Ectopic pregnancy and the sanctity of life

As Christians, we are unabashedly, 100% pro-life. We believe that life begins at conception; that every human life is created in the image of God; and that abortion is wrong in every case. This is where we differ from many other “pro-lifers” who are willing to grant that abortion may be merited in certain cases.

Abortion is murder – even in cases of rape, incest and when the life of the mother may be at stake. We must never reason from difficult cases to make ethical judgments and we must understand that modern bioethics and medical ethics are not reasoning from God’s law.

Doug Phillips recently broached the question of ethical treatment of ectopic (tubal) pregnancy on his blog when he posed the following question from the Witherspoon School of Law and Public Policy:

A mother conceives a child. The doctor tells the parents that they have a tubal pregnancy and that the baby has little to no chance of survival, but its continued life poses a threat to the life of the mother. What are the relevant biblical principles? What facts must be determined to make a biblical ethical decision? What medical options might be available. Is killing the baby through abortion defensible through Scripture? If so, defend your position? If not, defend your position? Are there other options?

Certain loud sectors of the blogosphere accused him of endangering the lives of countless women because he suggested they might not need to automatically and immediately abort an ectopic pregnancy.

I was intrigued by this question and the possibilities it presented, and I was not ready to accept the assumption that failure to aggressively treat an ectopic pregnancy amounts to suicide.  I stayed up until 1:00 that evening researching the subject, and here is what I learned.

ECTOPIC PREGNANCY

Ectopic pregnancy is a pregnancy in which the fertilized egg implants outside of the uterus. In 95-98% of cases, it implants inside the fallopian tube – this is why it is commonly referred to as tubal pregnancy. Other possible locations are in the cervix, an ovary, or in the abdomen where it will attach to a blood supply such as the bowel or liver.

TREATMENT OPTIONS

The standard treatment for ectopic pregnancy follows one of 3 courses: chemically induced abortion (usually by means of a drug called methotrexate); removal of the entire fallopian tube which contains the baby or a the affected portion of the tube; or removal of the baby and subsequent repair of the affected fallopian tube.

All 3 approaches directly result in the inevitable death of the child.

However, there is at least one more option: Wait. Be ready, but wait. Treat the mother if necessary but do not kill the child. No abortion.

The primary argument against the Watchful Waiting method of treatment is that it is dangerous to the mother. Alarmists will try to equate it to a death sentence – and for what? The child was doomed from the start, right?

No. The outcome is not so easily predicted as some would have you think.

PROGNOSIS/OUTCOME

Yes, there is a high likelihood that the child will die. How high? Nobody really knows, because nobody seems to recommend this approach. There was recently a documented case of anundiagnosed ectopic pregnancy that was delivered by c-section at full term. There are others as well: A baby born in 2000 was attached to the mother’s bowel, as was this one in 2005. This 1999 triplet developed in the fallopian tube, while his two sisters grew in the uterus. The triplet article states that there are 60-100 cases of babies growing outside the womb and surviving.

update: Here are 5 more documented cases of ectopic survivors. Thank you to Christina for the link.

Yes, these cases made headlines and amazed the whole world, but how many more cases would do so if we didn’t diagnose and automatically abort them? This site seems to indicate that the prognosis for the ectopic child is not entirely hopeless, at least in the case of abdominal pregnancy:

Prognostic: The abdominal pregnancy is associated with high maternal (0-20%) and perinatal (40-95%) mortality. Maternal mortality is about 5.1:1.000 compared with 0.7:1.000 in other ectopic gestations. The perinatal mortality has been traditionally high. However recent progresses have result in a 70-80% increase in the survival in fetuses older then 30 weeks…

But what about the mother? Is it right to sacrifice her life with so little hope of gaining the life of the child? In the case of abdominal pregnancies that are allowed to continue, the article above goes on to state that:

Mortality and maternal morbidity are directly related to the removal of the placenta during childbirth. The remove of the placenta depends on the degree of invasion, the location of insertion, the involvement of the other organs and the surgical access to the placental blood supply. If it is possible, the complete placental extraction should be done. If not, the placenta should be left at the place, following by occlusion of the umbilical cord. The subsequent management is expectant. The placental reabsorption can be accelerated with methotrexate, selective arterial embolization and secondary laparotomy.

So the life of the mother may be in danger, but she is far from doomed! There are procedures for dealing with the risks of advanced abdominal pregnancy – procedures which allow for the possible survival of the child!

For those pregnancies which implant in the fallopian tube (far more common than abdominal pregnancy), the dangers are surprisingly moderate. Although many will succumb to scare tactics, a plain reading of the statistics can be very reassuring.

STATISTICS

  • Currently, up to 1 of every 50-60 pregnancies is estimated to be ectopic.***
  • Over 100,000 ectopic pregnancies were reported in the US in 1992.
  • 1 out of 2000 ectopic pregnancies ended in the death of the mother for the 1970’s and 1980’s. The mortality rate has fallen even lower in recent years due to advances in medical care. Recent estimates put it at ~3 in 10,000.
  • At least 14 studies have documented that 68 to 77 percent of ectopic pregnancies resolve without intervention (American Academy of Family Physicians).
  • Tubal rupture occurs in approximately 20% of cases. The statistics seem to indicate that this is the number of women whose initial symptom is tubal rupture, i.e. they receive no treatment at all prior to rupture. Studies indicate that another 10-30% may experience rupture while under medical care.
  • Contrary to popular belief, death from rupture is rare where medical attention is available. In the US, 25-50 women die from ectopic pregnancy each year out of about 100,000 reported cases.

