“We’ve got to talk about making sure we don’t take away women’s rights to IVF, women who are childbearing age and want to give birth to children,” said GOP Rep. Nancy Mace, who was campaigning this week for former President Donald Trump in South Carolina. She added, “I’ll be working very hard to make sure that doesn’t happen.”

Democrats and left-leaning interest groups have banked on abortion rights as a major motivator for voters in the upcoming presidential election and fight for control of Congress. They believe abortion can be a winning issue as the debate widens to include increasing concerns over miscarriage care, access to medication, access to emergency care and now IVF treatments.

The GOP has struggled to talk about the issue while abortion-rights advocates have won races even in conservative-leaning states. Reproductive rights groups on Thursday compared the Alabama ruling to the impact of the Supreme Court’s Dobbs ruling that overturned Roe v. Wade and nullified a federally guaranteed right to abortion.

“This has hit a nerve in a way I haven’t seen since Dobbs,” said Mini Timmaraju, head of the abortion rights group Reproductive Freedom for All. “And it’s because folks didn’t believe this could happen but it’s happening.”

Biden issued a statement Thursday that called the Alabama decision a “direct result of the overturning of Roe v. Wade.” And Vice President Kamala Harris, in the middle of her “Fight for Reproductive Freedoms” tour, accused Republicans of hypocrisy.

“On the one hand, the proponents are saying that an individual doesn’t have a right to end an unwanted pregnancy and, on the other hand, the individual does not have the right to start a family,” she told an audience in Grand Rapids, Michigan.

The all-Republican Alabama Supreme Court ruled Wednesday that frozen embryos created through IVF are considered children under state law, potentially exposing families and clinics to criminal charges or punitive damages. In response, the state’s largest hospital and at least two other providers paused IVF treatments as they scrambled to assess the ruling’s impact.

Trump did not speak publicly about the ruling and his campaign did not immediately respond to a request for comment. The dominant front-runner in the Republican primary, Trump has for months resisted calls from anti-abortion advocates to support a national ban because he says it would be unpopular with the general public. The Biden campaign and abortion rights advocates last week seized on a news report that Trump had privately suggested support for a 16-week ban.

Former U.N. Ambassador Nikki Haley, Trump’s last major primary challenger, sided with the Alabama Supreme Court in a Wednesday interview with NBC News, saying “Embryos, to me, are babies.” A day later, she told CNN she did not want to shut down IVF treatments and that “Alabama needs to go back and look at the law.”

“One, you want to make sure that embryos are protected and respected in the way that they’re supposed to be,” Haley said. “Two, you want to make sure that parents have the rights to make those decisions with their doctor as they go through in what they’re going to do.”

New Hampshire Gov. Chris Sununu, a Republican, called the ruling “scary” while speaking at the POLITICO Governors Summit on Thursday. Alabama state Sen. Tim Melson, also a Republican, said he intends to file legislation to protect IVF services in the state.

But other Republicans backed the Alabama court ruling and suggested they would encourage women not to use IVF.

Catalina Stubbe, the national director of Moms for Liberty, a nonprofit that advocates for parental rights in education and has targeted discussions of race and LGBTQ identity in schools, said she empathized with women who want to be biological mothers through in vitro fertilization but felt they should adopt instead.

“There are many other options that moms can definitely take in consideration instead of IVF,” said Stubbe, who emphasized she was describing her position and not her group’s. “This is sad to create a life just to end up like an experiment for a laboratory.”

IVF is a common process by which people attempt to become pregnant, especially for couples having trouble conceiving, LGBTQ couples and people trying to prevent passing on terminal genetic illnesses or high risks of cancer. It is responsible for about 84,000 babies a year, according to the Centers for Disease Control and Prevention.

Legislation and court rulings defining life as beginning at fertilization or that give embryos legal rights may limit parts of the IVF process, including the removal of embryos that fail to implant in the uterus or the disposal of unused embryos.

Fertility doctors have been raising alarm bells over the risks of losing IVF access since Roe v. Wade was overturned as many patients frantically moved frozen embryos to states with more permissive abortion laws — a process that comes with increased cost, complexity and risk of damage to embryos.

Democratic Sen. Tammy Duckworth of Illinois, who has conceived two daughters through IVF, urged Congress to pass a bill introduced last month aiming to protect IVF access.

The Democratic Legislative Campaign Committee encouraged Alabamans to vote for Democratic candidate Marilyn Lands in a special election next month for a state legislative seat.

“This could be a determining factor in who is elected president and could have a big impact in who serves in Congress,” said Kathleen Sebelius, a Democratic former Kansas governor and secretary of U.S. Health and Human Services.

At the annual Conservative Political Action Conference meeting on Thursday, Lala Mooney of Charles Town, West Virginia, said she “absolutely” agrees with the Alabama ruling.

“Embryos are a potential child,” said Mooney, whose son is Republican U.S. Rep. Alex Mooney. “And the moment they’re fertilized, I think they become human beings.”

But Pat Parsley, a 76-year-old from Georgetown, South Carolina, who was waiting to hear from Haley at a campaign event Thursday afternoon, said she wants the former South Carolina governor to win the nomination but condemned the Alabama ruling.

“I think that is really scary. It’s scary for women. It’s scary for families,” said Parsley, who also said she believes abortion should be up to women. “I’m glad I’m not a young woman right now. I hate to say that. I mean, what young women are facing: We’ve gone backwards.”

___

Associated Press reporters Adriana Gomez Licon, Colleen Long, Michelle L. Price, Amanda Seitz and Ali Swenson contributed to this report.

___

The Associated Press receives support from several private foundations to enhance its explanatory coverage of elections and democracy. See more about AP’s democracy initiative here. The AP is solely responsible for all content.