What you need to know
- An ectopic pregnancy occurs when a fertilized egg implants outside the uterus. Without prompt treatment, it can cause life-threatening internal bleeding.
- Pelvic pain, vaginal bleeding, and dizziness can be signs of an ectopic pregnancy. Sudden, severe abdominal pain, shoulder pain, or fainting may signal internal bleeding and require emergency medical care.
- Ectopic pregnancies cannot continue safely. Treatment may involve medication or surgery, depending on your individual circumstances.
An ectopic pregnancy happens when a fertilized egg implants outside the uterus—usually in a fallopian tube, which connects the uterus to the ovaries. This type of pregnancy can’t develop normally, and without treatment, it can cause life-threatening complications.
In September, a ProPublica analysis of data from the Centers for Disease Control and Prevention found that deaths involving ectopic pregnancies nearly doubled between 2020 and 2025 compared with the previous six years. Death rates were also higher in states with strict abortion bans, raising concerns about delays in care. The findings highlight the importance of early diagnosis and timely treatment.
Here’s what to know about ectopic pregnancy, including symptoms to watch for, how it’s diagnosed, and when to seek medical care.
What causes an ectopic pregnancy?
After an egg is fertilized in a fallopian tube, it usually travels to the uterus, where it may implant and grow. But in one to two percent of pregnancies, the fertilized egg implants outside the uterus. This can happen when something slows or blocks its movement, such as scar tissue or inflammation, although the cause isn’t always known.
About 90 percent of ectopic pregnancies occur in a fallopian tube, but a fertilized egg can also implant in an ovary, the cervix (which connects the uterus to the vagina), the abdominal cavity, or scar tissue from a Cesarean section (C-sections).
Factors that can increase your risk of an ectopic pregnancy include:
- A previous ectopic pregnancy
- A history of pelvic surgery or pelvic inflammatory disease
- A history of infertility or in vitro fertilization (IVF)
- Endometriosis
- Becoming pregnant while using an intrauterine device (IUD)
- Smoking
- Being 35 or older
- Have one or more previous C-sections
However, an ectopic pregnancy can happen even if you don’t have these risk factors. Contact a health care provider after a positive pregnancy test to discuss when to begin prenatal care. If you experience symptoms of an ectopic pregnancy, seek medical care right away.
What are the symptoms of an ectopic pregnancy?
An ectopic pregnancy may not cause symptoms at first. When symptoms do occur, they often develop between four and 12 weeks of pregnancy and may include:
- Vaginal bleeding or spotting
- Pelvic or lower stomach pain, sometimes on one side
- Lower back pain
- Dizziness or weakness
About 15 percent of tubal ectopic pregnancies can cause the fallopian tube to rupture, leading to life-threatening internal bleeding. Warning signs may include sudden, severe abdominal or pelvic pain, shoulder pain, fainting, or extreme dizziness.
If you experience these warning signs, seek emergency medical care immediately. Don’t wait for a prenatal appointment. If you have milder symptoms and could be pregnant, contact a health care provider promptly for evaluation.
How is an ectopic pregnancy diagnosed?
Health care providers typically diagnose an ectopic pregnancy during the first 12 weeks of pregnancy using a combination of tests. Those tests may include:
- A urine test to confirm pregnancy
- A blood test to measure levels of human chorionic gonadotropin, or hCG, a hormone your body produces during pregnancy, to see if levels are rising more slowly than expected over time
- An ultrasound to determine where the fertilized egg has implanted
An ectopic pregnancy isn’t always visible on an early ultrasound, so your provider may need to repeat blood tests or an ultrasound before making a diagnosis.
Because an ectopic pregnancy can cause life-threatening internal bleeding, prompt diagnosis and treatment are critical. If your health care provider confirms an ectopic pregnancy, they’ll discuss the appropriate next steps based on your condition.
How is an ectopic pregnancy treated?
Treatment depends on factors such as your symptoms, hCG levels, and whether there’s a risk of internal bleeding.
If an ectopic pregnancy is diagnosed early and hasn’t ruptured, your health care provider may recommend methotrexate, a medication that stops the pregnancy from growing. It’s typically given as a single injection. Afterward, you’ll need regular blood tests to ensure your hCG levels are decreasing. Some people need additional medication or surgery if the first dose of methotrexate isn’t successful.
If your fallopian tube has ruptured or there’s a high risk of rupture, you will need surgery. This is often done laparoscopically, through several small incisions in your belly. The surgeon may remove the ectopic pregnancy on its own, or they may need to remove the affected fallopian tube. In many cases, you can still get pregnant even if you’ve had one fallopian tube removed.
How do abortion bans impact ectopic pregnancy care?
Many state abortion bans include exceptions for ectopic pregnancies. However, maternal health experts warn that fear of legal penalties may cause some health care providers to delay treatment until they can confirm a diagnosis, even when there are signs of a possible ectopic pregnancy.
Because an ectopic pregnancy isn’t always visible on an early ultrasound, confirming a diagnosis can take time. Delays in care can increase the risk of a fallopian tube rupture and life-threatening internal bleeding.
If you are experiencing delays in ectopic pregnancy care, contact the Repro Legal Helpline for free, confidential legal information and support about your rights.
How can I get mental health support after an ectopic pregnancy?
Having an ectopic pregnancy can bring up feelings of grief, sadness, or uncertainty about future pregnancies. If you’re struggling, talk with your health care provider about mental health support.
You can also get help by contacting the National Maternal Mental Health Helpline or Postpartum International.
Can I prevent an ectopic pregnancy?
There’s no guaranteed way to prevent an ectopic pregnancy, but you can reduce your risk by avoiding smoking and protecting yourself against sexually transmitted infections.
If you’ve had an ectopic pregnancy before or have other risk factors, talk to your health care provider when you’re planning a pregnancy or as soon as you know you’re pregnant. Early monitoring can help identify a possible ectopic pregnancy before serious complications develop.
For more information, talk to your health care provider.