Left: President Joe Biden delivers remarks to the National Association of Counties Legislative Conference on Feb. 12 in Washington. Right: Nikki Haley, former governor of South Carolina and 2024 Republican presidential candidate, during a bus tour campaign event in South Carolina on Feb. 21.
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Left: President Joe Biden delivers remarks to the National Association of Counties Legislative Conference on Feb. 12 in Washington. Right: Nikki Haley, former governor of South Carolina and 2024 Republican presidential candidate, during a bus tour campaign event in South Carolina on Feb. 21. / Evan Vucci/AP; Victor J. Blue/Bloomberg via Getty Images

An Alabama Supreme Court ruling that frozen embryos are considered children could have sweeping implications for access to in-vitro fertilization across the country — and is becoming 2024 presidential campaign fodder.

President Biden called the decision "outrageous and unacceptable" and "a direct result of the overturning of Roe v. Wade."

Biden said in a statement that his administration "won't stop until we restore the protections of Roe v. Wade in federal law," a key tenet of his reelection campaign.

Biden's comments came one day after Republican presidential hopeful Nikki Haley seemed to side with the Alabama court's decision, telling NBC News, "Embryos, to me, are babies."

"When you talk about an embryo, you are talking about, to me, that's a life. And so I do see where that's coming from when they talk about that," the former South Carolina governor said.

When asked about Haley's comments Wednesday, a campaign spokesperson pointed to a Thursday Newsmax interview.

"Be very careful how you do this because number one, you don't want to take those fertility treatments away from women. It is very important that women like me have the ability to have that blessing of a baby," Haley clarified.

"But you also want to treat those embryos with respect – whoever is holding them – and make sure that there's a clear indication of what is expected from the parents who provide it, and what's expected from the provider that holds them," she confirmed.

The Alabama ruling sparks concern from reproductive health advocates

The Alabama case involved a pair of wrongful death lawsuits brought by couples whose frozen embryos were destroyed in an accident at a fertility clinic. Writing for the court majority, Justice Jay Mitchell said nothing excludes "extrauterine children" from a state law governing the wrongful death of a minor.

"Unborn children are 'children' ... without exception based on developmental stage, physical location, or any other ancillary characteristics," Mitchell wrote in the decision issued Friday.

The decision could have wide-ranging ripple effects on the legality of and access to IVF. During the process of in-vitro fertilization, embryos are created in a lab using a couple's egg and sperm, and then implanted. But more embryos are typically created than are implanted, and instead can be stored, donated, or destroyed, said Mary Ziegler, a UC Davis Professor of Law who has written extensively about abortion law.

"Some anti-abortion groups argue that if an embryo was a person, every single embryo created has to be implanted, either in that person who's pursuing IVF, or some other person who 'adopts the embryo,' " Ziegler told NPR's All Things Considered. "So as a result of that, it may radically change how IVF works, how cost effective it is and how effective it is in allowing people to achieve their dream of parenthood."

In light of the court ruling, Alabama's largest hospital network, the University of Alabama at Birmingham Health System, has paused its IVF treatments "as it evaluates the Alabama Supreme Court's decision."

"We are saddened that this will impact our patients' attempt to have a baby through IVF, but we must evaluate the potential that our patients and our physicians could be prosecuted criminally or face punitive damages for following the standard of care for IVF treatments," a UAB spokesperson said in a statement.

Alabama Fertility Specialists announced on its Facebook page Thursday that it would also be pausing new IVF treatments "due to the legal risk to our clinic and our embryologists." And the Center for Reproductive Medicine in Mobile, the clinic at the center of the Supreme court lawsuit, has also halted IFV services.

Barbara Collura, President and CEO of RESOLVE: The National Infertility Association, called the court's ruling and the move by UAB "horrifying signals of what's to come across the country."

"Less than a week after the Alabama Supreme Court's devastating ruling, Alabamans in the midst of seeking treatment have had their lives, their hopes and dreams crushed," Collura said in a statement. "We will continue to fight to maintain and increase access to care for the 1 in 6 adults nationwide who struggle with infertility."

Abortion is expected to be a key issue on the trail — again

Haley has in the past discussed her struggles with infertility, and told NBC on Wednesday that she conceived her children through artificial insemination, a process that does not involve creating embryos in a lab.

Throughout the campaign, Haley has said she is "unapologetically pro-life," but called on the GOP to show "compassion" and "find consensus" on the issue of abortion.

But that puts Haley out of step with many in her party, who have called for a national 15-week abortion ban and championed abortion restrictions at the state level.

Democrats, meanwhile, see abortion as a winning issue. Voter registration data suggests that the overturning of Roe motivated women voters ahead of the 2022 midterms. And in every ballot initiative since Dobbs v. Jackson, the Supreme Court case that overturned Roe, the anti-abortion measure lost, even in solidly red states.

Speaking in Grand Rapids, Mich., Thursday, Vice President Kamala Harris said the fallout of the Dobbs decision shows "elections matter."

"What we have seen on this issue is over the course of now, a year and almost a half — people who are suffering every day in our country as a result of this," Harris said. "[Former President Trump] was clear in his intention to hand pick three Supreme Court justices who would overturn the protections of Roe v. Wade. And he did it. And that's what got us to this point today."