The Church and ectopic pregnancy for health care workers

[Houro]

G’day everybody,

A quick question that I can’t find an answer to. What does the Church teach on the role of the health care worker in an ectopic pregnancy? I’m a midwife and we normally administer a drug that aborts the fetus in order to save the mother. I just want to know what the Church says about this. Am I committing a mortal sin because I’m directly aborting this baby? And I’d like a real answer, not just speculation, that will not help me next time I’m faced with this situation again.

Thanks in advance!

PS: Not sure why this question wasn’t important enough to be answered when I asked it in the AA forum… I’m faced with the reality of having to kill a human, it scares me, I couldn’t find an answer and nobody helped me… There must be a reason but I’m just a bit disappointed at the moment…

 

[kage_ar]

Please see your Priest. From the Catechism, bold added. I am so sorry you have cooperated in abortions, and than you now know this is wrong. Seek the healing power of confession.

The National Catholic Bioethic Center will be able to help you

ncbcenter.org/NetCommunity/Page.aspx?pid=183

As will Priests for Life and Nurses for Life
priestsforlife.org/

nursesforlife.org/Welcome_Page.php

The Catechism

scborromeo.org/ccc/p3s2c2a5.htm#2271

2271 Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law:

You shall not kill the embryo by abortion and shall not cause the newborn to perish.75
God, the Lord of life, has entrusted to men the noble mission of safeguarding life, and men must carry it out in a manner worthy of themselves. Life must be protected with the utmost care from the moment of conception: abortion and infanticide are abominable crimes.76

2272 Formal cooperation in an abortion constitutes a grave offense. The Church attaches the canonical penalty of excommunication to this crime against human life. "A person who procures a completed abortion incurs excommunication latae sententiae,"77 "by the very commission of the offense,"78 and subject to the conditions provided by Canon Law.79 The Church does not thereby intend to restrict the scope of mercy. Rather, she makes clear the gravity of the crime committed, the irreparable harm done to the innocent who is put to death, as well as to the parents and the whole of society.

2273 The inalienable right to life of every innocent human individual is a constitutive element of a civil society and its legislation:

"The inalienable rights of the person must be recognized and respected by civil society and the political authority. These human rights depend neither on single individuals nor on parents; nor do they represent a concession made by society and the state; they belong to human nature and are inherent in the person by virtue of the creative act from which the person took his origin. Among such fundamental rights one should mention in this regard every human being’s right to life and physical integrity from the moment of conception until death."80

"The moment a positive law deprives a category of human beings of the protection which civil legislation ought to accord them, the state is denying the equality of all before the law. When the state does not place its power at the service of the rights of each citizen, and in particular of the more vulnerable, the very foundations of a state based on law are undermined. . . . As a consequence of the respect and protection which must be ensured for the unborn child from the moment of conception, the law must provide appropriate penal sanctions for every deliberate violation of the child’s rights."81

 

[Rence]

G’day everybody,

A quick question that I can’t find an answer to. What does the Church teach on the role of the health care worker in an ectopic pregnancy? I’m a midwife and we normally administer a drug that aborts the fetus in order to save the mother. I just want to know what the Church says about this. Am I committing a mortal sin because I’m directly aborting this baby? And I’d like a real answer, not just speculation, that will not help me next time I’m faced with this situation again.
QUOTE]

The church does NOT allow methotrexate to treat ectopic pregnancy because the primary action/intent is to abort the fetus. It’s never acceptable by the Church to abort the fetus.

The Chuch does allow removal of the fallopian tube in the case of ectopic pregnancy.

The removal of the fallopian tube is primary, and it’s intention is to treat the ectopic pregnancy and to save the life of the woman. The loss of the fetus within the tube is secondary and isn’t the intention, it’s an unfortunate result of removing the tube. This all falls under the principle of “double effect”.

According to the CCC, it is a mortal sin to participate in an abortion.

