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I will do a point-by-point thread on this when I have time later today, but for now I’d like to emphasize that you SHOULD NOT TAKE MEDICAL ADVICE FROM THE FEDERALIST. This article is illogical word salad quackery, and it’s dangerous. #ectopicpregnancy #abortion
1/ Ok, here's my [very lengthy] full response to this. It’s hard to even know where to start with this article, because so much of it is so, so wrong. The first and most important thing to note is that you should NOT get your medical advice from the Federalist.
2/ It also needs to be said that if you have had an ectopic pregnancy and followed medical advice to have it treated, you did the thing that reduced your risk of dying. Go you! #ectopicpregnancy
3/ Per CDC & ACOG, ectopic pregnancies still cause about 3% of pregnancy-related deaths in the US and are the leading cause of pregnancy-related death by hemorrhage [bleeding]. In less developed countries, 10% of people who have ectopic pregnancies die as a result. TEN PERCENT.
4/ Healthcare providers don’t recommend treating an ectopic pregnancy because we don’t want to be sued (as the author alleges without evidence), we recommend treatment because we don’t want you to die. #EctopicPregnancy
5/ Having had the experience of literally running to the OR to save someone’s life from a ruptured ectopic not once but MANY times, I can tell you that we are primarily motivated by a desire to see you happy and healthy and Not Dead.
6/ Treatment of #ectopicpregnancy is not an #abortion no matter how much this author wants it to be. It’s treatment of a pregnancy that will in all likelihood fail and risks the life and/or health of the pregnant person in every single case.
7/ Do some ectopics resolve on their own? Of course. No one’s disputing that. But certain factors must be present for a healthcare provider to offer or recommend allowing an ectopic to resolve on its own vs recommending interventions like medication or surgery.
8/ Wanting to continue an ectopic pregnancy to see if you can get a viable fetus for delivery is extraordinarily dangerous, and goes against the advice of every reputable medical source.
9/ Most of the examples in the literature of ectopic pregnancies at later gestations are NOT from people who have CHOSEN to continue an ectopic but rather were misdiagnosed, didn’t present for care until later in the pregnancy, or live in a lower-resource setting w/o diagnostics
10/ The author gets into some fuzzy math and misrepresentation of research and statistics to support her assertion that expectant management (i.e. doing nothing) is a perfectly fine thing to recommend to patients. This is bollocks.
11/ The low death rate from ectopic pregnancy in the US is evidence that we diagnose ectopics early and treat appropriately. It is NOT evidence that ectopic pregnancies are safe to continue, as the author seems to suggest.
12/ Remember that 10% of people with ectopic pregnancies in less developed countries DIE. It’s probably not because they were given the “option” to continue the pregnancy. It’s because they didn’t have access to sufficient diagnosis and treatment. Many preventable deaths.
13/ The remainder of the “studies” cited are great examples of How Not To Use Medical Evidence.
The article in “Celebrate Life” magazine (certainly a paragon of unbiased scientific information) cites some pretty wild sources.
The article in “Celebrate Life” magazine (certainly a paragon of unbiased scientific information) cites some pretty wild sources.
14/ There's a case series of 300 patients in the late 19th and early 20th c. whose author only personally saw a fraction of the cases AND there is no commentary on whether or not the fetuses nor pregnant ppl survived. My suspicion is that outcomes were NOT GOOD.
15/ This is NOT evidence to support continuing an #ectopicpregnancy; at best it is a review of what used to happen before early diagnostics and safe medical and surgical treatment.
16/ The same “Celebrate Life” article talks about autotransfusion– where a person’s own blood is collected and returned to them in an attempt to prevent death from hemorrhage. Autotransfusion DOES NOT “TREAT” ECTOPIC PREGNANCY. AUTOTRANSFUSION TREATS BLOOD LOSS.
17/ To imply that autotransfusion is an effective (let alone safe) option for treating ectopic pregnancy tells me everything I need to know about the Federalist author’s inability and/or unwillingness to honestly interpret study data.
18/ It’s also very telling that she chose to highlight only one of the studies that looked at autotransfusion as a way save lives and prevent morbidity from hemorrhage due to already-ruptured ectopics.
19/ She ignores the other study that looked at autotransfusion in the setting of acute blood loss from ectopics and other causes of hemorrhage. In the study she ignores, almost 50% of the patients died. HALF.
20/ We also don’t know the measures used to examine morbidity and mortality in the first study that claimed a low death and complication rate. If they had a very narrow definition of transfusion-related outcomes, they may not have have captured later complications like infection.
21/ How a study is designed is important and we are not given any information about that in the abstract. I’d love to believe the Federalist author looked up, paid for, and read the full articles, but I suspect that didn’t happen.
22/ The 1982 paper she cites as evidence that ectopic pregnancies can survive outside the uterus was a case series from 1947-1977 & was a commentary on the adaptability of pregnancy tissue in being able to implant in other tissues besides the uterus.
23/ There is absolutely no information given about the fate of the pregnant people involved. Placental tissue is extremely invasive when it doesn’t implant into the lining of the uterus (where it belongs).
24/ Placentas that grow into liver, colon, bladder, the outside of the uterus, the ovary, etc very often cause irreparable damage to those organs. Every advanced ectopic pregnancy must be removed surgically, and sometimes other organs are lost with it.
25/ The other [3] cases of ectopic gestation infant survival are from lifenews.com and from a website called prolifewithoutexception.com. Totally unbiased sources, obvs.
26/ Where are the peer-reviewed studies? Why are there no case series from more recently than 1977? Why do all the reputable medical organizations advise against continuing an ectopic pregnancy?
27/ Hint: it’s not because we Love Abortion So Hard. It’s because we care about pregnant ppl, & ectopic pregnancies are unpredictable and dangerous. It’s because every person with an ectopic pregnancy is at risk of rupture, hemorrhage, organ damage, loss of fertility, and death.
28/ To say that healthcare providers should be offering unproven and frankly reckless options for treatment of ectopic pregnancy is careless, unethical, and just plain stupid. This is an incredibly irresponsible article & @FDRLST should be ashamed of running it.
