What if I take the abortion pill & my pregnancy is ectopic?

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Ectopic pregnancy. The term has appeared in many news articles recently, especially in relation to abortion. But what exactly is an ectopic pregnancy? What happens if a woman takes the abortion pill without knowing that her pregnancy is ectopic? And how can she ensure that her pregnancy is not ectopic before moving on with an abortion? In this article, we are going to summarize the essential facts about ectopic pregnancy so that you feel empowered to make an informed decision.

What is an ectopic pregnancy?

An ectopic pregnancy, as its name suggests, is a pregnancy that is out of place. While normal pregnancies grow in the uterus, an ectopic pregnancy is located outside of it, usually in a fallopian tube (which is where egg and sperm meet). 

In some rare cases, the fertilized egg can also attach itself to other parts of a woman’s body, namely, her belly, her ovary, her cervix (which is the opening of the uterus), or to a scar from a previous C-section. To give you an idea, 90% of the time, an ectopic pregnancy will be in a fallopian tube, 1% in the abdomen or the cervix, and 1 to 3% of the time, it will be found in a c-section scar. 

Even more rarely, a pregnancy can be both normal and ectopic, meaning that one embryo will be located in the uterus and another one outside of it. It’s called a “heterotopic” pregnancy and can be trickier to diagnose. 

Although Lifeline cannot officially diagnose an ectopic pregnancy, our medical staff are trained to provide limited ultrasounds that check whether your pregnancy is located in the uterus. Since ectopic pregnancies are usually nonviable (unless they are in the abdominal cavity, but even then, only a couple of successful cases have been reported in scientific journals) and can become life-threatening if left untreated, it’s important to get medical care. In case there is any doubt about the location of your pregnancy, our registered nurses will refer you to a doctor for further examination. Ectopic pregnancies represent 1 to 2% of all pregnancies, but certain factors can make a woman more at risk for having one. 

Who is more likely to have an ectopic pregnancy?

According to ACOG, about half of ectopic pregnancies don’t have a clear cause. However, the following risk factors can make a woman more likely to have an ectopic pregnancy:

Medical Conditions:

• Anatomical abnormalities of the fallopian tubes: if the tubes are misshapen, the fertilized egg will have a harder time traveling through them to reach the uterus.
• Previous infections and PID: Sexually Transmitted Infections can cause inflammation and scarring in the reproductive tract, as well as lead to Pelvic Inflammatory Disease. Other infections can also cause PID.
• Endometriosis: an often painful chronic disorder in which a similar type of cells to those lining the uterus grow in other organs such as the ovaries, the fallopian tubes, or the intestines. If these cells grow inside the fallopian tubes, they can block the way for the fertilized egg to implant in the uterus. 
• Tubal, abdominal, or pelvic surgeries: such as surgical treatment of a previous ectopic pregnancy or the removal of the appendix. These could lead to scarring that can in turn increase the risk of ectopic pregnancy.
• Being 35 and older: being older increases the risk of negative reproductive outcomes such as miscarriage, stillbirth, but also ectopic pregnancy. 

Medical History:

• Smoking: a woman who smokes or who is exposed to secondhand cigarette smoke is 4 to 20 times more likely to have an ectopic pregnancy if she gets pregnant.
• IUD and tubal ligations: these methods of contraception are usually very effective and therefore don’t increase the risk of ectopic pregnancy. However, if a woman were to get pregnant while having an IUD inserted (especially if it’s a hormonal IUD), or after getting her tubes tied, then the pregnancy is more likely to be ectopic.
• History of ectopic pregnancies: a woman who had an ectopic pregnancy once is 17 times more at risk of having another.
• Fertility treatment: fertility treatments such as IVF can increase not only the risk of a typical ectopic pregnancy but also the risk of heterotopic pregnancies (in which one embryo is implanted in the uterus and the other outside of the uterus). Studies have shown that although a heterotopic pregnancy happens in 1 to 4,000 to 1 in 30,000 cases in natural pregnancies (meaning, pregnancies that did not require fertility treatment), their prevalence is 1 in 100 when a woman uses IVF. 
• Multiple abortions: some studies have shown that having more than one abortion can also increase the risk of ectopic pregnancy in the future. 

Several steps are usually necessary to get a proper diagnosis of an ectopic pregnancy. Even if you plan to have an abortion, we recommend that you get these evaluations. Skipping them could put your health at risk. 

How is an ectopic pregnancy detected?

An ectopic pregnancy starts just like any other pregnancy. The pregnant woman may notice that her period is missing. Her breasts might be tender. She might experience some abdominal cramps. Additional symptoms can make her suspect an ectopic pregnancy. These include:

• Light vaginal bleeding
• Severe abdominal pain
• Dizziness
• Shoulder pain

Or maybe just a feeling that something is off. When in doubt, her first step should be to take a pregnancy test to confirm that she is indeed pregnant. At Lifeline, we provide lab-quality pregnancy tests at no cost. 

If the result is positive, the next step is to get an ultrasound. Most doctors order a viability ultrasound (also called a dating ultrasound) around the 8th week of pregnancy. But ultrasound can detect an ectopic pregnancy as early as 6 weeks. Our medical team is trained in performing ultrasounds that check whether your pregnancy is located in the uterus. 

Lastly, your doctor may also order a blood test if the ultrasound is inconclusive. These are particularly helpful when a pregnancy is said to be “of unknown location”. This means that the ultrasound cannot find the gestational sac but your pregnancy test is positive. 

So what happens if I take the abortion pill?

Some women take the abortion pill without knowing that their pregnancy is ectopic, but this can be very dangerous. For one, the abortion pill cannot end an ectopic pregnancy. In addition, if she experiences bleeding, she may think that it’s a normal side effect of the abortion pill and delay seeking medical care. In turn, delayed treatment can lead to the rupture of the fallopian tube. This can lead to serious complications, even life-threatening ones. 

If your pregnancy is ectopic, your doctor will choose between 3 types of treatment:

• Waiting to see how it progresses and whether your body is dealing with it naturally 
• Medical: doctors give the woman a medication called methotrexate and it stops the pregnancy from growing. The body then reabsorb the pregnancy in the following weeks. Doctors usually chose this option when the woman is still early on in pregnancy.
• Surgical: two options are available, according to what the doctors see fit. The first one is to do a salpingostomy. In a salpingostomy, the doctors remove the pregnancy from the fallopian tube. The second option is to remove the entire fallopian tube because it burst open and cannot be repaired. It is called a salpingectomy.

Again, a pregnancy test can only confirm that you are pregnant. It cannot reveal anything about the location of the pregnancy, only an ultrasound can. If you suspect you might be pregnant, our medical team will perform a pregnancy test followed by an ultrasound to check for ectopic pregnancy.  

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Note: Abortion is illegal to perform in Missouri and may only be performed in the case of saving the life of the mother. This article does not constitute medical or legal advice. Consult your doctor or legal counsel to confirm information.