 

[momor]

Houro;6546977:

G’day everybody,

A quick question that I can’t find an answer to. What does the Church teach on the role of the health care worker in an ectopic pregnancy? I’m a midwife and we normally administer a drug that aborts the fetus in order to save the mother. I just want to know what the Church says about this. Am I committing a mortal sin because I’m directly aborting this baby? And I’d like a real answer, not just speculation, that will not help me next time I’m faced with this situation again.
QUOTE]

The church does NOT allow methotrexate to treat ectopic pregnancy because the primary action/intent is to abort the fetus. It’s never acceptable by the Church to abort the fetus.

The Chuch does allow removal of the fallopian tube in the case of ectopic pregnancy.

The removal of the fallopian tube is primary, and it’s intention is to treat the ectopic pregnancy and to save the life of the woman. The loss of the fetus within the tube is secondary and isn’t the intention, it’s an unfortunate result of removing the tube. This all falls under the principle of “double effect”.

According to the CCC, it is a mortal sin to participate in an abortion.

First off I accept that this is the Church’s teaching, but it does leave me scratching my head.

Tubal pregnancies are doomed from the start, the baby will never survive to the age of viability and we don’t yet routinely “transplant” them to the uterus. Instead of using a drug to terminate the non-viable pregnancy we incidentally terminate the pregnancy by removing the fallopian tube to prevent hemorrhage and possible maternal death. What have we done that is morally better? Nothing in my opinion. The baby loses it’s life either way but now the mother has lost a fallopian tube which may impede her future fertility and she has been subjected to a potentially dangerous surgery.

 

[jphelins]

I do not know specifically what the church says about the abortion of an ectopic pregnancy but I agree with momor that an ectopic pregnancy is doomed from the start, as if it is not aborted it would kill the mother, and if the mother died then the fetus couldn’t survive. Also I question what Rence says about removing the fallopian tubules, as there are a lot of fractions within the church that prohibit agonist any surgery as it is a “disfigurement” of the body. In with case the use of methotrexate would seem to be the better option. Unfortunately in your position as a midwife, you are not able to make the decision of what treatment is offered (depending on where your located).

 

[Rence]

Well I can relate. A lot of rules of the Church leave me scratching my head So I understand your reaction.

But I know for a fact that methotrexate to treat ectopic pregnancies is forbidden by the Church. Why not just ask your priest?

Removing a ruptured fallopian tube is not a disfigurement. In addition, a woman’s fertility is not affected by the removal of a fallopian tube because she has another. Removing a fallopian tube does not hinder fertility. This option is allowed by the Church, and is a standard medical intervention for ectopic pregnancy. Why not just ask your priest?

However, the removal of the fallopian tube ensures that it won’t happen again in that tube. Retaining the tube risks the chance of it happening again.

If you question what the Church’s teachings regarding treatment of ectopic pregnancy, ask an apologist in the “ask an apologist” subforum or ask your priest. I certainly understand you not trusting online sources…I’ve had quite a few experiences with that myself and was put at ease by a nice lengthy conversation with our pastor

 

[momor]

Well I can relate. A lot of rules of the Church leave me scratching my head So I understand your reaction.

Good to know I’m not alone!

Removing a ruptured fallopian tube is not a disfigurement. In addition, a woman’s fertility is not affected by the removal of a fallopian tube because she has another. Removing a fallopian tube does not hinder fertility.

Typically, a woman ovulates from one ovary one month and from the opposite ovary the next. So removing one tube can potentially reduce her fertility by 50%

However, the removal of the fallopian tube ensures that it won’t happen again in that tube. Retaining the tube risks the chance of it happening again.

This is certainly true.

If you question what the Church’s teachings regarding treatment of ectopic pregnancy, ask an apologist in the “ask an apologist” subforum …

I think the OP said she tried this and didn’t get an answer.

 

[Rence]

Typically, a woman ovulates from one ovary one month and from the opposite ovary the next. So removing one tube can potentially reduce her fertility by 50%

Honest, it doesn’t. The eggs will just go down the remaining tube. A woman only uses one tube at a time, so if one is missing, she’ll just use the other.

