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In the days after former President Donald Trump declared that he’d make in vitro fertilization more accessible for Americans, the anti-abortion movement went to work. The activist Lila Rose urged her social-media followers not to vote for Trump, equating his enthusiasm for IVF with support for abortion. The Pro-Life Action League asked Trump to walk back his remarks, citing the “hundreds of thousands” of embryos that would be destroyed. Meanwhile, Kristan Hawkins, the president of Students for Life of America, tagged Trump’s running mate, J. D. Vance, in a social-media post arguing a different point: that the policy would “be encouraging families to delay childbirth.” Supporting IVF, in other words, would give women a free pass to put off child-rearing until they felt like it.
Anti-abortion groups have long had an uneasy relationship with IVF, because embryos are sometimes destroyed in the course of treatment, which is a problem if you believe that embryos are people. After Trump promised that he would make the government or insurers cover the cost of the procedure, though, a different anti-IVF argument has gained ground among some anti-abortion activists. IVF isn’t just destroying life, they say—it’s destroying the sanctity of the American nuclear-family unit.
The technological marvel of growing embryos in a petri dish has opened up biological parenthood to new groups of people, and not just those dealing with more traditional reproductive challenges. It’s helped enable a large cohort of women to have their first child in their late 30s and beyond. That change, alongside growing numbers of single women and LGBTQ couples seeking to have genetically related kids of their own, has helped fuel a veritable IVF boom. And IVF, in turn, has radically expanded the American notion of family beyond the default of mom, dad, and children.
Some of the most vocal opponents of IVF also oppose that changing definition of family. After Trump’s endorsement of IVF for all, Katy Faust, an anti-abortion activist, posted on X that “when you vote to ‘protect’ or subsidize #IVF, you are endorsing the manufacture of intentionally fatherless and motherless children”—that is, she suggests, children whose parents are single or queer. Hawkins told me in an interview that waiting to have a child until it becomes biologically challenging is a choice women aren’t entitled to make, and going through IVF asserts the same problematic bodily autonomy that abortion does. “We’re commodifying children,” she said.
But the movement to limit IVF has far less support than the anti-abortion movement. In a Pew Research Center poll published in May, 63 percent of Republicans and Republican-leaning independents said they support IVF, as did 60 percent of those who said abortion should be illegal. “As the reproductive-justice movement has become more mainstream, so has the idea that, not just that you have the right to abortion, but also that you also have the right to have children,” Lisa Campo-Engelstein, the chair of bioethics at the University of Texas Medical Branch, told me. “For the conservatives, that makes them very worried.” (Hawkins told me exactly that: “Children are not a right. They are a privilege.”) So now some activists are telling a different story about IVF: that it’s expanded the ability to have a family to specific groups of people who, in their view, shouldn’t.
The roots of this tactic go back more than half a century. Even before the birth of the first test-tube baby, conservative thinkers were distinctly preoccupied with what IVF might do to the structure of the American family. IVF was originally conceived to serve a very narrow medical purpose: allowing women with blocked fallopian tubes to get pregnant. Writing in 1972, the physician and bioethicist Leon Kass surmised that once IVF was achieved, nothing would limit it to infertile married couples. “Why stop at couples?” he wrote. “What about single women, widows, or lesbians?” As the fertility historian Margaret Marsh and the gynecologist Wanda Ronner wrote in their IVF history, The Pursuit of Parenthood, “Conservatives were almost universally opposed to in vitro fertilization as a threat to the moral order.” After IVF arrived in the United States in 1981, Kass’s predictions proved true: IVF became just one of the many tools that has removed barriers to parenthood for more diverse groups of people, alongside changes to adoption laws and less invasive technologies such as intrauterine insemination.
Anti-abortion activists maintained an uneasy peace with these new reproductive technologies until earlier this year, when the Alabama Supreme Court ruled that frozen embryos should be considered children. In the aftermath of the ruling, clinics in the state stopped providing the treatment for fear of legal liability. Defense of IVF on both sides of the aisle came swiftly. In Alabama, lawmakers passed legislation protecting clinics. Republican lawmakers tripped over themselves to pledge their support, even as those in the Senate blocked Democrats’ IVF-protection bill twice.
The anti-abortion movement has long claimed to be defenders of American families, and in recent weeks, some members have called on Trump to reduce the costs associated with childbirth instead of IVF. Since the Alabama ruling, they’ve also had to defend their objections to technology that has helped many people build families. Some have argued that fertility treatment harms women and families, because it can be sold as a miracle cure rather than the crapshoot that it is. Behind the scenes, the anti-abortion movement has been circulating talking points and policy recommendations designed to curb the practice of IVF. They’ve already had one major win, when the Southern Baptist Convention condemned IVF at its annual meeting this June.
These advocates are right about what’s at stake: Making IVF more affordable would expand even further the ranks of American parents. Most Americans who give birth through IVF are white. And rich, married, and heterosexual people tend to have the easiest access. The majority of people do not have benefits that cover fertility treatments, which average close to $50,000 per patient. Only about half of large employers offered fertility coverage in 2022, and fewer than half of states mandate coverage. And many fertility benefits that do exist exclude access to treatment for LGBTQ and single people. In Arkansas, a state mandate requires that eggs be fertilized with a spouse’s sperm to get coverage. Even deep-blue New York City’s health-insurance plan, which covers IVF for all employees, doesn’t cover costs associated with egg or sperm donation or with surrogacy, which LGBTQ couples or single people might require to start a family. Just this past March, the Department of Defense extended its own benefits policy after a lawsuit charged that the policy was discriminatory because it offered benefits only to married, heterosexual people.
Trump’s vision of fertility care for all could upend this status quo, making IVF benefits universal, rather than a perk of whom you work for or what state you live in. It could make parenthood more accessible to people who aren’t married and white and wealthy and heterosexual. And for anti-abortion activists, that might be the biggest threat of all.
By Margaret Marsh and Wanda Ronner
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