Ectopic Pregnancies Spike as Hospitals Hesitate To Offer Abortion-Adjacent Treatment

Kyleigh Thurman arrived at the emergency room of Ascension Seton Williamson in Round Rock, Texas, on February 21, 2023, bleeding and in pain. Doctors there ordered an ultrasound. It showed nothing in her uterus; however, it did turn up a mass near her right ovary and fallopian tube — a finding that, under the hospital’s own protocol, called for an OB-GYN to weigh in.That evaluation never happened. Staff diagnosed a miscarriage instead, handed her materials on how to “let nature take its course,” and sent her home with instructions to return in two days.When Ms. Thurman came back still bleeding, the hospital again noted signs consistent with an ectopic pregnancy and again discharged her without treatment. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus — almost always in a fallopian tube — where it can never develop into a viable, surviving pregnancy.It took the then 25-year-old’s own OB-GYN driving to the hospital to plead with staff before she finally received methotrexate, the drug used to stop the pregnancy from growing. By then it was too late. Ms. Thurman’s fallopian tube ruptured days later, and surgeons had to remove it to stop the internal bleeding, diminishing her future fertility.The Centers for Medicare and Medicaid Services confirmed that timeline in 2025. Investigators found the hospital violated federal law requiring emergency rooms to screen and stabilize patients before discharging them.Ms. Thurman is now suing Ascension Seton Williamson and a second hospital for malpractice; Ascension has denied the allegations in court filings, saying its clinicians provide medically indicated treatment for ectopic pregnancies.“I genuinely thought I was going to die,” Ms. Thurman told a reporter this month, describing the condition as “a time bomb you can’t control.”A recent analysis of federal death records produced by investigative news site ProPublica found that 196 American women between 10 and 54 years old died from complications of an ectopic pregnancy between 2020 and 2025, compared to 106 in the six years before that, an 85 percent increase that no health agency has yet explained.The figures, drawn from the Centers for Disease Control and Prevention’s mortality database, show a national death rate of 9.8 per one million live births in the most recent three-year stretch. In the 18 states that enacted strict abortion bans after the Supreme Court’s 2022 Dobbs ruling, the rate climbed to 13.1. In states without bans, it held at 7.1, which is still higher than the prior period of four maternal deaths per one million live births.Ectopic pregnancy is not especially rare, it impacts up to two percent of all pregnancies. However, with prompt treatment, it is one of the most survivable emergencies in obstetrics. Left untreated, it can rupture the tube and cause catastrophic internal bleeding, and maternal health specialists describe a death from the condition as an outcome that should rarely occur in American medicine.That insistence is what has drawn the attention of researchers who study the field.“It’s hard to quantify how much is due to the abortion bans, but there have been enough reports about patients with ectopic pregnancies whose care has been mismanaged in states with abortion bans that it is not surprising that deaths are rising,” a professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco, Dr. Daniel Grossman, tells The New York Sun.“This finding would usually be investigated by experts in the reproductive health division at CDC, but that division has undergone massive cuts in staff — so sadly, I’m not expecting much of a response from CDC,” Dr. Grossman adds.The Emerging Trend Without a Clear CauseThree years after Roe fell, one of obstetrics’ most treatable emergencies is suddenly killing more American women than at any point in over a decade. The search for a reason is now underway.The spike actually started at the beginning of the Covid pandemic. Hospitals nationwide were stretched thin, and routine obstetric care, along with the emergency kind, took a hit. But while most other pregnancy-related death rates spiked then settled back down once the worst of Covid passed, ectopic deaths didn’t follow that pattern; the number stayed up.Texas billing records back this up at the state level. Hospitals there logged 310 more cases of severe blood loss from ectopic pregnancy in 2023 and 2024 than in 2018 and 2019 — up 29 percent, a jump that began in the pandemic and hasn’t reversed since.Every state with an abortion ban writes in an exception for ectopic pregnancy. The pregnancy can’t become viable so removing the embryo is not considered an abortion. However, an early ultrasound sometimes can’t show exactly where the egg implanted, and that is where things get complicated. Doctors often have to act on suspicion, all while knowing a prosecutor could later decide they moved too fast.“The problem is not that patients are afraid to present to care or that physicians are afraid to address obstetric emergencies and issues like ectopic pregnancies, though both these things are true,” a professor of medicine in the Department of Obstetrics and Gynecology at the University of Washington, Dr. Sarah Prager, tells the Sun.“Patients and physicians and clinicians are afraid because of these laws. The fear would be eliminated, or significantly reduced, if we had laws that support health care for pregnant people that would include access to abortion,” she argues.Groups skeptical of that explanation contend the law itself is not the obstacle. The American Association of Pro-Life Obstetricians and Gynecologists has argued for several years that treating an ectopic pregnancy is legal in every state, distinct from abortion under most state statutes, and not something a hospital lawyer should hesitate over.The group attributes the hesitation doctors describe not to the statutes, but to what it calls a misinformation campaign by abortion-rights groups — warnings and ad campaigns the group says have convinced physicians the law is stricter than it actually is.