The recent Alabama Supreme Court decision that ruled frozen embryos to be children is shocking. The decision has shut down or jeopardized in-vitro fertilization (IVF) treatments for Alabama women and brought back vivid memories of the fight for IVF coverage in Massachusetts.

I happened to be present 35 years ago at the creation of “An Act Providing a Medical Definition of Infertility,” the state law that requires health insurers to cover all aspects and diagnosis of infertility, including IVF treatment. Massachusetts was the first state to offer such comprehensive coverage. In 2021, 5.4 percent of babies born in Massachusetts were via IVF treatment compared to the national average of 2.3 percent.

In 1987, I was research director for the Joint Massachusetts Health Care Committee, working for Sen. Edward Burke, a Framingham Democrat who chaired the committee. The senator and I discussed the backlash he was subject to from anti-abortion activists who spread themselves on the floor in the hall outside his office underneath oversized placards of bloody fetuses. A practicing Catholic, Sen. Burke was a reliable pro-choice vote who told me, “I really see myself as pro-family, not the way the people in the hallway paint me. Keep an eye out for legislation I could sponsor that might help there.”

Karen Sweet and Catlin Donnelly, volunteers with RESOLVE, a peer support organization for persons experiencing infertility, pitched the legislation that Sen. Burke would sponsor. They explained that health insurers viewed infertility akin to elective cosmetic surgery, and they wanted to change that. I had a flashback to my own experience with health insurance denying me coverage and I was primed to help.

A decade before, while living in Dallas, I made my first pre-natal appointment. I was working as a community organizer where I was one of few women on staff and the first to need pregnancy coverage. My obstetrician told me that insurance would not cover my pregnancy.

I had assumed that if I had health insurance, then it would cover my prenatal and delivery care. I telephoned the company and was informed that pregnancy is “elective” and therefore not covered except through a separate rider, which was not mentioned in any of the materials provided by the insurance agent when I signed up.

When I said I would like to buy that coverage, I was told I couldn’t, because now my pregnancy was a pre-existing condition. The hospital alerted me that the baby and I would not be discharged unless the bill was fully paid on a credit card.

During my long labor at Dallas Presbyterian Hospital, I lay exhausted in the delivery room, when I heard my doctor say, “There’s fetal distress. Heart rate dropping. We need to do a c-section.” He sounded alarmed.

“We don’t have insurance,” my then husband blurted out. “Then we’ll wait,” said my doctor.

I was panicked that my baby was in distress, so with the might parents summon to lift cars when their children are pinned underneath, I pushed out my child. I went home within 24 hours so as not to incur costs for a second day. The nurses discouraged breastfeeding and loaded me up with cans of free formula.

Ten years later, while meeting with the RESOLVE representatives at the Massachusetts State House, they did not need to convince me. I suggested they buy Judy Meredith’s “Lobbying on a Shoestring,” which they did, then followed its strategy.

The advent of new technology – mail merge – meant that Bob Sweet was able to send personalized letters to each state senator and representative. «A man who needs back surgery because his golf game may be compromised can get that covered, but a woman who needs fertility treatments in order to have a family has to pay for it herself,” the letters argued.

Sen. Burke championed the bill, calling it pro-life legislation. Constituents spoke passionately about how IVF offered them hope, overcoming the opposition of lobbyists from the health insurance industry and the Catholic Church, many of whose members were already comfortable bypassing the church’s position against any form of contraceptive or birth control. They had reconciled their faith with the need to have some control over the size of their families.

Despite a high percentage of legislators identifying as Catholic, including Senate President William Bulger, the bill moved forward through multiple committee readings and was passed without floor debate in the Senate or House. In October 1987, the legislation landed on Gov. Michael Dukakis’s desk. Only six years after the first IVF baby was born, Massachusetts residents had gained access to this new medical technology through their health insurance. No one could block the dreams of those who wanted to start a family in Massachusetts.

But in Alabama, and in many other states restricting women’s access to reproductive rights through judicial or legislative means, access to IVF has become precarious or shut down. Infertility is a medical condition, and health insurance ought to cover its diagnosis and treatment for everyone.

Meg Campbell is a Dorchester resident.