2:30pm - 2:45pm (CDT) | 2047.0 - Moving from an infertility to fertility model: A public health policy analysis and strategy toolkit for improving fertility care quality and equity in the United States

Session: Empowering Women and Rebuilding Trust in Maternity and Fertility Care

Program: APHA Committee on Womens Rights

Presenter: Sydney Perlotto, MPH

Abstract

Many people seek fertility care for a variety of medical, conditional, and relational reasons. However, pervasive social and structural barriers—including laws and policies—drive significant racial/ethnic, socioeconomic, and geographic disparities surrounding access to and uptake of fertility care. Furthermore, narrow policy models based on clinical definitions of infertility erase the family-building needs and experiences of single people, LGBTQ+ people, and disabled people.

This presentation uses a Reproductive Justice approach to examine how “the right to have a child” is shaped both by individual’s identities and their surrounding community and context—explaining how public health policies focused on fertility rather than infertility can better remedy health inequities facing pregnant and parenting people. The analysis involved reviewing the current public health and legal literature; examining relevant U.S. laws, policies, and litigation at federal and state levels; and outlining key vulnerabilities emerging in the post-Dobbs context.

By the end of the presentation, participants will be able to list a “toolbox” of fertility care strategies and rationales (n=25) across six dimensions of public health law and policy: surveillance/research, direct regulation, indirect regulation, information environment, place/community, and taxing/spending. Additionally, using Connecticut as a case study for policy change, participants will be able to discuss real-world implementation considerations for three promising state-level strategies (insurance coverage, paid leave, and fraud redress).

The rapidly evolving context of and intertwined attacks on U.S. reproductive rights make shifting to an expansive and inclusive policy model for fertility care an imperative within public health. Numerous opportunities for change exist.