“The Surgery I Needed to Save My Life”


“Thank God I was able to have the surgery I needed to save my life,” says a young woman who experienced an ‘out-of-place’ or ectopic pregnancy. She was able to terminate the pregnancy.

You can hear and respond to her story here.

Although she was courageous enough to tell her story in an undisguised voice, I felt that it would be unwise to expose her to harassment. Her thoughtfulness; her personal sense of loss; her gratitude that she was able to receive the care she needed – as well as her anger at close friends who expressed a belief that she should not have terminated the pregnancy – all come through the distortion quite clearly.

Family Planning Health Services (FPHS) begins another “40 Days for Life prayer vigil” in front of a few of our clinics in Central Wisconsin.  Although FPHS is not an abortion provider, the picketers come to conduct their public display of righteousness in part because we support the right of women to a safe and legal abortion.  As health care providers, we must fully face the realities of our patients’ lives and each of us must struggle with informing a decision-making conscience.

Therefore, we think it is a good time to open a discussion about this medically necessary pregnancy termination service.  We are grateful that a thoughtful and articulate woman, who received these services locally in June of this year, helped us by telling her story.

This podcast interview highlights some issues that are of great interest to reproductive rights and reproductive health care advocates and opponents.  The young woman’s interview is followed by an interview with a Wausau OB-Gyn physician who provides a medical description of ectopic pregnancies as well as the risks and available methods of treatment and intervention.

Here are some other thought-provoking quotes from the podcast:

  • “I have had friends who said that I should have ‘gone with God’s will,’ imposing their beliefs on my will to live.”
  • “We told a few people we thought would be supportive.  I chose poorly.”
  • “We need to train our physicians . . . They need to learn to do all of the procedures.”
  • “My husband and I really wanted this baby . . . It was DEVASTATING. To put on top of that grief, the insinuation that we did something wrong is completely insulting and heinous.”
  • “If they need to say they don’t provide abortions and then perform the life-saving procedures they did on me – then do it.”
  • “It’s difficult to know how many (pregnancies are ectopic) . . . but approximately 2 percent of pregnancies in the first three months.” Earl Zabel, M.D.
  • If the ectopic pregnancy is detected early enough, it can be treated with methotrexate administered by injection – and the pregnancy will deteriorate and disappear.  Earl Zabel, M.D.

I wonder how much harm is done to women because they know very little about ectopic pregnancy and they cannot be sure they can get the care they need.

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To schedule an interview with Lon Newman please contact Communications Director Rachel Perrone at rachel@rhrealitycheck.org.

  • cmarie

    the only way to treat an etopic pregnancy is to terminate it, otherwise the mother will die and obviously the pregnancy could not be saved regardless.  Even the rarest pro lifers who oppose abortion (or more accurately EC) for rape victims don’t oppose it if the mother’s life is in danger and with an etopic pregnancy there is no question of that.  I am almost 41 and generally anti abortion (with the obvious exception of rape) but this is the first time I have ever heard of anyone saying a young woman should have died rather than have treatment for an etopic pregnancy.  I’m very curious to know who exactly at the “40 days for life” prayer vigil advocated withholding this lifesaving treatment from women with etopic pregnancies.

  • robin-marty

    an example

    http://www.prolifephysicians.org/rarecases.htm

    The abortion exception for the life of the mother is the exception that most commonly seduces the sincere pro-lifer.  The scenario in which this exception is most frequently packaged is an ectopic pregnancy, which is when the embryo attaches somewhere inside the mother’s body in a place other than the inner lining of the uterus.  It is argued that in an ectopic pregnancy, an abortion must be performed in order to save the mother’s life.

    What is rarely realized is that there are several cases in the medical literature where abdominal ectopic pregnancies have survived!  There are no cases of ectopic pregnancies in a fallopian tube surviving, but several large studies have confirmed that time and patience will allow for spontaneous regression of the tubal ectopic pregnancy the vast majority of the time.  So chemical or surgical removal of an ectopic pregnancy is not always necessary to save the mother’s life after all.

    However, if through careful follow-up it is determined that the ectopic pregnancy does not spontaneously resolve and the mother’s symptoms worsen, surgery may become necessary to save the mother’s life.  The procedure to remove the ectopic pregnancy may not kill the unborn child at all, because the unborn child has likely already deceased by the time surgery becomes necessary.  But even if not, the procedure is necessary to save the mother’s life, and the death of the unborn baby is unavoidable and unintentional.

