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New Alabama law protects IVF, but still identifies embryo as a child


Late last night, Alabama's Republican governor, Kay Ivey, signed a bill designed to protect access to IVF, or in vitro fertilization. This comes after an Alabama court ruled last month that frozen embryos are considered children with a constitutional right to life. That ruling caused many IVF clinics to pause services. And for hopeful parents, the decision meant anxiety and uncertainty. The last time we spoke with Dr. Beth Malizia was a few days after the ruling, and she wasn't sure what the future would bring.


BETH MALIZIA: I've had to make several really, really difficult phone calls in the last several days to have patients where we are holding or modifying their plan for what's safe, and those are really hard phone calls to make.

SHAPIRO: Dr. Malizia is an infertility specialist at Alabama Fertility in Birmingham, and she's with us once again. Welcome back to ALL THINGS CONSIDERED.

MALIZIA: Thank you for having me back.

SHAPIRO: Does this new law clear up the uncertainty that you described the last time we spoke?

MALIZIA: It clears up the ability that we have to at least get back to patient care. The bill provides some immunity most importantly to patients, but also to clinics and manufacturers to be able to provide full spectrum and full services back in the office. So we are thrilled today. I made some really fun phone calls last night at 9:30, after the governor signed this bill into place, and we put embryos in this afternoon.

SHAPIRO: Wow. So you didn't even wait until office hours. You made the calls as soon as the bill was signed?

MALIZIA: Yes. We had patients literally teed up on medications awaiting this to pass, just biting our nails through the entire process. But we have worked very hard, as have, you know, hundreds and even thousands of people in the area and nationally to get this going. So we're thrilled.

SHAPIRO: I mean, this goes without saying for anybody who has experience with IVF, but timing is important. So whether the bill was signed into law last night or last week really makes a difference when you're talking about hormonal cycles and ovulation and things.

MALIZIA: That's exactly right. Yeah. So patients both have sort of a physiology to this that we need to pay attention to in terms of getting their cycle timed precisely for either an egg retrieval or an embryo transfer. And then there's other patients that come in and present to us with issues - medical conditions, cancer, a partner who's deploying - all sorts of reasons why they may need to undergo treatment as soon as possible. So days matter, and even weeks and months certainly matter.

SHAPIRO: Can you describe one of those phone calls that you made last night as soon as the bill was signed?

MALIZIA: Oh, gosh. I have a lovely patient named Amanda (ph), who I've treated for several years. She has a beautiful daughter from a previous IVF cycle and was all ready to put an embryo in. And we got the news of this decision. So I called her. She was crying. It was - I mean, it was a very emotional phone call. She was at the Statehouse to fight for this. So those kinds of patient phone calls is - you know, that's why we do this.

SHAPIRO: What have the last few weeks of uncertainty been like for you, your colleagues and your patients?

MALIZIA: (Laughter) We probably didn't eat or sleep very much. We have really been fighting very hard for this. The response from patients has been just amazing. Both the local and the statewide and then the national support that this has, you know, provided us and our team here and our patients has just been outstanding. The fight for Alabama families arose from this event. This was a single patient sending some emails to friends who sent emails to more friends who send emails to more friends. And now there is a coalition that is involved in this process that will begin fundraising for any future need.

SHAPIRO: And so is everything back to normal in your clinic now? Are things operating exactly the way they were before the decision was handed down?

MALIZIA: Yes. We are back to all of our normal procedures. We're having a little celebration with our staff today, and patients have been calling and celebrating. We've received tons of flowers and cookies and all sorts of things...

SHAPIRO: Oh, wow.

MALIZIA: ...To the office today as well.

SHAPIRO: When I began by asking you whether it cleared up the uncertainty, you said, yes, in a way, and you kind of hedged a little bit. In what way does it not?

MALIZIA: So the decision that the Alabama Supreme Court has made - that an embryo is a child - has not been redefined or clarified in any other way by this legislative bill. The legislative bill at least gives us protection so that we feel comfortable getting back to work and taking care of families in the state. But it doesn't necessarily answer that question.

Now, whether or not that's a question that needs to be answered more long term, whether that's something that the legislation is - or legislators are interested in remains to be seen. We have made many contacts now. We've spent many days at the Statehouse as a practice and as physicians. And our hope is that if there is further discussion about this, that we are involved in that process, even for just education about what this process entails.

SHAPIRO: Dr. Beth Malizia, I know you've got a backlog of patients who are eager for your help, so we're going to let you go. Thank you so much for talking with us.

MALIZIA: OK. Thank you. Appreciate it.

SHAPIRO: She's an infertility specialist at Alabama Fertility in Birmingham.

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Linah Mohammad
Prior to joining NPR in 2022, Mohammad was a producer on The Washington Post's daily flagship podcast Post Reports, where her work was recognized by multiple awards. She was honored with a Peabody award for her work on an episode on the life of George Floyd.
Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.