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When my colleagues and I started digging around in CDC data on pregnancy-related deaths, we noticed something surprising: the rate of ectopic pregnancy deaths had more than doubled in recent years. Nearly 200 women died between 2020 and 2025. So we set out to learn why 🧵

We started reaching out to experts who study maternal health. Many were surprised by these numbers, and had the same questions we had — has the rate of ectopic pregnancy increased? Has access to care changed?

Ectopic pregnancy is rare, affecting ~1-2% of pregnancies — but most studies on prevalence and risk factors are decades old. These pregnancies happen when an embryo implants in the wrong place, like the fallopian tube. Untreated, they can lead to catastrophic bleeding and death.

“A death related to ectopic pregnancy should really be a never event,” Dr. Alice Abernathy told us. But that relies on access to care, the diagnosis of a rare condition early in pregnancy, at a time when someone may not even know she is pregnant, and speedy treatment.

Experts told us that chaos and access issues at hospitals during Covid likely contributed to at least some of the deaths; ectopic pregnancy care often happens in the emergency department. But the surge persisted even after the pandemic’s worst effects waned.

Lawsuits describing delays in care in states that have banned abortion set us down another potential path. When we compared ectopic pregnancy death rates between states that implemented strict abortion bans after Dobbs and those that did not ban abortion, we saw a growing divide.

Most abortion bans include exemptions for ectopic pregnancies. But it can take time to get a definitive ultrasound image, even if there are other indicators that it is ectopic. Experts worry doctors are hesitating to offer treatment, which can increase risk to the mother.

In a state without an abortion ban, a patient and her doctor could weigh that diagnostic certainty against the risk of severe outcomes, and the mother could opt to terminate the pregnancy. In a state with a ban, that option may not exist.

After consulting a lawyer, Lowrimore drove to a hospital in Kansas, where abortion is legal, and was treated for an ectopic pregnancy within hours. Her lawsuit, in which an OB-GYN and 6 women who have been denied care are seeking to block the Arkansas abortion ban, is ongoing.

Of the three hospitals where Lowrimore alleges she did not receive timely care, two did not respond to requests for comment. The third, Mercy Hospital, said it provides “all medically indicated” treatment to save mothers.

Whose job is it to track ectopic pregnancy deaths and to understand the underlying causes? Early pregnancy outcomes are chronically understudied, and ectopic pregnancy deaths are rare enough that state maternal mortality review committees may not be able to identify this trend.

There is a possible workaround. Legally define pregnancy as an event that occurs exclusively in the uterus, and legally define what happens in a fallopian tube as a blockage.