    A chemical abortion with a medicine called methotrexate is often recommended by physicians to patients with early tubal ectopic pregnancies, when the baby may still be alive, to decrease the chances of a surgical alternative being necessary later, but we have found this to be an unnecessary risk to human life.  We offer the following true case to demonstrate this point.

    One patient was diagnosed with a tubal ectopic pregnancy by her obstetrician, and he informed her that they were fortunate to have made the diagnosis early and that she should have a methotrexate abortion.  The patient was pro-life, and did not want to take the medicine, but the physician insisted.  The baby was not going to survive, he argued, and a chemical abortion now could prevent the need for a surgical procedure later.  The chemical abortion would lessen her chances of a rupture of her fallopian tube and subsequent life-threatening hemorrhage.  The chemical abortion was also better at preserving future fertility than surgical removal of the ectopic pregnancy later.  Feeling like she had no other reasonable alternative, she took the methotrexate.

    >However, there was a complication.  Two weeks later, she still had vaginal bleeding and pelvic discomfort.  A repeat ultrasound confirmed the physician’s worst fears: his patient was pregnant with twins – one in the fallopian tube, and one in the uterus!  He missed the uterine pregnancy in his ultrasound examination, and that baby was dying from his prescription.

    Holding off surgery and watchful waiting in this case might have resulted in spontaneous resolution of the tubal pregnancy or would have required surgical removal of the tubal pregnancy when the embryo was likely to be dead, but in both cases the uterine pregnancy would probably have survived.  Unfortunately, the chemical abortion killed both babies, much to the dismay of this young pro-life woman.

    It is only ethical to remove the tubal pregnancy if spontaneous resolution does not occur after watchful waiting and if the physician is 100% certain that there are no twins.  At this point, the embryo in the fallopian tube is likely to be dead and, even if not, the death is unavoidable and unintentional, and the procedure is necessary to save the life of the mother. 

  • carolyninthecity

    I never knew abdominal pregnancies could potentially resolve themselves. That may be a comfort to someone who desperately wants a baby or who is very pro-life, personally I would never take that chance though. Allowing an embryo to gestate for a few more weeks is not more important than the next (god willing) 60 years of my life, or my future fertility. Despite this example I still think it’s outrageous to oppose termination in the case of ectopic pregnancy. That’s more pro-life then my brain can comprehend. 

  • cmarie

    I agree.  This is the first arguement of its kind I’ve seen, but it doesn’t seem to come from any of the people at the vigil in Washington.  I’m still waiting for the evidence that someone speaking for the protesters in Washington argued against treating etopic pregnancy.  After all, the Dr said it was their public prayer vigil which motivated him and his coworkers to “open a discussion about this medically necessary termination service” otherwise they might as well open a discussion about adult literacy….. no harm done but where’s the connection? 

  • beenthere72

    Patients at a clinic don’t have to explain to the protestors WHY they are visiting the clinic.   They don’t have to seek the protestors’ permission.    It’s NONE of their business.     None of them have the right to know which patient has an ectopic pregnancy and which doesn’t.    None of them have the right to decide which women has a right to an abortion and which doesn’t.    

  • jayn

    Oh, all pregnancies will resolve themselves.  Whether that’s in a good or bad way, though, remains to be seen.

     

    The fact that this woman’s pregnancy clearly wasn’t viable, and her life was in danger (not potentially, but actually) and people STILL say she shouldn’t have done anything about it?  That’s just…that’s truly anti-abortion rhetoric.

  • robin-marty

    No one other than physicians for life thinks that they potentially “resolve themselves.” They don’t. The only way that could happen is if you are lucky enough to have a tubal pregnancy destined for miscarriage already and just happens to end before it is large enough to rupture a tube.

  • jodi-jacobson

    You can easily find these exact kinds of comments from so-called pro-lifers, including members of the hierarchy of the Catholic Church. On this site. Arguing against saving women from ectopic pregnancy or denying that it happens.

     

    Moreover, emergency contraception is not abortion. It prevents a pregnancy from occurring in the first place.