Let’s do the math, shall we? In spite of the fact that hospitalization and surgical treatment pose risks of their own and many women have surgery without having experienced tubal rupture, we will generously assume that all of the reported deaths occur among those women who didn’t receive treatment until after rupture.

If there are 100,000 ectopic pregnancies reported each year and 20% of them result in rupture of the fallopian tube, then about 20,000 women are treated annually in the US for actual tubal rupture. A total maternal death toll of 50 would mean that 1 in 400 of those who experienced tubal rupture died. That’s a death rate of 0.25%.

Since rates of ectopic pregnancies have continued to increase rapidly while mortality rates for the mothers are decreasing, actual current numbers would look far better: a death toll of 25 (the number reported in 1992, the most recent I could find) would bring the chance of death after rupture down to 1 in 800, or 0.125% (20,000 ruptures divided by 25 deaths).

A mother who is aware of the situation and under a physician’s watchful care would likely fare even better. If we accept 40% as the rate of eventual tubal rupture (20% happening initially and the other 20% occurring during treatment and medical care), then we have a death toll of 25 out of 40,000 cases of rupture, or a 1 in 1,600 chance of death.

CONCLUSION

The chance of death for a mother who chooses not to abort an ectopic pregnancy appears to be something less than 0.25% – possibly as little as 0.06%, or about four times the risk of full-term labor and delivery.

Does this sound like a death sentence for those who would refuse to abort an ectopic pregnancy? Or does this sound like a reason to reconsider the standard course of action in a difficult situation?

We should always question the presuppositions of the scientific community – from stem cells to aborting tubal pregnancies – because they DO NOT reason from a Christian foundation. Once we begin to question them and their assumptions we start to realize that they are not as sure of their conclusions (or shouldn’t be) as they claim to be.

As Christians, we must always begin with God’s word and work from there. Some decisions will be easy and others will be difficult, but all must begin from the same foundation: God’s Word is authoritative and sufficient for every facet of life.

When we start from this presupposition, we just might find that the difficult decisions aren’t so difficult after all.

REFERENCES

CDC Ectopic Pregnancy Surveillance 1970-1978

Medline Plus Medical Encyclopedia

Ectopic Pregnancy: Dr. El-Mowafi

Ectopic Pregnancy on Wikipedia

Time and Risk of Ruptured Pregnancy

Study: An Institutional Review of the Management of Ectopic Pregnancy

Fast Facts on Ectopic Pregnancy

eMedicine: Ectopic Pregnancy

Ectopic Pregnancy: Risk Factors

*** Figures from the 1940’s estimated that about 1 in 30,000 pregnancies was ectopic. This number has skyrocketed due to common risk factors: hormonal birth control and IUDs, tubal ligations, STDs, PID (Pelvic Inflammatory Disease, usually a result of STD caused by promiscuity), in vitro fertilization, and abortions – all practices which many Christians find ethically questionable or morally wrong.

follow up here: Ectopic Pregnancy Clarifications

Comments

  1. Meredith – I just want to clarify – if the ectopic is in the tube (as 95% are) it pretty much WILL rupture every time. And a rupture can be varying degrees of severe, (my 2nd was as Karen described hers) so being near a hospital just may not be enough. I’m not getting the wrong end of the stick. If the ectopic is tubal, waiting for it to rupture is incredibly risky. It has nothing to do with blame.

    Ellen

  2. Meredith_in_Aus says:

    I really think some people are getting the wrong end of the stick here. If you are unaware that you have an ectopic pregnancy and you start feeling ill and barely make it to the hospital before passing out/bleeding to death, it is obvious that you are losing that dear baby. You are not to be blamed and Kim is not saying that THEN you should take a “wait and see” approach.

    From what I understand, Kim is talking, here, about those who, usually at an early ultrasound, are told that their pregnancy is not “viable” because it is tubal and must be terminated before the mother dies. Kim is not implying that it is not risky to take a wait and see approach here, but one that does need to be taken in order to avoid breaking the 6th commandment. If you are alerted to the fact that you have a tubal pregnancy, take precautions to ensure that you are close to a good hospital at all times. As Kim stated in her post, we don’t ACTUALLY know how many tubals do end in rupture because the standard treatment is to abort straight away.

    In Him

    Meredith

  3. I am deeply offended by the views made in “Ectopic pregnancy and the sanctity of life”.

    I am at present recuperating from life threatening surgery for an ectopic pregnancy. The hCG (pregnancy hormone) was continuing to rise albeit very slowly and it was pointed out to me that it was unlikely to be a viable pregnancy. That said, the fact the levels were increasing suggested there was something still growing inside me. To cut a long story short I was admitted for emergency as the medical professionals feared I had a ruptured ectopic. When I went tosurgery they had a tough time saving me as I was losing a lot of blood. I lost more than blood though. I lost a fallopian tube and a very much wanted child (I have had 4 miscarriages previous to this ectopic). How dare you describe the removal of an ectopic as abortion. I am outraged! If I had not had surgery it is very clear that not only would the foetus have died but I would have as well.

