Ectopic pregnancy: 'I was doubled over with pain, but I was also so angry at the situation'

Pregnancies outside the womb are as final as miscarriages, but also a threat to the mother if a ruptured fallopian tube causes bleeding

Sun, 07 Sep, 2025 - 10:16

Deirdre McArdle

In Ireland, one in 80 pregnancies is ectopic (750-800 each year).

Ectopic pregnancies are often grouped with miscarriages, but the experience can be dramatically different, and sometimes life-threatening.

An ectopic is a pregnancy that develops outside of the womb, most usually in one of a woman’s fallopian tubes.

“It cannot develop into a viable pregnancy and is considered a form of pregnancy loss,” says Keelin O’Donoghue, clinical lead for obstetric research in the INFANT centre, and head of the Pregnancy Loss Research Group (PRLG).

“Ectopic pregnancy is dangerous, because the fallopian tube can only expand so much before it ruptures as the pregnancy grows. A rupture can lead to intense abdominal pain and potentially life-threatening internal bleeding,” says Prof O’Donoghue.

There is no one particular risk factor. “Anyone who can get pregnant can have an ectopic pregnancy, but people who have had a previous ectopic pregnancy are at a higher risk of having a second.”

To raise awareness of ectopic pregnancy and establish national guidelines for diagnosis, treatment, and support, the PLRG, in association with Ectopic Pregnancy Ireland and the HSE, has released a booklet that is available online and will be distributed to maternity hospitals across the country in September.

“Our aim is to address the lack of accessible, reliable information and support for people who experience ectopic pregnancy,” says Oana Marian, PhD and researcher with the PLRG.

“During our research, we heard from many individuals who said they received little to no information or support after their diagnosis and treatment, and this led to feelings of anger and isolation.”

“What we’re trying to do is break the stigma around pregnancy loss, provide meaningful and impactful information, and ensure that people know where to find trusted resources. Crucially, the booklet also contains quotes from women who have experienced ectopic pregnancy, so we hear their first-hand accounts.”

The symptoms

In January 2021, Laura Guild had an ectopic pregnancy. She was using an intrauterine device (IUD), but was due to have it removed in the months ahead. “During those last few months, my period was irregular. This meant I wasn’t as clear with my periods as I would have normally been.”

Guild missed a period in November, but got a negative pregnancy test. “Then, I bled for the whole month of December. At the time, I put it down to issues with the coil, until January 2, 2021, when the pain and cramping became unbearable; I could barely stand.”

The signs of an ectopic pregnancy can vary, but they will typically start two weeks after a missed period.

They may include lower abdominal pain (maybe affecting one side), unusual bleeding that may differ in colour and intensity, and shoulder tip pain that does not go away after taking painkillers, though this latter could be a sign of internal bleeding.

Guild says: “When my partner came home, he took one look at me and insisted we ring KDoc [emergency out-of-hours care]. At that stage, I was aware of ectopic pregnancies, but didn’t think there was any chance I was experiencing one, because of the negative pregnancy test.”

A subsequent pregnancy test at KDoc pointed more resolutely towards an ectopic pregnancy. The doctor explained to Guild that it was a positive, but “a weak positive”.

“During an ectopic pregnancy, the doctor said that the pregnancy hormone (hCG) tends to be weaker than in a typical pregnancy.”

Keelin O’Donoghue, clinical lead for obstetric research in the INFANT centre, and head of the Pregnancy Loss Research Group (PRLG).

At Portlaoise Hospital, it was confirmed she was having an ectopic pregnancy and that the embryo was in her fallopian tube. “The nurse said ‘We have a positive pregnancy test, but an empty womb’. Once she said those words, that’s when it really hit me.”

The most common surgical approach to an ectopic pregnancy is a salpingectomy, where the fallopian tube is removed along with the embryo.

Surgery is not the only option: Conservative management, where hCG levels are monitored until they return to non-pregnant levels, can be used in the case of early detection.

In this case, the ectopic pregnancy resolves itself. Medical management is a methotrexate injection, which stops the pregnancy from growing; this can be used if no heartbeat is detected and hCG remains at a specific low level.

Guild was told she required emergency surgery.

She remembers having to sign a form that gave the surgeon permission to remove her embryo. “That was the hardest part, because it was basically giving permission for them to take my baby. I know I had no choice, because it was life or death, but I was distraught.”

After the surgery, Guild was put in a maternity ward with new mums and their babies. “I was doubled over with pain, but I was also so angry at the situation,” she recalls.

“In time, my physical pain healed, but I struggled mentally and was referred to a bereavement counsellor.”

Now the mother of a 13-month-old boy, Guild recalls being incredibly anxious during her successful pregnancy: “Because I’d had an ectopic pregnancy, I had an early scan, which showed that everything was where it should be. But every twinge, every scan, every spot of blood, I was terrified. That mental side of it stays with you for ever.”

Blood spotting

Francesca Paradisi had two ectopic pregnancies, one in 2008 and one in 2009.

At the time, Paradisi, now 51, was also dealing with fertility issues and was doing IVF: “IVF is very well controlled, so there is no uncertainty of when conception might have happened: You know exactly when.”

Two weeks after the embryo transfer, Paradisi did a home pregnancy test and got a positive result. At the clinic, they checked her hCG levels and confirmed the pregnancy.

A week later, Paradisi started experiencing some spotting. “I was a little worried, but the clinic told me that it was normal and not to worry.” But the spotting continued on and off for the next week, and another hCG test revealed a still-low level.

Typically, in early pregnancy, a woman’s hCG levels will double every 48 hours during the first few weeks, and this is generally a sign of a healthy intrauterine pregnancy.

Although Paradisi wasn’t feeling well physically, she wasn’t in “massive pain”, nothing that would suggest she required emergency surgery.

But a sudden shift in her hCG levels led the doctor at her clinic to diagnose an ectopic pregnancy, and insist Paradisi go directly to hospital for emergency surgery.

She had keyhole surgery to remove the embryo and her fallopian tube. “I recovered well after the first ectopic. I stayed overnight, but felt physically fine and mentally OK. I’m a scientist, so I was able to rationalise what happened.”

“For most people, an ectopic pregnancy happens just once. Most will have a healthy pregnancy in the future, even if they have had one fallopian tube removed,” says O’Donoghue.

A year later, after another round of IVF, Paradisi experienced a second ectopic pregnancy. Despite initial strong hCG levels, the spotting began again and her hCG levels became erratic.

A transvaginal scan at her clinic showed the embryo was not in her uterus, but in her remaining fallopian tube.

Once again, Paradisi had to have emergency surgery.

“I just couldn’t believe it happened a second time,” says Paradisi.

“I found it much harder to process it, and I felt like I needed something positive to come from the experience.”

That was when Paradisi was introduced to Susanne Brodigan, who herself experienced three ectopic pregnancies and went on to set up Ectopic Ireland.

“Suddenly, I didn’t feel alone anymore. At the time, I didn’t know anyone else who had gone through an ectopic pregnancy, so it was a very lonely time before I became involved with EP Ireland.”

Both Guild and Paradisi continue to work with Ectopic Pregnancy Ireland, which offers information and support to women who have experienced an ectopic pregnancy.

This support is all the more resonant as it comes from women who themselves have experienced an ectopic pregnancy.