  • lon-newman

    Here is an excerpt from Pro-Life Wisconsin’s (“Save them all. No exceptions”) web-page regarding ectopic pregnancies:

    Such operations are justified by the “principle of double effect,” because the death of the child is an unintended effect of an operation independently justified to save the mother’s life. They do not involve the intentional and willful destruction of an unborn child.

    The point I am hoping to promote a discussion about is that the Bishop’s Directives and even Pro-Life Wisconsin do make exceptions. They justify this exception by defining the procedure as other-than-abortion. Yet the termination of an ectopic pregnancy is the termination of a pregnancy, and therefore an abortion — whether viable or not and whether or not the primary intent of the procedure is the destruction of the embryo.

    These issues become more challenging in the discussion of Methotrexate (Frances Kissling has a response on this topic) or laparoscopic surgery because the procedure directly affects the embryo.

    If this exception is valid and ethical, it would seem there are likely to be other exceptions that would and should be valid and ethical.  It also seems that if this definition of abortion is the one that Pro-Life Wisconsin is using, then contraception, for many patients, would not meet their definition for several reasons and under several circumstances.  I make no claim to be a medical ethicist or a medical expert, but I think the assertions by opponents of safe and legal abortion that they make no exceptions or that hormonal contraception is “a chemical abortion” may be hard to defend or justify on their own terms and under their own definitions.

    Although my agency has a pro-choice position, the audio clip isn’t really an effort to take a position, as much as it is a personal story for the purpose of fostering a discussion. 


  • violetlorien

    …in the pro life physicians article at length with a number of people who are anti-abortion, I too can say confidently that there are far more people in the world than you might think who share the views in the article. But there’s one thing that really strikes me every time I see that link: the laser-like focus by its author on the idea of intent. What matters, it seems, is not really whether the mother or the fetus survive; its whether the intent of the doctors involved in their care was to terminate the pregnancy. Take the example of a pregnant woman who needs to take anti-seizure medication that will cause birth defects and deformities in the fetus. The pro-life physicians’ argument is that what matters is whether the doctor is intentionally terminating the pregnancy. Instead, they advocate giving the birth-defect-and-deformity-causing medication, knowing the risk to the fetus, because that’s obviously MUCH better/kinder/more moral.

     

    I admit that I don’t personally see or understand the distinction. But the tone of the article gives away their real concern: themselves. Who cares whether women die because their ectopic pregnancies go untreated for too long? At least the doctor didn’t INTENTIONALLY end a doomed pregnancy. Who cares whether the epileptic woman’s child spends their entire life in pain and agony because of the effects of the medication she was given? At least the doctor doesn’t have to live with having INTENTIONALLY terminated the pregnancy. 

  • lon-newman

    the reason for the focus on intent is because that is one of the criterion in the bishop’s directives – not because the ‘author’ – i guess that’s me – agrees with that rationale.

  • cmarie

    Oh, obviously the patients are not going to tell protesters why they are there.  Maybe I didn’t explain my question correctly.  The author said that these prayer vigils in Wisconsin led him and his coworkers to focus on etopic pregnancies.  I’m just wondering why.  Let me give an example.  I’m sure most pro choicers are horrified by Peter Singer, chair of (wait for it…..) Bioethics at Princeton University.

    “In my view, a newborn infant is not a person, whether they’re disabled or not. I think that there should be options for making life and death decisions for newborn infants, which do not exist for later beings who have become persons. In addition, there may be some people with severe cognitive disabilities who never become persons. In that case, the question about ending the life of someone with that kind of disability is like the question of ending the life of a newborn infant, I think different from ending the life of someone who is a person.”

    It would be counter productive to confront most pro choice people with his statements because the vast, vast majority of them disagree with him.    Likewise the anti etopic pregnancy topic.  Why concentrate on an issue that is so far out on the radical fringes?  Unless of course these particular protesters or a representative said they felt this way.  So far I’ve seen no indication that the people at the prayer vigil are opposed to life saving pregnancy termination at all.  So, I wonder why the doctors felt the subject was an appropriate response to the vigil.

  • violetlorien

    Lon,

    I was actually talking about the link that had been posted in the comments, http://www.prolifephysicians.org/rarecases.htm, not your article or your podcast. Sorry about that. 

