What impact will abortion and IVF have on the US presidential election?

Abortion and reproductive freedom are up for vote and debate in America today and will likely be a central issue in the upcoming ABC debate between Donald Trump and Kamala Harris.

Democrats view abortion as a “winning issue” this election after the Roe v. Wade ruling was overturned. They have had success at the state level since that decision in 2022 and hope to use those victories to keep the White House and Senate this fall, and perhaps even retake the U.S. House of Representatives.

Trump has made headlines recently over both abortion and in vitro fertilization, telling NBC News, “Under the Trump administration, we will pay for this treatment. [for IVF for] all Americans who get it; all Americans who need it.”

The former president also said last week that he would not vote for a controversial ballot proposal in Florida that would effectively prevent and overturn state laws restricting abortion, despite previously saying he “disagrees” with the state’s current restrictive abortion law because “it takes more time than six weeks.”

Abortion rights have lost ground since the Supreme Court’s Dobbs decision, with many states taking a restrictive stance.

IVF is also under threat. However, we are not yet like China, where a court recently denied an unmarried woman the right to freeze her eggs because “only married women are allowed to use this procedure.”

Yet America is beginning to resemble many other countries where, according to the United Nations, “too many women and girls are denied this fundamental freedom to make decisions about their own bodies.”

Little discussed in the abortion debates is the fact that American women are already lagging behind in maternal health. According to the Commonwealth Fund, “despite a decline since the COVID-19 pandemic, the United States continues to have the highest maternal mortality rate of any high-income country. And within the U.S., the rate is by far the highest among black women. Most of these deaths — over 80 percent — were likely preventable.”

What is particularly glaring about the restrictions on women’s reproductive freedom is that they defy established medicine and, according to the American Journal of Public Health, “endanger women’s mental and medical health.”

Two women in Texas have filed complaints against hospitals for “refusing to treat ectopic pregnancies” after the state banned abortions with some exceptions in 2022. Ectopic pregnancies cannot survive because they occur outside the uterus and are a “life-threatening condition that requires emergency treatment,” according to the Cleveland Clinic.

According to the Kaiser Family Foundation, “Pregnant women seeking an abortion who live in states where abortion is banned or restricted must either travel to another state or try to obtain medication abortion pills through a telemedicine appointment with an out-of-state doctor, but these options are not available to everyone. Some women may choose to have a self-instructed abortion, but some cannot have an abortion and must continue a pregnancy they do not want.”

The Guttmacher Institute reports that if “abortion were banned in all states, maternal mortality rates in the highest counties would increase by 24 percent; among non-Hispanic blacks, maternal mortality would increase by 39 percent.”

The controversy surrounding IVF also limits women’s options. In the six months since the Alabama Supreme Court ruled that embryos created through IVF were children with legal protections, anti-abortion activists have struggled to formulate positions that allow room for IVF treatments.

Some argue that while the concept of IVF is acceptable, current standard treatment methods such as egg stimulation and embryo cryopreservation are not, as this procedure can produce more embryos than can be safely implanted and these embryos are often later discarded.

Others are not so subtle. The Southern Baptist Convention, for example, voted in June to reject artificial insemination altogether.

Such religiously and politically motivated laws restricting reproductive care expose doctors to civil and criminal liability and, in some cases, jeopardize the very goals of family formation that anti-abortion activists claim to protect.

Reports from Alabama and Texas confirm that some patients are now changing their IVF treatments and, for example, taking their embryos to other states where abortion policies are less strict.

Abortion and IVF will continue to be critical election issues as more and more states put abortion on the ballot. Now is the time to get informed and educated, to look ourselves in the mirror and ask what kind of society and choices we want for ourselves, our daughters, and for all women and girls.

Susan Crockin is a senior scholar at the O’Neill Institute for National and Global Health Law and an adjunct professor at Georgetown University Law Center. Tara D. Sonenshine is a former Under Secretary of State for Public Diplomacy at the U.S. Department of State and currently a senior nonresident fellow at the Fletcher School of Law and Diplomacy at Tufts University.

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