    I am struggling to recover from this awful situation and to have read your bog above has made me SO UPSET. I appreciate others have opinions but how dare you make me feel like I have aborted my child. All I want is one child and I would and have done anything to get one child.

    You have made me feel even more of a failure than I already do. Thanks for nothing!

  4. Kim, I think there should be more clarification here…an ectopic pregnancy in the fallopian tube is 100% fatal for the baby. These account for 95% of all ectopic pregnancies. There are 5% that occur in the abdomen and have a small chance of survival. There are no accounts at all of survival in the fallopian tubes.

  5. To the author — How many untreated ectopic pregnancies have you endured?
    Your opinion is unimportant until you’ve put your life on the line to back it up.

  6. I’m not sure how I feel about this. I totally agree that an immediate diagnosis and action to end a pregnancy is not always wise (if that was the case the baby I am now pg w/wouldn’t be making me sick as a dog now since I was initially given the diagnosis of blighted ovum!). What is getting me is the “wait to rupture” message. I remember almost crawling into the ER, barely able to breathe, feeling the worst pain of my life (far worse than labor), and my tube was just on the verge of rupturing. I wouldn’t wish that on any woman. I remember being told that if God wanted to, He could move the pregnancy. But the reality is that He didn’t, my baby was going, I didn’t need to die as well.

  7. Judy,
    I am so sorry for the trials that you went through. Although, if there was no heartbeat, your child had already passed and so of course it wasn’t an abortion!

    How wonderful that you have three more precious blessings in your home! God is good, isn’t He!

  8. Thank you, Kim…. I’ve wondered if there was anyone else who believed the same on this. I’ve had many discussions about this with my husband… comparing it to if I were drowning and holding our youngest in my arms, and the only way to swim to shore was to let my newborn slip beneath the waves so I could reach the rest of my family. Does their age, or how many other children I have, or their survivability determine their worth? Just because they’re not visible yet doesn’t make them any less my child. That I would give my life so I didn’t have to be part of my baby’s death doesn’t mean I don’t love and cherish my other children. Still, I’m sure women who “watch and wait” are persecuted for their decision, even by most Christians.

  9. Thanks for this wonderful post! I have also been led to believe that ectopic pregnancies are a death sentence for the mother if allowed to continue.

    Thank you for the enlightenment!

  10. I have to agree with Judy. I’ve also read your blog and really appreciated your perspective on things. But I think you’ve gotten too far afield this time, with consquences that could be disastrous to someone. I too have experienced 2 ectopic pregnancies which resulted in ruptures at approximately 8 weeks. The first one, I didn’t even realize what a rupture/internal bleeding would feel like, and was just lucky to be going to the doctor for a routine checkup to confirm pregnancy. The second one I realized what was happening based on my first experience. I had, and I will put it in caps, NO TIME to waste on the 2nd. I got the hospital immediately and was rushed into surgery with my abdomen swelling from the bleeding. If I hadn’t had the first and the experience to refer to, I would have most certainly died on the second. So I have to respectfully disagree with your assessment that ectopics aren’t such a big deal or health risk. They are. My ectopics ruptured early before any diagnosis, but an ectopic can rupture at any point. I thought your post made it sound too much like a normal, high risk pregnancy.

    Ellen

  11. Judy,

    Your heartbreak is shared by many here.

    You did mention that both times the ultrasounds confirmed that there was no hearbeat, right? That is not the same as aborting a living baby. Just as taking care of a ruptured tube, the removal of a non-living baby from your body is not the same as abortion. The medical procedures did not end the life.

  12. Daily I come over to your blog. I would have to say that I have agreed with a high percentage of your views on things This is one that I have to respectfully differ. You see, I am a Christian, have had 2–yes 2 ectopic pregnancies and yes, both have ended in me having to do “something”.

    My first ectopic happened when my oldest was 3 1/2. After he had turned 6 months old we decided to leave it up to God to decided on our family. I had a very hard time getting pregnant and was thrilled to find out it finally happened. There was concern right from the beginning. I had taken numerous at-home and even dr. office test and they all came out negative. The doctor decided to send me for a quantitive pregnancy test (which measures not only if you are pregnant but the hormone level). That did come out positive but low. A few weeks past and I started spotting. First I went to the ER and the next day the doctors office. I was told I had a miscarriage and was sent on my way. The doctor had no empathy and straight up told me not to worry about it. I was told I was young, not to worry about getting pregnant again, and I had plenty of time. This didn’t help my breaking heart. For 3 weeks I had “show” and thought this was totally normal. Long story short…I went to see another doctor, found out I was still pregnant and my tube was bleeding out (I was over 10 weeks pregnant at this point). Surgery was scheduled for the next day. I remember going to the hospital the morning of the surgery and meeting with the nurse to go over medical history and sign papers giving permission for them to do an abortion—ABORTION!! I FLIPPED OUT!!!!! That was such a cruel, dirty word to me. How could they think that I would do such a thing. I also believe that life starts at conception. I was distraught. So much so that before surgery I met with the doctor again to make sure he did not make a mistake. There was no mistake about it. There was no viable pregnancy and at this point I WAS in danger. The ectopic left permanent scar tissue and damage to the tube. I wouldn’t realize how much until 6 years later.

