Abortion is a much more complex issue in life than it is in most arguments. An abortion can, in many ways, save a woman’s life. Pregnancy is not always positive and hasn’t always been romanticized like it generally is now, in most of human history, women had a lower life-expectancy than men— one in four women died in childbirth, and many women died from other complications of pregnancy before childbirth, like ectopic pregnancy. If you’ve ever wondered why in so much historic story-telling, old men married very young women, then there’s your answer. The tradition is based upon what was a biological reality for all women prior to modern medicine and contraception.
Before the 19th century, the mortality rate (the death rate) from ectopic pregnancies exceeded 50%. By the end of the 19th century, the mortality rate dropped to five percent because of surgical intervention. Statistics suggest with current advances in early detection, the mortality rate has improved to less than five in 10,000. The survival rate from ectopic pregnancies is improving even though the incidence of ectopic pregnancies is also increasing. The major reason for a poor outcome is failure* to seek early medical attention. Ectopic pregnancy remains the leading cause of pregnancy-related death in the first trimester of pregnancy. (emphasis added) [source]
(Homicide is the third leading cause of death for pregnant women at all stages of pregnancy.)
Approximately 1% to 2% of pregnancies are ectopic. An ectopic pregnancy occurs when the embryo implants somewhere other than the uterine wall, in the cervix, ovary, or even the abdomen; but ninety-eight percent of ectopic pregnancies take place in the fallopian tubes, which are the very fine tubes that connect an ovary to the uterus. About half of the ectopic pregnancies in the fallopian tubes abort spontaneously early in the pregnancy. The medical term for this is tubal abortion. Ten to fifteen percent of all pregnancies end in “spontaneous abortion” that usually occurs shortly after implantation, so that the woman bleeds around the normal time of her next period, and is likely unaware that she was pregnant. In everyday terms, spontaneous abortions are called “miscarriages.” Miscarriages are naturally occurring abortions.
It’s impossible for an embryo in a fallopian tube to develop into a viable fetus. In a normal pregnancy, the embryo plants itself in the woman’s uterine lining, which is made of thick-walled muscle that supports the embryo as nature intended. Embryos are surrounded with cells called “trophoblastic tissue” which is intended to implant in the uterine wall to form the placenta that will deliver nutrients and oxygen to the embryo and fetus from the mother. These trophoblastic cells must, by nature, be aggressive and invasive in order to burrow into the thick uterine wall. They multiply so rapidly, that one of the first lines of treatment recommended for any ectopic pregnancy is methotrexate— a cancer drug that kills the trophoblastic cells before they damage the woman’s body in a way that could kill her or threaten her fertility. Because the fallopian tubes are small and the walls thin, an embryo implanted there can tear through tissue and blood vessels until they cause internal bleeding.
After methotrexate disrupts the growth of the embryo which ends the pregnancy, the remaining tissue is usually reabsorbed by the woman’s body, or may pass to the uterus where it will be expelled during the next menstrual cycle. In the case that some of the trophoblastic tissue is not removed, it may form a tumor. Most of these tumors are benign, but some become malignant and develop into a condition called gestational trophoblastic disease, gestational trophoblastic tumors, or gestational trophoblastic neoplasia that can be life-threatening if not treated.
When a woman has access to affordable medical care and knows she is pregnant, but doesn’t know that the embryo is in her fallopian tubes, an ultra-sound usually reveals it. Then, it can be treated before the embryo does considerable damage to her reproductive system or kills her. Waiting to see if the embryo aborts spontaneously is not standard medical procedure because the odds that an embryo will develop into a viable fetus in the fallopian tubes are zero and the ectopic pregnancies that don’t self-abort are life-threatening. Saving the fallopian tube/ovary and preventing rupture are medical priorities. When the fallopian tube is ruptured, blood transfusions and surgical intervention is necessary to keep the woman alive, and she loses the fallopian tube and ovary. Continue reading