A Life Is A Life: Ectopic Ethics

I recently found out that an acquaintance of mine who was due two weeks before I am lost her baby. She was seven months along. Seven months. The news of her loss hit close to home. Miscarriages and stillbirths have really gotten to me during this third pregnancy, even more so than with my first two. With my first two, I breathed a sigh of relief once we were passed 27 weeks. Premature babies born at that stage have about a 90% chance of survival. The likelihood of losing my baby was very small by that point and it gave me some peace of mind. But this pregnancy is different. This time around, at nearly every stage of my pregnancy, a friend or an acquaintance that was due about when I am has miscarried or delivered a stillborn baby. It seems that at every turn there is another reminder that there is no guarantee my baby will survive long enough for me to hold. That’s a sobering thought, and a difficult one for this third trimester mama to handle.

The news of K’s loss was upsetting for another reason, too. It was not discovered until after she passed out and was taken to the hospital that K’s baby had developed outside of the uterus. He had survived this way for seven months, but by the time they got to the hospital it was too late to save him. Had they known sooner that K’s baby was ectopic, they almost certainly would have been able to safely deliver him prematurely via C-section. And yet, if they had known sooner, nearly everyone would have recommended an early abortion, because most people believe it is impossible for an ectopic baby to survive long enough to deliver safely. How many more ectopic babies could safely reach this stage of pregnancy and be delivered healthy if we were not so quick to accept common medical claims?

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            Early last year my husband and I were asked our views on ectopic pregnancies and whether or not an abortion would be acceptable in such a case. Neither of us knew much about ectopic pregnancies at the time, so our answer was based on what we did know – that life is a gift from God and that abortion is murder regardless of the motives and circumstances surrounding the act. The angry reactions to our stance were astonishing and prompted many hours of research on the topic.

            In a normal pregnancy the fertilized egg travels through the fallopian tube into the uterus and implants in the uterus wall. In an ectopic pregnancy the baby implants somewhere other than inside the uterus, such as the outside wall of the uterus, elsewhere in the abdominal cavity, or in the fallopian tube itself (referred to as a “tubal pregnancy”). Because this is not how a normal pregnancy is designed to develop, an ectopic pregnancy will often quickly and naturally end in a miscarriage. Sometimes the baby will continue to grow where it is implanted. This poses a potentially life-threatening risk to the mother as it can cause hemorrhaging and the mother can bleed to death.

            What most medical professionals will tell you is that a baby may possibly (though rarely) survive certain types of ectopic pregnancies, but that a tubal pregnancy means certain death to the child and almost certain death to the mother if it is allowed to progress. The fallopian tube is not designed to stretch as the child grows and is not conducive to sustaining life for nine months. Most of the time, when a tubal pregnancy is left to itself, the growing baby will burst the tube. Usually the baby, left unattached to a life-source, will die and the mother is at risk for severe internal bleeding.

Except, most medical professionals (usually due to their own ignorance) will not tell you that this is what “usually” happens. They will tell you that this is what always happens. That a baby cannot survive a tubal pregnancy. Ever. They will also tell you that the mother will probably bleed to death if the pregnancy progresses far enough to burst the fallopian tube. Because the baby will “certainly” die and the mother could "very likely" die, most medical professionals will recommend an immediate abortion. There is no sense in risking the life of the mother when the child is doomed to die anyway. Or, so the reasoning goes.

            The “pro-life group” is divided on this issue. There are those who 100% believe that it is never morally ethical to purposefully end the life of a baby. Then there are those who believe that in most cases it is wrong to end a baby’s life, but that certain situations do necessitate an abortion. During our research I posed the question to a number of my Christian friends and mentors: In an ectopic tubal pregnancy, is it morally ethical to end the life of the child in order to save the life of the mother? I had asked expecting to receive affirmation of my beliefs and perhaps help with more persuasive ways of wording what I already knew to be true. I was shocked by the responses I received. The majority of the Christians my husband and I contacted replied that abortion is usually wrong. But in the case of a tubal pregnancy, a circumstance in which they believe one innocent life (the mother) will die if you do not terminate the life of another (the baby), they argued that aborting the child is morally acceptable.

            Wait. What?

            Let’s back up. Why is abortion wrong? Because it ends an innocent life, which is murder. God clearly condemns murder. “You shall not murder” (Exodus 20:13). “Keep far from a false charge, and do not kill the innocent and righteous, for I will not acquit the wicked” (Exodus 23:7). Electing to end the life of a baby prematurely is murder, whether you think that baby will die anyway or not. It makes no difference whether that baby is located in the uterus where most babies safely grow or in the fallopian tube where it poses a risk to the mother’s life. To intentionally put an end to the innocent life of a child is murder.

            Many of those I contacted argued that if you know for certain that the baby is going to die anyway, it would be irresponsible to let the pregnancy take the life of the mother as well. The mother could survive just fine if the baby were removed. Why should two innocents die when one can live?

