Nearly 200 women died in the United States after ectopic pregnancies between 2020 and 2025, compared with about 100 deaths during the preceding six years, according to an analysis of Centers for Disease Control and Prevention data. The rise occurred nationwide but was substantially greater in states with abortion bans that prohibit the procedure at six weeks of pregnancy or earlier. Health experts say the data do not prove that abortion restrictions caused the increase, but they argue that delays and uncertainty created by those laws must be investigated. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most often in a fallopian tube. As the pregnancy grows, it can rupture the tube and cause massive internal bleeding. The condition affects up to 2% of pregnancies and is almost never viable. “With prompt and appropriate medical care, women should not die,” said Dr. Alice Abernathy, an obstetrician-gynecologist in Philadelphia. “A death related to ectopic pregnancy should really be a never event.” The increase began during the COVID-19 pandemic, when hospital systems were strained, but deaths remained elevated after many pandemic-related disruptions eased. Other forms of pregnancy-related mortality also rose during the pandemic and have since largely declined. Researchers cannot determine whether ectopic pregnancies themselves are becoming more common because federal agencies do not require hospitals to report all ectopic diagnoses. The available death data also do not consistently identify patients’ risk factors, such as prior ectopic pregnancies, infertility or infections that can damage the fallopian tubes. Abortion bans generally include exceptions for ectopic pregnancies. But medical providers and legal experts say those exceptions may not resolve difficult cases early in a pregnancy, when an ultrasound cannot yet show where the pregnancy implanted. Doctors may need to rely on symptoms, bleeding, abdominal pain and changes in pregnancy hormone levels over several days. Waiting for definitive ultrasound evidence can allow a dangerous pregnancy to continue growing, experts said. In states where providers face criminal penalties, some doctors may hesitate to act if they fear prosecutors could later challenge their diagnosis. Kyleigh Thurman, a Texas patient, said two emergency departments sent her home in 2023 despite signs of an ectopic pregnancy. Her fallopian tube later ruptured and had to be removed. Federal regulators found in 2025 that one of the hospitals failed to properly screen her for a suspected ectopic pregnancy and did not contact an obstetrician-gynecologist, violating federal emergency-care requirements and the hospital’s own policies. Thurman’s malpractice lawsuit is ongoing. “I genuinely thought I was going to die,” Thurman said. The Ascension Seton hospitals said their clinicians provide medically indicated treatment for serious or life-threatening pregnancy conditions, including ectopic pregnancies. The hospitals have denied Thurman’s allegations in court. Leitaea Lowrimore, an Oklahoma resident, said she visited three hospitals in Oklahoma and Arkansas after developing severe pain and bleeding in February. The hospitals diagnosed her with a “pregnancy of unknown location” but did not treat her for a possible ectopic pregnancy, according to a lawsuit. She ultimately traveled to Kansas, where she received methotrexate, a drug used to stop the growth of an ectopic pregnancy. Lowrimore is among several women and an obstetrician-gynecologist challenging Arkansas’ abortion ban. She also filed emergency-care complaints involving the hospitals she visited. Regulators cited Mercy Hospital in Fort Smith for failing to provide care during an eight-hour wait, while two other hospitals were not found to have violated the federal law. A Mercy spokesperson said the hospital provides medically indicated treatment in urgent, life-threatening pregnancy cases. The litigation is ongoing. Hospital data from Texas offered another warning sign. The analysis found that 310 more patients experienced substantial blood loss after an ectopic pregnancy in 2023 and 2024 than in 2018 and 2019, an increase of about 29%. The increase appeared to begin during the pandemic but remained high after Texas enacted some of the nation’s strictest abortion laws. Texas lawmakers passed legislation in 2025 that explicitly listed ectopic pregnancies among conditions covered by the state’s exception for preserving a patient’s life. But guidance issued by the Texas Medical Board uses an ectopic pregnancy visible on ultrasound as its example and does not fully address cases in which the pregnancy’s location cannot yet be confirmed. Physicians who perform an illegal abortion in Texas can face up to 99 years in prison. The medical board said its guidance is not intended to cover every clinical situation and that doctors who follow evidence-based medicine, emergency protocols and documentation requirements face minimal risk. Legal and medical advocates say broad exceptions still leave providers to navigate significant gray areas. “I don’t think specific exemptions address the massive gray areas that arise in pregnancy,” said Michelle Maloney, an attorney representing Thurman and other Texas patients or families who allege they were denied care. Experts also cautioned against claims that medication abortion obtained through telehealth is driving the increase in ectopic deaths. Studies have found lower ectopic pregnancy rates among people seeking medication abortions than in the general population. Telehealth providers screen patients for risk factors and follow up about symptoms, said Ushma Upadhyay, a University of California, San Francisco researcher who studies telehealth abortion care. The lack of a national investigation has frustrated maternal-health researchers. ProPublica shared its findings with more than a dozen experts, several of whom said they had not been aware of the rise. Caitlin Myers, a Dartmouth College economist who studies abortion policy, called the deaths “a potentially profound consequence of the regulation” that warrants investigation. The United States also lacks a national system for reviewing individual maternal deaths in depth. State committees conduct such reviews, but ectopic deaths are often too infrequent in any one state to reveal a clear trend. The increase becomes visible only when federal data are examined nationally. Researchers say staffing and funding cuts have further weakened the country’s ability to study maternal health. Most employees in the CDC’s Division of Reproductive Health were placed on leave or lost their positions, according to a lawsuit filed by state attorneys general. The CDC also ended funding in 2025 for a partnership that trained emergency-department physicians in obstetric emergencies, although the American College of Obstetricians and Gynecologists said its foundation now supports the work. The United Kingdom and Ireland responded to a similar increase in ectopic pregnancy deaths during 2021 and 2022 by investigating individual cases, improving early-pregnancy education and changing emergency-response protocols. Marian Knight, an Oxford University professor who leads the U.K.’s maternal mortality reporting, said identifying the problem was essential to addressing it. “If we’re not tracking and not just understanding the numbers, but understanding the why behind the numbers, we have no ability to respond,” Knight said. Dr. Courtney Schreiber, a professor of obstetrics and gynecology, said the national findings point to preventable deaths among younger women and should prompt a broader review of early-pregnancy care. “That is not what we should be seeing in the United States of America,” Schreiber said.