    Now that I had one ectopic my chances of another are increased. A year after the ectopic I did get pregnant and gave birth to a health little boy. 4 years after that I got pregnant again. As soon as a get pregnant or even think I am I am in the doctor’s office having blood work and ultrasounds. This time the test at home did come out positive. I figured I must be in the clear because last time it didn’t. The blood work began and every other day I was going to the doctor. In a normal pregnancy the hcg level doubles every 2 days. The first 2 set of blood work looked great. By this time I became a nurse. I remember the day of my 3rd set of blood work going for it at the hospital and then going upstairs to work. That night I started spotting. I broke down right then and there. My co-workers encouraged me to page the doctor to find out about the blood work. They figured when I saw that the blood work was fine it would put my mind at ease. Just the opposite occurred. The doctor informed me that my levels had dropped. She suggested I go home for the evening and she would see me in the office the next day for an ultrasound. Nothing could be seen on the ultrasound (unless the tube is actually bleeding out you will not see an ectopic pregnancy). For over 2 weeks we monitored my hcg levels (they would go up a little—from 300 to 325 then drop again to 200 just as an example) and did numerous ultrasounds. We were past the point that if it was a viable pregnancy we would be seeing a heart beat. NOTHING. Also my hcg level should have skyrocketed up–it didn’t. At this point it was decided that I should get 2 shots of methotrexate. As terrible as I had felt about the first ectopic this one was far worse…..and the fact that I didn’t need surgery actually made me feel worse. Believe me, this was NOT a decision we went into lightly—much time and prayer went into this.

    It has been 5 years since the last time it happened. Do I consider myself having 2 abortion? NEVER!!!!! And let me stress the NEVER!!! I 100% believe that this WAS the choice I had to make. Do you realize that you can actually go into shock if a ectopic goes untreated and the toxins start leaking into you body? I HAVE taken care of someone that went into shock right before my eyes (not from a ectopic) and I can tell you it is scary. I was able to get him to ICU just in time. Do you have an statics on how many people go into shock?

    Please, do NOT take this as an attack. That is not my intent. My intent was to show you a different side to this issue. I am not a statistic but I real woman that lived through this and still wonders the “what ifs”. I truly believe that when I get to heaven I will be greeted by 2 children I never knew but carried in my heart all these years.

    Since my last ectopic I have lost that tube to a ovarian cyst and I have not been able to get pregnant again. I have however adopted 3 beautiful children. It is my silver lining to such a horrible time in my life.

  13. I have read quite a few good points about miscarriages as well. From my own experience, I went through the blood work process instead of having a D&C. My body naturally took care of everything which was a blessing. I just had a horrible thought in my mind that if I let the doctors take care of things, I might kill a perfectly healthy baby. Our God is awesome and He does so many things that are amazing. I fully trust God’s plans more than any doctors advice.

  14. Here are some more ectopic survival stories.

    Personally, I’d try to get a doctor who would try to open the tube without harming the baby (to prevent rupture) and maybe reposition the tube to give the placenta the healthiest place to attach, which seems to be the outside of the uterus or the lining of the abdomen. Increase the chances of the baby’s survival if only a little bit.

    If enough women start pursuing these options, maybe within a generation or so ectopic pregnancies will be seen as more commonly able to result in a live birth, without any additional loss of maternal life. (There will always be the women who don’t realize they’re pregnant and die from a tubal rupture.)

  15. Angela H. says:

    Very good article, Kim! You’ve really made us think! This information you have to look for, dig for…..for a lot of doctors abortion is the only option in difficult situations. It is just sickening.

    I appreciate all of your (and Doug Phillip’s) thoughtful posts. Thank you for moderating the comments as well.

    Best wishes to you,
    Angela

    P.S. On a side note, I have to tell you about my afternoon, Kim. I had a midwife appt. today. I had my blood drawn and a Rhogam shot. I didn’t pass out or get light-headed! Yay! Last time around I nearly fainted and felt very nauseated. So, I was very happy. I was actually thinking about you during the visit. 🙂

  16. Lisa in ND says:

    WOW — that was the best article I have ever read on this subject. Thank you!! Your article was so thorough and thought provoking!

    Just a comment on the other poster’s comment about how doctors seem so eager to proceed with a D and C instead of letting a m/c happen naturally. When I was PG with my daughter, and part of an over-40 pregnancy forum, a woman on there posted her birth story. At about 6 weeks into her pregnancy, she had some bleeding. They did an ultrasound but said they could not find a heartbeat and she had lost the baby. She and her husband were devastated. The doctor quickly scheduled them for a D and C in a few days’ time. When they went in for the D and C, this woman and her DH insisted on another ultrasound (they had to do a LOT of insisting). They gave her one, and lo and behold, THERE WAS A HEARTBEAT! Her dates were just off a bit! And 7-1/2 months later, she had a healthy little boy.

