- In the United States, 1 in 50 pregnancies are ectopic.
- These pregnancies occur when a fertilized egg implants outside the uterus.
- Ectopic pregnancies are not viable, meaning they will never reach full term.
- Without treatment, they can lead to hemorrhaging and death.
As more U.S. states pass restrictions on abortion, concern has grown about whether people will be able to safely get care for ectopic pregnancies in a potentially post-Roe world.
Ectopic pregnancies can be extremely dangerous and life threatening. They occur when a fertilized egg implants and grows outside the uterus, most commonly in the fallopian tubes. The pregnancy is not viable; the embryo will not develop into a baby.
In the United States, 1 in 50 pregnancies, or 2 percent, are ectopic, according to Planned Parenthood. Left untreated, the condition can cause serious bleeding and become deadly.
Though anti-abortion legislation generally contains carve-outs for lifesaving emergency care for the mother, legal and medical experts have raised concerns that the legislative language may be vague enough that healthcare professionals may delay care for people with ectopic pregnancies.
Vineeta Gupta, MD, a maternal and child health physician and international human rights lawyer, says the vague and unclear language in anti-abortion bills regarding ectopic pregnancies creates fear, stigma, confusion, and added expenses, all of which increase barriers to care.
“What they are doing with reproductive health and abortion laws is creating all those four barriers to the highest degree,” Gupta said.
Do abortion bans include ectopic pregnancies?
Currently, the restrictive abortion laws that have passed in certain states do not outright ban abortions for ectopic pregnancies.
Though abortion restriction bills contain carve-outs for lifesaving care to the mother — which technically includes ectopic pregnancies — the vague language regarding what is and isn’t legal could confuse healthcare professionals and cause them to delay care out of fear of being prosecuted, according to experts.
Any delay in treatment for an ectopic pregnancy can be dangerous.
If an ectopic pregnancy has ruptured, the pregnant person needs care immediately because they could start bleeding and lose up to 2 liters up blood very quickly.
In Texas’ anti-abortion legislation that ended abortion after 6 weeks, there are exceptions for ectopic pregnancies.
But an NPR report found there’s still confusion around who is able to use the medication typically prescribed for certain ectopic pregnancies — methotrexate — since the state prohibits its use for abortions.
“It is just insane how the language can be very, very difficult to navigate,” said Gupta.
According to Dr. Cindy Duke, a dual board certified virologist and OB-GYN, says abortion legislation that could impact ectopic pregnancies reveals that people do not understand what constitutes a pregnancy.
“It is not a termination of pregnancy. It is literally a situation where someone’s life is at risk in a context where there will never be a viable baby,” Duke said.
All this confusion about what constitutes an abortion, and who can get one, may increase the barriers to reproductive healthcare and further contribute to health equity issues.
Potential moves to stop abortion, even for ectopic pregnancies
Additionally, newly proposed laws may be could make care more complicated.
Louisiana lawmakers recently revised a bill, changing the legal definition of “a person” from “a fertilized egg that has been implanted in the womb” to “a fertilized egg.”
That bill has not yet passed, but if it does, it could confuse healthcare professionals and potentially delay care.
Some state legislators have questioned why there should be exceptions for ectopic pregnancies, which are the leading cause of maternal death in the first trimester.
Others have previously tried to include provisions requiring doctors to move an ectopic pregnancy from the fallopian tubes to the uterus — a procedure that is medically impossible.
Missouri’s abortion bill originally banned abortions to treat ectopic pregnancies, but legislators deleted the ectopic pregnancy provision after public backlash.
During a state Senate debate regarding an anti-abortion bill in Oklahoma, a senator asked why there should be exceptions for ectopic pregnancies, The Washington Post reported.
For the Louisiana personhood bill, Nicholas Creel, an assistant professor of business law at Georgia College & State University who specializes in constitutional law, added that the language in the bill is extremely broad.
“That such a pregnancy can never result in a successful pregnancy and is a life threatening condition if not dealt with properly is ignored by the bill’s rather careless and medically ignorant construction,” said Creel.
He pointed out the language is so broad it may even criminalize in vitro fertilization, intrauterine birth control devices (IUDs), and some forms of emergency contraception.
Duke also emphasizes that the language in legislation is very broad.
“It really comes down to people being misinformed, and it’s led to poor legislation,” she said. “There have been legislators in different states in the United States who have at one point or another tried to introduce legislation that criminalized treatment of ectopic pregnancy.”
Duke said this nonviable pregnancy can be extremely dangerous if not treated quickly. If medical staff are concerned about these laws banning abortion, it’s possible it could cause delays that could be dangerous for the patient.
“It’s a true surgical emergency. It is not an abortion. Treating an ectopic is not an abortion. Similarly, there’s no way, it’s not possible, to take an ectopic and move it from its location into the womb,” Duke told Healthline.
The bottom line
As more states pass restrictions on abortion, concern has grown about whether people will be able to safely get care for ectopic pregnancies in a potentially post-Roe world.
Though anti-abortion legislation generally contains carve-outs for lifesaving emergency care for the mother, the language in these bills is often vague and confusing.
Reproductive rights lawyers say the vague language regarding ectopic pregnancies will increase barriers to care and worsen health equity issues.