In Missouri, people can still receive treatment for ectopic pregnancies
While the wording of Missouri's 2019 "trigger law" bans abortions in the cases of rape and incest, those who have ectopic pregnancies will still be able to get treatment, since the revised statutes lists "medical emergencies" as an exception.
However, Dr. Colleen McNicholas says that exception isn't as helpful as it seems. McNicholas is vice chair of American College of Obstetricians and Gynecologists' Missouri section and chief medical officer of Planned Parenthood for the St. Louis and Southwest Missouri Region.
"We always maintain that medical emergencies in abortion bans are essentially meaningless, because what they do is force physicians to decide how sick is too sick, and they really pivot medical decision-making away from what is clinically the most important and best approach for a patient, and now requires that physicians have to contemplate whether their medical decision-making will be able to withstand an investigation from the attorney general," McNicholas said.
What is an ectopic pregnancy?
An ectopic pregnancy happens when a fertilized egg implants anywhere outside the uterus, according to the American College of Obstetricians and Gynecologists. About 90% of ectopic pregnancies occur in a fallopian tube. As the egg grows, it can cause the tube to burst and cause major, potentially fatal, internal bleeding.
The fertilized egg could also implant in the cervix or on a cesarean scar.
The fertilized egg cannot develop normally outside the uterus, according to the Cleveland Clinic, and quick treatment of an ectopic pregnancy "is important to protect the mother’s life."
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An ectopic pregnancy cannot be moved to the uterus.
What are the treatments for ectopic pregnancies?
Ectopic pregnancies can be treated with medication or surgery, depending on the situation.
If the pregnancy has not ruptured the fallopian tube, a provider may use the medication methotrexate, which stops the cells from growing. The provider will monitor hCG levels in the blood, which is a hormone that indicates pregnancy.
If the fallopian tube has already ruptured or there's risk of it rupturing, emergency surgery is needed, according to the ACOG. The surgery is generally done laparoscopically, and removes either the pregnancy or the whole fallopian tube with the pregnancy.
"In tragic situations when a pregnant mother suffers from an urgent, life-threatening condition, Mercy provides all medically indicated treatment to save her life," said Mercy Hospital Springfield in an email.
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Being a Catholic health care system, Mercy follows the Ethical and Religious Directives for Catholic Health Care Systems.
The ACOG worries that abortion bans will impede treatment for ectopic pregnancy.
"We know that medical exceptions will cause delays in care, and they will cause harm to patients as hospitals figure out what their policies are and as physicians figure out how do they best take care of patients when they know the potential consequence of someone disagreeing with their care could be a potential felony conviction," McNicholas said.
Has Missouri passed laws to criminalize ectopic pregnancy treatment before?
Not exactly. In April, the Missouri House approved a legislative package that would have criminalized mail-order distribution of abortion drugs and blocked Planned Parenthood from receiving Medicaid funds.
This package included language from Branson Rep. Brian Seitz' bill, HB 2810. A previous version of HB 2810 included language that would have made it illegal in some circumstances to abort a potentially fatal ectopic pregnancy, but language was removed during the committee process.
More: House committee approves bill limiting abortion drugs, removes ectopic pregnancy language
The legislative package, HB 2012, died in Senate when the session ended in May.
Susan Szuch is the health and public policy reporter for the Springfield News-Leader. Follow her on Twitter @szuchsm. Story idea? Email her at sszuch@gannett.com.
This article originally appeared on Springfield News-Leader: Missouri abortion ban shouldn't impact ectopic pregnancy treatment