    I’ve heard other stories, too, of bleeding or problems in early pregnancy, when a woman went on to have a perfectly healthy baby.

    I’ve always wondered about the ectopic subject from a Biblical view. Kim, you did a great job!

  17. Hey Kim,
    My pregnancy before my son was an ectopic pregnancy. The Dr. told us that the baby would not survive it if we wished to abort the pregnacy. I told him I would not kill the baby under any circumstances and went to the end of my 4th month when the baby died. Even at that I did not want to have it removed but had no choice then.
    Well done article it brought back memories to read this.

  18. To echo the others, thank you for posting this.

    I wondered for a long time what the difference was in this kind of ‘surgical procedure’ and an outright abortion, and I even asked many of the members of my church when I was a teen, but they all assured me this was different. Still, my conscious was not convinced.

    As to Jennifer’s request for scriptural support for this argument, I would recommend Ecclesiastes 11:5, Jeremiah 1:5, and Psalm 71:6. It is not man who places into the womb, knits together, or brings forth from the womb.

    On a different but related topic, I have always wondered if pain medication during delivery was a sin, since it was Yahweh who decided to make birth painful. Isn’t our use of drugs, then, disobedience? Again, everyone I asked laughed and wanted to know if I would have my appendix out without drugs. Even at 17 I knew there was a major difference, but couldn’t get anyone to explain why it was laughable.

  19. I myself have had a stillborn baby and two miscarriages, the second causing me almost to bleed to death in my bathroom. The reason I bring these personal cases up is because I’m sick to death of women being scared to death by their doctors when a terminal fetal diagnosis comes up, or when an ultrasound and declining HcG levels suggest an imminent miscarriage. The standard rhetoric for doctors is abort or immediate D&C, with no watching and waiting at all.

    My husband and I, when told that there was no heartbeat with our last pregnancy, chose to watch and wait. I did massive amounts of research, talked to my doctor, and decided to just wait to see what happened. I was scared to death, though! A doctor who was not my OB chose to call me and tell me that he just had a patient in the ICU with sepsis due to an incomplete miscarriage. Still, we chose to watch and wait, as we thought this is what God was speaking to us. I was closely monitored by my doctor, with lots of blood tests to make sure the levels were declining. I was of the opinion that the lower the levels dropped, the more my body would let go of the baby. I was extremely adverse to letting man do something to my body that would render unnatural effects before my body was ready.

    In the end, it took 5 weeks from diagnosis to letting go, all the while being diligent in keeping an eye on my white blood cells to monitor the presence of infection. I did end up almost bleeding to death……but still, I would not have done anything different.

    So I guess I said all that to say I have learned that my doctor is not God and I will not allow myself to be scared anymore by statistics and rhetoric.

    Thanks so much for your incisive and brilliant article!

    Leanne in Longview

  20. Thanks so much for spending the time to research this. Doug Phillip’s blog, as usual, gave me something to think about. One of the biggest difficulties I run into is not arguing from a Biblical standpoint, as most people who would listen to an argument from a Biblical point of view generally don’t believe in abortion under any circumstances anyway, the problem I have is arguing a cause from a scientific standpoint for those who don’t place as much faith in God’s Word as my husband and I do (like most of our family). The time you spent researching this was definitely worthwhile. Thanks for some numbers to back up our faith based view.

    Tanya

  21. This was very interesting. I found it especially interesting that the ectopic pregnancy rates have increased so substantially in the past 60+ years. Scary. I’ve never done a lot of research into this subject. I will agree with the PP who said that tubal rupture is no simple thing. It means loss of the tube, (obviously) decreased fertility, and potential death through blood loss. I always thought it was weighing one life against the other- mother or child. I had no idea both could potentially survive. I’m thankful we’ve never had to personally deal with this. The most important thing in ANY decision is to trust God, that’s for sure.

  22. Wow, thanks for researching all that. I saw the article about the mother delivering a perfectly healthy baby the other week. Until then, I had no idea an ectopic pregnancy ever ended in anything but miscarriage or abortion.
    We just came back from the funeral of a baby who was given a fatal diagnosis at his first ultrasound. Somehow, people are always amazed when Christians choose to do the right thing and continue on with a pregnancy that may not end on a happy note!

  23. I totally understand your thoughts, though I do agree with both Doug and Kim in this matter (as I said above) – should have made that clearer, I guess!

  24. Amanda,

    Thanks for the apology.

    A major part of the problem is that those who disagree with Doug and Kim are reading conclusions into their writing, especially on this topic.

    The ethical starting point for Christians must be one that preserves the 6th commandment. We might all disagree with how this plays out in practice but we must start with at the same place. Namely God says “Do no murder”

    Does this immediately rule out certain treatment options?
    Sure.

    Does it immediately rule out everything except waiting?
    No

    It does limit us to treatments that will intend and attempt to preserve both lives – no matter how small the chance of success is – instead of intentionally taking one.

