The following article was originally published in the Ohio Capital Journal and published on News5Cleveland.com under a content sharing agreement.

The reproductive rights amendment passed by Ohio voters in 2023 included protections not only for abortion, but also for other medical care, such as miscarriage care and IVF treatments. Fertility doctors say the amendment was reassuring for patients, but with legal and political challenges remaining, these rights should not be taken for granted.

When the US Supreme Court overturned 50 years of nationwide abortion rights established by Roe v. Wade in the Dobbs decision in 2022, the issue of abortion and reproductive rights came to the forefront of American political life. Voters continue to list it as a top concern, along with the economy, democracy and immigration.

After 57 percent of Ohio voters passed a reproductive rights amendment in November 2023, legal challenges have been mounted against various Ohio anti-abortion laws, including mandatory 24-hour waiting periods and ultrasounds and six-month abortion bans Ohio weeks of 2019, no exceptions. for rape or incest that was enforced for several months after the Dobbs decision. A Hamilton County court temporarily blocked the last one in the fall of 2022 and on October 24. knocked her down for good. The Ohio attorney general has 30 days to appeal.

During the Ohio Reproductive Rights Amendment campaign, IVF was brought up as a right that the proponents of the measure sought to protectarguing that reproductive care of all kinds has interfered with the needs of IVF patients.

“No. 1 was very reassuring for patients,” said Dr. Rachel Weinerman, a reproductive endocrinologist and infertility doctor in Cleveland, who has previously seen patients take their fertilized embryos to other states because of regulations and uncertainty about rights of Ohio Breeding.

Abortion bans have been directly linked to fertility care by advocates and medical professionals because complications that can occur with IVF treatment, such as ectopic pregnancies and life-threatening miscarriages, can necessitate the care that can be classified as abortion care. A ectopic pregnancyrequires termination of pregnancy because the pregnancy is not viable and could be dangerous to the pregnant person, while spontaneous abortions are considered medical”spontaneous abortions.“

“In general, patients who do IVF do it because they desperately want to have children,” Weinerman said.

But when there are complications, patients must have the flexibility to make decisions that could mean terminating a pregnancy in order to preserve the possibility of a future pregnancy, a flexibility that is aided by the existence of Ohio’s reproductive modification.

Weinerman said there is still “daily concern” about the implementation and enforcement of last November’s No. 1 and other challenges to reproductive rights, especially with news of abortion bans in other states.

Dr. David Hackney, a maternal-fetal medicine specialist in the Cleveland area, also doesn’t see the problem solved just because of Ohio’s adoption of the reproductive amendment.

“You never take reproductive rights for granted, and it’s always best to frame things as an ongoing situation,” Hackney said.

The interest for a Alabama court case to determine whether a fertilized embryo can legally be considered human, along with several states debating so-called “personhood” bills for embryos. IVF is still on the table as a hot issue, both the presidential candidates and those in the Ohio race for a seat in the US Senate have taken their own positions on this issue, among other reproductive rights.

“Since Dobbs, there has been an outpouring of stories of patience,” Hackney said. “That brought these issues to life in a way they hadn’t before.”

IVF as a galvanizing force

Hackney works with high-risk pregnancies and has often had patients use IVF for pregnancy. In an ideal world, these patients could avoid talking about their pregnancies in the political realm, but Hackney said awareness is still important.

“I think it’s a critical issue, and even for people who aren’t directly affected by pregnancy itself, a lot of the laws are attacks on autonomy,” Hackney said. “Once you set a precedent for government interference in our private lives, then what’s the next barrier after that? And the next barrier after that?”

Some barriers already exist in the reproductive rights space, including IVF, for communities of color. The same complications that are possible for other pregnant people are present for women of color, but the outcomes are often different.

“Black women, when they finally get to the point of giving birth, still have higher rates of maternal mortality and complications,” said Linda Goler Blount, president of the DC-based Black Women’s Health Imperative. “This goes back to when black women complain that something doesn’t seem right, those complaints are less likely to be followed up, even with all the extra monitoring and specialists that come with IVF.”

Laws that define personhood to include fertilized embryos and limit abortion services only complicate matters during a trial with patients who have often had difficulty becoming pregnant despite their desire.

“You’re actually limiting the ability of people who want to have children to have those children and people to have families,” Weinerman said.

A electoral report on IVF of the UCLA Center on Reproductive Health, Law and Policy found that presidential candidates on both sides of the aisle “portrayed themselves as protective of this popular reproductive health care.”

Democrats have been overwhelmingly supportive of reproductive rights and Vice President Kamala Harris said he would sign legislation to create a federal right to abortion and gave broad support to IVF.

Former President Donald Trump has wavered on his views on abortion, but in August said he would support a plan to have a federal government. pay for IVF treatments.

“But the Republican Party platform, Republican legislative efforts and Project 2025 — a presidential transition project led by former Trump administration officials — reveals the party’s persistent support for ‘personality,'” the UCLA report said.

The person, the UCLA report said, is “irreconcilable with the current standard practice for IVF, which often involves creating more embryos than are used.”

The public, for its part, is “overwhelmingly” in favor of universal access to IVF, according to a Pew Research Center survey carried out at the beginning of this year.

The study found that 7 in 10 adults say IVF access “is a good thing,” a majority that extends across religious and political lines. Among Republicans and Republican independents, 63 percent support IVF, and 79 percent of Democrats and those who lean Democratic support it.

The position of those polled on abortion didn’t change much about IVF, according to Pew, with 60% of those who thought abortion should be illegal still supporting IVF treatment.

Goler Blount said it’s time for Americans to understand that while medical decisions should be made privately, the government is now part of those decisions.

“We have no choice, because it’s not just a decision between a person and their provider, because a provider, depending on where they are, has to weigh the possibility of prosecution,” Goler Blount told the Capital Journal .

For her, it grew women’s participation in elections shows progress in engaging voters based on their needs and their views on what government control should look like.

“I think with every successful election, we’re going to see more women supporting abortion as healthcare and IVF support and the full complement of healthcare,” Goler Blount said.

In Ohio, House Democratsintroduced a bill to provide “clarity” to medical professionals while working with IVF patients. The measure was brought up in the wake of Alabama’s passage of legislation protecting IVF in the wake of that state’s Supreme Court ruling that deemed fertilized embryos human.

Ohio’s bill has not been considered since it was introduced in April.

IVF protection bills from both sides were tried in the US Congress in September, but both were blocked in the US Senate.