Ectopic pregnancy: how to guide our people

If one of our congregants is diagnosed with an ectopic pregnancy, what guidance should be given to the couple by the church?

It’s especially difficult because it’s a matter of life and death for both mother and baby, and time is of the essence. Very easy to be caught flat-footed, unprepared. What preparation can be made, even? All the choices are bad. But…

This article, posted in an earlier thread, is the most helpful I’ve seen yet regarding ectopic pregnancy, and I commend it to any pastor or elder. Who knows when you may suddenly be called on to give counsel to someone in this situation?

I got two takeaways from this article:

  1. Encourage the couple to ask their doctor whether there is any evidence the baby is alive.

    Apparently in over 90% of ectopic pregnancies, by the time the ectopic pregnancy is diagnosed the baby has already died. Wouldn’t it be helpful for the couple to get what confirmation they can on that point and most of the time find that they are free to grieve the baby’s passing and take what measures are needed to help the mother without the added moral complexity of dealing with a baby’s life also.

  2. If the baby is alive, I suspect that it may be important to recommend salpingostomy (surgically opening the fallopian tube to remove the baby) or salpingectomy (removal of the entire fallopian tube) rather than means (such as methotrexate) that directly kill the baby.

    I know that, starkly stated, the default position is something approximating “We know that the baby will die anyway, so do whatever you need to to kill it, it doesn’t matter”; but this strikes me as a utilitarian argument that doesn’t take into account 2 Sam. 1:1-16.

    I think there is a difference between taking an action that in the past has always resulted in death when that death isn’t our purpose, and killing with our own hands. More ethics work is needed here. Even at this point I think I would ask a couple to consider it.

The article also did some work I found very helpful in re-framing the question of double effect as a question of when and how to separate mother and baby rather than whether and how to remove a diseased organ. Every time I had read the Roman Catholic position where removing the whole fallopian tube was better morally than removing the baby from the fallopian tube I thought something didn’t follow.

Thanks to @CWD for pointing me to this article.

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