Republicans are facing another political headache in the wake of the overturning of Roe v. Wade, this time involving in vitro fertilization procedures, that could spell disaster for the party heading into the 2024 election.

The latest hurdle comes out of Alabama after the state Supreme Court ruled last week that frozen embryos are legally children and that the destruction of embryos constitutes a crime under the state’s “wrongful death of a minor” law. 

Following the ruling, the University of Alabama at Birmingham health system announced it was halting its IVF procedures immediately over fear of lawsuits and prosecutions. It is the largest hospital in the state and the eighth-largest in the nation. Other healthcare providers in Alabama are likely to follow suit.

The GOP is already facing backlash from the state Supreme Court’s decision, particularly as the ruling not only negates public opinion on IVF but also can have personal consequences for nearly 1 in 6 Americans struggling with fertility problems, according to Politico. 

Alabama’s high court may have just placed a target on the backs of Republicans heading into a critical general election, as the embryo decision risks alienating swing voters and highlights another manner in which the striking down of Roe v. Wade is affecting more people than those who are anti-abortion. 

“It certainly intersects badly with general election politics for Republicans,” Stan Barnes, former GOP Arizona state senator and political consultant, told Politico. “When a state, any state, takes an aggressive action on this particular topic, people are once again made aware of it, and many think: ‘Maybe I can’t support a Republican in the general election.’”

Abortion was at the top of the ballot during the 2022 midterm elections, leading to Republicans suffering significant defeats and gaining only a slight majority in the House despite members and strategists predicting a “red wave.” Democrats have been aggressively campaigning on abortion for the 2024 election, and Alabama’s ruling hands them a major card to play as they try to paint the GOP as too extreme on women’s healthcare.

On Wednesday, Sen. Tammy Duckworth (D-IL) pushed her bill, introduced in January, that would protect IVF access.

“For years — even before Roe was overturned — I’ve sounded the alarm that they’d come for IVF,” she said. “It’s started in Alabama, but we can’t wait for the next red state to decide how women can start their families until we take action. We must pass my bill to protect IVF access for all.”

Republicans have been warned about this long before the Alabama court decision. Kellyanne Conway, former adviser to former President Donald Trump, traveled to Capitol Hill in December, telling congressional Republicans to take contraception and IVF protections seriously or risk defeat in 2024. She shared polling that 86% of voters support IVF, even those who regard themselves as “pro-life” and evangelicals, at 78% and 83%, respectively.

The ruling stemmed from a lawsuit from IVF patients whose frozen embryos were destroyed after being dropped on the ground in December 2020. The overarching ethical matter stems from the fact that in nearly all cases, many embryos are created, but only the most viable are selected. The unviable embryos are either donated, discarded, or frozen. Discarded embryos draw the most concern from some who believe destroying them is murder.

The justices ruled the patients could sue under Alabama’s Wrongful Death of a Minor Act, “which applies to all unborn children, regardless of their location,” according to the court’s ruling.

Republicans are likely to be split on this matter, particularly for those who view IVF as a way to create life, even if they also believe that life begins at conception. In a worst-case scenario, the ruling could mean there will be no IVF transfers in a state with a population of 5 million. 

Statistically, many GOP voters who have suffered from the inability to conceive naturally have undergone such treatments, so seeing that choice taken from them could do severe damage to independent and centrist Republican voters. 

National Republican Senatorial Committee communications director Mike Berg said there is “not a single Republican Senate candidate in the entire country proposing a ban on IVF.” However, other congressional campaign committees either refused to talk about the situation or avoided the question when asked by Politico.

Still, the decision is already making headway on the campaign trail, as eyes turned to Republican candidates to see how they would respond to Alabama’s high court ruling. Though no longer a 2024 presidential candidate, former Vice President Mike Pence has been vocal about his family using IVF, saying last year that he fully supports the process.

Former U.S. Ambassador to the United Nations Nikki Haley, who has been critical of Republicans for being too harsh on the topic of abortion and used artificial insemination to conceive her children, told NBC News in an interview she agreed with the ruling.

“Embryos, to me, are babies,” Haley said on Wednesday. “When you talk about an embryo, you are talking about, to me, that’s a life. And so I do see where that’s coming from when they talk about that.”

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However, Haley is already acknowledging that the ruling will be a sensitive topic, particularly when it comes to consequences for parents attempting to use IVF to build families.

“This is one where we need to be incredibly respectful and sensitive about it,” the former South Carolina governor said.