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Monday, December 5, 2016

If life begins at the point of conception, is in vitro fertilization (IVF) morally acceptable?

IVF, the process during which sperm fertilizes an egg in a laboratory, usually produces several embryos to raise the odds for a viable pregnancy. Embryos are then selected and implanted in a woman, who may have had difficulties conceiving, with the hope that at least one produces a healthy pregnancy.

The embryos that are not used are either donated to research (much like the fetal tissue from abortions), kept frozen for another cycle, discarded, or donated to another family.

But hardliners – those devoted to what’s called the Personhood Movement – want legislation that protects embryos as if they were people. (Former Arkansas governor Mike Huckabee declared that if elected president, he would extend 5th and 14th Amendment protections to zygotes.) This has obvious implications for those in favor of abortion rights, but, if carried to its logical conclusion, it would also affect providers and patients who use IVF.

So where’s the outrage directed at fertility clinics?

That’s the question Margo Kaplan, a professor at Rutgers Law School, asks in an op-ed published in The Washington Post. Kaplan, who conceived her two children through IVF, compares her experience to those of women seeking abortions:

In Pennsylvania (where my fertility clinic is located), a woman seeking an abortion must receive state-directed counseling designed to discourage her from the procedure. She must then wait at least 24 hours until she can continue. In other states, women are forced to undergo unnecessary and invasive ultrasounds, watch or listen to a description of the ultrasound, and hear a lecture on how the embryo or fetus is a human life. Clinics in some states must provide them with medically inaccurate information on the risks of abortion. After all that, women often cannot have an abortion without waiting an additional one to three days, depending on the state.

In contrast, all my husband and I had to do was sign a form. Our competence to choose the outcome of our embryo was never questioned. There were no mandatory lectures on gestation, no requirement that I be explicitly told that personhood begins at conception or that I view a picture of a day-five embryo. There was no compulsory waiting period for me to reconsider my decision. In fact, no state imposes these restrictions — so common for abortion patients — on patients with frozen embryos. With rare exceptions, the government doesn’t interfere with an IVF patient’s choices except to resolve disagreements between couples.

Why do anti-abortion activists and politicians exhaust themselves trying to defund and eliminate Planned Parenthood, while ignoring embryo-destroying fertility clinics?

Kaplan concludes that even though IVF necessitates the destruction of some embryos, the anti-abortion crowd leaves IVF clinics alone because the procedure exists to support women who want to be mothers. Pamela Haag in Big Think calls the discrepancy the “ideological ‘tell’ in abortion politics” — because for some abortion opponents, it’s clearly not just about the preservation of life: “It’s about women’s rights, women’s power, and women’s agency,” she writes.

This argument is one that is advanced by many, many women: Conservative, usually male, lawmakers just want to legislate women’s bodies. Specifically, vulnerable women. As supporters of Planned Parenthood consistently point out, the organization primarily serves poor women and women of color. IVF – due to its hefty price – is available mainly to affluent women.

Viewed in this context, the decision to persecute Planned Parenthood, yet not clinics that specialize in IVF, seems to be informed less by notions of the “sanctity of life” than by the demographics of the women affected. It’s not about saving or killing babies – it’s about making sure the “right” babies are born to the “right” people.

Yet nearly every GOP presidential candidate, many citing the same anti-choice rhetoric, has said that he (or she) supports defunding Planned Parenthood — even if it means shutting down the government — effectively dismantling an organization that helps millions of women get contraception and preventive reproductive health screenings. They maintain their stances despite the facts that the state investigations, which were prompted by videos released by the anti-abortion group Center for Medical Progress, have uncovered nothing, and that the vast majority of Americans support both Planned Parenthood and its receiving federal funding through Medicare. (The organization is fighting back, with an ad blitz in the states where the lawmakers calling for its defunding reside.)

Anti-choice politicians and activists like to point out that if Planned Parenthood had to shutter thanks to a loss of federal funding, community health centers would be there to take its place. But community health centers, which focus on primary care, are often overcrowded and already straining to handle all the new patients enrolled under the Affordable Care Act.

Texas provides a useful case study. As Ali Weinberg of ABC News explains, in 2011, legislators stripped Planned Parenthood and other abortion providers of taxpayer funding, which meant they could no longer be part of the Medicaid Women’s Health Program, providing women with family planning services. To make up for the loss of women’s health care services, clinics that did not have ties to abortion providers were recruited to take their place. A year later, the federal government stopped its Medicaid funding of the Women’s Health Program – meaning that the Lone Star State now needed to fill that funding gap.

So while other providers were scrambling to train medical professionals and integrate family planning services into primary care, some patients found that they had a hard time finding a provider. As Amanda Stevenson, a researcher at the University of Austin’s Texas Policy Evaluation Project, told ABC News, many women prefer going to a specialist – like a gynecologist – rather than a primary care doctor, because they feel it’s a more respectful and confidential environment.

There was an average 25 percent drop in women served by clinics with the Texas Women’s Health Program, with two districts reporting greater than 50 percent. The state’s Health and Human Services Commission showed that within two years, there were 63,581 fewer claims filed for birth control and almost 30,000 fewer women got any sort of service from the state-run health program.

This is partially why many say that abortion opponents fail to adhere to their stated “pro-life” ideology, since their policies actually end up harming the people already alive. And their ideology rings particularly hollow when they take a hard line on one procedure but aren’t so quick to apply the same standards to another.

Image: Intracytoplasmic sperm injection (ICSI) (via Flickr)

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