One of my closest friends was trying to conceive for well over a year, and when she finally became pregnant, she endured an ectopic pregnancy. It was the first time I'd heard of an ectopic pregnancy — after all, the condition affects only 1 in 50 pregnancies — but it's a life-threatening condition and something every person with a uterus should know about, whether they're actively trying to conceive or not.
Ectopic pregnancies have also become a point of discussion after the Supreme Court overturned Roe v. Wade, since there's confusion around whether the treatment of ectopic pregnancies could be considered an abortion — and thus may be restricted — depending on a state's particular abortion laws. Here's everything you need to know about ectopic pregnancies.
What is an ectopic pregnancy?
An ectopic pregnancy happens when a fertilized egg implants and grows outside the main cavity of the uterus, according to the Mayo Clinic. Most often, the egg latches on in the fallopian tubes (called a tubal pregnancy), a place where the embryo is not meant to grow. If the fertilized egg continues to grow in the fallopian tube, it can rupture, causing internal bleeding.
It's important to know that ectopic pregnancies are not viable, according to the Mayo Clinic. That means an ectopic pregnancy can't proceed normally, and that fertilized egg will not survive or grow into a fetus. Ectopic pregnancies are considered a life-threatening condition, and because of it, they require emergency treatment, according to the Cleveland Clinic.
What are the symptoms of an ectopic pregnancy?
An ectopic pregnancy is usually discovered within the first eight weeks of pregnancy, according to the Cleveland Clinic — and if not that early, then most are found within the first trimester (aka three months). Because ectopic pregnancies generally happen so early in pregnancy, and because most people don't realize they're pregnant until five or six weeks in, on average, it's possible you could experience an ectopic pregnancy before you even know you're pregnant.
My friend's ectopic pregnancy symptoms included bleeding, then very intense cramping, and she also began to feel weak. These are the typical red-flag signs of ectopic pregnancy, according to the Mayo Clinic. You may also feel shoulder pain or an urge to have a bowel movement. If you experience extreme lightheadedness, fainting, or shock, that's a sign your fallopian tube may have ruptured, and you should seek medical treatment ASAP. In general, you should contact your doctor immediately if you're experiencing any abnormal symptoms during pregnancy.
How is an ectopic pregnancy treated?
While my friend was in pain, her husband made the wise move of calling her obstetrician. With a quick ultrasound, she was diagnosed with an ectopic pregnancy. From there, she was given Methotrexate, a drug that stops cell growth and dissolves existing cells, meant to help her body absorb the pregnancy. That's most often given as treatment (via injection) in cases without unstable bleeding, according to the Mayo Clinic.
In my friend's case, her fallopian tube hadn't been affected by the ectopic pregnancy. In an ectopic pregnancy where a fallopian tube has ruptured or where it's at risk of rupture, you will likely need to undergo surgery to remove the pregnancy, according to the Cleveland Clinic. In some cases where a fallopian tube has ruptured, the tube can be saved. However, in many cases, it must be removed, according to the Mayo Clinic.
What causes an ectopic pregnancy?
Obstetricians can't say with certainty. However, you might be at a higher risk for an ectopic pregnancy if you have had an STD, pelvic inflammatory disease, or endometriosis, have already had an ectopic pregnancy, have had pelvic or abdominal surgery, are 35 or older, or smoke cigarettes, according to Planned Parenthood. The Mayo Clinic also notes that tubal pregnancies can happen if the fallopian tube is damaged by inflammation or misshapen, since it happens when a fertilized egg gets stuck on its way to the uterus.
If you get pregnant after you've been sterilized (i.e. you've had your "tubes tied" or tubal litigation) or while you have an IUD, it's more likely to be ectopic. However, since these two forms of contraception are very effective at preventing pregnancy overall (about 99.5 percent, according to the Centers for Disease Control and Prevention), it's unlikely, per Planned Parenthood.
Can you get pregnant after having an ectopic pregnancy?
If you've had an ectopic pregnancy, you have a higher risk of having another one, according to the Mayo Clinic — but that doesn't mean you'll never have a healthy pregnancy. My friend went through this tragic ectopic pregnancy, but she was persistent in wanting a family. After another year of trying to conceive, and with a little fertility treatment, she was able to get pregnant again and carry her baby full-term.
"Most [people] who have had an ectopic pregnancy can go on to have future successful pregnancies," according to the Cleveland Clinic. That said, you'll want to talk to your healthcare provider about what's best for your body and stay aware of the risks if you do become pregnant again.
—Additional reporting by Lauren Mazzo