Ectopic Pregnancy Treatment and Abortions, a not so brief discussion

The question of whether treatment of an ectopic pregnancy counts as an abortion seems to be brought up on a weekly basis in this sub. The general consensus is that it is not an abortion, but I’ve found that it can be argued that definition-wise, an ectopic pregnancy can be considered an abortion. Additionally, there is the semi-irrational fear of women being denied ectopic pregnancy treatment due to abortion laws, despite even the strictest of abortion bans explicitly citing an exception for ectopic pregnancy treatment. I say semi-irrational as in the years following Dobbs, there have been quite a few alleged cases of women being denied ectopic pregnancy treatment because the hospital feared violating abortion laws (again, despite ectopic pregnancy treatment being cited as a very clear exception). This is, of course, purely malpractice on the part of the hospital and the law is being used as a poor justification, but it shows that the debate of whether or not ectopic pregnancy treatment is an abortion is something that needs to be desperately clarified.

First off - what is an ectopic pregnancy? An ectopic pregnancy occurs when a fertilized egg implants itself in an area outside of the uterus. 95% of ectopic pregnancies occur in the fallopian tube; these are called tubal pregnancies. Ectopic pregnancies can also occur in the cervix, ovary, and abdominal cavity, but chances of ectopic pregnancies ending up in these locations are less than 1%.

Ectopic pregnancies are extremely rare, and have a 2% chance of occurring.

https://ectopic.org.uk/what-is-an-ectopic-pregnancy

The uterus is the only organ in the female reproductive system that is capable of harboring the developing fetus. Only the uterus is able to provide the necessary nutrients a fetus needs to develop, and it is also the only place capable of stretching and expanding as means of keeping up with the fetus’ growth. This is why ectopic pregnancies are non-viable, and why they pose a very major risk to the mother’s health. The fallopian tube cannot expand like the uterus does, so if the fetus continues to grow, it may lead to the tube rupturing and subsequently extremely severe internal bleeding. An ectopic pregnancy must be treated as soon as possible.

Ectopic pregnancy is usually treated either through surgery or medication, depending on how severe the damage from the ectopic pregnancy is.

The medication used in treating an ectopic pregnancy is called methotrexate. It stops the cells in the fetus from growing, and eventually the body absorbs the dissolved cells.

Methotrexate, the medication used in treating ectopic pregnancy, seems to sometimes be used in medically induced abortions, usually alongside the more commonly used misoprostol. I did find some articles detailing how patients who needed methotrexate (whether for ectopic pregnancy or another medical condition, like rheumatoid arthritis) were having extreme difficulty getting prescriptions due to state abortion laws, but they are all from 2022. The current state of methotrexate access is not completely clear, though it seems that special exceptions for methotrexate can be granted in the case of the non-abortion medical conditions that require them.

The surgical procedures typically done to treat an ectopic pregnancy are laparoscopic (keyhole) surgeries, specifically either a salpingostomy or salpingectomy. In a salpingostomy, the fallopian tube is cut into but the goal is to keep it intact. In a salpingectomy, one or both fallopian tubes are removed.

https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/diagnosis-treatment/drc-20372093

Most of the time, the fetus will pass away on its own while still inside the body. However, sometimes the fetus will still be “alive,” so to speak, upon the ectopic pregnancy being discovered. Here’s what the Lozier Institute has to say about it:

“Several studies have observed that only 5-7% of embryos in ectopic pregnancies are still alive when the ectopic implantation is first detected. Even when the embryo has died, removing the remains is important for the health of the mother, because cells of the deceased embryo can continue to multiply, and cause the mother’s fallopian tubes to rupture.”

https://lozierinstitute.org/dive-deeper/ectopic-pregnancies/ (WARNING: GRAPHIC IMAGE OF A TUBAL PREGNANCY)

With this detail, it is very much possible for someone to argue that treatment of an ectopic pregnancy can be considered an abortion.

While the exact specifics of the abortion definition may vary, at the very least it is unanimously agreed that an abortion involves the death of the fetus and the termination of the pregnancy before it reaches its natural conclusion (live birth). Some definitions state that abortions are only deliberately done, while others include miscarriages, sometimes called spontaneous abortions, as examples. Regardless, the point is that in an abortion, the life of an unborn fetus is ended.

So if the fetus in an ectopic pregnancy is still “alive,” then the goal of treating the ectopic pregnancy is to end the fetus’ life and stop it from growing, and thus in this way it fits the definition of an abortion. It is because of this that I personally view ectopic pregnancy treatments as potentially being abortions, depending on the state of the fetus.

Regardless of whether or not ectopic pregnancy treatment should be considered abortion, the most important thing is that it is something that is ALWAYS necessary. With the exception of a very tiny fistful of extremists, this is something that is unanimously agreed on. As of right now there is no tried and true method of transferring the ectopic fetus to the uterus (there does seem to be on article detailing this but it is only accessible through institutions, indicating that it has yet to become a true mainstream procedure), so unfortunately there is just no way to save the fetus in an ectopic pregnancy.