What effect will abortion, IVF have in the US presidential race? 

Abortion and reproductive freedom are on the ballot and up for debate in America today, and likely to be a central issue in the upcoming ABC debate between Donald Trump and Kamala Harris.  

Democrats see abortion as a “winning issue” this election, now that Roe v. Wade has been overturned. They have been successful at the state level ever since that 2022 decision, and they hope to capitalize on those gains to keep the White House and the Senate this fall, and maybe even take back the U.S. House. 

Trump, meanwhile, has been throwing curveballs recently on both abortion and in vitro fertilization, telling NBC News “under the Trump administration, we are going to be paying for that treatment [for IVF for] all Americans who get it; all Americans who need it.” 

The former president also said last week he will not vote for a controversial ballot measure in Florida that would effectively prevent and overturn state laws limiting abortion, even though he had previously said he “disagreed” with the state’s current restrictive abortion law because “you need more time than six weeks.” 

Abortion rights have been losing ground ever since the Supreme Court’s Dobbs decision as many states take restrictive positions.

IVF is also under threat. We are not yet like China, though, where a court recently denied an unmarried woman the right to freeze her eggs because “only married women may use the procedure.” 

Still, America is beginning to look like many countries where, according to the United Nations, “too many women and girls are denied this basic power over their own bodies.”  

Rarely discussed in abortion debates is how American women are already falling behind when it comes to maternal health. According to the Commonwealth Fund, “the United States continues to have the highest rate of maternal deaths of any high-income nation, despite a decline since the COVID-19 pandemic. And within the U.S., the rate is by far the highest for Black women. Most of these deaths — over 80 percent — are likely preventable.” 

What is particularly stark about restrictions on women’s reproductive freedom is how they defy established medicine and, according to the American Journal of Public Health, put “women’s psychological and medical health at risk.” 

Two women in Texas have filed complaints against hospitals for “denying them treatment for ectopic pregnancies” after the state banned abortions in 2022 with some exceptions. Ectopic pregnancies cannot survive, as they occur outside of the womb, and are a “life-threatening condition that requires emergency treatment,” according to the Cleveland Clinic. 

According to the Kaiser Family Foundation. “Pregnant women seeking abortion that reside in states that prohibit or restrict abortions either have to travel out of state or try to obtain medication abortion pills via a telehealth appointment with an out-of-state clinician, but these options are not accessible to everyone. Some women may turn to self-managed abortions, but some will not be able to obtain an abortion and have to continue a pregnancy they do not want.” 

The Guttmacher Institute reports that if “abortions were banned in all states, at the highest end, maternal mortality would increase by 24 percent; non-Hispanic Black people would face a 39 percent increase in maternal deaths.” 

Controversies over IVF are also limiting options for women. In the six months since the Alabama Supreme Court decision that characterizing embryos created through IVF as children with legal protections, anti-abortion lawmakers have struggled to frame positions that leave room for IVF treatments.

Some argue that, although the concept of IVF is acceptable, current standard-of-care practices, including egg stimulation and embryo cryopreservation, are not, as the process can create more embryos than can be safely implanted and are often later discarded. 

Others are not so subtle. The Southern Baptist Convention, for example, voted in June to oppose IVF altogether. 

Such religious and politically motivated laws limiting reproductive care are exposing physicians to civil or criminal liability, and in some cases threatening the very family-building goals that anti-abortion advocates proclaim to protect. 

Reports from Alabama and Texas confirm that some patients are now altering their IVF treatments, including moving their embryos to other states where abortion policy is less strict.  

Abortion and IVF will remain critical electoral issues as more states keep putting abortion on the ballot. Now is the time to get informed and educated, to look ourselves in the mirror and ask what kind of society and choices we want for ourselves, our daughters and for all women and girls. 

Susan Crockin is a senior scholar at the O’Neill Institute for National and Global Health Law and an adjunct professor at Georgetown University Law Center. Tara D. Sonenshine is former U.S. undersecretary of state for public diplomacy and currently senior nonresident fellow at the Fletcher School of Law and Diplomacy at Tufts University.