After 2 ectopic pregnancies I’m scared of what might happen without Roe v. wave | Health News from the Healthiest Communities

I have been pregnant five times. I have a child. A son, Sam, born the day he gave birth, weighing 6 pounds and 14 ounces, in 1997.

My other four pregnancies didn’t go as well. After Sam, carrying a baby past the first trimester proved impossible. I had a miscarriage early in the first trimester; a second in which the baby’s heart stopped beating between the ninth and tenth week; then two ectopic pregnancies, a condition in which an embryo implants outside the uterus. If left untreated, ectopic pregnancies can be fatal.

Joanne Faryon with her son, Sam Tari, in May at her law school graduation.(Courtesy of Joanne Faryon)

The two ectopic pregnancies snuck up on me. I was 39 when I stopped using birth control and left the rest to chance.

A few months later I had spotting for over a week and made it an unusual time.

I also had a sharp pain in the lower left side when I extended my leg to get out of the car, or sometimes when I jog or twist my hips in a certain way.

“Have you taken a pregnancy test? asked a friend after describing my symptoms.

It was positive. I was taken to emergency care where a doctor confirmed my pregnancy with a blood test and performed a transvaginal ultrasound. But there was nothing in my uterus – no sign of a fetus.

The doctor told me I was having a miscarriage. I asked her if it was possible it was a “tubal” pregnancy, the term my friend had used when I called her that day. I didn’t know at the time that the medical term was “ectopic”.

“No,” said the doctor. “We didn’t see anything in your fallopian tubes,” referring to the thin passageways that carry the fertilized egg from the ovary to the uterus or womb.

She sent me home and told me to call my gynecologist for a follow up.

I did it. The nurse said my doctor wouldn’t see me until I finished miscarrying. Wait until I stop bleeding, in other words.

Over the next few days, the bleeding got worse, as did the pain. I took another pregnancy test. It was still positive. I called my doctor’s office. The doctor still wouldn’t see me ― I was still having a miscarriage.

A few days have passed and nothing has changed. I searched for “ectopic” on the internet.

I decided to drive myself to the emergency room.

A blood test showed that I was still pregnant. A doctor ordered another transvaginal ultrasound. It was extremely painful. The technician performing the procedure told me it wasn’t supposed to hurt.

“But it is,” I told him.

When it was over, the ER doctor confirmed what I already knew: there was no baby in my womb. What about left side pain? The technician couldn’t see the left tube or the area around it well because there was too much gas in my abdomen.

It had now been two weeks since that first home pregnancy test. I was still pregnant. No baby in my womb. Bleed again. Still in pain. I went to bed this Saturday morning and I cried. I asked my husband to call my gynecologist’s office. The doctor reviewed my records―the lab results of the two blood tests I had over a two-week period. More importantly, my human chorionic gonadotropin (pregnancy hormone) levels had increased over time, meaning I was not miscarrying. The embryo was growing somewhere outside the uterus. “Take her to the emergency room,” the doctor said. “She has an ectopic pregnancy.”

The most common place for an ectopic pregnancy is in one of the fallopian tubes. As the embryo divides and grows, if the fragile tube ruptures, a woman could bleed to death. It’s the most common cause of death from pregnancy in the first trimester.

In the emergency room, I received an injection of methotrexate. It’s an old drug, originally prescribed to treat cancer. It targets rapidly growing cells and is sometimes used in combination with misoprostol for early abortions. It’s the gold standard for treating many ectopic pregnancies that haven’t ruptured…yet.

After the shot, I went home and went to bed. I slept all day. For the next week I had my blood drawn and my HCG levels were tested every third day. Shooting works if levels drop at least 15% between the fourth day and the seventh day. In my case, this did not happen. My HCG levels stayed about the same. The fetus was not growing, but the pregnancy was not over either.

My feelings were so complicated, and even now, nearly two decades later, I struggle to articulate them. On the one hand, I felt like I was slowly killing my baby. I knew logically that this was a pregnancy that could never come to term. And if left untreated, it could have killed me. I was scared. I felt like a walking time bomb. Every time I stretched out my left leg, I felt a sharp pain. What if a sudden movement causes the tube to break? I desperately wanted my HCG number to decline to save me, and it made me feel incredibly guilty.

I changed doctors at the end of that first week when my gynecologist still couldn’t see me. My new doctor told me I needed another injection of methotrexate. Again, I had to take blood every three days. This time my HCG levels went down. In early August, about two months after finding out I was pregnant, my levels were finally close enough to zero that I was no longer considered pregnant.

More than two years have passed. I was 41 years old. I had given up on having another baby, but I had all the first signs. My breasts were sore, I was tired, and instead of having regular periods, I was bleeding. And I felt this lower left pain. I took a pregnancy test. It was positive. I went to emergency. I told the triage nurse that I had the same symptoms as before.

Once you’ve had an ectopic, you’re at greatest risk to have a second.

The hospital did blood tests and confirmed that I was pregnant. My HCG number was low―turns out being just a little bit pregnant does exist.

I had a transvaginal ultrasound which again was painful. There was no fetus in my uterus, but this time the technician saw something near my left ovary and fallopian tube. However, it was not final.

The ER doctor told me it could be a corpus luteum cyst — a common growth that sometimes appears on a woman’s ovary after ovulation.

Maybe I was just very early in the pregnancy, the doctor said, and it wasn’t ectopic. I could give it a little more time, she suggested, and see what happens. She left the decision to me.

I found myself alone in the emergency room, crying hysterically. I called my sister.

“I don’t know what to do,” I told him.

“What does your instinct say? ” she asked.

I told the doctor I wanted methotrexate.

Monday morning, my regular gynecologist called me with a more definitive diagnosis. She thought I had a second ectopic pregnancy. It turns out that one doctor’s corpus luteum cyst is another doctor’s ectopic pregnancy. This time I only needed one dose of methotrexate. My HCG levels continued to drop and within weeks I was no longer pregnant.

For the next decade, I lived in fear of getting pregnant. I felt like a baby killer. I asked my doctor to tie my tubes, but she discouraged me, saying it wouldn’t be 100% effective against another ectopic pregnancy. My husband didn’t want to have a vasectomy and I had a Mirena IUD which releases a small amount of hormones and is 99% effective in preventing pregnancy. I kept pregnancy tests under my bathroom sink until I was 53 – I must have taken 50.

Ectopic pregnancies are considered rare. But rare is a relative term. Especially if it happens to you, not once, but twice. Almost 6 million women became pregnant in 2017. Ectopic pregnancy occurs in as many 2% of those case ― that’s over 100,000 women. Moreover, the diagnosis of ectopic pregnancies is not simple; science says sojust like my own experience.

Ectopic pregnancies can resolve on their own – or maybe not. They can also rupture and lead to death. I don’t know what would have happened to me if I hadn’t been prescribed methotrexate in both cases. But I’m sure my chances of survival would have been significantly lower without Roe’s protection against Wade.

Joanne Faryon is a professor at Columbia University’s Graduate School of Journalism and a freelance journalist and producer.

This story was produced by KHN (Kaiser Health News), a national newsroom that produces in-depth journalism on health issues and a major operational program at KFF (Kaiser Family Foundation). It was published with permission.

Leave a Comment