Introduction

On November 5^th, 2024, millions of Americans will head to the polls to exercise their constitutional right to vote. In addition to the presidential candidates, there are 34 senate seats up for reelection and a host of federal, state, and local offices on the ballot.[1] During this time of political transition, it is imperative that voters think critically about the state of reproductive rights at the state and national level. Since Roe v. Wade was overturned, fourteen states have enforced total abortion bans and another seven states have passed early gestational bans, including Iowa.[2] In 2023, the Iowa state legislature passed a bill outlawing most abortions after six weeks.[3] Shortly afterward, a lower court blocked the ban following a legal challenge brought by abortion providers and the American Civil Liberties Union.[4] Earlier this year, the Iowa Supreme Court overruled the lower court’s decision, and the law went into effect on July 29 at 8 a.m.[5] The Iowa ban has deprived women of an essential form of healthcare. Before the law took effect, abortion was legal in Iowa up to the twentieth week of pregnancy, giving the majority of women who wanted to terminate a pregnancy time to do so.[6] Now, because of the ban, Iowans are forced to seek abortion services in nearby states, such as Illinois, Minnesota or Nebraska.[7]

This blog post delves into the evolutionary origins of pregnancy, the risks that fetal personhood poses to women’s reproductive health, and the consequences of recent political developments on reproductive freedom in America. As we will see, evolution transitioned mammalian embryos from external to internal development, leading to pregnancy as we know it, but recent technological innovations have reversed this process, allowing human embryos to be fertilized and preserved outside the body. Conservative efforts to grant personhood to fertilized embryos threatens reproductive services, resulting in two unfortunate outcomes: inconsistent exceptions for in vitro fertilization (IVF) or outright bans on assisted reproductive technologies. As Iowa approaches the general election, voters should elect politicians who respect the unique biological status of pregnancy by drafting laws that prioritize a pregnant woman’s interests over those of a developing fetus. 

The Evolution of the Placenta

The story of pregnancy begins with a retrovirus. Unlike regular viruses, which generate copies of themselves in a cell’s cytoplasm, retroviruses convert the retroviral RNA of an infected cell into DNA.[8] The altered DNA is then transcribed and integrated into the DNA of the host organism through a process known as retrotransposition.[9] Essentially, this creates alterations to the DNA of the host cell. When retrotransposition occurs in the gametes of an organism (spermatozoa or oocytes, in humans), the mutated cells can pass on to the next generation in accordance with Mendelian Inheritance, leading to new traits in the resulting organism.[10] Traits that confer advantages to an organism gradually become more common, as those organisms survive long enough to reproduce and spread their genetic material. What makes retroviral infections special, then, is their ability to alter the DNA of organisms over multiple generations, leading to widespread genetic mutations. Retroviral genomes that successfully integrate with a host’s genome and are passed on to subsequent populations are known as endogenous retroviruses (ERVs).[11] The field of palaeovirology has found that as many as 500,000 genomes, or 8% of the total human genome, derive from ERVs.[12] In fact, human pregnancy as we know it would not be possible without the influence of multiple ERVs throughout our species’ history.[13] 

            Roughly 130 million years ago, a protomammalian, egg-laying ancestor was infected with a retrovirus.[14] This retrovirus altered the cellular DNA of the host organism’s genome, enabling it to create proteins that had the ability to fuse things together.[15] At some point in time, one of the organisms’ infected egg cells met a sperm, was fertilized, and hatched into a baby protomammal with copies of that virus’ DNA written into its cells.[16] Through subsequent generations, and many more mutations, the resultant fusional proteins morphed into syncytin, a family of envelope proteins.[17] Syncytin is essential to the structure and function of the human body’s only temporary organ: the placenta.[18] Without syncytin, a woman’s body would be incapable of forming a placental wall or suppressing her natural immune response that, if left unchecked, would identify a developing fetus as an alien substance and destroy it.[19] Placentas serve as barriers between a mother’s body and that of the fetus, protecting the latter from the former, while also connecting the essential functions of both, such as the delivery of oxygen and nutrients, the circulation of blood, and the removal of waste.[20] 

            The evolution of pregnancy is remarkable. What began as a chance infection millions of years ago set in motion physiological changes that drastically altered the mechanisms of mammalian reproduction, resulting in a shift from embryos gestating outside the body (as self-contained eggs) to within the womb (protected and nourished by the placenta). The result is a unique biological state, one where the interests of the pregnant woman and the developing fetus often, but not always, align. Acknowledging the unique genealogy of mammalian pregnancy, and human gestation, in particular, is the first step in ensuring that our laws and contemporary medical practices respect reproductive rights. 

