When One Religion’s Rules Become Everyone’s Law: What Fertility Patients Need to Know Right Now

The courts are moving fast. Your access to IVF, contraception, and miscarriage care may depend on paying attention.

On May 1, 2026, the 5th U.S. Circuit Court of Appeals issued a ruling that sent immediate shockwaves through reproductive medicine. The court blocked the mailing of mifepristone prescriptions nationwide — reinstating a requirement that the medication be dispensed only in person at a clinic. Mifepristone is used in nearly two-thirds of U.S. abortions. It also treats early miscarriage. The ruling affects every state in the country, including states where abortion remains legal.

That ruling didn’t come from a medical authority. It didn’t come from the FDA, which has repeatedly affirmed mifepristone’s safety over 25 years of use. It came from a court acting on a lawsuit brought by the state of Louisiana — a state with a total abortion ban — arguing that FDA rules allowing mail-order access “undermined” its abortion restrictions.

This is where we are. And fertility patients need to understand what it means.

This Is Not About Abortion

The fight over mifepristone is being framed as an abortion debate. But the medication also treats early miscarriage — a reality that affects one in four known pregnancies and many fertility patients. When access to mifepristone is restricted, miscarriage patients lose a safe, evidence-based treatment option. When telehealth prescribing is blocked, rural patients, patients with disabilities, survivors of domestic violence, and low-income patients lose access to care they cannot easily replace with an in-person clinic visit.

The ACLU (American Civil Liberties Union) stated clearly in response to Friday’s ruling: “This is going to affect patients’ access to abortion and miscarriage care in every state in the nation.”

That includes fertility patients. That includes you and people you love that are struggling with pregnancy loss and infertility.

The Personhood Movement and What It Means for IVF

To understand the full scope of what is at stake, fertility patients need to understand one concept: fetal personhood.

Fetal personhood is the legal theory pushed by certain groups that human life — with full legal rights — begins at the moment of fertilization. It is the cornerstone of the anti-abortion movement’s long-term legal strategy. And it directly threatens IVF.

Standard IVF practice involves creating multiple embryos, testing them for chromosomal abnormalities, transferring the most viable ones, and freezing others for future use. Some embryos do not survive the process. Some are not used. Some are donated to research. These are not incidental outcomes — they are the medical realities of a process that gives millions of people the chance to become parents.

If personhood begins at fertilization, every embryo not surviving or is not transferred becomes a potential legal liability. Every unused embryo in a freezer becomes a rights-holding person under the law. Every IVF provider who performs pre-implantation genetic testing and discards embryos with chromosomal abnormalities becomes, under this logic, a potential target for criminal or civil action or both.

This is not theoretical. In February 2024, the Alabama Supreme Court ruled that frozen embryos are “extrauterine children” under the state’s Wrongful Death of a Minor Act. Several IVF clinics in Alabama immediately suspended operations. The Alabama legislature moved quickly to provide liability protections for IVF providers — but the court’s reasoning remained. The legal framework exists. The question is how far it travels.

Nationally, 85% of Americans oppose laws that would make IVF illegal. But the Southern Baptist Convention voted in 2024 to oppose IVF, citing concerns about embryo destruction. And Project 2025 contains language that legal experts say is “incompatible with IVF, as well as some forms of contraception.”

When It Already Happened: Real Disruptions to Real Patients

This is not a future threat. It has already happened — and the patients who lived through it were not statistics. They were people mid-treatment, mid-cycle, hoping for their miracle.

Alabama, February 2024 — the proof of concept

When the Alabama Supreme Court ruled that frozen embryos were children under state law, the disruption was immediate. Within the first week, two of Alabama’s eight IVF clinics paused treatments — including the large clinic at the University of Alabama at Birmingham Health System. Patients who were scheduled for embryo transfers — the final step of their IVF cycle — had those procedures cancelled. One facility suspended even the transfer of embryos to out-of-state facilities. The confusion was total.

The American College of Obstetricians and Gynecologists put it plainly: “In early 2024, those restrictions came to pass when people in Alabama temporarily lost access to IVF because of a court decision related to the state’s personhood law that exposed IVF providers and clinical staff to legal jeopardy, rendering them unable to confidently deliver care to patients.”

Citizens rallied at the state capitol. The Alabama legislature moved quickly — passing a bipartisan bill granting IVF providers civil and criminal immunity. IVF resumed. But the state constitution’s personhood language remained unchanged. The legal framework that caused the disruption is still there.

A patient who lived it

Jacqueline Brock spent seven years in fertility treatment before a third round of IVF produced two embryos and one healthy pregnancy. Now, with one embryo still frozen, she and her husband face uncertainty about their options. “I had to stop going to outings with our friends because they’d bring their kids or talk about their kids, and I would just cry,” she said. “I didn’t go to a lot of baby showers and things because I couldn’t physically handle it.” Seven years. Three rounds. And now the legal status of the embryo that represents their remaining hope is unsettled.

