Tara Harding is a nurse practitioner who's been helping North Dakota women get pregnant for five years. But for her own fertility treatment, Harding is going to Colorado.
The 38-year-old runs a women’s health clinic in Bismarck that specializes in fertility treatment. In June, she plans to have surgery to address one of her own health concerns: endometriosis, a uterine condition that makes it more difficult to conceive. If she can’t conceive naturally after that, she will turn to in vitro fertilization—just not in her home state.
“I’m not going to take any risk with [my embryos] locally and be worried about not being able to move forward with the treatment.” she said.
The cause of Harding’s location shift is not a change in North Dakota law, but a state Supreme Court decision in Alabama that ruled frozen embryos had the same rights as children, temporarily suspending IVF services in the state. No other state has made a similar decision—and Alabama has since passed legislation protecting patients and providers from legal consequences— but fertility doctors in conservative states told The Daily Beast some of their patients are still taking proactive measures.
Dr. Nicole Ulrich is an IVF provider at Audubon Fertility in New Orleans, which outlawed abortion as soon as Roe v Wade was overturned in 2022. She said that sent a wave of patients rushing to her office with questions. Now it’s happening again.
Ulrich said two patients asked to expedite their fertility treatment in recent weeks. One was considering IVF and decided to start sooner than expected in case the ability to do so was legislated away. The other already had a child through IVF and several embryos stored out of state. She decided to start the process of having a second child sooner than planned, for similar reasons.
“I’m excited for them that they're taking the next step in their journey but it also makes me so sad that they feel like they have to change their plan or speed up their plan because of what’s happening politically,” Ulrich said. As a provider, she added, “you’re making decisions based on not exactly what’s the best medical decision for the patient, but on external factors.”
A model of the female reproductive system and an embryo transfer catheter at West Coast Fertility Centers on Feb. 29, 2024, in Fountain Valley, CA.
Ulrich’s clinic already stores patients’ embryos outside of the state; Louisiana is the only state? with a law preventing the destruction of extrauterine embryos, leading many providers to store them in another jurisdiction. But since the Alabama decision, Ulrich said, at least five patients have asked to move their embryos out of the clinic’s long-term storage facility in Texas, fearing a similar outcome there.
Other patients have sought her advice on what they should do.
“I often tell them I wish I had a crystal ball,” she said. “I don't think it will happen here, I just have to hope that cooler heads will prevail.”
The decision in Alabama, in a case filed by two families that lost frozen embryos in a storage facility accident, caused backlash around the country—and across party lines. Even former President Donald Trump said he “strongly” supported IVF access and called on Alabama lawmakers to preserve it—which they did, passing a law to shield providers and patients from liability last week. But Republicans in the U.S. Senate failed to do so nationally, blocking a bill that would have established a federal right to the treatment.
No other state has a similar court case looming, but at least 14 are considering laws that would grant “personhood” to fetuses, according to NPR. Two states are weighing bills that would define personhood as beginning at fertilization for the purposes of homicide and wrongful death cases, and six are considering measures to allow women to seek child support for fetuses.
In Florida, lawmakers paused debate on a bill that would allow parents to sue over the wrongful death of a fetus because of “questions and concerns” following the Alabama decision. But Dr. Preston Parry, who practices in Mississippi but stores his patients’ embryos in Florida, said two in the last week asked to move their embryos out of the Sunshine State.
Dr. Samuel Brown, a provider in Florida, said dozens of patients asked to move up their IVF treatment in the wake of the Alabama decision.
“We have patients that weren't quite ready to add to their family and it is expediting them, it’s making them say, ‘Let’s go ahead and transfer these embryos now so we don't have to deal with this atrocity later,’” he said.
In Iowa, Republicans in the state House passed a bill this week that would make it a felony to cause the death of an “unborn person,” without any exceptions for IVF. The bill must still be passed by the Senate and signed by the governor, but IVF providers in the state said they were already flooded with calls from worried patients.
Dr. Abigail Mancuso, a fertility doctor at the University of Iowa hospital system, said patients have called all three of their locations since the bill passed the House, asking whether they should move their embryos out of state. Dr. Amy Sparks, director of the hospital system’s IVF labs, said a higher number of patients than usual asked to discontinue storage—in other words, to dispose of their embryos—in recent weeks.
Sparks said she did not know whether the hospital system would be able to continue providing IVF treatment if the Iowa bill passed.
“This is a stressful job to begin with, and we do our absolute best,” she said. “But if we can’t have that trust with our patients and people are at risk of being charged with a felony, why would you want to continue offering services in the state?”
She added that she was surprised to see the bill move ahead given the national backlash to the decision in Alabama.“You just wonder, ‘Geez, did they turn off the news or are they that blind?’” she said.
Even women in states without fetal personhood bills are considering moving their embryos elsewhere. Amanda Zurawski is suing Texas over its abortion ban, claiming she was unable to end a dangerous pregnancy despite an exemption in the law for medical emergencies. She announced shortly after the Alabama decision that she will move her embryos to another state, telling NBC News she “[does not] want them in a state where a similar ruling could very likely take place.”
North Dakota is also not considering a fetal personhood bill, but Harding said she does not want to start the IVF process there only for it to adopt something similar while she is in the middle of the process. She and her partner are already budgeting for the extra cost and inconvenience of traveling out of state for every appointment.
Still, she said, she sees a silver lining to the whole situation.
“I think the one thing this did was bring the infertility community together,” she said. “Since I've been involved in over six years, it's the loudest and most productive, quick change that we've seen happen.”
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