Ohio legislator didn't consult with doctors before crafting bill on ectopic pregnancy

Columbus, Ohio, Dec 17, 2019 / 18:01 pm

An Ohio state representative told the Cincinnati Enquirer Dec. 17 that he did not consult with doctors before crafting a bill that would allow insurance providers to pay for procedures to "reimplant" embryos removed from ectopic pregnancies – a procedure that does not yet exist.

State Representative John Becker (R-Union Township, Clermont County) introduced House Bill 182 in April, which would prohibit insurers from covering abortions. It provides an exception for "a procedure for an ectopic pregnancy, that is intended to reimplant the fertilized ovum into the pregnant woman's uterus," allowing insurance providers to cover such a procedure.

An ectopic pregnancy occurs when an embryo implants outside the uterus, usually in the fallopian tube. Once implanted, the embryo's growth is likely to rupture the Fallopian tube, which can cause the death of both mother and child.

Both pro-life and pro-choice advocates have noted that no standard procedure currently exists to reimplant the embryo.

According to the Enquirer, Becker consulted Barry Sheets, a lobbyist for the Right to Life Action Coalition of Ohio, in crafting the bill. Neither Becker nor Sheets responded to CNA's calls for comment by press time.

HB413, also in the Ohio Legislature and cosponsored by Becker, includes a provision that doctors must attempt to "reimplant" ectopic pregnancies in a woman's uterus "if applicable." The bill, which has garnered attention around the world, is currently in committee.

"I heard about it over the years," Becker reportedly told the Enquirer, referring to the reimplantation procedure.

"I never questioned it or gave it a lot of thought."

There is dubious evidence of two cases of successful reimplantation, in 1917 and in 1980. The 1917 case is poorly documented, and the 1980 case used falsified research.

Dr. Mary Jo O'Sullivan, a high-risk obstetrician and Professor Emeritus of Obstetrics and Gynecology at the University of Miami, is skeptical of the 1917 case, with the doctor's case report the only evidence that it occurred.

"You have no way of proving that happened. You have to accept what the guy wrote," she commented.

Dr. Lorna Cvetkovich, an OB-GYN with the pro-life medical practice Tepeyac Center, told CNA in May that the 1980 case was found to have used falsified research.

Becker reportedly told The Enquirer he hadn't seen the two studies until after The Enquirer requested examples of research in May, and now acknowledges that there is no standard operating procedure for reimplanting ectopic pregnancies, WOSU radio reports.

"[Reimplantation] is so theoretical at this point, that I can't imagine how anybody would vote to approve this," O'Sullivan told CNA in an interview earlier this month.

"It's food for thought, no question about that. Maybe it will stimulate some kind of research to see whether this can actually be done, at least in animals."

There are three common medical procedures to address ectopic pregnancies, she noted, only one of which is widely considered to be moral.

The patient may be offered methotrexate, which is an anti-cancer drug that stops the embryo's cells from dividing; the Fallopian tube can be opened and the embryo "scooped" out, a salpingostomy; or the segment of the tube can be transected on each side and removed completely, a salpingectomy.

In all of the procedures, the embryo dies. However, in the first two, the procedure itself is an act to end the life of the embryo. A salpingectomy, in contrast, is an act to remove the damaged portion of the fallopian tube.

For this reason, salpingectomies are generally considered moral under the principle of double effect: the objective of the surgery is the removal of the affected tube, and the embryo dies as an undesired –  although foreseen – side effect. Since there are no alternative procedures that can save the life of the embryo, this process is considered morally acceptable.

O'Sullivan said in her view, the methotrexate treatment and the salpingostomy are both abortions.

"What you're doing this time [in a salpingectomy] is you're taking out damaged section of tube, and since it's removed it's cut off from its blood supply, and ultimately the little baby, the little fetus, will die," O'Sullivan explained.

"In the other two cases, the baby is going to die, too. But both of them are direct attacks on the baby itself. In this latter one, you primary intent is to remove the diseased section of the tube, and you know that the outcome of that will be the loss of the pregnancy."