What is an ectopic pregnancy (and what does it have to do with abortion pills)?

First, some basics:  In a healthy pregnancy, once the egg has been fertilized by the sperm, the fertilized egg makes its way through the fallopian tube and  attaches to the uterine lining, so it can grow inside the uterus. In an ectopic pregnancy, the fertilized egg attaches somewhere other than the uterus, like the fallopian tube (also called a tubal pregnancy, the most common kind of ectopic pregnancy) or ovary. While this is a rare situation, it's an urgent one. Fallopian tubes can tear if they're stretched too much, and if rupture occurs, it can lead to internal bleeding and infection. Because a fertilized egg can't successfully grow outside the uterus, an ectopic pregnancy is not viable.

An ectopic pregnancy usually starts off like a normal pregnancy with normal pregnancy symptoms. An ultrasound can detect ectopic pregnancy after 6 weeks, but signs to look out for include severe pelvic pain, shoulder pain, vaginal bleeding and spotting, weakness, dizziness, and fainting. If you experience these symptoms, you should seek medical care immediately, but keep in mind that these can also be symptoms of ovarian cysts or other conditions. Treatment for ectopic pregnancy is either shots of methotrexate, which ends the pregnancy by stopping the growth of the fertilized egg (this doesn't damage the fallopian tube), or laparoscopic surgery, which can result in scarring in the fallopian tube or in the tube needing to be removed.

Abortion pills will not end an ectopic pregnancy. If you have an ectopic pregnancy and do take them, you may experience bleeding, but you won't see the clots that you would if you were terminating a normal pregnancy, since the fertilized egg is continuing to grow elsewhere. If you take abortion pills and don't bleed, an ectopic pregnancy might be one reason for this, but there are others — if you've obtained abortion pills from an unreliable source, they may not contain mifepristone or misoprostol. You may not have taken enough misoprostol (you need 12 pills of 200 milligrams each to terminate a pregnancy up to 12 weeks). And of course, confirming your pregnancy is essential before taking abortion pills.

Ectopic pregnancies are rare (1.5-2% of pregnancies), but you should be aware that they are a possibility, and will impact the efficacy of abortion pills. For more information on how to get the pills, how they work, and more, visit our FAQs.