Linacre Institute Paper: Moral and Medical Considerations in the Management of Extrauterine Pregnancy
The incidence of ectopic pregnancy has increased by 600% in the last two decades. I When the government began counting ectopic pregnancies in 1970, the estimated rate was 4.5 per 1,000 reported pregnancies or 17,800 women. That compared to a rate of 19.7 per 1,000 pregnancies or 108,000 women in 1992. CDC epidemiologists attribute the rise to chlamydia and other sexually transmitted diseases that can scar the fallopian tubes. Lesser contributory causes are failed tubal sterilization, the increased use of drugs and surgery to induce ovulation and indeterminate factors such as smoking and stress. Ectopic pregnancy rates are highest among women over 30 and minority women. Given this dramatic increase, issues related to medical and morally permissible management of ectopic pregnancy have escalated in Catholic health care institutions. The medical problem can be summarized as follows: There is an increase in pelvic inflammatory disease which qualifies as a pandemic and which follows logically in the United States and elsewhere from the climate of permissiveness and promiscuity known as the "sexual revolution" . Pelvic inflammatory disease denotes medically serious infection in the fallopian tubes and ovaries. The patient may be quite ill in some cases but there are many instances where the infection is clinically silent and unrecognized in women of child-bearing age and may go untreated for long periods. The disease has a predilection for the delicate sensitive lining of the tubes known as the endosalpinx. (In some