Louisiana — already restricting embryo decisions

Alabama is not alone. In Louisiana, patients who do not intend to store or use an embryo may already be forced to relinquish control over it to a doctor or clinic — because state law limits what patients can do with their own embryos. This is not a hypothetical. It is current law.

Italy — a cautionary tale

The United States is not the first country to let ideology and religion drive reproductive medicine policy. Italy once mandated that only three eggs could be fertilized in a single IVF cycle and that every fertilized embryo had to be transferred. The results were medically catastrophic. IVF success rates collapsed. Multiple pregnancy rates — including dangerous triplet pregnancies — soared. The law was eventually struck down, but not before patients paid the price for a policy built on ideology and religion, not medicine.

Eleven states — and counting

Alabama is not an outlier. At least eleven states currently have fetal personhood laws on the books that legal experts say could be applied to IVF at any time. ACOG has noted that as of now, none of those laws are actively restricting IVF access — but adds carefully: “It is unknown whether that will continue into the future.”

That uncertainty is the point. Providers who cannot predict their legal liability cannot confidently deliver care. Patients who cannot predict the legal status of their embryos cannot plan their treatment. The chilling effect of personhood laws on IVF access does not require a court to act. It only requires the threat to exist.

According to an analysis by Pregnancy Justice, a reproductive rights nonprofit, provided to TIME Magazine (2024), the following states have personhood laws broad enough to potentially threaten IVF access:

States with broad or vaguely worded personhood laws that could directly put IVF at risk:

• Alabama
• Arkansas
• Georgia
• Indiana
• Kansas
• Louisiana
• Mississippi
• North Dakota
• Tennessee

States with feticide or wrongful death laws broad enough to potentially apply to embryos:

• Michigan
• Oklahoma
• South Dakota
• North Dakota
• West Virginia
• Texas

The legal expert warning

“In the IVF context, embryo personhood would be extremely harmful to patients and providers, who could be criminalized, for example, for discarding an embryo or for transferring an embryo that then does not implant,” said Karla Torres, senior counsel at the Center for Reproductive Rights.

Discarding an embryo. Transferring one that fails to implant. These are not edge cases. These are standard outcomes in every IVF cycle. If personhood laws reach IVF, every routine step of a standard IVF cycle becomes a potential criminal act.

When Contraception Becomes a Target

The same personhood logic that threatens IVF also threatens contraception — and the implications for certain patients are severe.

Some forms of hormonal contraception — including IUDs and emergency contraceptives — work in part by preventing implantation of a fertilized egg. Under strict personhood doctrine, this makes them “abortifacient.” Students for Life, one of the largest anti-abortion organizations in the country, lists virtually all forms of hormonal contraception as abortifacient on their website.

For most couples, this is a deeply unwelcome legal overreach into private medical decisions. For some couples, it is a matter of medical survival.

Consider a couple who carries a gene for a deadly heritable condition — Huntington’s disease, Tay-Sachs, severe combined immunodeficiency, or any of dozens of others. They need to remain on contraception while they pursue preimplantation genetic testing through IVF, so they can transfer only unaffected embryos. For them, contraception is not a lifestyle choice. It is part of a carefully planned medical protocol designed to prevent the birth of a child who would suffer and die.

A legal framework that classifies their contraception as an act of harm — or that creates criminal liability for discarding embryos that carry a fatal mutation — does not protect life. It endangers it.

When Miscarriage Becomes a Crime

Brittany Watts — Ohio, 2023 Brittany Watts was arrested and charged with felony abuse of a corpse after experiencing a miscarriage at home in her toilet. She had been to a hospital prior to her miscarriage but left when she felt she was getting inadequate treatment. When she returned after her miscarriage, a nurse called police and reported that Watts had given birth at home and did not want the baby. A grand jury declined to move forward with the criminal case in 2024. Watts later filed a lawsuit alleging medical professionals conspired with a police officer to fabricate criminal charges against her. Prochoicenc

Amari Marsh — South Carolina, 2023 A college student in Orangeburg, South Carolina named Amari Marsh went from miscarrying a fetus in her bathroom to being investigated for a homicide. She told investigators she didn’t realize she was pregnant until she went to an ER with severe pain. Police became suspicious that she may have sought to end the pregnancy. She was jailed and accused of homicide by child abuse — before the fetus was even autopsied. An autopsy later showed the fetus died of natural causes due to an infection Marsh was unaware of. Prochoicenc

Selena Maria Chandler-Scott — Georgia, 2025 The arrest of Selena Maria Chandler-Scott, who miscarried in Tifton, Georgia, reflects the growing criminalization of pregnancy, experts say. Illume Fertility