    Violet

  • cmarie

    I’m sorry, I don’t understand which comment you are responding to.  If its mine are you saying that a bishop representing the people at the vigil said some of them were opposed to termination of etopic pregnancies? thanks

  • colleen

    Why concentrate on an issue that is so far out on the radical fringes?

     

    Because within the bat shit crazy world of the ‘pro-life’ movement it isn’t on the radical fringes. Indeed a full 15% of the American public believe that women (and little girls) should not be allowed abortions for any reason whatsoever and those 15% make up the bulk of the ‘pro-life’ movement.

    Your clergy is occasionally honest. Indeed the ….wait for it….’medical ethicist’  for the Phoenix diocese has this to say:

     

    It is not better for a woman to have to live the rest of her existence knowing that she had her child killed because her pregnancy was high risk.

     

    In the rant found here:

    http://www.catholicsun.org/2010/phxdio-stjoes/Medical-Ethics-Director-Statement-05172010.pdf

     

  • crowepps

    The information I have seen is that 50% of ectopic pregnancies spontaneously abort.  Treated with medical or surgical intervention, the other 50% of women can be saved.  Untreated, all of the women will die.  Ectopic pregnancy is STILL the leading cause of death due to pregnancy complications in the first trimester.

    What is rarely realized is that there are several cases in the medical literature where abdominal ectopic pregnancies have survived! 

    This is the ‘pray for a miracle’ argument and it’s absolutely bogus.  The medical literature does indeed contain “several cases” over the past HUNDRED YEARS.  During that same lengthy time tens of millions of women had ectopic pregnancies and millions of them died.

  • crowepps

    From what I have read, it seems like the focus on ‘intent’ is an argument that the important thing is “right thinking”.  Fundamentalists of whatever stripe are far less interested in the actual results of their ideology in the real world than they are in the idea that it is the RULES which are important rather than the actual people involved.  Their position is that people should never be allowed to actually make moral decisions but instead everyone should be required to follow their preprinted checklist of ‘good behavior’.

     

    Since all women SHOULD want to be mothers and all conceptions SHOULD result in a healthy live infant then the messy realities of reproduction, pregnancy complications, etc., are irrelevant.  Everybody is supposed to act as though those shoulds actually are true, even when everybody is well aware that they are not.  Fundamentalists are so focused on what people SHOULD be like and how easy the world would be to navigate if humanity was neatly divided into ‘men who are interchangeably identical to each other (like men SHOULD be)/women who are interchangeably identical to each other (like women SHOULD be)’ that they have zero tolerance for dealing with the diverse behavior of actual real people who don’t conform to the mythos.

  • cmarie

    thanks for proving my point colleen

    you realize of course if I asked many prolifers why they criticize, oh say… yourself, the simplist minded would say something like “because within the bat shit crazy world of the “pro choice” movement it isn’t on the radical fringes, indeed a full 15% of the American public believe parents and eugenicists should be able to kill anyone up to two years old and certain disabled people of any age for any reason whatsoever and these 15% make up the bulk of the “pro choice” movement”.

    Your personal hero Margaret Sanger is occasionally honest.  In fact here’s a quote of her’s from the 20′s that I have no doubt you personally are responsible for (just like I control every word coming out of the Archdiocese of Pheonix)

    On the rights of the handicapped and mentally ill, and racial minorities:
    “More children from the fit, less from the unfit — that is the chief aim of birth control.” Birth Control Review, May 1919, p. 12

    thanks again for wording it all so much better than I did!

  • cmarie

    thanks for proving my point colleen

    you realize of course if I asked many prolifers why they criticize, oh say… yourself, the simplist minded would say something like “because within the bat shit crazy world of the “pro choice” movement it isn’t on the radical fringes, indeed a full 15% of the American public believe parents and eugenicists should be able to kill anyone up to two years old and certain disabled people of any age for any reason whatsoever and these 15% make up the bulk of the “pro choice” movement”.

    Your personal hero Margaret Sanger is occasionally honest.  In fact here’s a quote of her’s from the 20′s that I have no doubt you personally are responsible for (just like I control every word coming out of the Archdiocese of Pheonix)

    On the rights of the handicapped and mentally ill, and racial minorities:
    “More children from the fit, less from the unfit — that is the chief aim of birth control.” Birth Control Review, May 1919, p. 12

    thanks again for wording it all so much better than I did!

