Facts Are Important: Understanding Ectopic Pregnancy
Facts are important, and essential care must never be legislated or regulated based on false or inaccurate premises. This includes lifesaving treatment of ectopic pregnancies.
An ectopic pregnancy occurs when a fertilized egg implants and grows in a location that cannot support the pregnancy. Almost all ectopic pregnancies—more than 90%—occur outside of the uterine cavity in a fallopian tube, but they can also implant in the abdomen, cervix, ovary, and cesarean scar. An ectopic pregnancy in any location is life threatening. This is because as the pregnancy grows, it can cause the structure where it is implanted to burst, or rupture. A rupture can cause major internal bleeding and is a life-threatening emergency that requires urgent surgery.
A tubal ectopic pregnancy will never be viable. It cannot move or be moved to a place in the uterus where it can safely grow to delivery. There are two methods used to treat a tubal ectopic pregnancy: medication and surgery.
Treatment of a tubal ectopic pregnancy through medication works by preventing the cells in the pregnancy from growing. Medication can only be used for treatment in patients who are stable and whose ectopic pregnancy has not ruptured.
Some patients, including those for whom medication is contraindicated or those who have a ruptured ectopic pregnancy, may require surgery. In a surgery for a tubal ectopic pregnancy, the entire pregnancy may be removed from a fallopian tube or the tube may be removed with the pregnancy. An ectopic pregnancy in the cervix or cesarean scar may be removed with a dilation and curettage procedure.
Treatment for ectopic pregnancy requires ending a nonviable pregnancy. This treatment exists within the spectrum of lifesaving care during pregnancy, including induced abortion that also ends a pregnancy. While the indication and treatment for ectopic pregnancies is distinct from the indication and provision of induced abortion, they are both essential, critical aspects of health care.
Policies Impacting Ectopic Pregnancy
Patients with an ectopic pregnancy must have timely access to all treatment options.
- An untreated ectopic pregnancy is life threatening; withholding or delaying treatment can lead to death.
- Laws limiting, restricting, or directing treatment of ectopic pregnancy are dangerous and unethical.
Bans on Abortion Threaten Treatment for Ectopic Pregnancy
Abortion bans threaten to impede ectopic pregnancy treatment. For example ...
- Legislation that bans abortion care for those with an ectopic pregnancy or mandates how clinicians treat ectopic pregnancies does not reflect the clinical reality of ectopic pregnancy management and could result in delays or even denials of care.
- Abortion bans—even those with exceptions for ectopic pregnancy—can generate confusion for patients and health care professionals and can result in delays to treatment. Health care professionals should never have to navigate vague legal or statutory language to determine whether the law allows them to exercise their professional judgment and provide evidence-based care.
- Any application of an abortion ban that affects those in need of treatment for ectopic pregnancy is inappropriate and will certainly cost lives.