I think the OP said she tried this and didn’t get an answer.

Just ask your priest then.

 

[momor]

Honest, it doesn’t. The eggs will just go down the remaining tube. A woman only uses one tube at a time, so if one is missing, she’ll just use the other.

Smart eggs? Let’s see, go left, go right

 

[Whitacre_Girl]

Honest, it doesn’t. The eggs will just go down the remaining tube. A woman only uses one tube at a time, so if one is missing, she’ll just use the other.

Wait, this doesn’t make any sense.
http://www.mcgillivf.com/common/sitemedia/FemaleSystem.gif

The tubes connect one ovary to the uterus and are on opposite sides of the other. An egg from an ovary where the tube has been removed or damaged cannot travel to the other fallopian tube to be fertilized. In order for what you say to be true, the ovary connected by the now damaged tube must be rendered totally inactive. Otherwise it stands to reason that the woman’s fertility was just slashed in half.

I’d really like to see a medical article or something from a medical source that says that fertility isn’t reduced by the removal of a damaged fallopian tube. This is a head scratcher, indeed!

For the record, I understand the church’s position. I can see where they are coming from and it makes sense. However, while I will never advise anyone to act contrary to church teaching (including myself!) I can’t help but feel sometimes like this issue is just splitting hairs. I mean, if the woman can retain full fertility after treating an ectopic pregnancy, shouldn’t she do that instead? Although, if one retains full fertility after one tube is removed, awesome. That’s probably why God gave us two!! On the flip side, what if the woman is operating on just the one, but an ectopic pregnancy happens again. Is she then required to render herself sterile to save her life? You can see how, while I believe we need to follow the church, the logic of their decision isn’t always clear to me. I guess that’s why I am just a lay person!

 

[Rence]

Wait, this doesn’t make any sense.
The tubes connect one ovary to the uterus and are on opposite sides of the other. An egg from an ovary where the tube has been removed or damaged cannot travel to the other fallopian tube to be fertilized. In order for what you say to be true, the ovary connected by the now damaged tube must be rendered totally inactive. Otherwise it stands to reason that the woman’s fertility was just slashed in half.

No, I didn’t mean the ovary (without a fallopian tube) would send out an egg that would cross over to the remaining fallopian tube (though it’s possible, it’s also insignificant). I didn’t say anything about them crossing over I said the eggs would go down the remaining tube. To clarify, the ovary with the remaining tube would send it’s egg down it’s own tube in order to support fertility.

I’d really like to see a medical article or something from a medical source that says that fertility isn’t reduced by the removal of a damaged fallopian tube. This is a head scratcher, indeed!

From the mayo clinic mayoclinic.com/health/pregnancy/AN00088

• Pregnancy is possible with only one fallopian tube — as long as you have one or both ovaries, you still ovulate, and the remaining fallopian tube is healthy.

Normally, a single egg is released each month by one of the ovaries. The egg travels to one of the fallopian tubes — typically the adjacent tube — where a sperm may fertilize it. The fertilized egg then travels to the uterus.

Ovulation tends to alternate between the ovaries. If you have only one fallopian tube, you’re most likely to conceive on a month in which the egg is released from the ovary nearest your fallopian tube. Although it may be possible for an egg released from one ovary to travel to the fallopian tube on the opposite side, this is rare. Instead, any eggs released from the ovary on the opposite side typically won’t have a chance to be fertilized. The egg will simply break down, and you’ll have your next period as usual.

