President Donald Trump recently dubbed himself the “fertilization president” after signing an executive order that called for policy recommendations to expand access to in vitro fertilization (IVF). U.S. reproductive health debates have long focused on abortion, but Mary Ziegler, a leading historian of U.S. reproductive law, says policy moves like the IVF order are reviving—and complicating—thorny discussions around fetal personhood: the belief that embryos and fetuses should be granted the same legal rights as people.
In her new book Personhood: The New Civil War over Reproduction, released in April, Ziegler traces the rise of the fetal personhood movement and highlights its widening influence. If fully realized, fetal personhood laws could upend not just abortion access but also miscarriage care, contraception, stem cell research and fertility treatment, among other areas of health care and science. The Alabama Supreme Court offered a glimpse of these consequences in February 2024 when it ruled that frozen embryos are legally equivalent to children under the state’s civil wrongful death statute. That high-profile decision sent shockwaves through Alabama fertility clinics, many of which temporarily shuttered for fear of lawsuits over providing in vitro fertilization, a procedure that sometimes involves the damage or disposal of embryos.
Fetal personhood has been established in 17 states, either by law or judicial decision. The federal government’s stance is murkier. Though the Trump administration has scaled back support for abortion access—by dropping a Biden administration lawsuit that had aimed to defend emergency abortion access in Idaho, for example, and barring federal funding for elective abortions—it has stopped short of pushing a national abortion ban or strict limits on abortion pills.
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A forthcoming report, expected by mid-May, will lay out the Trump administration’s IVF policy recommendations and could offer the clearest blueprint yet for its broader reproductive health agenda. It may also reveal how the federal government plans to walk a tightrope between two vocal and powerful constituencies: antiabortion activists, who support fetal personhood laws, and pronatalists, who push for policies that encourage higher birth rates. Many pronatalists view fertility technologies like IVF as tools to combat population decline, putting them at odds with personhood advocates who oppose practices that risk destroying embryos.
In a conversation with Scientific American, Ziegler discussed her new book and the history and future of the U.S. fetal personhood movement.
[An edited transcript of the interview follows.]
How do you define fetal personhood?
People from different backgrounds—scientists, lawyers, or otherwise—may be familiar with “personhood” in different contexts. But in U.S. politics, the term doesn’t refer to being biologically human or alive but specifically to having constitutional rights. In my book, I focus on this legal claim—not a scientific, philosophical, bioethical or religious one. And it’s this legal conception of personhood that is reshaping U.S. politics and medicine.
In this context, fetal personhood states that constitutional rights begin the moment an egg is fertilized, meaning an embryo holds the same rights as you or me.
In the immediate aftermath of the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision in 2022, which overturned Roe v. Wade, much of the national conversation understandably focused on abortion access. But how have fetal personhood laws affected, or how could they affect, other domains of reproductive medicine and science?
At this point in the history of the U.S. antiabortion movement, fetal personhood claims in states that enact these laws require punishment for anyone who damages an embryo. Under this framework, current IVF practices are deeply problematic because they involve the creation, storage and sometimes destruction of embryos, all of whom would be seen as rights-holding individuals under personhood laws. So the antiabortion movement has advocated for rules that punish people who provide or receive IVF or for regulations that permit only one embryo to be created and implanted at a time. Both scenarios would radically transform fertility medicine by either outlawing or heavily restricting the way IVF is offered.
This logic also applies to embryonic stem cell research: you wouldn’t permit certain experiments on persons, so you couldn’t permit that research on embryos or allow the creation of embryonic stem cell lines. Any area where embryos or fetuses are even arguably involved is fair game under these laws. For example, contraceptives are at risk because some antiabortion leaders believe they can induce abortions, even if scientific experts generally disagree with that conclusion.
President Donald Trump has called himself “the father of IVF” and promised to make fertility treatments more accessible. Those stances seem to clash with the pro-fetal-personhood base that supports him. Can the federal government reconcile these positions?
IVF has forced a wedge between the Republican Party and the antiabortion movement, largely because the procedure is so popular. Seven in 10 Americans support access to IVF.
Two important dynamics branch off from this. First, antiabortion groups are still pursuing restrictions, even though those policies are deeply unpopular. Second, Republican politicians—particularly at the federal level, where elections are more competitive—are sometimes willing to ignore antiabortion leaders when it comes to IVF. President Trump may continue promoting pro-IVF policies even if it alienates parts of the antiabortion movement. But that political calculus won’t apply everywhere. In state legislatures or courts where elections are less competitive, or where only primary voters matter, we’re likely to see continued pushes for IVF restrictions because the threat of voter backlash is much lower.
The Trump administration is reportedly preparing recommendations for IVF and reproductive health care policies soon. What do you anticipate will be in that report?
I expect it will focus on lowering the cost of IVF, which is expensive and often paid for out of pocket. That may be difficult to actually enact because the federal government has been aggressive about wanting to spend less on everything.
Another question worth asking is about the best way to meaningfully expand IVF access, given that the federal government’s recent layoffs and funding cuts have eliminated teams at the National Institutes of Health and Centers for Disease Control and Prevention that were dedicated to tracking IVF outcomes and improving maternal health. If the goal is to improve fertility care and reproductive health, cutting those programs could undercut the effectiveness of any new initiatives.
Looking ahead, how do you think the fetal personhood movement will shape the future of U.S. reproductive health care and scientific research?
It’s fair to assume that most Americans genuinely care about fetal life. The bioethicalquestions that scientists navigate when conducting, for instance, embryonic stem cell research, are real concerns many nonscientists share. But the fetal personhood movement isn’t engaging those questions through nuanced ethical deliberation. Instead it’s pursuing a blunt strategy of criminalization, which many voters find unappealing. Fetal personhood advocates are increasingly focusing on state and federal courts, however, where voters have less direct influence, and that could lead to much more sweeping changes in how scientific research and medical care are practiced in the U.S.
For that reason, anyone working in medicine or science, even those who don’t see themselves as doing abortion-related work, should be paying attention. The impacts of the fetal personhood movement, if successful, would ripple far beyond reproductive health clinics.