What about Ectopic Pregnancies?

Question: “Can you tell me what the abolitionist’s stance on medically necessary abortions. As a woman who has been in this rare situation, I’m interested to know where this movement falls on that.”

It is essential to take the time and honestly consider these critically important matters.

There are rare times in a pregnancy when the child is growing in the mother’s body somewhere other than the womb, for example, in the fallopian tube, abdominal cavity, and very rarely inside one of her ovaries. Typically, doctors consider these pregnancies fatal so abortion is the prescribed solution. “It’s better to save the mother by aborting the unborn child than to do nothing and allow both of them to die,” they say. Studies show that not all, not even most, ectopic pregnancies threaten the life of the mother. However, many result in the death of the child. How do abolition bills deal with these types of situations? Is the mother, the doctor, or both liable for the murder of the child?

Abolition Bills and Ectopics

Abolition bills give mothers and doctors with no intention of killing a preborn child the confidence that the law will protect them as equally as it protects the baby. Abolition bills recognize and establish that life begins at fertilization/conception and provides preborn humans from that point onward with the same legal protections against murder as anyone else. They assert due process and equal protection under the law.

Here is the exact language of Senate Bill 13, an abolition bill in Oklahoma. “It is the intent of the Legislature to provide to unborn children the equal protection of the laws of this state; to establish that a living human child, from the moment of fertilization upon the fusion of a human spermatozoon with a human ovum, is entitled to the same rights, powers, privileges, justice, and protections as are secured or granted by the laws of the state to any other human person.”

Consider the language of Section 16-3-107 of the proposed abolition bill in South Carolina named, “South Carolina Prenatal Equal Protection Act of 2023.” This section deals with ectopics.

(A) Medical care or treatment provided with the requisite consent by a licensed physician to avert the death of a pregnant woman that results in the accidental or unintentional injury or death of her unborn child when all reasonable alternatives to save the life of the unborn child were attempted or none were available does not constitute a violation of this article.

(B) Mistake or unintentional error on the part of a licensed physician or other licensed health care provider or his or her employee or agent or any person acting on behalf of the patient shall not subject the licensed physician or other licensed health care provider or person acting on behalf of the patient to any criminal liability under this article.

(C) Medical care or treatment includes, but is not limited to, ordering, dispensation, or administration of prescribed medications and medical procedures.

Attorney Bradley Pierce, of the Foundation to Abolish Abortion, offers the following explanation of this section in his drafter’s notes. Medical care or treatment provided with the requisite consent by a licensed physician to avert the death of a pregnant female that results in the accidental or unintentional injury or death of her unborn child is not a crime when all reasonable alternatives to save the life of the unborn child were attempted or none were unavailable.

Some might call this a “life of the mother” provision. For example, this language would allow a physician to treat a life-threatening ectopic pregnancy. It is important to point out that this is not an abortion “exception.” The common non-medical meaning of the term abortion is the intentional destruction of a fetus. In this instance, the death of the preborn child is an un-intended result of a treatment used as a last resort to avert the death of the mother.

It is important to note that the bill does not allow for direct abortion but only allows for the “unintentional” death of the child in these specific circumstances. Therefore, for example, it does not allow for the use of methotrexate to intentionally cause the death of the child. This is in agreement with the Dublin Declaration. Further, Subsection (B) clarifies that health care providers, etc. cannot be prosecuted for mistakes or other unintentional errors.

Southern Baptists for Abolishing Abortion is in agreement with Attorney Pierce.

Abolition bills promote proper life-saving intervention and intention, and deter murderous intervention and intention. In the event, of last resort, that doctors intervene and exhaust their ability to save the life, and the child dies, they performed medical triage and before the law of God and man can stand justified in their actions with a clear conscience.

Ectopic and Medical Necessity Keys

Ectopic pregnancies are a tragedy during which medical triage is necessary, with doctors never ceasing to treat both mother and baby as human beings and upholding the Hippocratic Oath by exhausting all possible options to save as many human lives as they can. We affirm the conclusions of the Dublin Declaration stating that, “direct abortion is not medically necessary to save the life of a woman” and that “the prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women.”

We deny that treatment for miscarriages and ectopic pregnancies are murder by abortion. The predominant number of babies that implant somewhere other than the uterus pass away before any treatment is given. Removal of a deceased baby is not abortion. In cases of surviving ectopics, we must not equivocate between preterm delivery (leading to the unintended and inevitable death of the baby) and the intentional destruction of the baby by abortion through Dilation and Evacuation (D&E) or Dilation and Curettage (D&C). This conflation of preterm delivery with intentional destruction also impugns grieving parents who are forced to deliver the child early.

Further, we must press for doctors to utilize medical advancements, such as those found in in vitro fertilization (IVF), for relocation and implantation of an embryo in an ectopic pregnancy.