Keep in mind that fertility may be affected by other factors as well. You’re less likely to conceive if one of your fallopian tubes was removed due to a tubal pregnancy or infection. In such cases, the remaining fallopian tube may not be normal. Conception is also less likely if you have only one ovary and it’s on the opposite side of your only fallopian tube.
*

For the record, I understand the church’s position. I can see where they are coming from and it makes sense. However, while I will never advise anyone to act contrary to church teaching (including myself!) I can’t help but feel sometimes like this issue is just splitting hairs. I mean, if the woman can retain full fertility after treating an ectopic pregnancy, shouldn’t she do that instead? Although, if one retains full fertility after one tube is removed, awesome. That’s probably why God gave us two!! On the flip side, what if the woman is operating on just the one, but an ectopic pregnancy happens again. Is she then required to render herself sterile to save her life? You can see how, while I believe we need to follow the church, the logic of their decision isn’t always clear to me. I guess that’s why I am just a lay person!

As I said above, a lot of church teachings make me scratch my head. To elaborate: the way they push having more and more and more kids, even to the point of telling a married couple they should be celibate if they’re finished having children, one would think they’d favor saving the fallopian tube over removing a fetus that is going to die anyway. A lot of ectopic pregnancies reabsorb. None of them survive. Most of the time the tube ruptures and can’t be saved. I would think that if ectopic pregnancy is diagnosed early enough to save the tube, that this would be the better choice, but the Church doens’t agree. It’s not the first time we don’t agree I didn’t say I agreed with the teaching. I just answered your questions. Don’t shoot the messenger

 

[momor]

No, I didn’t mean the ovary (without a fallopian tube) would send out an egg that would cross over to the remaining fallopian tube (though it’s possible, it’s also insignificant). I didn’t say anything about them crossing over I said the eggs would go down the remaining tube. To clarify, the ovary with the remaining tube would send it’s egg down it’s own tube in order to support fertility.

But you disagreed with me when I said fertility would be cut in half. What else could we think you meant!

Quote:
Originally Posted by momor
Typically, a woman ovulates from one ovary one month and from the opposite ovary the next. So removing one tube can potentially reduce her fertility by 50%

Rence
Honest, it doesn’t. The eggs will just go down the remaining tube. A woman only uses one tube at a time, so if one is missing, she’ll just use the other.

 

[JReducation]

Go to www.usccb.org Click on Life Issues and you will find all of the information that you need. They also have a newsletter to which you can subscribe.

Fraternally,

Br. JR, OSF

 

[Viki63]

As I said above, a lot of church teachings make me scratch my head. To elaborate: the way they push having more and more and more kids, even to the point of telling a married couple they should be celibate if they’re finished having children, one would think they’d favor saving the fallopian tube over removing a fetus that is going to die anyway.

Two points: the church does not tell married couples to be celibate if they’ve finished having children. NFP is always an option.
I hear your frustration, Houro, with the logic of the church. but I think she (the church) is correct. Direct abortion is gravely contrary to the moral law/ The death of the child cannot be willed as the first effect, although it can be allowed as a side effect of what must be done to save the mother’s life.The church says every human life is sacred, and needs to maintain that stance; otherwise she will end up sliding down the slippery slope that the rest of the culture has taken.
Once you know that this is grave matter, it is a mortal sin to participate in a direct abortion. As you did not know until now, you have probably not commited a mortal sin. But it’s always best to talk to a priest.
(Sometimes questions asked in the Ask an Apologist forum get lost somewhere. I’m sure Father wasn’t ignoring your question.)
God bless.

 

[puzzleannie]

I as there are a lot of fractions within the church that prohibit agonist any surgery as it is a “disfigurement” of the body. ).

there is no Catholic teaching that holds this, please don’t confuse the issue with irrelevancies. OP has been given excellent advice, first see her own priest, immediately, and second to educate herself on the issue, the Catholic bioethics center and other good links

restate the question this way: suppose a woman’s fertility will be compromised unless her 3 year old child is killed. The moral issue is the same. Direct murder with intent to murder is never an option. yes this is a brutal statement. direct abortion is a brutal act. Please see your priest today.

you will find your question has been answered on AAA if you do a search, vary your keywords, the name of the drug would work too, or the word ectopic. also there are fuller discussions on the moral issues and reasoning involved on the Morality Forum that will help you with the background

