Page Summary:
If continued pregnancy threatens the life of the mother, and there is no way to save the child, an ethical case can be made for the justifiability of abortion—whether you want to call it abortion or not.
The reason abortion is wrong is because it ends the life of an innocent and helpless human being. Unequivocally. But what if continued pregnancy will kill the mother, and thereby kill her child? Could abortion be justified then? Of all the possible variables we could attach to the abortion question, this one is the most ethically challenging. But before we examine the moral legitimacy of aborting a child to save the mother, here is some important context:
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It is only in extremely rare cases that abortion can even be mentioned as a potential means of saving the mother's life. Former Surgeon General C. Everett Koop, stated in a 1996 New York Times editorial that "partial-birth abortions are not needed to save the life of the mother."1 Sixteen years earlier, he'd written: "In my thirty-six years in pediatric surgery I have never known of one instance where the child had to be aborted to save the mother's life."2 Even Planned Parenthood's Dr. Alan Guttmacher acknowledged, “Today it is possible for almost any patient to be brought through pregnancy alive, unless she suffers from a fatal illness such as cancer or leukemia, and, if so, abortion would be unlikely to prolong, much less save, life.”3
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It is important that we not conflate a life of the mother exception with a health of the mother exception. When the Supreme Court struck down all state abortion bans in 1973, they ruled that states could not prohibit abortion during the first two trimesters of pregnancy for any reason and could only prohibit abortion during the third trimester so long as the pregnancy was not a threat to the mother’s health. The Court then defined health to include "emotional, psychological, (or) familial" trauma—thereby making abortion effectively legal through all nine months of pregnancy. While it may be justified to perform an abortion to save a mother from dying, it is not justified to save her from “emotional trauma.”
Those who oppose abortion can and do differ about when, if ever, it is justified. But whether you allow for any exceptions or not, there is good reason to make a categorical distinction between an elective abortion and what we might call an emergency abortion. That is, an abortion performed for no other reason than to save the mother from a likely death. Some abortion opponents try to get around the difficulty by not calling such procedures an abortion, but this semantic maneuvering does not materially change what is happening. As an overarching principle, when the life of the mother is threatened by continued pregnancy, everything possible should be done to save both the mother and the child. During the second half of pregnancy, the pregnancy can often be ended prematurely by inducing labor and using aggressive neonatal care to sustain the life of the child outside the womb.
When pregnancy endangers the life of the mother during the first half of pregnancy, the most ethical course of action is much harder to pinpoint. Here's the tension. The fundamental reason that abortion is condemnable is because it kills an innocent human being. What do you do, then, when the existence of one human being, through no fault of their own, threatens the life of another human being? Do you end the life of the child, to save the life of the mother? This is the dilemma we face. Philosophically, we might justify the decision to abort a life-threatening pregnancy this way:
A) If the pregnancy continues, the mother will die. If the mother dies, the child will die.
B) If the pregnancy is ended through abortion, the child will die, but the mother will live.
In both instances the child will die. Since there is no way to save the child, but there is a way to save the mother, it is morally expedient (even necessary, perhaps) to save the mother by ending the life of the child—on the premise that it is better to save one life, than to lose two. This conclusion has nothing to do with valuing one life over the other. It merely recognizes that since there is no way to save the baby, the most ethical course of action is to save the mother.
Though such thinking may be ethically sound as it applies to the hypothetical conditions above, real-world circumstances are never so cut and dry. Quite simply, statement A is flawed. We can say with certainty that if the mother dies, the child will die, but we can never say with certainty that if the pregnancy continues, the mother will die. In order to be accurate, the beginning of Statement A would need to be re-rendered as such:
A) If the pregnancy continues, the mother might die...
There is a huge difference between "will" and "might," and this is where it gets tricky. Does the morality of aborting a life-threatening pregnancy depend on the severity of the threat to the mother? Is it a matter of percentages and probability? For a pregnant woman in the United States, there is currently a .018% chance that the pregnancy will kill her, which includes pregnancy-related deaths occurring up to a year after the pregnancy has ended. This number has been steadily rising for decades due to increases in average maternal age and decreases in average maternal health but is still less than two-tenths of one percent. In 2024, there were a reported 665 maternal deaths in the United States, which works out to 17.9 maternal deaths for every 100,000 live births.4 Pregnancy, by its very nature, carries the risk of death. It is generally an infinitesimally small risk, but a risk nonetheless. Is a .018% risk to the mother’s life severe enough to morally justify abortion? What if the risk to her life were 1%, or 10%, or 50%? What if there was a 90% chance the mother would die?
