Alabama’s state Supreme Court ruled last Friday that frozen embryos are considered children and people who destroy them could be held liable for wrongful death. The ruling doesn’t explicitly ban IVF, but it threatens the ability of families and medical providers to participate in the treatment.

The first-of-its-kind ruling has alarmed doctors, hopeful parents, and startup founders and investors in the women’s health space. At least three IVF clinics in Alabama, including the University of Alabama Birmingham, paused treatments in the aftermath of the ruling.

“This ruling puts thousands of families who are undergoing fertility treatments at risk of not building the families they deserve,” Kate Ryder, the founder of fertility benefits platform Maven, wrote on LinkedIn yesterday. “Timing is everything in an IVF journey,” she added, and even a few days or weeks without access can devastate families who have spent their savings (and injected themselves with hormones multiple times a day) in the hopes of conceiving.

After Roe v. Wade was overturned in 2022, we saw a flurry of activity in the women’s health category as startups and investors responded with telehealth abortion access and other solutions. How Silicon Valley can respond to the Alabama ruling isn’t as clear; the fertility category is already the most crowded and mature in women’s health, from IVF to employer benefits to egg-freezing. In 2022, fertility tech startups raised $800 million (the digital health category in the U.S. overall raised $15.3 billion that year). Maven, one of the category’s leaders, is valued at $1.35 billion and is approaching a possible IPO.

There’s a lot of value in the business of fertility—and yet, to many building in the category, this ruling comes as no surprise. “Startups innovating in women’s health are no stranger to regulatory hurdles,” Lux Capital’s Deena Shakir, an investor in women’s health companies, including Maven, told me. For now, it’s up to more mature businesses to support their Alabama customers.

As recently as 2022, Republican former Vice President Mike Pence said he opposed abortion but supported IVF, which he and his wife used to have their children. GOP presidential candidate Nikki Haley, who conceived her son via artificial insemination, at first seemed to support Alabama’s court decision but then walked back those comments. Democrats have tried to protect IVF from politics; Sen. Tammy Duckworth (D–Ill.) has introduced the Access to Family Building Act, which hasn’t passed.

“My prediction is that it will only highlight the need for better solutions in the market,” Shakir says of the long-term effects she anticipates.

Some lawmakers in Alabama have vowed to protect IVF. But until that happens, people in anti-abortion Alabama once again have lost agency over how to build their families—whether their choice is to have children or not. “Women and families suffer, daily, as a result of these actions,” Ryder said. “We must do better.”

Emma Hinchliffe
emma.hinchliffe@fortune.com

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PARTING WORDS

"People don’t need beauty. They need a feeling that they are alive and there is tomorrow."

- Ukrainian nail chain cofounder Antonina Krolyvets describing why she opened her locations less than a month after the country's war with Russia started