Roe v Wade: What is an ectopic pregnancy and how dangerous is it?

Anti-abortion legislation in the US could outlaw abortions even in medical emergencies

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The US Supreme Court is expected to issue a ruling that, if upheld, will make abortion illegal in 26 states in America.

A draft opinion leaked this week by Politico showed that the initial majority opinion written by Justice Samuel Alito would strike down Roe v Wade, the landmark ruling that led to the constitutional right to abortion in the US.

Alito was quoted as saying that the landmark ruling was “egregiously wrong from the start”, despite the law allowing hundreds of millions of women access to safe abortions since it was passed in 1973.

The draft opinion over Dobbs v Jackson Women’s Health Organisation, which is the first major abortion rights challenge that aims to ban most abortions after 15 weeks of pregnancy, comes amid a wave of anti-abortion legislation in Republican-led states.

Last week, Oklahoma approved a bill to outlaw abortions after six weeks of pregnancy, even in the case of rape and incest.

While the bill makes exceptions for medical emergencies, such as ectopic pregnancies, state senator Warren Hamilton questioned why it should do so during a debate on the wider abortion ban.

Hamilton, who also opposed the exceptions for rape and incest, asked: “I wonder how we square that with the idea of justice for all.”

His comments prompted hundreds of women on social media to share their experiences with ectopic pregnancies and how having an abortion saved their lives, and accused Hamilton of wanting to “sentence women to death”.

“When I see lawmakers pushing the 100 per cent false claim that, actually, you can carry an ectopic pregnancy to term and it can be totally fine, it makes me want to explode,” one person wrote.

Another said: “I had to terminate an ectopic pregnancy. It was a wanted child but the pregnancy had to be terminated since I didn’t want to die. When ectopic pregnancies aren’t terminated, it’s always a disaster.”

What is an ectopic pregnancy?

An ectopic pregnancy occurs when a fertilised egg does not implant itself in the womb, but gets stuck in one of the fallopian tubes, which connects the ovaries to the womb.

According to the NHS, when this happens, it is “not possible to save the pregnancy” and could pose a major risk to the pregnant woman’s health if the pregnancy continues.

In the UK, around one in every 90 pregnancies is ectopic, equivalent to around 11,000 pregnancies a year.

What are the symptoms of an ectopic pregnancy?

An ectopic pregnancy does not always cause symptoms and may only be detected during a routine pregnancy scan. However, if you do develop symptoms, they tend to occur between the fourth and 12^th week of pregnancy.

Symptoms can include a missed period or other signs of pregnancy, stomach pain that feels low on one side of the body, vaginal bleeding or a brown watery discharge, pain in the tip of your shoulder, and discomfort when using the toilet.

However, these symptoms are not necessarily signs of a serious problems and can sometimes be cause by other problems.

If you have a combination of any of the symptoms and you might be pregnant, you should contact your GP or call 111 right away as ectopic pregnancies must be treated immediately.

How is an ectopic pregnancy treated?

If you are experiencing an ectopic pregnancy, the NHS lists two types of treatment to terminate the pregnancy.

In some cases, the fertilised egg dissolves by itself but you must be carefully monitored in case it doesn’t. If it doesn’t, you can get an injection of medication called methotrexate, which will stop the pregnancy from growing and prevent it from rupturing. The pregnancy tissue then gradually becomes reabsorbed by the body.

The second treatment is surgery, which involves a keyhols surgery under general anaesthetic to remove the fertilised egg, usually along with the affected fallopian tube.

How life-threatening is an ectopic pregnancy?

If an ectopic pregnancy continues without being terminated, it will continue to grow in the fallopian tube and can cause the tube to rupture.

According to the Mayo Clinic, this can lead to heavy bleeding in the abdomen, which can become life-threatening.

If you experience severe abdominal or pelvic pain accompanied by vaginal bleeding, extreme light-headedness or fainting, and shoulder pain, you must seek emergency medical help immediately.

In the US, bleeding from ectopic pregnancy causes 10 per cent of all pregnancy-related deaths and is the leading cause of maternal deaths in the first trimester, according to parenting charity Verywell.