HF 2575: Iowa’s Personhood Bill

On March 7, 2024, the Iowa House of Representatives passed HF 2575, colloquially known as the personhood bill.[21] The bill made several changes to existing legislation, such as increasing penalties for the nonconsensual ending of a pregnancy and defining an “unborn person” as “an individual organism of the species homo sapiens from fertilization to birth.”[22] House Democrats opposed the bill on the grounds that it endangered Iowans’ access to in vitro fertility treatments.[23] In particular, Representative Beth Wessell-Kroeschell, a Democrat from Ames, argued that the bill would introduce the “same chaos” for IVF services in Iowa as in Alabama.[24]

A few weeks prior, on February 16^th, 2024, the Alabama Supreme Court made a first-in-the-nation decision: it ruled that frozen embryos were “unborn children” for purposes of civil liability and that embryos were protected under the state’s Wrongful Death of a Minor Act.”[25] Shortly after the bill passed, three fertility clinics suspended IVF services out of concern for legal action.[26] To preserve IVF access within the state, Alabama Governor Kay Ivey signed an immunity bill, SB-159, less than three weeks after the Supreme Court’s ruling.[27] The bill grants criminal and civil immunity for the “death or damage to an embryo” perpetrated by “any individual or entity when providing or receiving services related to in vitro fertilization.”[28] Alabama’s attempts to carveout legal immunity for assisted reproductive technologies speaks to the conceptual and functional problems of a the fetal personhood agenda. In its judicial reasoning, the Alabama Supreme Court cited many religious documents, theologians, and biblical passages to support the idea that fetuses were “unborn children.”[29] Presumably, fertilized embryos would also be “created in the image of God” and equally deserving of legal protection under this idea.[30] By granting immunity for IVF services, Alabama’s politicians have sent a clear and frightening message: fetuses are “unborn children” when they are contained internally (within a woman), but may be discarded as “genetic waste” when they are contained externally (through cryopreservation). 

HF 2575 died in committee, as the Iowa Senate Judiciary did not advance the bill before the final legislative deadline of the season.[31] Senator Brad Zaun, a Republican from Urbandale, explained that the committee withheld the bill due to “concerns about in vitro fertilization and the negative effects and unintended consequences with that.”[32] Although the immediate threat to Iowa’s IVF treatments has been averted, this reprieve may be short-lived, as the legislators who initially passed the bill with a 58-36 vote remain in office. Legislation promoting fetal personhood continues to pose a risk to the reproductive freedoms of Iowans, with the future of these rights likely to be determined in the upcoming election on November 5, 2024. 

The Democratic Party and the Iowa Election

On July 21, 2024, President Joe Biden announced his withdrawal from the presidential election and officially endorsed Vice President Kamala Harris for the Democratic ticket.[33] With less than four months before the election, the announcement shocked voters and galvanized a stagnating political campaign.[34] Since then, Harris has made reproductive rights a central focus of her platform, with Democrats nationwide rallying to protect access to abortion, contraception, and fertility treatments.[35] In Iowa, the Harris campaign’s growing momentum has significantly impacted local races. Nonpartisan elections analysts now consider Iowa’s 1st and 3rd Districts – represented by Republicans Mariannette Miller-Meeks and Zach Nunn – to be political toss ups, shifting from their earlier “lean Republican” status.[36] While Iowa remains a largely Republican state, the outcome of these races could shape control of Congress and key positions in the Iowa Legislature.[37] Notably, both districts feature candidates who have actively opposed reproductive healthcare services within the state. 

Miller-Meeks and Nunn have both taken steps, directly and indirectly, to restrict Iowans’ access to reproductive technology. Neither Republican supported the Access to Family Building Act, a Congressional bill aimed at safeguarding the right to use assisted reproductive technology and genetic materials.[38] Instead, they co-sponsored a non-binding resolution that outwardly expresses support for IVF but caries no legal weight or administrative backing for providers or patients.[39] Additionally, both voted in favor of legislation that posed a significant threat to IVF access within the state.[40] 

Conclusion

Reproductive freedom grants women the right to decide when, where, and how they will become pregnant, if at all. Respecting reproductive freedom requires granting women access to abortion and assisted reproductive technologies. Attempts to enshrine fetal personhood in law threatens individual access to IVF and is often used by conservatives to curtail abortion access. Against the backdrop of the general election, local races between Democratic and Republican candidates will likely decide the scope of reproductive rights for women in Iowa. As voters head to the polls, it is imperative that they think critically about what healthcare services they wish to make available for themselves and the women in their life.