            Hold up. Back up. Why is abortion wrong? Because it ends the life of an innocent person. “Do not kill the innocent and righteous” (Exodus 20:13).

            “But the baby is going to die anyway. If we go ahead and end its life just a few hours early, an innocent woman will go home alive.”

“Do not kill the innocent” (Exodus 20:13).

“But the baby cannot possibly survive!”

            “Do not murder” (Exodus 20:13).

            “But what if this woman has three other children at home to take care of? We can’t just let her die!”

            “Do not kill the innocent” (Exodus 20:13).

            Whether that child lives 80 years after birth or whether it dies at 7 weeks gestation in the fallopian tube, that baby has life. That baby has a soul. Let’s be honest. Do we really believe that life begins at conception? Do we really believe that every life is precious? Do we really believe that God meant what He said when He commanded us not to take the life of the innocent? Really? Then why is it okay to end the life of a baby because we are afraid of what will happen if we allow it to live? A life is a life, no matter how brief. No matter how short that baby’s life may be, it is still a LIFE. We have no right to end it.

We don’t always know what we think we know. We are not God and we can never know 100%, without a doubt, that a baby has no chance of survival. When I began researching I too thought that it was absolutely certain that all tubal babies die prematurely. That’s what everyone was telling me. The overwhelming majority are convinced that there is no way such a baby can naturally survive, and that we do not currently have the medical advances to intervene and save the child. Even the Association of Pro-Life Physicians states that, “There are no cases of ectopic pregnancies in a fallopian tube surviving.”[i] But what if we were all wrong? I am so thankful that there was one woman I contacted who chose to look deeper. She sent me here: Ectopic Personhood: Fact Sheet on Ectopic Pregnancy. This enlightening article corrects several myths surrounding ectopic pregnancies. Let’s look at some of those myths.

Myth #1: Ectopic pregnancies are not viable

This has been proven false over and over, in various types of ectopic pregnancies.

Valdir Gabriel – Delivered at 8 months after being carried in an area between the stomach and uterus.

Durga, the "Miracle Baby" – It was not discovered until the doctors performed a scheduled C-section at 38 weeks that Durga had been growing in her mother’s ovary. Durga was 6lbs 3oz when she was born in May 2008.

Baby Attached to Colon and Uterus – In 1985, a baby who had been growing outside the uterus was delivered live at 34 weeks.

Eva Cawte – It was discovered at a 20 week scan that Eva had implanted outside the uterus. The doctors suggested aborting the baby, but Eva’s parents decided to continue the pregnancy. In July 2010, Eva was delivered alive at 30 weeks.

For many more abdominal ectopic pregnancy survival stories, take a look at this page: Another Baby Survives Ectopic Pregnancy. For even more information, go here: Successful Ectopic Pregnancies.

“Okay,” you might be saying, “but those are abdominal ectopic pregnancies. We understand that a baby can occasionally survive an ectopic pregnancy in some places outside of the uterus. But, what about tubal pregnancies, the kind where the baby implants in the fallopian tube? Doesn’t that always mean death to the child?”

Myth #2: There are no cases of ectopic pregnancies in a fallopian tube surviving

As mentioned earlier, this is even stated by the Association of Pro-Life Physicians. But they’re wrong. Some abdominal ectopic pregnancies actually started out as tubal pregnancies. The tissue from a developing placenta is capable of relocating from the tube to various other sites in the abdomen. Many abdominal pregnancies are simply a progression of tubal pregnancies in which the tube burst and the baby re-implanted elsewhere.

Ronan Ingram – One of a set of triplets, Ronan was a tubal baby. While his sisters developed normally inside the uterus, Ronan implanted in his mother’s fallopian tube. As is often the case, the tube ruptured. But to everyone’s surprise, Ronan survived and reattached to the outside wall of the uterus, creating his own womb, and there continued to thrive. In September 1999, all three babies were delivered alive and healthy via C-section at 29 weeks. The triplets are now 15 years old.

Katie Pratt – In a case similar to Ronan, but years earlier, Katie was a tubal baby who also burst through the tube and re-implanted on the main blood vessels.

Myth #3: The mother will almost certainly bleed to death if the tube ruptures

The actual danger of a mother bleeding to death in the U.S. due to a ruptured tube is pretty small. Don’t get me wrong, the potentially severe internal bleeding is a major concern. However, “Treatment with autotransfusion instead of abortion has a success rate of 99.84%.”[ii] Autotransfusion is basically taking the blood the mother is losing, filtering it, and pumping it back to her. One study showed that in Israel the lowest survival rate for women who did not abort their babies prior to rupture was 88%![iii] In the U.S., some figures suggest that you would have close to a 97.7% chance of surviving an ectopic pregnancy. Even if you do not have an abortion before your tube ruptures, you still have an extremely high chance of survival.

