Treating Ectopic Pregnancy Is Not the Same as Abortion Care

Among the aggressive anti-abortion measures proposed in the United States, a Missouri bill has prompted particular outrage from medical professionals and reproductive rights advocates.

The bill, introduced by Missouri Rep. Brian Seitz, seeks to criminalize the production and use of drugs in performing an abortion. The original bill sought to prohibit the termination of ectopic pregnancies. After receiving heavy backlash, Missouri lawmakers passed the bill out of committee today without the language about ectopic pregnancies.

“This proposed law has no standing in medical science and threatens the lives of all pregnant patients,” Anna Whelan, MD, an OB-GYN and maternal fetal medicine physician in Rhode Island and fellow with Physicians for Reproductive Health, told Verywell in an email. "Treatment of ectopic pregnancies and abortion care are simply not the same."

How Common Are Ectopic Pregnancies?

Most ectopic pregnancies occur in the fallopian tube. Rarely, an egg can also implant on an ovary, the cervix, the abdominal cavity, or within a cesarean section scar.

The egg cannot survive in these conditions, and the growing tissue can cause bleeding that is dangerous to the pregnant person.

In the United States, about 1–2% of pregnancies are ectopic. If left untreated, they can be fatal. Ectopic pregnancy accounts for almost 3% of all pregnancy-related deaths.

“[Ectopic pregnancies] can be treated successfully when care is able to be accessed expediently,” Whelan said. “Any delay in the treatment of ectopic pregnancies is life threatening.”

Treatment for an Ectopic Pregnancy

Early warning signs of ectopic pregnancy include vaginal bleeding, abdominal pain, and low blood pressure, usually between six and 10 weeks after fertilization.

If someone experiences these symptoms after receiving a positive pregnancy test, they should seek medical attention, Whelan said.

The most common way to diagnose an ectopic pregnancy is by ultrasound. An ultrasound of an ectopic pregnancy typically won’t show a pregnancy sac seen inside the uterus. A provider may instead see the sac, an embryo, or bleeding outside of the uterus. In some cases, patients may also experience abnormalities in their hormones.

Although the Missouri bill intends to criminalize the illegal distribution and prescription of medications like mifepristone and misoprostol, the drugs that comprise the abortion pill, they are not recommended for the treatment of ectopic pregnancies.

When treatment is necessary for an ectopic pregnancy, a provider may prescribe a medication called methotrexate, which stops the pregnancy from growing by preventing cell growth.

In most cases, ectopic pregnancies must be removed surgically. This usually involves laparoscopy to perform salpingostomy (removing the ectopic pregnancy but leaving the fallopian tube in place) or salpingectomy (removing all or part of the fallopian tube). In some cases, a laparoscopic approach isn’t suitable, and a salpingectomy is performed via an abdominal incision.

Legislators Nationwide Are Limiting Abortion Access

The slew of anti-abortion legislation comes on the heels of a Texas law, passed in June, which banned abortions after about six weeks into a pregnancy—before most people realize they are pregnant.

Most recently, the Oklahoma Senate passed six abortion-limiting bills, including one that would ban abortions after 30 days from a woman’s last period. According to the Guttmacher Institute, 26 states have laws or constitutional amendments in place that would make them certain or likely to ban abortion if the Supreme Court were to overturn Roe v. Wade. The organization identifies another five states that are likely to ban abortion under such circumstances.

The Missouri bill would make it a Class B felony to illegally manufacture, produce, or prescribe medical devices and drugs used for abortion. A separate bill proposed this month would allow individuals to sue anyone who helps a Missouri resident get an abortion out of state.

Under the bill originally introduced by Rep. Steiz, terminating an ectopic pregnancy would have been a Class A felony—a conviction that carries a penalty of 10 years to life in prison.

Still, reproductive rights advocates said bills like this one are harmful as they indicate a lack of understanding by politicians seeking to regulate pregnancy and abortion.

“The proposed legislation perpetuates dangerous misinformation,” Whelan said. “It is efforts like these that continue to add to the pregnancy-related mortality crisis in the United States.”