    I know you didn’t intend to cause harm to anyone’s reputation but there are those who have jumped to those conclusions and smeared Doug’s name because of it. When that happens folks go from talking about the 6th commandment to breaking the 9th.

    Thanks again for the retraction.

    Perry

  25. Mrs. Bowen says:

    Thank you for this post. I wasn’t even aware of other options besides abortion.

  26. What a timely post! Dh and I were just talking about this the other day.

    For all I knew, it meant a death sentence. I guess it still could in some instances.

    If I had cancer and chose to lose my life to save my baby’s, I’d be considered very noble.

    I can’t help it that people would think I was stupid rather than noble to lose my life in the case of an ectopic. We’d pray like crazy for His Will in our lives, that’s for sure!

    Each time I’ve been pg I’ve wondered if it’s been ectopic. I don’t know why they are always a concern to me.

    All things are possible with God. EVEN the *medically* and *scientifically* impossible. The bumble bee shouldn’t fly and a baby shouldn’t be able to survive if it doesn’t attach in XYZ place.

    We should never forget that we serve an omnipotent God!

  27. Jennifer,
    The Biblical argument is found in Exodus 20: Thou shalt not murder.
    The purpose of this post is to show that the statistics need not scare us if we take a stand on this matter. Even if the numbers were different, the statistics would not decide the matter for us, but in this case I think the numbers are far more encouraging than most people realize.

  28. Thanks for posting this. I also had always thought that an ectopic pregnancy was inevitably fatal for the child (doesn’t mean you should kill him first, though!)

    I also have always wondered why I have never heard of an attempt to transplant the baby into the womb? Did you come across anything like that in your research?

    I do know several women who had a ruptured tube.

    And, although I have not had to make the decision myself (thankfully), I have always thought that if faced with the decision I would do “watchful waiting” myself (didn’t know this was a medical option, I thought more I’d have to go home and unplug the phone!) If my baby only has a few more weeks to live, why would I cut that most precious time short?

  29. Gosh, Perry – you’re totally right. I apologize to you and Kim – I thought I remembered him delving into the scientific aspect of it all, but I just re-read and I was way off. So sorry…

  30. Amanda,

    What claims did Doug make?

    I’m not aware of any claims other that an ETHICAL claim that we should not reason like a consequentialist and say if the baby is going to die anyway we might as well kill it.

    Doug posed a question to illustrate the difference between the starting point that says “the end justifies the means” and one that states “Thou Shalt Not Murder” (no matter how difficult the situation is.)

  31. Harmony,
    I don’t know where you found those numbers, but none of the research I came across indicated a 100% rupture rate for untreated ectopic pregnancies; to the contrary, there are many studies which show that about 70% will resolve on their own, ending in a miscarriage – like Amanda’s, above.
    I do think you are right, though, that the medical community needs to work toward saving the life of the child. It is theoretically possible, though highly risky and carries a very low rate of success. I doubt that a woman with an ectopic pregnancy could find a surgeon willing to try.
    With more research, it could very well become an available option. What a wonderful thing that would be!

  32. Being not yet married but looking forward to be and to become a mother, the results of your research are very interesting, KimC. Thank you!

  33. Kim,
    Great post and well researched!

    I wanted to add to your list of what can predispose a woman to ectopic pregnancies: D&C’s (not just for selected abortions, some are done for incomplete miscarriages, and other female issues, so be careful in choosing to have any of these uterine lining “scraping” procedures), c-sections (even one previous c-section increases your risk of ectopic and with more c-sections the risk goes up with each one (not to mention that c-sections also greatly increase your risk of having placenta previa in future pregnancies, but I won’t go there now – lol), and also tubal ligation (might seem silly, but women do still ovulate after having their “tubes tied” and are at greater risk of having a tubal pregnancy because if a pregnancy does occur, the baby’s way of getting to the uterus us blocked. Even if a woman has a tubal reversal, she is still at increased risk for an ectopic pregnancy). If anyone wants links to the studies supporting this info, just let me know.

    I had an ectopic pregnancy after our first child was born. It took 6 months to properly diagnose, due to an incompetent doctor and that the pregnancy didn’t rupture my tube, but deteriorated slowly, causing many hormonal complications for my body. Mine presented with having my cycle be 3 weeks late without a positive urine test (course that was way back in the 80’s and home tests were not as sensitive as they are now), then my cycle started, but things were not quite normal. I started to have pain on my left side, so I went to my OB/GYN who ordered a blood pregnancy test, which was positive, then an ultrasound which the radiologist report said there was a mass on the left side consistent with an ectopic pregnancy. My OB said, no way, there isn’t an ectopic because he didn’t feel anything when he palpated my abdomen, and since my uterus was empty and I was spotting I was having a miscarriage. Young and naive, we believed him. He said to get a quantitative HCG (pregnancy hormone level) to see how much HCG was in my system. It was low,like 15, but not less than 2, which is the standard I believe to say the woman is not pregnant and/or that a miscarriage has completed. Standard medical care would have the OB repeat the quantitative until the number came down under 2, and if it didn’t, to further investigate why it was not.