Both mother and baby CAN survive implantation in the fallopian tube. Is it rare for the baby to survive? That’s a tricky question. More than half of all tubal pregnancies end in early miscarriage. The ones that don’t are usually aborted upon discovery. So, perhaps it is rare, but perhaps that is only because we don’t give them a chance.

It boggles my mind that there is not more research being done to find ways of preserving the life of the baby, especially given that in the U.S. the mother has an extremely high chance of survival even if her tube does rupture. If a baby can detach and reattach naturally, wouldn’t it be great if we could find a way to successfully transplant these babies into the uterus? Hmm… That sounds familiar… Oh, that’s right. It’s been done. And it was done 100 years ago this year.

September 13, 1915, C.J. Wallace, M.D. operated on a 27-year-old woman for a fibroid tumor and discovered an ectopic pregnancy in her left tube. After removing the tumor, Dr. Wallace made the quick decision to attempt to transplant the baby into the uterus. Following the surgery, the patient was carefully monitored for two weeks and then released. The pregnancy progressed normally and a healthy baby boy was delivered on May 2, 1916.

In a 1916 issue of Surgery, Gynecology and Obstetrics, Dr. Wallace relates the particulars of the operation and comments,

“Why have we all these many years been so willing to deprive these little children of the right to live just because they were started wrong. In this day of advanced surgery, with the art of transplanting different parts, and, in fact organs of the body, I wonder at the escape of so important a procedure, entailing so little danger, as the transplanting of an ectopic pregnancy from the fallopian tube into the uterus, thus permitting the child to develop and be born as was its intention before its progress was obstructed.”[iv]

His article goes on to point out that the structure of the tube is practically the same as in the uterus and that the uterus actually keeps up with the gestation of the baby for a time, thus providing an excellent environment for transplantation.

“Up to a certain point the tubal gestation is identical with the intra-uterine gestation. Up to a certain point the uterus keeps pace with the tubal gestation and actually forms a decidua, enlarges, softens, grows darker in color, and in fact takes on all the early features of pregnancy.”

Amazing! You can read the original article here: Transplantations of Ectopic Pregnancy from Fallopian Tube to Cavity of Uterus. Dr. Wallace went on to say, “I have not the least doubt that many such transplanted ectopic pregnancies will be reported in the future.” Unfortunately, he was sadly mistaken.

I was only able to find one other case where such a surgery was attempted: Tubal Embryo Successfully Transferred in Utero. In 1980 a 27-year-old woman was found to be carrying an ectopic baby in her fallopian tube. The baby was immediately removed, placed in a saline solution, and then successfully transplanted into the uterus. A healthy infant was born at term.

To me, all of this is fascinating, remarkable, inspiring. But completely beside the point. The fact that a baby does have a chance, however slim it may be, of surviving an ectopic pregnancy does not change the fact that intentionally ending the life of an unborn baby is murder. Period. It is not wrong to kill the child because there is a chance he could survive. It is simply wrong to kill the child!

We humans aren’t as smart as we think we are. But God in His wisdom gave us a command. You. Shall. Not. Murder. In the case of a tubal pregnancy, you have no way of knowing whether or not that baby could be one of the ones to survive. You have no idea whether the mother would actually bleed to death if the tube ruptured. You can’t know. But it doesn’t matter. Because you DO know what God has to say about ending the life of an innocent person. The stakes may seem high to us, but the consequences of disregarding a law of God are much more grave.

Note: For more information on ectopic pregnancy, please visit http://www.personhoodinitiative.com. One page of particular interest may be Ectopic Personhood, in which it is estimated that 24% of tubal babies could be delivered alive. Also consider, it is estimated that roughly 40% of pregnancies diagnosed as ectopic are later discovered to be normal, intrauterine pregnancies [Presumed Diagnosis of Ectopic Pregnancy].

Note #2: I do not necessarily believe that attempting to transplant a baby into the uterus is the best course of action. The number of babies who safely grow where they naturally implant makes me think it might be wisest to leave them where they are while under careful monitoring and then deliver via C-section somewhere around 29-30 weeks.

[images courtesy of FreeDigitalPhotos.net]

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[i] The Association of Pro-life Physicians, “Are There Rare Cases When an Abortion is Justified?” http://prolifephysicians.org/app/?p=59

[ii] The Personhood Initiative, “Fact Sheet on Ectopic Pregnancy” http://www.personhoodinitiative.com/fact-sheet-on-ectopic-pregnancy.html

[iii] The Personhood Initiative, “Fact Sheet on Ectopic Pregnancy” http://www.personhoodinitiative.com/fact-sheet-on-ectopic-pregnancy.html

[iv] Surgery, Gynecology and Obstetrics pg. 578, “Transplantations of Ectopic Pregnancy from Fallopian Tube to Cavity of Uterus”