figurine with a void shape of a child and family of parents with a child. Surrogacy concept.

Regulating International Commercial Surrogacy

By Hannah Rahim

In January 2024, Pope Francis called for a universal ban on surrogacy as a threat to global peace and human dignity, claiming that the practice is a “grave violation” of the mother and child’s dignity and based on the “exploitation of situations of the mother’s material needs.” Surrogacy raises complex ethical and legal issues, particularly in cases of international surrogacy, where people seek surrogacy services from another country. There is currently no regulation of international surrogacy. Creating such regulation is important to allow appropriate access to surrogacy services while mitigating its harmful consequences.

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cell with pipette and needle.

Are Embryos Children? The Alabama Supreme Court Says Yes

By Joelle Boxer

This month, the Alabama Supreme Court held that the term “children” in a state statute includes embryos, or “extrauterine children.”

As fertility treatments like in vitro fertilization (IVF) involve the creation of multiple embryos, not all of which are implanted, the implications of this ruling could be far-reaching. Four million births each year in the U.S. are via IVF, an important pathway to parenthood for couples with infertility, LGBTQ couples, and single parents.

This article will examine the Alabama Supreme Court’s decision in LePage v. Mobile Infirmary Clinic and its consequences for Americans building their families through fertility services.

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Birmingham, Alabama - February 8, 2020: University of Alabama at Birmingham UAB Hospital title and logo on brick facade.

The Beginning of a Bad TRIP – Alabama’s Embryonic Personhood Decision and Targeted Restrictions on IVF Provision

By Katherine L. Kraschel

Last week, the Alabama Supreme Court called frozen embryos created via in vitro fertilization (IVF) “extrauterine children” and referred to the cryotanks where they are stored as  “cryogenic nurser(ies).” The Court sided with couples who claim the accidental destruction of frozen embryos created through IVF and cryopreserved ought to be treated equally to the death of a child. 

The case, LePage v. Center for Reproductive Medicine, involves plaintiffs seeking punitive damages from an Alabama fertility clinic for the “wrongful death” of their embryos that were destroyed when a patient in the hospital where they were stored removed them from the cryotank. While the lower Alabama Courts concluded that the cryopreserved embryos were not a person or child under the state’s law, the Alabama Supreme Court disagreed and held that the state’s Wrongful Death of a Minor Act “applies to all unborn children, regardless of their location,” and that the  plaintiff’s wrongful death claims could proceed. 

Thoughtful scholars have argued that existing state laws do not sufficiently redress mistakes and accidents that occur in the process of fertility care, pregnancy, and birth. However, the ends do not justify the means in this case; likening frozen embryos to children is not a legally sound mechanism to hold fertility clinics accountable for negligently storing embryos. It illustrates how sympathetic stories can be used to further the agendas of those who seek to equate embryos and fetuses  to “people” under the law and undercut the critical role modern fertility care plays in (re)defining the bonds that create families, and particularly, many LGBTQ+ and single parent families. 

Specifically, lawmaking in fertility care stands to fuel the movement to create fetal personhood rights and a federal abortion ban. It may also signify an inflection point in regulating assisted reproduction reminiscent of pre-Dobbs targeted restrictions on abortion provider (TRAP) laws that sought to limit abortion provision by imposing restrictions. TRAP laws’ new sibling – targeted restrictions on IVF Provision – or TRIP laws, as I call them, stand to rob patients of their ability to build their families by compelling physicians to provide less effective, more expensive care. TRIP laws will erect barriers and exacerbate long standing racial disparities in accessing fertility care, and they will disproportionately impact members of the LGBTQ+ community who wish to build families through fertility treatments.  The Alabama decision is severe, but it should serve as a warning to state legislators with a new responsibility to safeguard reproductive health care without the floor of Roe’s protections – proceed with extreme care and regard for “unintended” consequences of regulating fertility care.  Read More

. Group of pregnant women and women with children. Vector illustration

#MaternalHealthAwarenessDay: Three Policies to Push

By Joelle Boxer

Today is Maternal Health Awareness Day, focused on the theme “Access in Crisis.”

“Crisis” is the right word, yet still an understatement. In the U.S., for every 100,000 live births in 2021, nearly 33 pregnant people lost their lives. In Norway, that number was 2. Black and Native American women in the U.S. are particularly at risk, with death rates 2-3 times higher than those of white women, due to structural racism.

What can the law do to prevent these deaths? Medicaid pays for more than 40% of births in the U.S., covering 64% of Black mothers and 66% of Native American mothers. Examining efforts at the federal and state level, I highlight three options, leveraging Medicaid as a policy lever.

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Rows of gold post office boxes with one open mail box.

Plan to See ‘Plan C’ This Year

By Joelle Boxer

Tracy Droz Tragos’ new documentary, “Plan C,” follows the work of a grassroots organization dedicated to improving access to the abortion pill by mail in the U.S., while navigating an increasingly restrictive legal landscape.

There is no better time to hear the perspectives of these patients, providers, and activists. Just last month, the U.S. Supreme Court took on a case to determine the legal status of the pill, also called mifepristone. With a decision expected in June 2024, Tragos’ film shows us what’s at stake.

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An ordinary classroom in an African school.

Two Years On: The Reversal of Tanzania’s Education Policies for Adolescent Mothers

By Joelle Boxer

In November 2021, Tanzania’s Ministry of Education reversed a policy preventing adolescent mothers from attending public schools. Two years on, research shows the movement for #ArudiShuleni (“Back to School”) requires continued support.

Prior to the policy change, an estimated 6,55015,000 Tanzanian girls and adolescents were forced out of school each year due to pregnancy, while thousands more were subject to coercive pregnancy testing. The reversal has fundamental implications at the intersection of rights to sexual and reproductive health care and education.

This article will review the expulsion policy, efforts leading to its reversal, and the government’s recent re-entry guidelines, with a focus on the driving role of civil society.

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FAIRFAX COUNTY, VIRGINIA, USA - NOVEMBER 4, 2008: Women voters at polls during presidential election, paper ballots.

Taking Abortion to the Polls: What To Expect in Ohio

By Joelle Boxer

Dobbs “return[ed]” the authority to regulate abortion to “the people and their elected representatives.” The people of Ohio will act on that authority on November 7, demonstrating yet again the emerging role of referenda in American abortion law.

The referendum will determine if “The Right to Reproductive Freedom with Protections for Health and Safety Amendment,” or Issue 1, is added to the Ohio Constitution. It reads as follows: “Every individual has a right to make and carry out one’s own reproductive decisions, including but not limited to decisions on contraception, fertility treatment, continuing one’s own pregnancy, miscarriage care, and abortion.”

The amendment would establish a constitutional right to abortion before fetal viability (around 22-24 weeks gestation), and would include exceptions for later term abortions in instances where it is necessary to protect the pregnant person’s life or health.

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