    We go on our way. My cycles come back, still a bit odd. I become pregnant a couple months later and start to miscarry within a week of a positive pregnancy test. I end up in the ER because the bleeding is so heavy (which has me scratching my head because the “last” miscarriage I just spotted….). The bleeding lessens, but does on and on. For weeks. I decide I have lost confidence in my OB and find a new, female OB. She is great. Very compassionate and very suspicious that something is not right. I tell her all about the previous miscarriages just a couple of months ago and about the ultrasound that my previous OB said was “wrong”. She thinks on this. The most pressing concern is how long I have been bleeding and she thinks there must be something leftover from this most recent miscarriage still in the uterus causing the bleeding. So, she does a D&C in the hospital ( I was put under). She says it appeared there wasn’t anything there, but it was cleaned out, none-the-less and so the bleeding should stop now. It does not. I see her again a week or two later, still spotting. This time, she is about out of ideas and wants to do another D&C right there in her office to see if there is anything, clots, tissue, something that she missed before. I agree to this, and will forever wish I hadn’t. Being awake for this is very unpleasant and painful. There is hardly even any blood in my uterus, just enough to keep me spotting all these weeks.

    She sends us home and says to call if there are any problems. Over the weekend I started having very bad pain on my left side, which then brings back that ultrasound report back to mind. I call my new OB on Monday and she says to me that she has been thinking about me all weekend and also thinking about that previous ultrasound. She says I need to get a quantitative HCG (here we go again!) and stay at the hospital while it is run stat and probably will be going into surgery from there. The quantitative is not less than 2, big surprise right? It is low, like 12 or so.

    I can’t remember very clearly what all happened after that, but I think they must have done a ultrasound, which as this point was inconclusive. So, we headed into exploratory surgery, with the thought that I had a deteriorating ectopic pregnancy. Exploratory showed a small mass in my left tube. There wasn’t a live baby there by this point. It has been 6 months by my estimation since that pregnancy was conceived and if it has not died and deteriorated, but had been more acute, or ruptured it would have been easier to diagnose. As it was, my doctor was very good about not removing my tube, but actually sliced the tube lengthwise to make a small slit and remove what was left, and stitch my tube back up. After that was done she put water via syringe through my tube and it went through. Of course, there were not guarantee’s that scar tissue would not block the tube later. I am very thankful for an OB who cared about preserving my fertility!

    So, there it is, my very weird ectopic pregnancy story, just to add to your collection of how some ectopics actually “play out”. Mine was not typical at all, especially since I was able to get pregnant while I had an ectopic. Even the small amount of pregnancy hormone was enough to totally mess up my body and probably is also what caused my body to reject the new pregnancy ( or so I was told at the time).

    Praise the Lord, He has blessed us with many more children since then!

  34. p.s. Should have also mentioned that my ectopic pregnancy ended in a miscarriage. I forgot that crucial link between the clauses! 🙂

  35. I have had an ectopic pregnancy and what a lot of pro-abortion-in-this-case people aren’t mentioning is that a huge percentage (I’m not sure exactly what) of ectopic pregnancies spontaneously miscarry, rendering the decision moot.

    Thanks for all your research – Doug Phillips’ article piqued my interest as well, though I do wish he would have backed up his claims with better cited medical evidence, as you have. (I am in agreement with both of you, for the record, I just think he could have presented evidence better.)

  36. Kim,

    Just because women don’t die from ruptured tubes doesn’t mean it’s not still dangerous. Nearly 100% of the mothers who choose not to abort (or do not know in advance that the pregnancy is ectopic) have tubal rupture. That’s not a death sentence, for sure (I know a woman who lived through a severe tubal rupture), but the point is that a very high percentage of non-aborted tubal pregnancies *will* end in tubal rupture. Obviously the chance of maternal death is much lower if the doctor is monitoring the pregnancy, but the truth is that there is still a danger and a risk.

    Now, is it worth the danger and the risk to abide by your conscience and not terminate the pregnancy? I think so. But I think it’s being sort of disingenuous to make it out that ruptured tubes are no big deal. The woman I knew who had a tube rupture collapsed on her bathroom floor in pain and fainted when her tube burst. Her husband hadn’t left for work yet, or she would have been left there for hours before she was noticed missing. She lost several pints of blood by the time she arrived at the hospital.

    What I’d MUCH rather see is a pro-life ob/gyn who finds a way to move the baby into the uterus. That would, IMO, be a much better solution than “we’ll monitor you so that you won’t die when your tube ruptures”. Tubal rupture is no picnic. It is pain, and losing pints of blood, and can indeed be life threatening. Can you imagine saying that to a woman who isn’t a Christian? How can you ask her to risk her life when, if something did go wrong, she would be forever lost? No, it would be much better if there were a procedure that could be done that would save the baby’s life and be much less dangerous to mom.

    Please don’t misunderstand me. I’m NOT advocating abortion as a means to ‘cure’ ectopic pregnancies. I just think there are enough pro-life people out there that we should be able to come up with something better than ‘watch and wait’, because until we do the pro-abortion crowd WILL NOT listen to us.

