Ectopic pregnancy deaths spike

Ectopic pregnancies generally occur in the first trimester after a pregnancy fails to properly implant in the uterus and starts to develop elsewhere, typically in a fallopian tube. The embryo grows until it causes the organ to rupture, which can lead to catastrophic bleeding.

While ectopic pregnancies are rare — impacting only up to 2% of pregnancies in the United States — they've long been recognized as the leading cause of maternal deaths in the first trimester.

However, with quick and appropriate medical care, maternal health experts say that women shouldn't die from ectopic pregnancies. At the same time, a ProPublica analysis of CDC data found that deaths resulting from an ectopic pregnancy have nearly doubled in recent years.

Specifically, ProPublica found that almost 200 women died following an ectopic pregnancy between 2020 and 2025, compared with around 100 deaths in the six years prior.

"A death related to ectopic pregnancy should really be a never event," said Alice Abernathy, an ob/gyn in Philadelphia.

Although rates of many pregnancy-related deaths increased during the COVID-19 pandemic, those climbs have largely subsided, except for deaths related to ectopic pregnancies, ProPublica found. And while the uptick in ectopic pregnancy deaths has occurred nationwide, the climb has been significantly steeper in states that banned abortion following the Supreme Court's overturning of Roe v. Wade in 2022.

For example, in Texas, ProPublica found that more than 310 more patients experienced substantial blood loss following an ectopic pregnancy in 2023 and 2024 compared to 2018 and 2019, which marks a 29% increase. Similar to ectopic pregnancy deaths, the rise seems to have started during the COVID-19 pandemic, but the rate of complications has stayed elevated after hospital systems stabilized and Texas passed its restrictive abortion ban.

Notably, in 2025, Texas passed the Life of the Mother Act, which attempted to clarify which kinds of abortions are allowed by law, explicitly adding ectopic pregnancies to the list.

While many state abortion bans include exceptions for ectopic pregnancies, experts worry that doctors are hesitating to provide treatment without an unquestionable diagnosis, which can take time and increase risks to the mother.

Ectopic pregnancy symptoms typically begin with abdominal pain and bleeding, which send women to the ED where doctors use ultrasounds to locate where the pregnancy has implanted.

However, embryos aren't always visible on an ultrasound early in a pregnancy, meaning the pregnancy could be ectopic, a miscarriage, or a normal pregnancy that's too small to see. Doctors are also able to assess whether the pregnancy is likely ectopic through blood tests over the course of multiple days.

If the pregnancy is ectopic, the risk of rupture increases the longer treatment is delayed, and in a state without an abortion ban, a patient could decide at any point the risk isn't worth taking and choose to terminate the pregnancy.

A nationwide lack of awareness, research, and data are also likely contributing to the rise in ectopic pregnancy deaths, ProPublica reports. For example, no one is tracking whether women who experienced ectopic pregnancies also had at least one common risk factor, like a history of ectopic pregnancies, infertility, or use of hormonal intrauterine devices.

There also hasn't been any public research addressing the connection between recent ectopic pregnancy death rates and untreated infections like gonorrhea and chlamydia, both of which increased significantly during the first years of the COVID-19 pandemic before dropping again. These infections can lead to pelvic inflammatory disease, which causes fallopian tube scarring and increases the long-term risk of developing an ectopic pregnancy.

There have also been cuts to government agencies researching maternal health trends. For example, CDC's Division of Reproductive Health lost the majority of its 100 employees, according to a lawsuit filed by over a dozen states' attorneys general last year.

In addition, the entire team that ran the Pregnancy Risk Assessment Monitoring System, which is a significant source of data for state and local governments as well as maternal health researchers, is on paid administrative leave. This team includes many researchers who would have been responsible for investigating the rise in deaths related to ectopic pregnancies, current and former CDC employees told ProPublica.

"You're losing the capacity to know what's going on with pregnant women," said Lee Warner, former chief of CDC's women's health and fertility branch. "It's going to take decades to build this capacity back."

A spokesperson for HHS said the agency continues to track maternal mortality trends, investigate their causes, and provide funding for research. "This important work is being accelerated across the Department to support healthy mothers, healthy babies, and strong families," they said.

Overall, experts say more research is necessary to determine the exact causes behind the rise of ectopic pregnancy deaths. Courtney Schreiber, a professor obstetrics and gynecology, said the analysis from ProPublica "raises concerns that young women are dying from a preventable cause at an increasing rate. That is not what we should be seeing in the United States of America."