In this article we hear from Sarah Cleveland (OB/GYN) in response to the common argument for abortion when it comes to ectopic pregnancies and the life of the mother.

Why answering this questions matters

When I tell people that there is no medical reason for an abortion, people often bring up the issue of ectopic pregnancies. Even well-meaning, concerned pro-life people bring this up. They don’t know how to answer it and for this reason may say they are “pro-life” with exceptions”. This is the loophole pro-aborts need to push abortion on demand, without restrictions, and without apology. If we are to abolish the evil of abortion, we would do a service to ourselves to better understand what is (and is not) an ectopic and how it relates to abortion.

What is an Ectopic Pregnancy

An ectopic pregnancy is a pregnancy in an abnormal location. It is also called an extrauterine pregnancy, meaning a pregnancy outside of the uterus. Most of the time (95-97%) they are found in the fallopian tubes. True ectopic pregnancies are rare. In tubal ectopic pregnancies, the mother may present symptoms of pelvic pain, spotting, nausea, and abnormal hCG levels. By the time, the ectopic is located, mostly before 7 weeks LMP, (dated from last menstrual period), the baby is already dead. There is nothing in the tubes to sustain a new life.

Why ectopic pregnancy is not an abortion

Via ultrasound, we can detect an abnormal area between an ovary and the uterus. It contains chorionic villi, (the primitive cells that would make the placenta), maternal blood, pregnancy cells and debris, and a non-living microscopic baby. What we see is a small (1-3cm) heterogeneous area in the pelvis, not a living baby with a heartbeat.

The danger of a tubal pregnancy is that the tube is not very elastic, highly vascular, and not designed to carry a pregnancy.

If it ruptures, the mother will have internal bleeding which will likely cause maternal death without immediate treatment. So, we intervene to remove the ectopic, often surgically, from the mother. This is not an abortion.

What should we be doing someone has an ectopic pregnancy

For the even more rare instances when a tubal pregnancy is found to be still living, (I have seen 2 in my ultrasound career of 13 years and the babies were each between 7-8 weeks), the ethical treatment, some have argued, would be watchful waiting.

If the mother is stable, she can be sent home with strict orders about what to watch for and what to do if/when things start going bad. Or we can admit the mother to the hospital if she is unstable. Here, serial ultrasounds and blood work should be done to monitor hCG levels as well as monitoring the mother’s vitals. Once the baby dies, surgery to remove the tube is then morally acceptable.

Some physicians also prescribe a drug called methotrexate to attack and kill the ectopic. (Even though the baby is not living, other cells can be, and their growth needs halted, such as the chorionic villi and amnion.) This is not as effective as surgery, but it is less invasive, and some doctors decide to give this a try first to see if it will dissolve.

by Sarah Cleveland, RDMS (AB, OB/GYN)

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The information in this article can be found in the book: Callen’s Ultrasonography in Obstetrics and Gynecology 4th Edition