Alabama — capital murder charges for a stillbirth A mother of six was wrongly convicted of capital murder in Alabama after suffering a stillbirth at home. nih

California — Adora Perez In California, outrage about the prosecution of Chelsea Becker for “murder of a human fetus” after her pregnancy ended in a stillbirth led to the reversal of Adora Perez’s conviction on similar charges — after she spent nearly four years in prison. The cases spurred lawmakers to ban such prosecutions in 2022. nih

The scale of it: Prosecutions related to pregnancy increased significantly after Dobbs. In the first year after the decision — from June 2022 to June 2023 — there were at least 210 pregnancy-related prosecutions, the highest number documented in a single year since Pregnancy Justice began tracking cases. PolitiFact

“The Dobbs decision unleashed and empowered prosecutors to look at pregnant people as a suspect class and at pregnancy loss as a suspicious event,” said Dana Sussman, senior vice president of Pregnancy Justice

The Constitutional Question Nobody Is Asking Loudly Enough

The United States Constitution’s First Amendment contains two religion clauses. The Establishment Clause bars the government from making any law “respecting an establishment of religion.” The Free Exercise Clause protects the right to practice one’s religion as one chooses.

As Thomas Jefferson wrote: “The legitimate powers of government extend to such acts only as are injurious to others. But it does me no injury for my neighbor to say there are twenty gods, or no God. It neither picks my pocket nor breaks my leg.”

Religious liberty, in the American tradition, is not a zero-sum game. One person’s religious conviction does not carry the legal authority to govern another person’s medical care.

Yet the laws and rulings that now threaten access to IVF, contraception, and miscarriage care rest almost entirely on a specific theological belief: that human life, with full legal personhood, begins at the moment of fertilization. This is not a scientific consensus. It is a religious doctrine — one held by some faith traditions and explicitly rejected by others.

America is not a theocracy. The First Amendment exists precisely because the founders understood the danger of allowing any single religious tradition to govern everyone’s lives. And yet that is exactly what is happening in reproductive medicine right now — and fertility patients need to understand it personally, not abstractly.

A vocal and organized segment of the Christian right is not simply opposing abortion. It is pursuing a legal framework that would embed one specific theological belief — that full human personhood begins at the moment of fertilization — into the law of the land. If that framework succeeds, it does not just end abortion. It ends IVF as it is currently practiced. It criminalizes routine steps in embryo handling. It restricts or bans the contraception that some couples depend on for medically necessary reasons. It gives courts and legislatures the authority to override the medical decisions you make with your doctor.

The Supreme Court’s decisions do not stay in the abstract. They travel. Dobbs traveled to Alabama, where IVF clinics closed. It traveled to the 5th Circuit, where mifepristone — used for miscarriage care — just became harder to access for every patient in every state. The next ruling travels too. Every personhood case working its way through state courts right now carries the potential to land in your fertility clinic, in your treatment plan, in the conversation with your reproductive endocrinologist about what you are legally allowed to do with your own embryos.

This is not a political issue. It is a direct, documented, ongoing threat to the medical care of anyone who needs IVF, anyone who uses certain forms of contraception for medical reasons, and anyone who faces pregnancy loss. Pay attention. The courts are moving fast — and they are moving toward your exam room.

The argument cuts both ways. If the government cannot restrict religious practice, it also cannot impose one religion’s doctrine as the governing standard for everyone’s medical care.

Telehealth: A Lifeline Under Threat

Before this week’s mifepristone ruling, telehealth had been transforming access to reproductive care — including fertility care — in ways that benefited patients who had long been underserved.

For fertility patients in rural areas, telehealth meant the difference between a three-hour drive to a reproductive endocrinologist and a video consultation from home. Research confirms that patients who live farther from fertility clinics and have longer durations of infertility are the most likely to use telehealth — and that new patients seen via telehealth are equally likely to pursue treatment as those seen in person.

When telehealth is restricted for miscarriage medication, it sets a legal precedent for restricting telehealth in reproductive medicine more broadly — a precedent that fertility patients should watch carefully.

What This Means for You — Right Now

The legal landscape is moving fast and it is not moving in a patient-friendly direction. Here is what fertility patients need to do:

• Know your state’s laws. The fertility legislation landscape varies dramatically by state. Use INCIID’s Fertility Legislation Tracker at inciid.org/fertility-legislation-tracker to see what’s active, passed, or failed in your state.
• Ask your clinic direct questions. Ask your reproductive endocrinologist how your state’s current laws affect your specific treatment plan. Ask what happens to your frozen embryos if the legal status of embryos changes in your state.
• Understand what personhood laws mean for your embryos. If you have frozen embryos in storage, ask your clinic what their legal obligations are under current state law and how a personhood ruling would affect your options.
• If contraception is part of your medical plan, protect it. Document that plan with your physician. Medical necessity creates a different legal and ethical context than elective use.
• Pay attention to what is happening in the courts. The mifepristone ruling is headed to the Supreme Court. The personhood cases working through state courts will shape the future of IVF access.
• Vote and make your voice heard. 85% of Americans support IVF access. That majority needs to show up — in elections, in legislative comment periods, in conversations with elected representatives.

