Katie Martin went through a lot to become a mom.
Earlier last month, the Omaha woman delivered her third child. Luke, like his older siblings, was conceived with the help of in vitro fertilization.
But Martin, 37, is concerned that the passage of new laws further restricting access to abortion in the United States and the likely overturning of Roe v. Wade could have the unwanted side effect of preventing her and others from taking that route to add to their families.
“It’s emotionally and financially taxing and worth every bit of it,” she said of in vitro fertilization, which helped her become a mom. “And I’m here for the fight.”
Martin’s concerns are shared by doctors with the state’s two fertility clinics, both of which are in Omaha, as well as other patients and family members. A number of them have formed a new Facebook group called Save IVF Nebraska to advocate for ensuring access to fertility treatments in the state. Formed last Monday, it had more than 640 members by Thursday.
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Dr. Elizabeth Constance, a reproductive endocrinologist with the Heartland Center for Reproductive Medicine, said she can’t count the number of patients who messaged her within minutes of the leak of a draft Supreme Court opinion outlining the proposed overturning of Roe v. Wade. The patients wondered whether they still would be able to use the frozen embryos held by the clinic or proceed with a planned egg retrieval, one of the early steps in the in vitro process.
“These are people who have had to work very hard, often for multiple years, spending tens of thousands of dollars, to build the family they’ve always dreamed of,” Constance said. “To have even the possibility of having that taken away from them is very scary.”
Of particular concern is a bill adopted by the Oklahoma Legislature that bans most abortions. It defines an unborn child as “a human fetus or embryo in any state of gestation from fertilization until birth.” Oklahoma Gov. Kevin Stitt signed the measure, the nation’s most restrictive, into law Wednesday.
Dr. Abigail Delaney, a reproductive health specialist with Methodist Reproductive Health Specialists, said that definition calls into question whether clinics can freeze extra embryos for future use. Reproductive health specialists typically fertilize several eggs at a time in order to maximize the chances that one embryo results in a successful pregnancy.
With such language, Delaney said, specialists also wonder whether they still would be able to freeze eggs and sperm collected from cancer patients about to undergo treatment that will leave them infertile, which makes up a considerable portion of the work the specialists do. Those patients later will require in vitro fertilization to create babies.
Another question: Will they still be able to conduct genetic testing on embryos for viability and to check whether they carry genes for deadly ailments such as Huntington’s disease or Fragile X syndrome?
So-called trigger laws in 13 states use similar definitions to Oklahoma’s. The laws would ban abortion in those states if the Supreme Court overturns Roe v. Wade.
A similar trigger bill, Legislative Bill 933, died in the Nebraska Legislature this spring. Gov. Pete Ricketts has said he won’t decide whether to call a special session focused on abortion until the Supreme Court releases its official opinion on the issue. Ricketts has said, however, that Nebraska needs to be ready to outlaw abortion, and he strongly supported LB 933.
LB 933 also defines an unborn child as “throughout the embryonic and fetal stages of development from fertilization to full gestation and childbirth.”
“The language of these bills really matters ... (as) to whether or not we can do what we do every day so patients can build the families they want,” Delaney said.
Sandy Danek, executive director of Nebraska Right to Life, said the same bill may be brought back in either a special session or the regular legislative session.
The language, she said, may need to be clarified. But the measure, she said, is not intended to apply to in vitro fertilization or to treatments for women who suffer miscarriages or ectopic pregnancies, the potentially life-threatening situation in which a fetus begins to develop outside the uterus.
“We’re concerned about the intentional act of killing a child in the womb,” Danek said.
Proponents of the bill, she said, did their best to answer such questions during debate on the bill and will continue to do so.
“It’s unfortunate when those misunderstandings are put out there in the public eye,” she said.
But Scout Richters, an attorney with the ACLU of Nebraska, said the language in the law, not the intent, is what matters.
When proponents of LB 933 were asked on the legislative floor to address concerns about in vitro fertilization and birth control, she said, “they couldn’t point to any specific language that would not implicate those things.”
Defining fertilization as the key point for banning abortion, she said, means that in vitro fertilization, emergency contraception and some forms of birth control all could be affected.
Constance said such a law would make it difficult for the clinic to recruit new physicians and embryologists. Candidates won’t want to risk losing their livelihoods or facing prosecution.
Delaney noted that more large companies are covering fertility treatments. Hindering access to them could affect their recruitment. And if such treatments no longer were available, patients would face the added cost in both time and money of traveling to other states to get them. Delaney said she already has patients who drive from western Nebraska for the treatments.
Constance said the specialists’ first goal is to educate Nebraskans about the impact such bills could have. The roughly one in eight couples who experience infertility already are aware. But even those who don’t face such challenges know someone who does.
The second aim, she said, is to encourage legislators not to support bans — because one appears likely — that don’t have clear and specific language that excludes in vitro fertilization.
“Day in and day out, 100% of our time and energy and passion is funneled into helping people have highly desired pregnancies,” Constance said. “There’s truly no more pro-family aspect of health care than what we do.”
Martin, the Omaha mom, and her husband, Joel, turned to in vitro fertilization after all other methods failed to produce a child. Two attempts at intrauterine insemination resulted in ectopic pregnancies. One ended with a medication abortion, the other with the removal of one of her fallopian tubes.
After that point, she said, she was told that to have children, in vitro fertilization was the route the couple would have to take.
Now the Martins are busy with three young children. Martin said she recognizes that Nebraska is a conservative state. She said she doesn’t have to have opinions on every part of the Roe v. Wade debate. But she does on this one.
“This issue is not so black and white,” she said. “There’s no right-wrong way to build a family. When people think of Roe v. Wade, they think of unwanted pregnancies. It has so many more fingers and tentacles that need to be researched and addressed.”