What Is an Ectopic Pregnancy and What Are the Treatment Options?

An ectopic pregnancy occurs when a fertilized egg implants somewhere other than the uterus, usually in the fallopian tubes. It is essentially an “out-of-place-pregnancy.” Approximately 1 in 80 pregnancies are ectopic and can be fatal if the fallopian tube ruptures thereby causing internal bleeding. Therefore, ectopic pregnancies are considered a serious condition that must be treated. Regretfully, it is not possible to move the pregnancy into the uterus meaning that these pregnancies will not result in the birth of a baby.[1]

The most common symptom of an ectopic pregnancy is lower abdominal pain, which can start as early as four weeks into the pregnancy and up to 12 weeks or sometimes even later. Because abdominal pain can have several different causes, it is important to rule out ectopic pregnancy. Without early treatment, it can lead to tubal rupture and the need for emergency medical care. Other symptoms include: missed or late period, unusual vaginal bleeding, shoulder tip pain, bowel or bladder problems, a positive pregnancy test, and feeling faint or collapsing. Someone experiencing some or all of these symptoms should seek medical attention as soon as possible.[2]  

When people think about treatment for an ectopic pregnancy, they usually think of surgical treatment or medical treatment with methotrexate. Surgical treatment involves removing the ectopic pregnancy while the woman is under general anesthesia and at times also involves removing the affected fallopian tube. The second treatment option involves injecting the woman with a medication called methotrexate in early pregnancy in order to avoid surgery. The methotrexate causes the embryo to stop developing and it is then reabsorbed into the body leaving the fallopian tube unharmed.[3]   

There is also a third little-known treatment option called expectant management, which “is usually defined as watchful waiting or close monitoring by medical professionals instead of immediate treatment.”[4] Research has shown that if a woman’s condition is being properly monitored and the pregnancy hormone level (beta hCG) is dropping, 50% of ectopic pregnancies will end on their own without the need for surgery or medicine.[5] Doctors may not mention this option in which case women may need to ask that it be considered.

Before choosing expectant management, the doctor first needs to determine that the woman’s pregnancy hormone level is low, she is in general good health, her pain level is manageable, and the ectopic pregnancy is small and there is no bleeding into the abdomen. Once approved, the patient then does blood tests every few days to ensure that the pregnancy hormone level continues to decrease and the doctor monitors her general health to ensure there are no worrisome changes. On average, it takes around four weeks for a woman’s beta hCG hormone to return to pre-pregnancy levels.[6]   

If one believes in the sanctity of life and that life begins at conception, one might grapple with the ethical dilemma presented with removing an ectopic pregnancy or taking medication to stop the embryo’s growth. While these ectopic embryos from a biblical view are indeed precious lives, the predominant understanding amongst pro-life proponents is that treating an ectopic pregnancy is not abortion because the pregnancy, which is outside the uterus, is in no possible way viable and its removal treats a life-threatening condition. Stated simply, there is no way for the baby to develop because it has no room to grow outside the uterus. By contrast, the definition of an abortion is the intentional removal of a viable pregnancy from the uterus.[7] It may be helpful for some to think of an ectopic pregnancy as similar to a miscarriage because both signal the tragic and yet unpreventable loss of a baby. With that said, as with miscarriages, for many women an ectopic pregnancy is an emotionally difficult ordeal that may require time for processing and healing.

For those concerned about the intentional ending of the unborn child’s life through the first two treatment options discussed above, expectant management may be a preferable option for the woman who meets the criteria and is not in imminent danger of internal bleeding. If a woman suspects she has an ectopic pregnancy, it is of upmost importance that she consults with her physician, who can recommend the best course of action based on her unique situation.

For more information, check out https://ectopic.org.uk/. 

[1] “What is an Ectopic Pregnancy?” The Ectopic Pregnancy Trust, accessed May 9, 2025, https://ectopic.org.uk/what-is-an-ectopic-pregnancy.

[2] “Ectopic Pregnancy Symptoms,” The Ectopic Pregnancy Trust, accessed May 9, 2025, https://ectopic.org.uk/ectopic-pregnancy-symptoms.

[3]“Treating an Ectopic Pregnancy?” The Ectopic Pregnancy Trust, accessed May 9, 2025, https://ectopic.org.uk/treating-an-ectopic-pregnancy.

[4] Ibid.

[5] Ibid.

[6] “Treating an Ectopic Pregnancy?” The Ectopic Pregnancy Trust, accessed May 9, 2025, https://ectopic.org.uk/treating-an-ectopic-pregnancy.

[7] “Ectopic Pregnancy Treatment is Not an Abortion,” Open Arms Real Choices Clinic, accessed May 9, 2025, https://realchoicesclinic.com/ectopic-pregnancy-treatment-is-not-an-abortion/.