At this point, we would do well to get as specific as we can. What are the real-world scenarios in which continued pregnancy poses a legitimate threat to the mother's life and it is not possible to end the pregnancy through premature delivery? The list is not a long one, though it can’t be definitively capped. Conditions that pose relatively minor threats in isolation can become serious problems if they stack up. Nor can every possible combination of complications be anticipated ahead of time.
The most prominent individual threat to a mother’s life early in gestation is ectopic pregnancy—a condition that occurs when the embryo implants in the fallopian tubes (or in the ovary, abdomen, or cervix) instead of in the uterus. Ectopic pregnancy is estimated to occur in 1-2% of all pregnancies. It is almost always fatal to the baby and can be fatal to the mother as well. WebMD identifies ectopic pregnancy as the leading cause of maternal deaths in the first trimester, and a 2023 study by the University of Illinois blames it for 5%-10% of all pregnancy-related deaths. Though the CDC's annual maternal mortality reports do not include ectopic pregnancy as a categorical cause of death, a 2024 study reports that 23% of pregnancy-related hemorrhage deaths owe to ectopic pregnancy. Based on these percentages, the number of annual maternal deaths in the U.S. owing to ectopic pregnancy could be as low as 20 or as high as 70.
Despite the odds, there have been a handful of documented cases where undiagnosed ectopic pregnancies have yielded successful live births. Such cases are exceedingly rare, but they do exist. In 1999, a healthy baby boy was delivered in London after having implanted in his mother's fallopian tube. When the tube ruptured, the embryo attached itself to the mother's uterus and spent the rest of the pregnancy in the mother's abdominal cavity. The doctor who delivered the baby estimated that an embryo has a one in 60 million chance of surviving an ectopic pregnancy. In 2000, a healthy baby girl was delivered in Nottingham (UK) despite the fact that she spent the duration of her ectopic pregnancy attached to the lining of her mother's bowels. In 2005, a woman in Hertfordshire (UK) gave birth to a healthy baby girl who spent the entire pregnancy in her mother's abdomen. In 2008, an ovary-based ectopic pregnancy delivered a healthy baby girl in northern Australia.
In 2025, a Los Angeles woman’s undiagnosed ectopic pregnancy ended in the birth of a healthy 8-pound baby boy. Her son had implanted on the sidewall of her pelvis and developed entirely within her abdomen. A 22-pound ovarian cyst prevented the mother and her doctors from discovering the pregnancy until days before her child was born. The U.S. News & World Report article covering the story cites a 2023 Ethiopian study asserting that the fetal mortality rate for abdominal pregnancies is up to 90%.6
Percentages are hard to come by, but BBC News reports that babies who implant outside the uterus only have a 5% chance of survival while there is a 10% chance that the mother will die.7 A 2003 Canadian Broadcasting story on the successful delivery of an ectopic pregnancy in Canada quotes Dr. Robert Sabbah as saying that the baby only had about a 1% chance of survival.8 A report on ectopic pregnancy published by the American Academy of Family Physicians (AAFP) tells us a number of things:9
1) Ectopic pregnancy occurs at an estimated rate of 19.7 cases per 1,000 pregnancies in North America. Though this rate was arrived at by analyzing data from 1990–1992, a 2012 CDC report cites that it is still the most reliable in existence.10
2) In the United States, the case-fatality rate has declined from 35.5 maternal deaths per 10,000 ectopic pregnancies in 1970 to only 3.8 maternal deaths per 10,000 ectopic pregnancies in 1989. Using different metrics, the CDC reports that between 2003–2007, there were 0.5 maternal deaths related to ectopic pregnancy for every 100,000 live births.11
3) To date, at least 14 studies have documented that 68 to 77 percent of ectopic pregnancies resolve without intervention.
The first thing to note is that a significant majority of ectopic pregnancies are never treated, somewhere between 68–77%. In most of these cases, the embryo miscarries without medical intervention and the pregnancy ends without further incident. If we split the difference between between 68% and 77%, we get 72.5%. Using the AAFP estimate that there are 3.8 maternal deaths per every 10,000 ectopic pregnancies, and assuming that all of the deaths occurred to women who received no medical intervention, we can say that there are 3.8 deaths for every 7,250 (10,000 x 72.5%) untreated ectopic pregnancies—putting the likelihood of maternal death around .05%.
