when it comes to mobilizing on either side?

NAUTA: Yes. I mean, I think reproductive rights, the idea — the basic idea that the state is getting in the way of women and families is, you know, reproductive choices is clearly not sitting well with the majority of Americans. Polling shows that — for all the issues we’ve just talked about, right, for abortion, for IVF and for contraception. What I saw in — and sorry, to your question on the election, I think next it’s quite clear who this helps. It helps Democrats. The Republican position on these issues is not in line with the majority of Americans. What I saw in Arizona — in fact, the Arizonans, I think it was a few days ago, handed in these signatures for their ballots initiative, and they’ve managed to collect I believe over 800,000 signatures, most in the state’s history for this petition to protect abortion. And so — and they are one of many states that have done this. So, in November, we will see a number of states, including Florida, including Nevada. And if these signatures are — if enough of them are verified in Arizona, you know, important swing states, not just voting on a president, but also voting on their state’s constitution and whether it should have a protection to abortion. So, that really matters. That really, really matters. And what was inspiring to see in Arizona is just how broad a coalition these grassroots movements are finding to get — because basically they have to collect signatures from ordinary Arizonans, and I saw a range of people signing, this is not just your classic reproductive rights people signing them, it’s libertarians, it’s, you know, Trump voters who are very angry about the state getting into these kind of issues. So, it definitely resonates. It will play — it will net help Democrats. I guess the big question is, will it help them enough?

SREENIVASAN: Do you think that the choice of candidate will matter in how this plays out? I mean, the current uncertainty around President Biden and whether he’s going to be the party’s nominee or not, with the advocates that you spoke to, either on the pro-life side or the IVF side, do they have any thoughts on that?

NAUTA: I think that the choice of candidate is a totally fair question. I think the advocates are not wild about Joe Biden on this issue. He’s — you know, he’s not comfortable with the word abortion. They all track whether he said it. That they much prefer a Kamala Harris on this issue, who’s more comfortable talking about the subject. It’s a double-edged sword though, because I would say that it’s not the activists that the Dems need to worry about, it’s probably more the people in the middle who are in favor of some access to abortion, who would not, you know, call themselves sort of a part of the abortion positivity movement, which is more on the activist side. And so, it’s a double-edged sword for Dems in terms of who they go for. There’s no way they’re going to go for anybody. You know, if Joe Biden isn’t the candidate, I find it impossible to imagine, you know, the basic credential is you’re going to have to be pro-choice.

SREENIVASAN: Yes.

NAUTA: But within that, there’s a real balancing act. You know, do you go for a candidate who the activist wing is really comfortable with, who’s happy to talk about abortion as being, you know, a non-stigmatized issue, something that everybody should be able to approach and not really talk about term limits or do you go for someone who actually — strangely, Joe Biden actually is not that — I personally believe he’s not that bad a candidate, because in his discomfort, and he’s had an evolution, right, in terms of where he stands on the issue, he’s probably actually voicing the discomfort of quite a lot of sort of middle America.

SREENIVASAN: Sacha Nauta, the social affairs editor of The Economist, thanks so much for joining us.

NAUTA: Thank you.