Let's Watch The Making Of An 'Extrauterine Child'!
This week, the Alabama Supreme Court surprised absolutely no one with a ruling that frozen embryos created through the process of in vitro fertilization are children. Somewhere in its blizzard of references to Biblical verses, Christian theologians, even something called “The Manhattan Declaration,” the court essentially confirmed the long-time anti-abortion ideology that life begins at conception and no matter the method of conception, even a flash-frozen fertilized egg is alive. The Alabama Supreme Court found that frozen embryos are protected under the state’s wrongful death statutes. The decision even went to the trouble of coining a word for these new living beings: extrauterine children.
The Alabama decision has caused several of the state’s in vitro fertilization (IVF) clinics to close their doors for fear that if a frozen embryo is destroyed, discarded or even lost during the IVF procedure, it would leave the doctors and the clinics and even the patients vulnerable to prosecution for killing extrauterine children.
People like husbands, lovers, parents, even older children of pregnant women attend the live births of children all the time, so, if Alabama is now saying that any embryo is a child, whether fresh, frozen, or in the process of being used in an IVF, why don’t we attend the medical procedure that amounts to the creation of one of these brand new microscopic children!
The process begins with a woman, although not necessarily the woman who, if the IVF is successful, will actually give birth to a living, breathing child. In vitro fertilization involves what is euphemistically called harvesting a woman’s eggs. It begins with the production of a woman’s eggs being chemically encouraged using something called “ovarian hyperstimulation.” Adequately stimulating the ovaries isn’t enough, however. In order to be able to retrieve eggs, the time of ovulation must be predictable, and that’s where the “trigger shot” comes in. Once the ovarian follicles are developed enough, a shot of hormones is administered, setting the ovulation schedule for 38 to 40 hours after the shot.
Now comes the time for harvesting the eggs via “transvaginal oocyte retrieval.” The woman, who throughout the process is referred to as “the patient,” is taken to an operating room and usually put under general anesthesia so that a fine needle guided by transvaginal ultrasound can be inserted through the vaginal wall into her ovarian follicles, from which multiple eggs, usually somewhere between 10 and 30, are aspirated. The eggs come out in a solution of follicular fluid and are quickly removed to another room where they are cleansed of cumulus cells and prepared for fertilization.
Meanwhile, a man’s sperm has been similarly prepared in a process called “sperm washing,” which removes seminal fluid and inactive, or dead, sperm cells.
Any eggs or sperm that are not to be used can at this point be separately frozen. It should be noted that either of these two necessary elements in the creation of life that are not chosen to be used can be destroyed. That’s okay with the state of Alabama, because it takes the next step for them to become “extrauterine children.”
Now the eggs and the sperm are introduced in a liquid medium, the proverbial “test tube” or “petri dish,” although neither is actually used in the process. In certain cases involving low sperm count, a single sperm can be injected into a single egg by intracytoplasmic injection. This is done under a microscope.
Once the eggs are fertilized, they are put into a so-called growth medium and allowed to grow for two to four days, through the cleavage stage, when the embryo splits into two cells, to the blastocyst stage of six to eight cells.
Get this: At this point, the embryos are “graded,” to determine the quality of the embryo and its likelihood of resulting in a live birth. By removing one or two cells from the blastocyst stage, embryos can be genetically analyzed for birth defects or inherited diseases, and depending on who’s doing the grading and what the criteria are, one or more of the embryos can be chosen over the others. An embryo at this point can even be chosen to provide embryonic cells that can be used to cure a sick child the woman has previously given birth to.
Now the embryo, or more often, embryos, can be inserted into the woman’s uterus through a thin catheter. If one or more of the implanted embryos attaches to the wall of the uterus and grows into a fetus, they can become actual, live, breathing children.
Or they can be frozen and become extrauterine children.
Amazing, isn’t it? The Alabama Supreme Court decision was made by nine Republican justices because there are no justices appointed by Democratic governors and confirmed by the state Senate. The vote was 8 to 1. Alabama is one of the states that has a law declaring that life begins at conception, the holy grail of the anti-abortion movement.
There are two other states with laws declaring that life begins at conception: Missouri and Mississippi. Legislatures in at least 14 more states have introduced so-called fetal personhood bills this year alone. But when the IVF clinics in Alabama began to shut down on Wednesday and the shutdowns continued yesterday and today, all of a sudden it occurred to the geniuses in the Republican Party who have been pushing for religion to be a determining factor in our government and laws, and for laws to be passed declaring that life begins at conception, that maybe this whole blastocyst-is-a-kid thing isn’t such a good idea.
Suddenly it occurred to Republicans that all those couples out there who have problems having children, or single women who want to give birth via IVF, won’t be able to do it because the process by its very nature involves the destruction of some of what Alabama called extrauterine children.
Republican presidential candidate Niki Haley, whose initial response to the Alabama ruling was, “Embryos, to me, are babies,” was described as “walking back” her comment.
South Carolina Congresswoman Nancy Mace, who is a sponsor of the federal Life at Conception Act, which would write into law that life begins when an egg is fertilized, was on Twitter-X today saying, “We should do everything we can to protect IVF for women everywhere.”
There is going to be a lot of Republican shifting into reverse in the coming days and months. When you mix politics and religion, bad things can happen. And when you take away the rights of more than 50 percent of the population to make their own healthcare decisions and turn those decisions over to a bunch of state legislatures and governors and state courts, worse things happen.
One of the major reasons that the anti-abortion movement has been squeamish about IVF for decades is that fundamentalist Christians don’t like the idea of messing around with nature, which introducing needles and drugs and operating rooms and all that medical gear certainly amounts to.
They are not squeamish about telling women what to do with their bodies, however. The result that is emerging from this political shitstorm is that Republicans are fine with prodding and poking and injecting and inserting things into women’s uteruses so long as it results in the birth of a baby, or as the Alabama Supreme Court has proven, the creation of an extrauterine child.
But prod her and poke her and give her shots and insert things in her uterus because she doesn’t want a child? That’s a no-no.
There is an essential contradiction Republicans have constructed: if you’re pregnant and don’t want to have the baby, you can’t stop your pregnancy. But if you’re infertile and you want to start a pregnancy, you can’t do that, either. Either way, if you are a woman, you are not in control of your own body. Laws, and court decisions written by Republicans are.
Despite their attempts to back and fill and shift into reverse and obfuscate and tell outright lies to solve this contradiction, it is about to come home for Republicans at the ballot box.
Lucian K. Truscott IV, a graduate of West Point, has had a 50-year career as a journalist, novelist, and screenwriter. He has covered Watergate, the Stonewall riots, and wars in Lebanon, Iraq, and Afghanistan. He is also the author of five bestselling novels. You can subscribe to his daily columns at luciantruscott.substack.com and follow him on Twitter @LucianKTruscott and on Facebook at Lucian K. Truscott IV.
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