  37. Jennifer says:

    So, the gist of your argument is that the life of the mother isn’t actually at risk with an ectopic pregnancy. Am I getting that right?

    If we’re supposed to arguing from the Bible about this, how come I have yet to see a Biblical argument put forward?

  38. Thanks for the research Kim. I’m going to share it with Rich. We love stastistics to back up already held beliefs. 🙂

  39. Thanks Kim, what an eye opener. I have never actually known anyone who had an E P. ALL that I “knew” about it was from word of mouth, from 30 years ago. I have to wonder, how much we mom’s who haven’t been there really do know about it. Thanks for doing the research and opening our eyes.

  40. Meredith_in_Aus says:

    Kim

    Thanks for doing the research. My curiosity was piqued by Doug’s (I should probably call him “Mr Phillips'” since I don’t *know* him) blog, too. The only ectopics I have known have been one’s to have ruptured, but his article (plus the recent news story) led me to begin thinking, “so, just what is it that I don’t know about.”

    I was also aware of all the contraceptive/STD etc effects. I really do hope that more people (women, particularly) are becoming aware of those effects. Thanks for pointing them out on your blog – sure to open the eyes of many.

    What I really want to begin researching is the effect that previous hormonal BC use has on menopause symptoms, particularly excessive monthly bleeding. I’m sure other things would play into it too – number of *partners* (this apparently effects birth outcomes, too), STDs, and, of course, nutrition. You haven’t done this for me, have you? Any chance?

    Good job.

    In Him

    Meredith

  41. Melissa,
    Actually those stats *are* reflective of maternal risk. At least 20% of ectopic pregnancies begin or end with tubal rupture – that’s about 20,000/year in the US. Of those 20,000 less than 50 die.
    But I heartily agree that as Christians we don’t make our decisions by statistics!
    My point was that those who do claim to make their decisions based upon statistics really don’t have such a strong statistical case as they might think.

  42. Thanks so much for posting this. I have always believed that abortion is wrong in ALL circumstances, but during my second pregnancy, I remember lying in bed shaking with fear one night because I was having some symptoms of an ectopic pregnancy. I was begging God that my pregnancy was normal (obviously), but also that if it turned out to be ectopic, that he would give me the strength to do what I knew was right. Everything turned out to be fine, and the result is sitting right next to me trying to “help” me type. Your research reaffirms my beliefs from both a scientific and Biblical standpoint, but I almost got to learn how hard it is to stick by those beliefs when the difficult situation actually presents itself.

  43. Oops. I just deleted a legitimate comment that landed in the spam folder.
    If it was yours, please feel free to repost. Sorry!

  44. melissaknits says:

    I would like to point out that the statistics on ectopics are not necessarily reflective of actual maternal-fetal risk. The overwheming majority of these pregnancies end in abortion but are counted statistically as an ectopic with a positive outcome (i.e. mother did not die) thereby weighting the statistics in favor of low maternal death. Historically the majority of women carrying an ectopic didn’t know this was an issue until they presented at their caregiver’s office or in an ER with unexplained severe pain, sometimes accompanied by fever, sometimes ruptured, sometimes about to rupture. Today, the majority of ectopics are diagnosed before symptoms ever occur, well before rupture is probable, and the baby aborted. The decrease in maternal mortality/morbidity is directly related to the abortion of the majority.

    From the AAFP link:
    Ruptured ectopic pregnancy is the leading cause of maternal mortality in the first trimester and accounts for 10 to 15 percent of all maternal deaths.

    So the good news may really be that ectopics should not be automatically and immediately aborted but we don’t really have statistical proof that ectopics carry only a 0.25% risk of maternal morbidity, because not enough women choose to carry their ectopics to the point of rupture or death of themselves of their babies.

    That said – no, I would not choose to abort an ectopic. I would wait until the baby was dead either by rupture or by lack of blood to the placenta, and then allow removal of the tissue to prevent sepsis. The statistics really are not relevant if you are truly looking at this from God’s perspective. Either it’s a baby or it’s not, either we kill it or we don’t. The statistics just give one side or the other an excuse/reason to do what it chooses. Where’s God in that?

  45. Christy says:

    I saw this story the other day and thought that you guys might enjoy it as well (if you havent already seen it)

    http://abcnews.go.com/Health/wireStory?id=4961947

  46. Great job Hunney (as usual)

    🙂

  47. Thanks for posting on this topic. I hadn’t ever researched it myself, but had always wondered why ectopic pregnancies were seemingly ‘automatically’ ended. Thank you for your refreshingly biblical perspective!

  48. Thank you so much for this post. I am againt abortion in all cases. I have discussed the issue of ectopic pregnancy with many people and how I would never choose to end the life of my child. I knew there was a possibility that the baby and I would be just fine but I didn’t have alot to back it up. Thanks for doing the research for me. I am also glad to see that there are other people out there that think there is absolutely no reason to have an abortion.

  49. That’s crazy. I have always thought that there was no way a fetus could survive an ectopic pregnancy (I also have been pronouncing it egg-topic my whole life). I didn’t even know there was a chance of carrying the pregnancy to term.

    I definitely have a different take on this now.

    Thanks.

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