INCIID’s Position

INCIID does not take a position on abortion. We are not an abortion advocacy organization.

INCIID is an organization that from it’s inception three decades ago fights for patients who want to build families — and we take an unequivocal position on this: laws that make IVF legally perilous, that restrict access to miscarriage care, that classify medically necessary contraception as criminal, and that impose one religious tradition’s definition of personhood on everyone’s medical decisions — regardless of their own faith, their own values, or their own medical reality — are a direct threat to the patients we serve.

America’s constitutional tradition of separating church and state exists precisely to protect people of every faith — and no faith — from having someone else’s religious doctrine written into law as the governing standard for their lives.

Fertility patients deserve access to evidence-based care. They deserve the right to make medical decisions in consultation with their doctors, not in fear of courts and legislatures that have substituted theology for medicine.

INCIID will continue to track this legislation, publish accurate information, and advocate for the patients who have trusted us since 1995.

Resources

• INCIID Fertility Legislation Tracker
• INCIID Reproductive Medical Terms
• ASRM — American Society for Reproductive Medicine

References

1. NPR. Court restricts abortion access across the US by blocking the mailing of mifepristone. May 1, 2026.
2. CNN. Appeals court blocks FDA rule that allows women to obtain abortion drugs by mail. May 1, 2026.
3. ACLU. Federal Appeals Court Orders Nationwide Restrictions on Common Medication for Abortion and Miscarriage Care. May 1, 2026.
4. CBS News. Drugmaker asks Supreme Court to halt ruling blocking online access to abortion pill mifepristone. May 2, 2026.
5. PRRI. Embryo Personhood’s IVF Problem: What the Data Reveals. April 2026.
6. The Nation. Abortion Bans Are Never Just About Abortion. November 2025.
7. Cornell Legal Journal. The Legal Consequences of the Fetal Personhood Movement. 2025.
8. Princeton Legal Journal. The First Amendment and the Abortion Rights Debate. March 2025.
9. UC Berkeley Law. Considering Abortion Restrictions Through the Lens of Religious Freedom. May 2024.
10. State Court Report. Religious Freedom Claims Could Provide New Path to Protect Abortion Rights. September 2024, updated July 2025.
11. PMC/PubMed. Traits of patients seen via telemedicine versus in person for new-patient visits in a fertility practice. Fertility and Sterility, 2021.
12. ASRM Ethics Committee. Ethical Considerations for Telemedical Delivery of Fertility Care. 2024.
13. MultiState. Fertility Care and IVF Access in 2025: State Legislation and Federal Policy Highlights. November 2025.
14. PolitiFact. Fact-checking Kamala Harris on Project 2025 limiting access to IVF, contraception. July 2024.
15. Corbin, Caroline Mala. Religion Clause Challenges to Early Abortion Bans. Boston University Law Review. 2024.
16. ACOG. Counseling Patients on Access to IVF. American College of Obstetricians and Gynecologists. 2024.
17. NPR. The push for embryo rights in state legislatures worries IVF patients and doctors. June 2024.
18. ABC News. What are the potential risks to fertility and reproductive care post-Roe v. Wade? June 2024.
19. NBC News. Abortion bans and IVF: Why providers and lawyers are confused after Roe v. Wade decision. July 2022.
20. Johns Hopkins Bloomberg School of Public Health. The Alabama Supreme Court’s Ruling on Frozen Embryos. February 2024.
21. The Marshall Project. “Miscarriages Illegal? These States Investigated Them as Crimes.” April 2, 2025.
22. NBC News. “Woman’s arrest after miscarriage in Georgia draws fear and anger.” April 6, 2025.
23. The Marshall Project / Frontier. “Some states are turning miscarriages and stillbirths into criminal cases against women.” October 31, 2024.
24. “Post-Roe, pregnant women face growing risk of criminal prosecution for charges much broader than abortion.” September 24, 2024.
25. Pregnancy Justice. Annual Report on Pregnancy-Related Prosecutions. 2024. pregnancyjusticeus.org
26. Reingold, R. “IVF Changed America. But Its Future Is Under Threat.” TIME Magazine, 2024. Analysis sourced from Pregnancy Justice nonprofit organization.

INCIID provides health information and patient advocacy. This article does not constitute legal advice. Consult a reproductive endocrinologist about your individual treatment plan and a legal professional about how state laws may affect your specific situation.