 

[Whitacre_Girl]

No, I didn’t mean the ovary (without a fallopian tube) would send out an egg that would cross over to the remaining fallopian tube (though it’s possible, it’s also insignificant). I didn’t say anything about them crossing over I said the eggs would go down the remaining tube. To clarify, the ovary with the remaining tube would send it’s egg down it’s own tube in order to support fertility.

okay…But that means that in conjunction with what is stated below:

From the mayo clinic mayoclinic.com/health/pregnancy/AN00088

• Pregnancy is possible with only one fallopian tube — as long as you have one or both ovaries, you still ovulate, and the remaining fallopian tube is healthy.

Normally, a single egg is released each month by one of the ovaries. The egg travels to one of the fallopian tubes — typically the adjacent tube — where a sperm may fertilize it. The fertilized egg then travels to the uterus.

Ovulation tends to alternate between the ovaries. If you have only one fallopian tube, you’re most likely to conceive on a month in which the egg is released from the ovary nearest your fallopian tube. Although it may be possible for an egg released from one ovary to travel to the fallopian tube on the opposite side, this is rare. Instead, any eggs released from the ovary on the opposite side typically won’t have a chance to be fertilized. The egg will simply break down, and you’ll have your next period as usual.

Keep in mind that fertility may be affected by other factors as well. You’re less likely to conceive if one of your fallopian tubes was removed due to a tubal pregnancy or infection. In such cases, the remaining fallopian tube may not be normal. Conception is also less likely if you have only one ovary and it’s on the opposite side of your only fallopian tube.
*

Fertility is then affected. Any time a woman ovulates from the ovary with the removed tube, she cannot become pregnant. That means half her ovulations are sterile. She can’t conceive. So fertility is definately affected.

As I said above, a lot of church teachings make me scratch my head. To elaborate: the way they push having more and more and more kids, even to the point of telling a married couple they should be celibate if they’re finished having children, one would think they’d favor saving the fallopian tube over removing a fetus that is going to die anyway. A lot of ectopic pregnancies reabsorb. None of them survive. Most of the time the tube ruptures and can’t be saved. I would think that if ectopic pregnancy is diagnosed early enough to save the tube, that this would be the better choice, but the Church doens’t agree. It’s not the first time we don’t agree I didn’t say I agreed with the teaching. I just answered your questions. Don’t shoot the messenger

No shooting of the messenger here! It seems like you and I are on the same page - confusion!!

I see them saying that the death of the child cannot be willed as a first effect. I don’t think any mother facing an ectopic pregnancy wills the death of her child. I think she is seeking the removal of a deadly situation in a way that allows her to best go on and have other children. That is, if the ectopic pregnancy is diagnosed early enough for this to be an option. I can see that the church wants to avoid a slippery slope, but their logic in ruling on this case makes absolutely no sense to me. I can’t help but feel it’s a near no-win situation for the catholic mother. She not only bears the pain of losing her precious unborn child, for whom nothing can be done to save his or her life; but then has to negatively impact her fertility so having another child is less likely. I dunno. I guess all I can do is pray this never happens to me or anyone I know.

 

[Rence]

Fertility is then affected. Any time a woman ovulates from the ovary with the removed tube, she cannot become pregnant. That means half her ovulations are sterile. She can’t conceive. So fertility is definately affected.

Yes, and no. If you’re expecting to get pregnant on any given month, yes, I can see how that would make one think that having one tube would make one less fertile. But on the flipside, the reality is, just because an egg travels down the fallopian tube doesn’t mean conception will take place. So the fact that eggs are being sent down means that a woman is still fertile. I’ve seen many reports of women having multiple children after one fallopian tube is removed. Being fertile is contingent on many things. One of them being, the surviving tube is defective as well.

