Sen. Tammy Duckworth has been outspoken about how she used in vitro fertilization (IVF) to grow her family. And now that Sen. Lindsey Graham has introduced a national 15-week abortion ban, Duckworth is highlighting how abortion restrictions could make going through IVF difficult — or even impossible.   

Duckworth, a Democrat from Illinois, began considering the future of IVF in a world without Roe v. Wade even before federal abortion guarantees were overturned this summer.  Ahead of the Supreme Court decision, Duckworth, said the American Society for Reproductive Medicine sent out a message to members who practice IVF, telling them their ability to do so could be in jeopardy if they live in a state that defines life as beginning at the fertilization of an egg. 

For Duckworth, hearing that felt personal. 

“When I had IVF, three of my embryos were non-viable, and we decided to discard those three fertilized eggs,” Duckworth said. “That now could potentially be manslaughter at best and murder at worst for a physician.”

No such charges have been brought since the decision in Dobbs vs. Jackson Women’s Health Organization this summer, but the language in many state bans is unclear, and some worry about the impact on physicians’ willingness to practice under the threat of criminal charges. and Graham’s bill would not explicitly ban IVF, though. It prohibits abortions at 15 weeks and doesn’t contain language about “personhood” — the term commonly used to define life beginning at fertilization, which many physicians who care for patients with infertility believe could significantly impact IVF if fertilized eggs are granted full legal standing. In IVF, eggs are fertilized in a laboratory and resulting embryos are then transferred into a patient’s uterus. Though Graham’s bill does not mention IVF, concerns remain about the trickle-down effects of a federal abortion ban on assisted reproductive technology.  

Graham’s bill isn’t going anywhere in the current Congress: Democrats control the evenly split Senate, and many of his fellow Republicans don’t back it. Senate Minority Leader Mitch McConnell has critiqued the strategy behind Graham’s bill, recently telling press that his party would prefer to see states deal with abortion directly instead of addressing the issue through federal legislation. But Graham continues to make the case for it.

Speaking on “Fox & Friends” this week, Graham said that abortion is “not a states’ rights issue. This is a human right issue.” He continued, “I am not going to sit on the sidelines in Washington, D.C., and tell the pro-life community, ‘Washington is closed for business.’” 

Sean Tipton, the chief advocacy, policy and development officer of the American Society for Reproductive Medicine, said IVF providers and patients are concerned that the bill, even without passing, will have a “chilling effect” on reproductive health care.

“The real problem is that we’re in for a prolonged period of uncertainty around reproductive laws,” Tipton said.

Still, Tipton stressed that IVF remains legal in all 50 states. “There are a lot of access issues that are well beyond the letter of the law, and the literal letter of the law is bad enough.”

Tipton said he is especially concerned about how the Graham proposal may impact IVF patients, who have a higher rate of miscarriages and pregnancy complications that could result in seeking an abortion in the second trimester. Given that many fetal abnormalities are not detectable until 18 to 20 weeks gestational age, “those people are not going to be able to get the care they need.”

Duckworth said that since the Graham bill’s introduction, she finds herself thinking a lot about the miscarriage she had after a round of IVF that resulted in needing to have a dilation and curretage (D&C) — a procedure that was necessary to safely empty the contents of her uterus to even make the possibility of a future IVF cycle, and pregnancy, possible. D&C’s are routinely performed to help safely manage miscarriage and to perform abortion in the second trimester. Whether because of a miscarriage or an elective abortion, the procedure itself remains the same. Graham’s bill doesn’t address D&C procedures, but some advocates worry that any abortion bans could threaten access to this procedure for those experiencing miscarriage because physicians could be required to prove the necessity of the  procedure.

“We have to speak about [the proposed federal abortion ban] in plain language,” Duckworth continued. “Those of us who have lived experience have to be upfront about it. I’ve not been vocal about having had a D&C procedure after having a miscarriage. It was devastating to me. But now I’m openly talking about it because I want people to understand what this means.”

Duckworth is up for reelection this year and has been campaigning on the issue of securing abortion access, both nationwide and in Illinois. The incumbent Democrat is comfortably leading in the polls against her Republican challenger, Kathy Salvi, and Duckworth’s seat is considered a safe one. Surrounded by states that significantly restrict abortion access, Illinois is considered a critical state for abortion access in the Midwest — a place where abortion providers are actively seeking to open new clinics to help accommodate the even more intense need for care there following the Dobbs ruling triggering bans in so many of its surrounding states.

Duckworth stressed that she wants voters to understand that in thinking about a federal abortion ban, the scope of whom this ban could impact goes far beyond abortion providers and extends to physicians who provide a range of what many Americans think of as basic health care services. 

“I just got through spending August traveling around Illinois, in all of the very conservative red districts. … People come up to me and say, ‘Well I’m not a pro-choice voter — I’ve never voted on the issue of choice before, I vote Republican — but the thing that has made me decide who to choose [to vote for] is that I now, I will vote on choice’,” Duckworth said. “People are really terrified about what this means for their health care.”