When ‘Experts’ Get It Wrong

September 30, 2014

My feathers are ruffled. Earlier today, I read this: http://www.nbcnews.com/health/womens-health/hidden-dangers-miscarriages-scar-would-be-moms-n212646

I came across it on Facebook after Resolve posted it and several friends shared it. I applaud the message. I think it’s important for people to understand that pregnancy can be dangerous. It’s one of my core beliefs in being Pro-Choice that women should not be forced to continue any pregnancy because pregnancy can be dangerous and traumatic.

But it does a disservice to awareness to convey incorrect medical information. How can we expect people to understand and believe these dangers are real when the ‘experts’ can’t properly define them?

A woman characterized as a “professor of obstetrics and gynecology at Brown University and a maternal-fetal specialist” was quoted as saying “Most typically, in an ectopic pregnancy (when the egg is fertilized in the fallopian tubes), the fetus can’t can’t grow before bursting.”

Sigh. Where to begin?

Perhaps with a lesson in normal pregnancy. Let’s go back to the birds and the bees, shall we?

In a normal pregnancy the ovary releases an egg into the fallopian tube. Sperm must find that egg IN THE TUBE within about 24 hours in order to fertilize it. It then takes 5-7 days for the fertilized egg (often referred to as an embryo at this stage) to travel down the tube and arrive in the uterus. If all goes well, the embryo will ‘hatch’ and implant itself in the uterine lining inside the uterine cavity and grow for approximately 9 months.

So. As you can see…fertilization of the egg is SUPPOSED TO HAPPEN IN THE TUBE. That is not abnormal or ectopic. By this ‘expert’ definition all normal pregnancies are ectopic.

WTF!?!?
I can only hope NBC misquoted her.

So what *is* an ectopic pregnancy?

An ectopic pregnancy occurs when an embryo (regardless of where it was fertilized – fallopian tube or petri dish for IVF) implants somewhere other than the uterine lining inside the uterine cavity. Most commonly the location is the fallopian tube but it can occur in other locations – including the uterus. Some ectopic pregnancies occur in or on the cervix or in the uterus but too close to the fallopian tube (interstitial or cornual – the 2nd most common type of ectopic pregnancy). Or, in my case, inside the uterine wall (intramural). Which is why I always teach that ectopic pregnancies occur in a location other than in the lining inside the uterine cavity. They can also occur in or on the ovary or in the abdomen, completely outside the reproductive system.

Point being this: ectopic pregnancy has nothing to do with where the egg was fertilized. It is about where the resulting embryo implants (which is also why I have an issue with saying a doctor implants an embryo via IVF but that’s another issue).

I have seen doctors and lay people alike use the words tubal and ectopic interchangeably because tubal ectopics are the most common type of ectopic pregnancy. Being most common does not mean the same. Here’s a handy Venn diagram in case you’re confused.

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Note: While I tried to make these representative of real life proportions, I did not measure them to scale. Nor do they represent an exhaustive list of types of pregnancies. They serve the specific purpose of this post.

If you find anything incorrect here please correct me. My goal is to be accurate without being overly technical. As such, some details have been purposefully sacrificed. If you take issue with that, just let me know and I’ll find a way to be more inclusive of all information.

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2 Responses to “When ‘Experts’ Get It Wrong”

  1. Elizabeth Says:

    Thank you! I had an ectopic pregnancy in my ovary several years ago. When I tell people that, it’s almost like they don’t believe me. I’m always like, “Oh no sir, I assure you that I’m right on this one. Trust” Although I have to say, that before my first ectopic (my second was a good old fashioned ruptured tube…classic I know), I don’t think I knew that an ectopic could be outside of the tube either. What an education infertility gives us.

    • Fox Says:

      Yeah my first one was in my uterus. Which really threw me off. But it wasn’t inside the uterine cavity so it’s still ectopic. And like you, my second one was boring by comparison and in the tube. It is quite the education.


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