Washington (AFP) - When a Democrat ousted Republicans from a district in deeply conservative Alabama this week, she won hearts and minds with a pitch about repealing the state's no-exceptions abortion ban and protecting reproductive rights.

Marilyn Lands's triumph was the first major test of public reaction to a court ruling that halted in vitro fertilization (IVF) in the state -- and the latest demonstration of the threat the issue poses to the Grand Old Party (GOP).

Democrats framed the vote as a sign of what to expect in November as President Joe Biden vies for reelection against Donald Trump, the Republican former president who takes credit for ending federal protections for abortion access. 

Lands lost an election for the same state House seat two years ago, but her 25-point victory margin on Tuesday came after the Alabama Supreme Court ruled that embryos created by IVF should have the rights of children.

The decision meant clinics could be open to lawsuits for destroying abnormal or non-viable embryos and several announced that they were suspending their IVF programs as the issue became a national political flashpoint.

"This win points out how the Republicans are on seriously shaky ground when it comes to these topics -- especially IVF, which might be the hill the GOP actually perishes on in November," said Aron Solomon, a political analyst for legal marketing agency Amplify.  

"If the GOP actually needed more of a wake-up call on IVF, last night was it. It looks like the Democrats are finally getting pretty good at making reproductive rights a big deal in elections, figuring out the recipe to sway how people decide to vote." 

'Outrageous and unacceptable'

According to polls, a comfortable majority of Americans think abortion should be legal in most cases, and around half of US states have measures in place to protect access.

Other reproductive health care, such as contraception and IVF, is even more popular and experts, NGOs and voters galvanized by the threat to their freedoms denounced the Alabama ruling, while Biden called it "outrageous and unacceptable."

When Trump and other national Republicans joined the chorus of disapproval, state lawmakers rushed out a legislative fix to allow clinics to reopen. But the damage had been done.

The Alabama defeat was another blow to conservatives' hopes to enact severe restrictions on reproductive health care nationwide after the US Supreme Court -- bolstered by three Trump appointees -- gutted abortion rights in 2022.

Republicans claimed victory in the ruling -- which overturned the 40-year-old "Roe v. Wade" precedent -- and quickly enacted strict bans or restrictions in most states they control.

But the party has struggled to stake out a definitive position on the issue and was punished in the 2022 midterm elections as candidates lost key battlegrounds to pro-choice candidates.

Democrats are expected to give women's bodily autonomy top billing again in 2024, characterizing Trump as the architect of attacks on reproductive rights.

'Major warning'

"Trump overturned Roe v. Wade, paving the way for attacks on women's freedoms like we saw in Alabama -- now he's running to ban abortion and gut access to IVF nationwide," said Biden's campaign manager Julie Chavez Rodriguez.

The first signs of voter discontent over Roe v Wade came in deeply conservative Kansas and Kentucky, as well as the swing state of Michigan, where voters rejected referendum proposals in 2022 that would have effectively banned abortion.

South Carolina's Senate and Nebraska's legislature -- both about two-thirds Republican -- rejected a near-total prohibition and a six-week ban respectively as conservatives defied their own parties to block the legislation.

Ohio voters passed a constitutional amendment that enshrines reproductive freedom and Florida's Supreme Court is considering whether similar proposals should go before voters in November.

There are pushes for ballot measures in November protecting abortion in Missouri, Arizona, Arkansas, Colorado, Montana, Nebraska, Nevada and South Dakota.

"The issue has the potential to mobilize Democratic voters, and some Republicans, in a way Biden himself might not," said Princeton University political scientist Julian Zelizer.

"This is a very personal issue and for many Americans the policies related to (IVF) reveal how far this might all go."