“Fearmongerers continue to claim that prolife laws prevent doctors from treating ectopic pregnancies. This is categorically false!” the CEO of the group, Dr. Christina Francis, posted on X. “Treating an ectopic pregnancy is not an abortion,” Dr. Francis said. “Lies about these laws which lead to doctors hesitating to treat are the actual harm to patients.”Still, Ms. Thurman’s case is not solitary. Multiple pending lawsuits illustrate the gap between the written exception and what patients say they experienced. A Texas woman, Kelsie Norris-De La Cruz, says a doctor at Texas Health Arlington Memorial Hospital told staff that discharging her was “not in her best interest,” and the hospital sent her home anyway. She sought a second opinion hours later, was diagnosed with an ectopic pregnancy, and went into surgery; she lost a fallopian tube and most of an ovary. She has since filed a federal complaint against the hospital.An Oklahoma woman, Leitaea Lowrimore, also claims in a lawsuit that she was turned away by three hospitals across two states last February, with one physician allegedly warning that treating her could cost him years in prison. She crossed into Kansas and received medication within hours of arrival.When the Exception Doesn’t Reach the Emergency RoomA 2025 study in the Western Journal of Emergency Medicine surveyed physicians after Dobbs and found nearly a quarter of those practicing in states with abortion restrictions had delayed care for patients with potential or confirmed ectopic pregnancies. More than half said they’d changed how they practiced medical care — repeating tests, arranging alternative care — in situations where they once would have treated the symptoms on the spot.JAMA Network Open published another study in 2026 that examined physicians across ban states more broadly, finding the same pattern held across all pregnancy-related conditions beyond just ectopic cases.“Studies show that this type of hesitation is increasing,” a professor of professional practice at Columbia University’s School of International and Public Affairs, Jennifer Klein, tells the Sun.“This hesitation is happening because doctors in ban states can face criminal penalties, including felony charges, steep fines, and prison time, if they do not comply with the state abortion ban.”Dr. Klein also points out that exceptions in state abortion ban laws often contain vague language and restrictions, making it hard for doctors and hospitals to determine when they can provide care.Texas is the one state that has tried to close that gap. Lawmakers passed the Life of the Mother Act in 2025, explicitly naming ectopic pregnancy among the conditions doctors may treat. It shifts the burden of proof in criminal cases onto the state.In February 2026, the Texas Medical Board issued its first training for physicians under the new law, walking through nine emergency scenarios and confirming that treating an ectopic pregnancy at any location in the body is never considered an abortion. No other state with a ban has produced this guidance. Alternative ExplanationsResearchers caution that abortion policy is unlikely to be the sole driver of the national increase. States with bans have long had weaker Medicaid coverage and worse maternal health outcomes overall, making it difficult to isolate one variable, and some anti-abortion advocates have pointed instead to the growth of telehealth medication abortion.Published research on outcomes among telehealth abortion patients argue the opposite: rates of ectopic pregnancy among women receiving telehealth care run lower than in the general population in part because telehealth providers screen out higher-risk patients before prescribing.Most researchers agree that no one in the federal government is currently positioned to find the answer. The CDC’s Division of Reproductive Health has lost most of its roughly 100 employees after President Trump ordered 10,000 layoffs to the Department of Health and Human Services in April 2025.That restructuring swept up the data division that tracks pregnancy loss, the Pregnancy Risk Assessment Monitoring System, which works with state and local health officials to collect maternal and infant health data. Several groups have sued to restore these federal functions, saying states can provide data, but someone needs to collate it and investigate what it means.“State maternal mortality review committees are in place to assess factors that lead to maternal deaths. Given the rise in ectopic pregnancy deaths that is happening across states, a federal effort would need to be coordinated,” an associate professor in the Department of Family Science at the University of Maryland School of Public Health, Dr. Marie Thoma, tells the Sun.Whether any of this becomes a political liability heading into November is unknown, but polling so far says probably not. The share of Democrats who call abortion critical to their vote has fallen to 36 percent this year from 55 percent in 2024, according to the Public Religion Research Institute, and campaign spending on abortion-themed ads is running at roughly a quarter of its 2024 pace.Several states are still expected to put abortion measures before voters this fall. However, strategists on both sides of the debate say the issue no longer carries the charge it did in the first elections after Dobbs, even as the death toll from one of its narrowest, least contested corners climbs.Health and Human Services Secretary Robert F. Kennedy Jr. told Congress during a round of hearings in April that improving maternal health was a priority for the department, and a spokesman for the agency told ProPublica that it continues to track maternal mortality trends and fund related research. Yet, Ms. Klein says that response so far has not matched the scale of the problem.“If the Trump administration is committed to improving maternal health outcomes, they must respond and commit to investigating this trend,” Ms. Klein says. “If states won’t overturn their abortion bans, they must establish clear and workable medical exceptions for the life and health of the pregnant patient.”

Ectopic Pregnancies Spike as Hospitals Hesitate To Offer Abortion-Adjacent Treatment

Ectopic Pregnancies Spike as Hospitals Hesitate To Offer Abortion-Adjacent Treatment

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