Another way to look at the data would be to compare tubal ruptures with total deaths. Medscape reports that in 1992, there were 108,800 cases of ectopic pregnancy in the United States, with a maternal death rate of 2.6 deaths per 10,000 ectopic pregnancies.12 This is consistent with what the CDC reportis in Pregnancy-Related Mortality Surveillance. Between 1991–1999, 237 women died as a result of complications associated with ectopic pregnancy—an average of 26 deaths per year.13 Returning to the Medscape report, we find that in 20% of all ectopic pregnancies, tubal rupture is the initial symptom.14 In other words, these women were not aware that their pregnancy was ectopic until their fallopian tube ruptured. Since tubal rupture, and subsequent hemorrhaging, is the primary threat that an ectopic pregnancy poses to the life of the mother, let's conservatively assume that all maternal deaths relating to ectopic pregnancy happened as a result of an untreated, tubal rupture. If that is the case, we can divide the total number of deaths (26) by the total number of untreated tubal ruptures (108,800 x 20% = 21,760) to arrive at an overall maternal death rate for untreated ectopic pregnancy of .119%. Placing this number alongside the AAFP estimates, we arrive at a fatality rate for untreated ectopic pregnancy somewhere between .05–.119%.
In light of this data, it becomes clear that even an untreated ectopic pregnancy is not generally fatal. Nevertheless, the risks of continuing an ectopic pregnancy are real, and the baby's chance of survival are almost nonexistent. The American Association of Pro-Life Obstetricians & Gynecologists (AAPLOG) goes so far as to say, "Continuation of [an ectopic] pregnancy cannot result in the survival of a baby and entails a very substantial risk of maternal death or disability."15 Though they're not being totally honest in asserting that it is "impossible" for a baby to survive an ectopic pregnancy, you get the point. The prospects for survival are not good. AAPLOG also notes that by the time an ectopic pregnancy is discovered (usually by 7 to 8 weeks gestation), "the embryo has (already) died in the majority of cases."16 This may simplify the ethics of medical intervention, but even when the embryo is still alive, AAPLOG unequivocally recommends removing the embryo by medical or surgical intervention. The process is always fatal to the embryo, and though such treatment bears procedural similarities to abortion, it must viewed through an entirely different lense. The death of the embryo or fetus is the sole purpose of an elective abortion. It is the undesired and unavoidable result of surgically or medically treating an ectopic pregnancy. For these reasons, AAPLOG "does not consider treatment of ectopic pregnancy by standard surgical or medical procedures to be the moral equivalent of elective abortion, or to be the wrongful taking of human life."17
Some anti-abortion groups argue that the removal of the fallopian tube is the only ethical way to treat ectopic pregnancy, but this approach does far more damage to the mother's body and still results in the death of the baby.
This page was last updated on August 12, 2026. To cite this page in a research paper, visit: "Citing Abort73 as a Source."
- C. Everett Koop, “Why Defend Partial-Birth Abortion?” The New York Times, Sep 26, 1996.
- C. Everett Koop, “Abortion: Deception-on-Demand,” Moody Monthly, May 1980, 24.
- Alan F. Guttmacher, “Abortion–Yesterday, Today and Tomorrow,”The Case for Legalized Abortion Now (Berkeley, Calif.: Diablo Press, 1967).
- Centers for Disease Control and Prevention, “Maternal Mortality Rates in the United States, 2024,” March 2026. https://www.cdc.gov/nchs/data/hestat/hestat113.htm
- U.S. News & World Report, “‘The Best Gift Ever’: Baby Is Born After the Rarest of Pregnancies, Defying All Odds,” Dec 24, 2025. https://www.usnews.com/news/health-news/articles/2025-12-24/the-best-gift-ever-baby-is-born-after-the-rarest-of-pregnancies-defying-all-odds
- BBC News, “Bowel Baby Born Safely,” Mar 9, 2000.
- CBC News, “Rare Baby Survives Outside Womb: Montreal Doctor,” Aug 12, 2003.
- American Academy of Family Physicians (AAFP), “Ectopic Pregnancy,” Feb 2000.
- Centers for Disease Control and Prevention, “Ectopic Pregnancy Mortality — Florida, 2009–2010,” Feb 17, 2012, Editorial Note.
- Ibid.
- Vicken P Sepilian, MD, MSc, “Ectopic Pregnancy,” Medscape. Aug 2, 2012, Overview.
- Centers for Disease Control and Prevention, “Pregnancy-Related Mortality Surveillance—- United States, 1991—1999,” Feb 4, 2003.
- Vicken P Sepilian, MD, MSc, “Ectopic Pregnancy,” Medscape. Aug 2, 2012, Presemtatopm.
- American Association of Pro-Life Obstetricians & Gynecologists, “What is AAPLOG’s Position on Treatment of Ectopic Pregnancy?” July 2010.
- Ibid.
- Ibid.
Footnotes
