- 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, which means they will never come to term.
- Without treatment, they can lead to bleeding and death.
As more US states pass restrictions on abortion, concern grows over whether people will be able to safely obtain care for ectopic pregnancies in a potentially post-Roe world.
Ectopic pregnancy can be extremely dangerous and fatal. 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. If left untreated, the condition can cause severe bleeding and become deadly.
While anti-abortion legislation often contains restrictions for life-saving emergency care for the mother, legal experts and physicians have raised concerns that the legislative language could be vague enough that healthcare providers could delay care for people with ectopic pregnancies.
Vineeta GuptaMD, maternal and child health physician and international human rights lawyer, says vague and unclear language in anti-abortion laws on ectopic pregnancy creates fear, stigma, confusion and additional expense, which increases barriers to care.
“What they’re doing with reproductive health and abortion laws is creating all four of these barriers to the highest degree,” Gupta said.
Currently, restrictive abortion laws that have been passed in certain states do not totally prohibit abortion for ectopic pregnancies.
While restrictive abortion laws contain exclusions for vital care for the mother – which technically includes ectopic pregnancy – vague language about what is and is not legal can confuse healthcare providers and cause them to delay care for fear of being sued, according to experts.
Any delay in treating an ectopic pregnancy can be dangerous.
If an ectopic pregnancy ruptures, the expectant mother needs immediate care as she can start bleeding and lose up to 2 liters of blood very quickly.
Inside Texas anti-abortion legislation who ended the abortion after 6 weeks, there are exceptions for ectopic pregnancy.
But one NPR report found that there is still confusion about who can use the medication normally prescribed for certain ectopic pregnancies – methotrexate – as long as the state forbids its use for abortions.
“It’s just insane how language can be very, very difficult to navigate,” Gupta said.
According Dr. Cindy Dukea board-certified virologist and gynecologist, says abortion legislation that can affect ectopic pregnancies reveals that people do not understand what constitutes a pregnancy.
“It is not a termination of pregnancy. It’s literally a situation where someone’s life is on the line 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 it can increase barriers to reproductive health and further contribute to health equity issues.
In addition, newly proposed laws 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 uterus” to “a fertilized egg.”
This bill has not yet passed, but if it does, it could confuse healthcare professionals and potentially delay care.
others have tried include provisions requiring doctors to move an ectopic pregnancy from the fallopian tubes into the uterus – a procedure that is medically impossible.
Missouri’s abortion bill originally banned abortions to treat ectopic pregnancies, but lawmakers deleted the ectopic pregnancy provision after public backlash.
During a state Senate debate on an anti-abortion bill in Oklahoma, a senator asked why there should be exceptions for ectopic pregnancy, The Washington Post reported.
For the Louisiana Personality Bill, Nicholas Creelassistant professor of business law at Georgia College & State University specializing in constitutional law, added that the language of the bill is extremely broad.
“That such a pregnancy can never result in a successful pregnancy and is a life-threatening condition if not treated properly is overlooked by the rather careless and medically ignorant construction of the project,” Creel said.
He pointed out that the language is so broad that it could even criminalize in vitro fertilization, intrauterine birth control devices (IUDs), and some forms of emergency contraception.
Duke also emphasizes that the language in the legislation is very broad.
“It really comes down to people being misinformed, and that has led to poor legislation,” she said. “There have been lawmakers in different states across the United States who, at one point or another, have tried to introduce legislation that would criminalize the treatment of ectopic pregnancy.”
Duke said this unviable pregnancy could be extremely dangerous if not treated quickly. If medical staff are concerned about these laws that prohibit abortion, it is possible that this could cause delays that could be dangerous for the patient.
“It is a true surgical emergency. It’s not an abortion. Treating an ectopic is not an abortion. Likewise, there’s no way, no way, to take an ectopic and move it from its location to the uterus,” Duke told Healthline.
As more states pass restrictions on abortion, concern grows over whether people will be able to safely obtain care for ectopic pregnancies in a potentially post-Roe world.
While anti-abortion legislation often contains exceptions for life-saving emergency care for the mother, the language of these laws is often vague and confusing.
Reproductive rights advocates say vague language about ectopic pregnancy will increase barriers to care and worsen health equity issues.