EWTN Catholic Q&A
etopic pregnancy
Question from mary melissa on 01-23-2014:

Is the surgical procedure that is necessary to treat a etopic pregnancy considered Abortion?

The baby is 8 weeks and attached in the tubes not the uteris. Our parish priest has blessed the Mother and baby inutero.

We are all so sad for this couple.

Answer by Judie Brown on 01-23-2014:


I sent your question to our expert M.D. and here is his response:

In order to answer this question properly there are a few points to consider. If on a sonogram the fetus, regardless of the gestational age, has a heartbeat, the surgical procedure usually performed called a salpingostomy is a direct abortion and is not permitted under any circumstance. This is a direct attack on the fetus because the tube is opened (salpingostomy) and the live fetus is removed (direct abortion). The tube is then left to heal. Likewise, the use of the chemotherapy methotrexate, is also forbidden when a fetal heart is present. The chemotherapy actually destroys the placental attachment of the fetus causing it to expire (direct abortion). The fetal remains are left in the tube to be gradually reabsorbed and no surgery is done. I must in good conscience re-emphasize the fact that no matter how convincing these arguments might seem ( saving the tube in the first case or avoiding surgery in the second) these procedures are immoral and therefore forbidden. They are not allowed to be performed in Catholic hospitals. Finally, not only are they immoral, they are bad medicine. Since ectopic pregnancies occur because there is a blockage in the tube which causes the fertilized egg to implant there in the first place, both of these procedures cause further scarring in that already compromised tube and a recurrent ectopic is more likely. I must add the caveat that if on the other hand, the fetus shows no sign of life on repeated sonograms and falling hormonal levels, fetal death can be confirmed. Only then, after due diligence, and the physician is confident there has been a natural fetal death (tubal miscarriage) these procedures may be ethically performed. I however would not because of what I said about the real possibility of recurrent ectopic s in the future.

What then can be done? I am very aware of the fact that a ruptured ectopic pregnancy is a medical emergency which if unrecognized or delayed can result in maternal as well as fetal loss. The tube itself cannot stretch enough to support a pregnancy to viability. As the fetus grows it will eventually rupture the tube which is a life threatening surgical emergency. This is one clinical situation where the principle of double effect is used to solve the dilemma. As I stated above, the cause of the ectopic is a disease process in the tube such as infection, scarring from prior surgery, endometriosis, etc. which causes the blockage. Therefore, the tube can be removed (totally) even if contains the fetus. The intent is to remove a diseased organ( the tube) which coincidentally contains a pregnancy. There is an indirect, unintended, fetal loss. The principle of double effect is valid in that the primary procedure, that is removal of a diseased tube, is in itself not immoral. What follows, the fetal loss, is un intended but reluctantly tolerated. Again removing the diseased tube prevents the recurrence of another ectopic in the future.

Yes this is complicated and these principles are difficult to understand. One cannot let the emotional component here cloud one's decisions. This requires thorough analysis of the situation and prayer on the part of the practitioner. As I have said numerous times in this forum, it is important to choose a good prolife physician and if possible a Catholic hospital for your care where you have the best chance of receiving ethical treatment.

I do hope I have not confused you with this rather technical response. However this is such an important issue, I must try the best way I know to point out the issues surrounding the ethical treatment of ectopic pregnancy. My prayers are with the parents and child involved in this case.

Anthony N Dardano, Md, FACS, FACOG