Dr. Christina Francis | March 25, 2024
Under the FDA’s relaxed protocols, women are at far greater risk of a deadly ectopic pregnancy.
‘I’m very sorry, but you have an ectopic pregnancy.” As an OB/GYN hospitalist I find myself delivering these painful words to patients increasingly often. An ectopic pregnancy—when an embryo implants outside the uterus—is fatal for the baby and can threaten the mother’s life if it isn’t swiftly treated. It is the leading cause of maternal death in the first trimester.
Rising ectopic pregnancy rates are more dangerous in light of the widespread use of the abortion drugs mifepristone and misoprostol, whose side effects include pelvic pain and bleeding—also the symptoms of an ectopic pregnancy. In Food and Drug Administration v. Alliance for Hippocratic Medicine, the Supreme Court on Tuesday will consider the FDA’s decision to relax safety protocols for administering those drugs. The changes increase the likelihood that a woman will mistake a life-threatening ectopic pregnancy for normal abortion-drug side effects.
OB/GYNs have noted a dramatic rise in the number of women seeking emergency care for ectopic pregnancies. Kaiser Permanente documented it in a study of nearly a million pregnancies over a decade. It found a “significant increase” in ectopic pregnancies, “largely driven by increasing incidence in younger women.” Last month alone I treated six women with ectopic pregnancies; even a few years ago I didn’t treat that many in a year. The stark increase prompted me to ask the hospital where I’ve worked for the past 10 years if it had tracked this in its internal data. The recorded number of patients with ectopic pregnancies has doubled in the past eight years.
Several factors likely contribute to the spike. Patients with a history of pelvic inflammatory disease, a condition whose primary causes are gonorrhea and chlamydia, have a threefold increase in the risk of ectopic pregnancy. Patients with intrauterine devices, while unlikely to conceive, are 600% more likely to have an ectopic pregnancy if they do. Advanced maternal age also increases the likelihood a woman will have an ectopic pregnancy. Gonorrhea and chlamydia rates have been rising, IUDs are increasingly the birth-control method of choice, and women are having babies later in life. It’s unsurprising that ectopic pregnancies are increasing.
This is an excerpt from a Wall Street Journal Article. Click here to read the full article.
