A Republican in the Missouri House and a Democrat in the state Senate have both filed bills to protect in vitro fertilization in the wake of an Alabama State Supreme Court decision that put the legality of the practice into question.
The conflicting approaches to addressing the issue underscore the continuing divide between the two political parties over abortion.
IVF is a medical practice where, through a complex, arduous and expensive process, eggs are removed from a person's body and fertilized by sperm in a lab setting. That fertilization creates embryos, which can later be put back into the person in hopes that they will become pregnant. Not all of the eggs removed will become embryos.
The Alabama State Supreme Court reached the ruling in February based on the state's abortion ban. The court specified that the Alabama Wrongful Death of a Minor law made no distinction between embryos existing in a person's body and those created in a lab.
The Alabama State Legislature addressed the issue by passing a law stating that no one can be prosecuted for administering or participating in IVF, allowing clinics to reopen.
Missouri faces a similar predicament as the state's abortion ban is similar to the one in Alabama.
The Missouri Court of Appeals in St. Louis has ruled previously on the legal status of embryos. In 2016, the court ruled that IVF-created embryos were a matter of "marital property of special order." This has provided legal protection for doctors and patients in the IVF field.
That court ruling cited abortion protection offered by Roe Vs. Wade, which was overturned in 2022. Since then, a sweeping state abortion ban has taken effect, leading advocates and lawmakers alike to be concerned about what lies ahead.
Sen. Tracy McCreery, D-Olivette, quickly filed a bill after the Alabama ruling.
"When we saw what happened in Alabama, the Senate Democrats decided we had to do something because we're getting calls from all over the place," McCreery said. "This is an issue that affects all kinds of families, including families that are very conservative politically."
She added that IVF has been in her mind since Roe vs. Wade was overturned. Her bill, SB 1486, goes straight at Missouri's abortion ban and specifies that the abortion ban's definition of an unborn child does not include in vitro fertilization embryos that have not been implanted in a body.
House Bill 2845, filed Rep. Bill Allen, R-Kansas City, states that the IVF process is protected under law and that no one can be prosecuted for undergoing or administrating it.
"IVF and procedures like it have been helpful to my family and the families of many Missourians," Allen said. "My bill seeks to protect IVF and stays away from politically controversial subjects (like abortion)." His bill language tracks the language adopted by the Alabama legislature to address IVF.
Joanna Beck Wilkinson, a lawyer who specializes in reproductive rights, said she would support a bill that excludes embryos that have not been implanted from the definition of unborn children.
She worries that the broadness of Missouri's statutory definition of unborn child as inside the human body opens up IVF to legal challenges like what happened in Alabama.
Shvetha Zarek, a physician who provides IVF services, said she feels the House bill that protects IVF but doesn't venture into the abortion ban is better because it explicitly clears all IVF practices and avoids the controversial abortion ban.
The contrast speaks to the overarching lack of clarity of what's legally acceptable in people's health in a post-Roe v. Wade world.
"It's scary," Wilkinson said. "I would say it definitely deters doctors and lawyers from helping people who are in this (getting reproductive care) position. ... There's a reason that all those clinics are like packing up and moving out (of Alabama), they're not willing to conduct these procedures in Alabama, it puts us in a really scary position."
She added that in a "perfect world, Missouri would put something in the constitution saying that women have decisions about their own bodies."
Danielle Faith, a St. Louis-based advocate who runs support groups and provides resources to people going through the IVF process, said she feels that IVF is not a conservative versus liberal argument.
"I don't know what's more pro-life than IVF," Faith said.
National conservative figures who are pro-life have promoted finding protections for IVF. Yet, even if most lawmakers want to protect IVF, they have varying perspectives on what protecting IVF means.
Sen. Mary Elizabeth Coleman, R-Arnold, a major contributor to Missouri's move to ban abortions, told KSDK that if IVF was in violation of Missouri's abortion ban a case would have already been brought to the courts challenging it. She added that she opposes enshrining IVF protections into law because it will make it harder to prosecute doctors in malpractice suits.
Despite no lawsuits being filed to challenge IVF, the hazy language regarding embryos in Missouri's abortion ban has created uncertainty in the eyes of legal experts. The abortion ban defines conception as "the fertilization of the ovum of a female by a sperm of a male" and an "unborn child" as "the offspring of human beings from the moment of conception until birth and at every stage of its biological development, including the human conceptus, zygote, morula, blastocyst, embryo and fetus."
Wilkinson said that language is too broad and could open the door for Missouri courts to rule similarly to the ones in Alabama, even with the history of protective case law.
Freedom Caucus member Sen. Rick Brattin, R-Harrisonvile, said he supports IVF and would be in favor of passing some legislation but wants patients to create one embryo at a time instead of a "plethora of embryos" that are stored indefinitely.
The process of creating embryos is costly and physically taxing. That's why several are created and stored so that repeated attempts can be made to implant the embryos into the body. It's a lengthy process involving shots, drugs and procedures to obtain the embryos, so if they could only be retrieved one at a time, it would be very challenging and too costly, according to Zarek.
Katelin DuBois, a St. Louis woman who has been going through the IVF process for four years, called out Brattin's comments specifically: "He doesn't understand. Why are you so bent out of shape over an inventory of embryos when the success rate of thawing them is incredibly high? I should have a choice on what to do with my embryos at the end."
She's referring to the process where embryos can be frozen and thawed for use at a later time. The success rate of this process is high, according to the National Institute of Health, and it gives people more options regarding what they want to do with the embryos and when.
IVF is one of the only ways people dealing with infertility can get pregnant. Infertility rates have risen over the past few decades, affecting about one in six people. Between that and each cycle costing around $20,000, Zarek and Faith said they feel it's essential to mandate insurance companies cover infertility.
Fifteen states mandate insurance coverage for IVF. Missouri is not one of them. Zarek said that most of her clients have to go into debt to cover their IVF treatment.
The legislative future of IVF is uncertain. Senate Majority Floor Leader Sen. Cindy O'Laughlin, R-Shelbina, said she hasn't thought much about the topic yet and isn't planning on fast-tracking McCreery's bill. Senate Minority Leader Sen. John Rizzo, D-Independence, said he plans to discuss the bill with leadership.
"I think I can say the entire Democratic caucus in the Senate is very much on board with making sure McCreery's bill gets passed so that we can protect the (IVF) process, whether that'd be with the bill or in amendment form. You saw the state of Alabama already corrected it. And that's not some liberal state," Rizzo said.
Allen said House Floor Leader Jonathan Patterson, R-Lee Summit, plans on adding his name as a sponsor to the bill. With the floor leader behind it, the bill should have some promise in the House.
Neither the Senate nor House bill has had hearings as the legislature returns this week from a week-long break. There is little time to act before the session ends on May 17.
The work of the Missouri News Network is written by Missouri School of Journalism students and editors for publication by Missouri Press Association member newspapers.