Rising Ectopic Pregnancy Rates in the U.S.: What Women Should Know

The American College of Obstetricians and Gynecologists reports that more than 90% of ectopic pregnancies occur in a fallopian tube, though implantation can also occur in the abdomen, cervix, ovary, or a cesarean scar.

The uterus is the only organ capable of supporting a growing baby. When implantation occurs in the fallopian tube, rupture can occur, posing imminent harm or death to the pregnant woman if not diagnosed and treated promptly.

The American Association of Prolife Obstetricians and Gynecologists (AAPLOG) emphasizes that ectopic pregnancy is a life-threatening condition to the mother, whose life must be protected when treatment options are reviewed.

How does this increased threat to women relate to chemical abortion?

Healthcare professionals are raising concerns about chemical abortion and undiagnosed ectopic pregnancy. When abortion pills are taken without prior assessment or ultrasound, ectopic pregnancy may go undetected.

Symptoms of ectopic pregnancy can mirror those of chemical abortion, and abortion drugs may mask warning signs.

AAPLOG has called this a “deadly convergence that cannot be ignored.”

The significant increase in chemical abortion use has increased risks for women self-managing abortions. Based on FDA and abortion industry data, over 25,000 women and girls required emergency care after taking abortion drugs.

Abortion pills are increasingly obtained through Telehealth providers and abortion websites without pre-assessment due to the removal of safety protocols by the FDA.

A recent study highlighted the growing need for clinicians to be prepared to treat complications related to self-managed medication abortion.

What is causing the increased numbers of ectopic pregnancies?

1. Certain birth control and emergency contraception

Ectopic pregnancy is significantly more likely if conception occurs while an IUD is in place. IUD use has increased substantially, according to the CDC.

Women using progestin-only contraceptives (excluding Depo-Provera) also face increased ectopic pregnancy risk, particularly with levonorgestrel implants.

Emergency contraception may also affect implantation, especially if ovulation has already occurred.

2. STDs, STIs, and PID

Women with a history of pelvic inflammatory disease (PID) face a threefold increased risk of ectopic pregnancy. PID is closely linked to rising rates of gonorrhea and chlamydia in the United States.

Known risk factors include:

• Previous ectopic pregnancy

• Fertility treatment

• Older age

• Pelvic inflammatory disease

• Tubal surgery

• Endometriosis

• Abdominal surgery

• Intrauterine Device (IUD)

• Emergency contraception

• Cigarette smoking

What are the signs and symptoms of an ectopic pregnancy?

Common symptoms include:

• Vaginal bleeding

• Lower abdominal, pelvic, or back pain

• Dizziness or weakness

If rupture occurs:

• Fainting

• Low blood pressure

• Shoulder pain

• Rectal pressure or bowel problems

How is an ectopic pregnancy treated?

Treatment depends on gestational age, symptoms, and location.

AAPLOG explains that the baby has often died by the time diagnosis occurs, but continued tissue growth can cause life-threatening hemorrhage. Early treatment offers the best chance for future fertility.

Treatment options may include:

• Expectant management

• Medication to stop pregnancy growth

• Surgery to remove the pregnancy and sometimes the fallopian tube

How can healthcare systems protect women?

• Pregnancy testing and early assessment

• Bloodwork to confirm hCG levels

• Early ultrasound to confirm intrauterine pregnancy

• Regular STD/STI testing and treatment

• Patient education on higher-risk devices and drugs

• Exclusion of ectopic pregnancy prior to chemical abortion through in-person assessment and ultrasound.