Ectopic pregnancies, when gestation takes place outside the uterus, account for an estimated 2 percent of all pregnancies. Most commonly, implantation begins in a fallopian tube but occasionally on an ovary or against the abdominal wall. Usually the pregnancy miscarries without a woman knowing she was pregnant.

Because of the nature of an ectopic pregnancy, the child would normally have no hope of survival. And surgery may be necessary to save his mother’s life. These are tragic situations, but they are not the intentional killing of an innocent person who could otherwise survive.

Unfortunately, since the overturning of Roe and Casey, there has been much misinformation on the internet and in the media about ectopic pregnancies, and claims that women will not be able to receive medically necessary treatment in states that have restricted elective abortion. This is a straw man and/or a red herring argument.

What do doctors have to say? The American Association of Pro-Life Obstetricians “recognizes the unavoidable loss of human life that occurs in an ectopic pregnancy, but does not consider treatment of ectopic pregnancy by standard surgical or medical procedures to be the moral equivalent of elective abortion, or to be the wrongful taking of human life.” (See their position statement on ectopic pregnancies.)

They also say, “Although treatment for ectopic pregnancy results in the unfortunate death of the embryo, this is not the intent of the treatment. The intent is to save the life of the mother. The sole intent of an abortion is to end the life of the developing human being. Therefore, legislation restricting induced abortion should not be seen to limit a physician’s ability to treat ectopic pregnancy.” (Emphasis mine.)

They state, “To clarify, elective abortion is defined as those drugs or procedures used with the primary intent to end the life of the human being in the womb. Elective abortion is not treatment of a miscarriage or an ectopic pregnancy nor is it separating the mother and the baby at any gestational age to save a mother’s life. There are no laws in any state in the United States which criminalize treatment of any of these conditions.”

This is a great video from Live Action, done by neonatologist Dr. Kendra Kolb, explaining the pro-life reply to “abortion can be medically necessary.” Her comments on ectopic pregnancies start at the 3:23 mark:

(The whole “Pro-Life Replies” series is excellent. You can see all the videos here, including How to Reply to: “Women Will Die From Illegal Abortions” and How to Reply to: “A Fetus Is Not A Person.”)

Finally, here’s an excerpt from an episode of The World and Everything in It, specifically addressing the new pro-life laws and ectopic pregnancies:

MARY REICHARD, HOST: Let’s get right to it. Is it now illegal in some states to treat miscarriages and ectopic pregnancies?

LEAH SAVAS, REPORTER: The short answer is no, but we can approach this no from two angles. The first one is legal, and the second one is medical. So I'll start by looking at the legal side of this.

If you actually look at the laws in the 21 states that already have protections for unborn babies, they all make exceptions to allow for abortions when the life of the mother is at risk. So that's the key part. So women can still get abortions if the pregnancy is threatening their lives. That would include removing ectopic pregnancies, because if the baby who in an ectopic pregnancy implants in the fallopian tube, or somewhere else outside of the uterus, if the baby's allowed to grow, the fallopian tube could rupture, the mother could bleed to death. That is obviously a life threatening situation. Another life-threatening situation would be when a baby miscarries but does not fully evacuate the mother’s body. If the baby’s allowed to remain there, that could lead to an infection and that could threaten the woman’s life as well. So in those two cases, obviously, there are good medical reasons to remove the baby.

REICHARD: But that wouldn’t count as an abortion, would it, if the baby has already died? Abortion ends a life, and there’s no life in that case.

SAVAS: That’s correct. But this is where things can get a little confusing for some people because one medical term for miscarriage is a “spontaneous abortion.” That’s sometimes what it’s called medically. But many laws get really specific about what counts and what doesn’t count as an abortion. And it clarifies in definitions that miscarriage and ectopic pregnancy removal is not an abortion.

One of those states that makes that clarification is Arkansas. They have a conditional law that went into effect the day that the Supreme Court overturned Roe v. Wade. It prohibits abortion except to save the mother’s life. And in the definition section, the legislation defines abortion and clarifies that the act is not an abortion if performed with the purpose to remove a dead unborn child caused by spontaneous abortion or removing ectopic pregnancy. That’s a direct quote from the law.

REICHARD: What about states with laws that don’t make that clarification?

SAVAS: So, my state of Michigan is one of those states that has a law protecting babies from abortion in all cases. There’s a debate right now as to whether or not it’s actually in effect. But that’s a totally different story. It does make exceptions for the life of the mother, but doesn't make these clarifications about ectopic pregnancies and miscarriages. So I talked to the legislative director of Right to Life of Michigan about this and she referred me to a part of the public health code that does define elective abortion and clearly states that it does not include treating a woman who has had a miscarriage or who has an ectopic pregnancy. But again, even if a state doesn’t make this clarification in another part of the law, doctors always have that life of the mother exception to fall back on.

REICHARD: So there is a legal difference between, say, removing an ectopic pregnancy and an elective abortion. But is there any difference medically?

SAVAS: Yes, there is a medical difference and even Planned Parenthood says so. If you go to their website, they have a page that talks about ectopic pregnancy. And on one of the questions that it’s answering on the page, it says that treating an ectopic pregnancy—and this is a quote from the page—"isn't the same thing as getting an abortion.” It then goes on to clarify that abortion involves ending a pregnancy that’s in the uterus, while removing an ectopic pregnancy is removing a pregnancy that has implanted outside of the uterus, usually in the fallopian tubes. And you have to remove that through laparoscopic surgical procedures or a drug called methotrexate. And that's exactly what the page says on Planned Parenthood.

Listen to the whole episode here.

Photo by Towfiqu barbhuiya