I had been taught in school that ectopic pregnancies were nonviable and life-threatening, requiring rapid removal to ensure no harm came to the woman. Because of that information, I had come to the conclusion that an ectopic pregnancy was a situation where an abortion was a morally acceptable option. After my personal encounter I was left questioning the viability of the pregnancy and the data surrounding this abnormal pregnancy. To that end, let’s talk about the facts on ectopic pregnancy.
Ectopic comes from the Greek word ektopos, which simply means “out of place”. It indicates that the pregnancy is occurring somewhere other than the uterus. Ectopic pregnancies occur in about 1-2% of all pregnancies. The majority of occur in the fallopian tube (97.7%), hence the name “tubal pregnancy” that is sometimes used instead of ectopic. Other places the egg may implant include the cervix (0.2%), ovary (0.2%), and abdominal cavity (1.4%).
The egg goes through the usual fertilization process, but due to an abnormality in the anatomy or function of the fallopian tube, ovary, or uterus, the fertilized egg does not implant in the uterus. This is dangerous to the mother because these other sites are not able to stretch to accommodate a growing child like the uterus, and may rupture, resulting in internal bleeding and intra-abdominal infection. Also, there may not be sufficient blood supply to feed the growing baby, resulting in death of the child and subsequent infection if not identified and removed. Both cases may prove to be life-threatening, with about 9% of pregnancy-related deaths being attributed to ectopic pregnancy.
This issue is not as black and white as we would like it to be. When two lives are hanging in the balance, who do you choose? If you choose to terminate the pregnancy, one life is ended. If you choose to attempt to carry the pregnancy as far as possible, two lives may end. Medical care is advancing and maybe one day we won’t have to decide which life to save, but for now, these women have to make a very difficult decision, and we have to choose where we stand.
After my personal encounter I found that I was near tears. In spite of all the good I did for my patients that day, my one thought when I went home at night was the 16 year old girl and her baby. Ending a life, even to save another, was not something I could justify and it continues to grieve my heart. I stand accountable for what I chose to do, but I also know that it changed my beliefs for the better. I cannot stand there and ask a woman to risk her life for a child that may not survive, but I will not be the one who preemptively ends the child’s life either. The situation will present itself again, and I will fight for the lives of my patients, the mother and the child.