First, the approach in true healthcare, under the Hippocratic Oath, is “do no harm.” Meaning: do everything you can to save a life. Abortionists are not aiming to save a life. On the contrary, they are aiming to take life. In the situation of ectopic pregnancy and a living baby, a doctor would have two patients, mother and baby, with both of their well being in mind.

Second, an ectopic pregnancy is an emergency situation that should be managed and monitored in a hospital emergency room, not an abortion clinic. Abortion clinics schedule their life-taking murders in advance. Emergency rooms provide life-saving care immediately.

Third, if the doctor is doing everything he/she can to save both lives, his/her training in medical triage will assist him/her in providing care. Should the baby die in the process of trying to save both lives, then just as in any other triage situation, he/she is neither a murderer nor held liable as such. He/she neither had the intent to murder nor the ability ultimately to save the life he/she was trying to save. Like any other healthcare law affecting doctors, abolition bills would not punish a well-meaning doctor for trying to save a life.

Fourth, all states already have laws on record, which would still be in effect with the passage of an abolition bill, protecting doctors from prosecution if they “make a good faith effort to save the life of a patient, but are unable to do so.”

Fifth, a mother whose intention is to do all she can to save and not kill her baby is both not a murderer, nor will she be held responsible for her baby’s death in an ectopic pregnancy she could not control, or the doctor could not save.

Sixth, each state’s homicide laws, which would be the enforcement mechanism in the event an abolition bill was passed, would not punish a mother or a doctor for attempting to do all they could to save the life of the baby.

Abortion Exceptions and Loopholes

What’s further, if a Pro-Life bill leaves an abortion exception for the “life of the mother” or any other loophole, it will be abused. An exception for ectopic pregnancies to be treated and given the full range of care is not necessary. The presence of a life of the mother exception for an abortion in an abolition bill would only serve as an unnecessary loophole. Abolition bills make no exception for ectopic abortion, because there should be no such thing as a doctor who intervenes with the intention to kill a child.

Caring for ectopic pregnancy is not abortion.

Language allowing an abortion procedure to save the life of the mother is unnecessary because: 

  1. Treating ectopic pregnancies is not D&E or D&C abortion.
  2. Our current homicide laws already sort out these situations to serve justice for the victim and punishment for the criminal; and, 
  3. Doctors are already operating under the Hippocratic Oath and daily making professional decisions just like this when treating multiple patients at once and triaging. Under true healthcare, the doctor’s intent isn’t to take a life. It is to save all he can. He is not criminalized for doing that now and won’t be under an abolition bill. An abolition bill would serve to send the death of the baby into the currently applicable investigatory processes and laws, whether by the hospital, law enforcement, or both.

Language addressing the life of the mother also allows for too many exceptions because: 

  1. It is unnecessary to add exemptions to current laws dealing with culpability in homicides,
  2. If you add that language, you make exceptions for justice and equal protection under the law. As was said before, doctors do not need exceptions for providing life-saving care. Provide health care without the intent to take a life. If it happens in the process of having to save the mother, under an ectopic, it is no different than other triage situations with multiple critical patients. Exceptions are loopholes abortion-minded doctors and mothers will exploit.

Expectant Management: Three Options

Expectant Management” of high-risk pregnancies applies to cases in which the doctor monitors the pregnancy closely but does not administer any direct treatment.” In cases of ectopic pregnancy or other situations that present potential threats to the physical health of the mother, the pregnancy is carried until one of three actions take place:

  1. Self-resolution: For ectopic pregnancy, this means spontaneous migration of the baby (fetus) to a viable location, or miscarriage.
  2. Inducement & Delivery: If self-resolution does not take place, and the baby is alive (viable), then labor is induced and livesaving measures are administered to the child, and mother, if needed, so that both mom and baby survive, or
  3. Surgical Delivery: The pregnancy presents an immediate threat to the life of the child, mother, or both, at which point either labor is induced, or surgery is performed. The child is born, not dismembered through abortion. The child may very well not survive, and while this would be a tragedy, it would not be intentional murder. This procedure is performed in a hospital under doctors, not scheduled in an abortuary.

In any case, abortion is never medically necessary. The abolitionist affirms the Hippocratic Oath and believes that the life of the mother and the life of the child are equally valuable, and should be afforded equal protection, dignity, and respect. Public policy and medical treatment should also reflect that reality.

Further Resources

Sarah Cleveland, a RDMS, registered sonographer of 16 years has given several internviews and testimonies in legislative sessions.

Senator Joseph Silk, the author of Senate Bill 13, answered several questions on these and other similar topics.

~By Dusty Deevers, Pastor, Grace Community Church of Elgin, OK.

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