https://www.insider.com/ohio-a...-pregnancies-2019-11

Ohio's proposed abortion ban would require doctors to reimplant ectopic pregnancies, but that's not possible

In Ohio, anti-abortion-rights groups and 20 Republican lawmakers recently proposed an abortion ban that would, in most cases, consider doctors who perform abortions guilty of aggravated murder and subject to a life sentence or the death penalty, The Columbus Dispatch reported.

The proposal, presented on Thursday, acts as an update to Ohio's "heartbeat bill" that Gov. Mike DeWine signed in April but US District Judge Michael Barrett later blocked from going into effect. A "heartbeat bill" outlaws abortions as soon as a fetal heartbeat can be detected, or after about six weeks, when most people still don't know they're pregnant.

The new proposal would also require doctors to attempt to reimplant ectopic pregnancies in the uterus, where it's supposed to grow. Ectopic pregnancies occur when a fertilized egg attaches itself outside the uterus, where it can't develop.

But the Ohio proposal ignores the fact that reimplanting an ectopic pregnancy is "physiologically impossible," said Dr. Chris Zahn, the vice president of practice activities at the American College of Obstetricians and Gynecologists. In fact, attempting that is extremely dangerous, and the technology needed to do it doesn't even exist.

 

Ectopic pregnancies are often treated through fallopian-tube removal

According to the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention estimated that in 1992, the last year that national data was tracked, 2% of all pregnancies were ectopic.

Since a fertilized egg can't develop outside the uterus, when an ectopic pregnancy occurs the egg has to be removed along with any damaged tissue to prevent damage to the person's reproductive system.

Sometimes a medication called methotrexate can be used to help the person's body absorb the pregnancy tissue outside the uterus and potentially save the fallopian tube where the egg attached. But removing a fallopian tube often is the only way to treat an ectopic pregnancy.

Fallopian-tube removal is a common treatment for people who have ectopic pregnancies because the fallopian tubes are the most common place for ectopic pregnancies to happen. (They occur less often in the ovary, the abdominal cavity, or the cervix, according to the Mayo Clinic.) The surgery requires doctors to cut open the abdomen.

Left untreated, a fertilized egg outside the uterus could grow and rupture the fallopian tube and cause heavy bleeding or even death, according to the Mayo Clinic. Ruptured fallopian tubes accounted for 2.7% of all pregnancy-related deaths from 2011 to 2013, according to ACOG.

Treating the ectopic pregnancy, however, "can certainly save a mom's life," Zahn told Insider.

Reimplanting the fertilized egg in the uterus 'is not possible'

Once the fertilized egg, the damaged tissue, and the fallopian tube are removed from the pregnant person's body, it's impossible to reimplant the pregnancy in the uterus, because no procedure exists to do so, Zahn said.

"It is not possible to move an ectopic pregnancy from a fallopian tube, or anywhere else it might have implanted, to the uterus," he said.

Even if there were such a procedure, it still probably wouldn't be possible, because in many cases the fertilized egg is not intact after an ectopic pregnancy, Dr. Donnica Moore, the host of the podcast "In the Ladies' Room with Dr. Donnica," told Insider.

Attempting to reinsert an ectopic pregnancy could result in an infection, a miscarriage, or the body rejecting the reimplantation, Moore said.

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