  • colleen

    thanks for proving my point colleen

     

    I didn’t ‘prove your point’ cmarie. I pointed out that you are incorrect when you describe those who would rather see women dead than be allowed a life saving abortion as “the radical fringe”. They are the core of your movement and, indeed, your spiritual leadership. I would be happy to provide links to numerous polls if you doubt me.

    Margaret Sanger is not a personal hero of mine although I do tend to donate to Planned Parenthood every time I read one of your diatribes.

     

  • prochoiceferret

    you realize of course if I asked many prolifers why they criticize, oh say… yourself, the simplist minded would say something like “because within the bat shit crazy world of the “pro choice” movement it isn’t on the radical fringes, indeed a full 15% of the American public believe parents and eugenicists should be able to kill anyone up to two years old and certain disabled people of any age for any reason whatsoever and these 15% make up the bulk of the “pro choice” movement”.

     

    The “simplist minded,” however, might have more trouble actually backing up that statement with citations that indicate any reputable pro-choice organization whatsoever holds those positions.

     

    Your personal hero Margaret Sanger is occasionally honest.

     

    Thomas Jefferson, along with many other of the Founding Fathers, owned slaves. I guess the fact that we’re opposed to slavery means the U.S. Constitution is bunk and should be repudiated.

  • crowepps

    I hope you realize that in the late 1890′s and early 1900′s, eugenics was wildly popular and it was hoped that poverty could be eliminated by using birth control to prevent those who were considered likely to be poor from being conceived in the first place.  A fuller quote from Sanger:

    “Everywhere we see poverty and large families going hand in hand. Those least fit to carry on the race are increasing most rapidly. People who cannot support their own offspring are encouraged by Church and State to produce large families. Many of the children thus begotten are diseased or feeble-minded; many become criminals. The burden of supporting these unwanted types has to be bourne by the healthy elements of the nation. Funds that should be used to raise the standard of our civilization are diverted to the maintenance of those who should never have been born.”

    http://www.discussanything.com/forums/archive/index.php/t-25417.html

    This philosophy, which like all philosophies turned out to have unforeseen major problems when it was imposed wholesale on the real world (as ProLife philosophy has in Mexico and Nicaragua) was advocated by not just Sanger and Stopes but also by Theodore Roosevelt, Alexander Graham Bell and John Harvey Kellogg.  I’m sure you will agree that the ‘stigma’ of their outrageous views almost a hundred years ago demands that we protest their views by extending that stigma to national parks, telephones and cornflakes.

  • cmarie

    you did it better than I did…and (as you can see), I’ve been trying all morning to find the link between the Wisconsin prayer vigil/protesters and the anti etopic treatment people.  Obviously, I don’t dispute the existance of the people you quote (just as you don’t question the quotes I attributed to Peter Sanger), it’s the connection between these protesters and this issue I’m looking for so thanks for the link to that.

  • arekushieru

    Regarding intent, generally, ProLifers don’t see a placenta or uterus as life.  The intent in ALL abortions is to terminate the implantation of the fetal placenta into the uterus.  If they are not protesting against abortion in the case of ‘unresolvable’ ectopic pregnancies, then I can only deem them hypocrites, hypocrites in name and practice/theory.

  • cmarie

    So it sounds like, (even if we assume Pro Life Wisconsin speaks for the people at the rally), they have stated that they recognise that etopic=mother’s life in danger=medically necessary abortion.  So, they don’t even argue this point with you.  It sounds to me like you are saying “they do approve of abortion if the mother’s life is in danger but they really should approve even when her life isn’t in danger.”  So, you disagree on the larger issue, but within the subject of etopic pregnancies, it sounds like the people at the prayer vigil absolutely agree with you.  But, anyone reading your article could easily conclude that the opposite was true, in face I’ve been waiting since yesterday morning to see the quote from these vigil leaders condeming lifesaving abortions and am surprised to learn now that they understand as well as anyone else that etopic pregnancy does endanger the mother’s life and abortions are necessary in cases such as those.  It just seems to me that if I were a spokesperson for this clinic, and I wanted to engage these protesters in a dialogue, I would focus on one of the multiple issues we differ on, rather than the one we already agree on.  Thanks for the response though.