Here’s some interesting information about ectopic pregnancy that I think you’d appreciate Whitacre Girl
nlm.nih.gov/medlineplus/ency/article/000895.htm

I see them saying that the death of the child cannot be willed as a first effect. I don’t think any mother facing an ectopic pregnancy wills the death of her child. I think she is seeking the removal of a deadly situation in a way that allows her to best go on and have other children. That is, if the ectopic pregnancy is diagnosed early enough for this to be an option. I can see that the church wants to avoid a slippery slope, but their logic in ruling on this case makes absolutely no sense to me. I can’t help but feel it’s a near no-win situation for the catholic mother. She not only bears the pain of losing her precious unborn child, for whom nothing can be done to save his or her life; but then has to negatively impact her fertility so having another child is less likely. I dunno. I guess all I can do is pray this never happens to me or anyone I know.

Definitely pray it doesn’t happen to you or anyone you know. It’s not pleasant no matter what you do about it. And whether you’re chemical induced, or whether the tube is removed, if it was ‘just one of those things’ you’re probably good to go. But if the tubes are impaired in some way it really doesn’t matter what route you choose.

I agree: I’d think that in this lose-lose situation the Church would favor protecting fertility in this situation especially how much they emphasize the importance of having children and being ‘open to life’. But I’m sure they have their reasons…

 

[Rence]

Two points: the church does not tell married couples to be celibate if they’ve finished having children. NFP is always an option.

I agree with you 100% However, having this apparent “opinion” has been a neverending battle for me on this forum with some members. I’ve been told several times that the Church dictates that if a couple is done having children, they are “sinning” by using NFP as a birth control method, and should abstain. I’m VERY glad you and I share the same thoughts in this matter

I hear your frustration, Houro, with the logic of the church. but I think she (the church) is correct. Direct abortion is gravely contrary to the moral law/ The death of the child cannot be willed as the first effect, although it can be allowed as a side effect of what must be done to save the mother’s life.The church says every human life is sacred, and needs to maintain that stance; otherwise she will end up sliding down the slippery slope that the rest of the culture has taken.

You explained that much better than I tried to. Thanks

 

[Rence]

But you disagreed with me when I said fertility would be cut in half. What else could we think you meant!

Quote:
Originally Posted by momor
Typically, a woman ovulates from one ovary one month and from the opposite ovary the next. So removing one tube can potentially reduce her fertility by 50%

Rence
Honest, it doesn’t. The eggs will just go down the remaining tube. A woman only uses one tube at a time, so if one is missing, she’ll just use the other.

Sorry about that. I guess I’m not going by someone who expects to get pregnant every cycle, which doesn’t happen for most people anyway otherwise NFP wouldn’t be used to try and get pregnant. In addition, keeping the impaired fallopian tube increases the risk of repeat ectopic preganancy. If the other tube isn’t impaired as well, it’s fully functional and by removing the impaired tube, your chances of conceiving and having normal pregnancy are actually higher when you weight it against keeping a damaged tube. I completely understand what you’re saying now that it’s not some ungodly hour and I should be in bed, but the chances of diagnosing a tubal pregnancy before it causes damage to the fallopian tube is low, and against the Church’s teachings anyway (which require you to wait and see, not flush out the tube and save it).

 

[Mamanurse]

Honest, it doesn’t. The eggs will just go down the remaining tube. A woman only uses one tube at a time, so if one is missing, she’ll just use the other.

Just ask your priest then.

I just had an ectopic pregnacy and got back from the hospital yesterday. I asked this exact question to my surgeion. My fertility will NOT be reduced to 50%, my eggs from left ovary, my left tube was removed, will make their way over to the right one and my chances of getting pregnant again are that same as anyone else. I am thankful that I was not a candidate for the use of Methotrexate because I made me uncomfortable that I was intentionally aborting my child…on the other hand, I didn’t know that this was considered an abortion, so thank God I didn’t have that done. Unfortunately, so some woman, ectopic pregnancies are emergencies so they don’t get an opportunity to really research these moral issues, thankfully we had the surgery.