Reimplanting Ectopic Pregnancies

Every time some idiot Congressman tries to introduce the impossible into law, it makes national news.  This time it’s Ohio attempting to mandate the reimplantation of ectopic pregnancies.  As always, there’s a lot of uninformed people out there expressing their opinions, often quite loudly.

In this case, there’s also some well-intentioned experts oversimplifying the issue for mass consumption.  Which is potentially excusable for politics; most politicians are… well, calling them idiots would itself be an oversimplification.  But I think we can agree that most politicians are hardly medical experts, and if they were their specialty probably wouldn’t be either obstetrics or gynecology.

All things being equal I’m not horribly upset at people like Dr. Zahn telling The Guardian that reimplantation isn’t possible.

However, if you care about the details, it must be acknowledged that, in some very early cases, it is physically possible to reimplant. It’s very difficult and not often attempted, but it is possible. The trouble is, it’s likely to cause scarring on the very organs that are about to be stressed, stretched, and strained to their utmost. Moreover, the irritation alone is likely to induce ejection, and using drugs to suppress that is somewhat dangerous — more to the fetus than the mother.

It’s regrettable that we have so little expertise in this field, because for certain nonstandard uterine constructions (often involving scarring) it would be extremely useful to have a more effective set of techniques. Couples that can’t easily have kids might, in a moderate percentage of cases, be able to employ reimplantation. It would be far less dangerous than most fertility drugs, for example.

But we don’t.

The main reason we don’t is that there’s only very rarely an opportunity to make the attempt. By the time the condition is discovered, enough damage has probably been done to the fetus that it would not recover — not to mention the mother.  Ectopic pregnancy is a major cause of death, and it’s frequently asymptomatic. We’d need constant awareness and monitoring of early pregnancies in order to have the chance to develop reliable procedures and protocols, and we’re decades from having the resources to do even this on any large scale — though it’s certainly arguable that we should; early monitoring could be used to prevent a lot of birth defects.

One thing that might be attempted by those in favor of pursuing reimplantation technology is privately funding small-scale studies on high-risk subsets of the population in order to develop reliable surgical techniques and the appropriate corresponding drug protocols. Until that’s been done, there’s no sense even considering mandating this; we lack the ability to make it happen even in those cases where we very much want to.

So why in God’s name would we be trying to mandate it in any case where it wouldn’t be practicable?  I won’t even mention “wanted”, because that’s a whole ‘nother thing, and we’re not there yet.

However, there are two other aspects of this proposed law that ought to be mentioned:

(1) It’s a bill, not a law.  It’s one of thousands of bills proposed in a single state’s lower chamber.  It hasn’t gone through committee; it hasn’t been reviewed; it hasn’t even been voted on.  So it’s a bit early to get upset.

(2) The language says “if applicable”, and lists this as an example.  Under any present reading of the law in a criminal court, it would not be considered applicable.

Bottom line?

  • For voters, this is nothing to get excited about.  It’s something to watch.
  • For Ohio politicians:  If you don’t have time to learn about this, at least consult some experts before drafting your laws.  It’ll save time and embarrassment.

 

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