Alabama’s largest hospital paused IVF treatments on Wednesday as providers and patients across the state scrambled to assess the impact of a court ruling that said frozen embryos are the legal equivalent of children.

The University of Alabama at Birmingham health system said in a statement that it must evaluate whether its patients or doctors could face criminal charges or punitive damages for undergoing IVF treatments.

“We are saddened that this will impact our patients’ attempt to have a baby through IVF,” spokeswoman Savannah Koplon said in a statement.

Doctors and patients were gripped by a mixture of shock, anxiety and fear as they weighed how to proceed in the wake of the ruling by the all-Republican Alabama Supreme Court that put in question the future of IVF.

Alabama Frozen Embryos
Containers holding frozen embryos and sperm are stored in liquid nitrogen at a fertility clinic in Fort Myer (Lynne Sladky, AP file)

“Disbelief, denial, all the stages of grief. I was stunned,” said Dr Michael C Allemand, a reproductive endocrinologist at Alabama Fertility, which provides IVF services.

Dr Allemand said they are having daily discussions about how to proceed. He said IVF is often the best treatment for patients who desperately want a child and the ruling threatens doctors’ ability to provide that care.

“The moments that our patients are wanting to have by growing their families — Christmas mornings with grandparents, kindergarten, going in the first day of school with little backpacks — all that stuff is what this is about. Those are the real moments that this ruling could deprive patients of,” he said.

Justices — citing language in the Alabama Constitution that the state recognises the “rights of the unborn child” — said three couples could sue for wrongful death when their frozen embryos were destroyed in an accident at a storage facility.

“Unborn children are ‘children’… without exception based on developmental stage, physical location, or any other ancillary characteristics,” Justice Jay Mitchell wrote in Friday’s majority ruling.

Mr Mitchell said the court had previously ruled that a foetus killed when a woman is pregnant is covered under Alabama’s Wrongful Death of a Minor Act and nothing excludes “extrauterine children from the Act’s coverage.”

Alabama chief justice Tom Parker, in a scripture-draped concurring opinion, wrote that, “even before birth, all human beings bear the image of God, and their lives cannot be destroyed without effacing his glory”.

While the court case centred on whether embryos were covered under the wrongful death of a minor statute, some said treating the embryo as a child — rather than property — could have broader implications and call into question many of the practices of IVF.

The fertility clinic and hospital in the Alabama case could ask the court to reconsider the decision or ask the US Supreme Court to review the matter if they believe there is a conflict with federal law.

The Alabama Supreme Court decision partly hinged on anti-abortion language added to the Alabama Constitution by voters in 2018, stating it is the “policy of this state to ensure the protection of the rights of the unborn child.”