Missouri Anti-Abortion Bill Sows Confusion Over Ectopic Pregnancies

13 Mar 2022, 07:37 AM IST

(Bloomberg) -- State lawmakers around the country are ramping up efforts to curtail abortion in all forms. But one Missouri bill in particular is drawing ire for criminalizing the use of certain drugs to treat ectopic pregnancies, which are not viable and potentially life-threatening. Here's a quick rundown on the medical issues associated with the condition and how it fits into the current abortion debate.

What is an ectopic pregnancy?
Ectopic pregnancies occur when a fertilized egg implants in the fallopian tube or anywhere else outside of the uterus. They occur at a rate of 19.7 cases per 1,000 pregnancies in North America and are the leading cause of maternal mortality in the first trimester, according to a study published by American Family Physician. If left untreated, they can rupture internal tissue, cause heavy bleeding and pose significant health risks.

Sterling Ransone, the president of the American Academy of Family Physicians, said ectopic pregnancies are an issue of maternal health that can have long-lasting physical and mental health effects on families. While unable to comment directly on any specific bill, he expressed concern about how legislation can get in the way of a physician's ability to treat patients. “As an academy, we're extremely concerned about any potential legislation that could cause an inability for our patients to receive life-saving treatment, it puts us in a very difficult position," he said.

What does the Missouri bill say?

Introduced by House Representative Brian Seitz, a Republican, HB 2810 seeks to criminalize the production, sale, and transport of abortion-inducing medication and other devices meant “to be used for the purpose of performing or inducing an abortion.” The bill specifically cites abortions performed to end an ectopic pregnancy as covered under the proposed restrictions.

“This is what it looks like when uneducated politicians try and legislate our bodies,” said Colleen McNicholas, Planned Parenthood’s chief medical officer in St. Louis and southwest Missouri. “Ectopic pregnancies, if not treated promptly, become life-threatening. Banning any provision of care related to ectopic pregnancies will put people’s lives at risk.”

In an email, Seitz said his bill has been misrepresented and that he’ll offer an amendment next week to clarify the language. “This bill does nothing to curtail that LEGAL activity, as it can present a clear and present danger to the mother,” he said about the treatment of ectopic pregnancies. He added that the bill “is designed to curtail the illegal transportation, manufacture, sale, use, etc. of otherwise legal drugs.”

Is this the first time ectopic pregnancies have come up in debates about abortion?

No. In 2019, an Ohio lawmaker introduced legislation that would have prohibited insurers from covering abortion services but provided an exception for doctors to “reimplant” an ectopic pregnancy into a woman’s uterus, a procedure that mainstream medical professionals don’t consider viable. The lawmaker eventually conceded he hadn’t studied whether such a thing would be possible.

What’s the context for the Missouri bill?

Lawmakers across the country passed 108 new laws meant to limit or ban abortion last year, according to the Guttmacher Institute. It was the highest number of abortion restrictions enacted since the 1973 decision of Roe v. Wade. Missouri is one of 25 states where abortion would be automatically banned in all or most cases should Roe be overturned, potentially affecting 36 million women of reproductive age, said Elizabeth Nash, a state policy analyst with the Guttmacher Institute.

Lawmakers across the country are also widening the scope of bills they introduce as the Supreme Court debates the validity of a 15-week ban that Mississippi lawmakers enacted in 2018, Nash said.

“They are anticipating this overturning of abortion rights in the next few months,” she said. “What we're seeing are legislators who are, in a matter of fact way, stripping us of these rights that we hold.”