QUESTION: My husband and I recently had a ruptured ectopic pregnancy. I have some questions about going forward and understanding the morality of possibly trying for another baby. The doctor has informed me that I have a 1 in 4 chance of having another ectopic pregnancy. The doctor also mentioned that they would begin monitoring my hCG levels as soon as I got a positive pregnancy test. From my understanding, they would do three blood draws within 48 hours of each other. They would also try to get in an ultrasound as soon as possible (although this current pregnancy ruptured before anything would have been seen on an ultrasound). If the hCG numbers were not doubling as they should, the doctor mentioned aspirating the uterus to make sure it was ectopic and then giving methotrexate to end the pregnancy.

This is obviously not the information that we wanted to receive, and we are trying to process everything in the light of God’s Word. We would love to have another child if God would bless us with one. But I am worried about having another ectopic pregnancy. I am worried about having to rely on doctors to make a decision of whether or not the baby is ectopic and being told to end that life, before having solid evidence that the baby actually is ectopic. I also have some worries about having another ruptured ectopic and trying to recover from that again.

Can you help us navigate the information from the doctor in view of God’s Word?

ANSWER: I have a few thoughts on the information you provided.

Statistics: The statistics you cited are accurate, but weighted more negatively. From what reading I have done on the subject, the recurrence risk after one ectopic is in the 10–27% range, with many studies clustering closer to 10–20%. So a 1 in 5 chance for another ectopic pregnancy would best reflect contemporary research. That being said, when it happens to you, it is 100%, and if it doesn’t happen to you, that means it is 0%. The overall average change of a pregnancy being ectopic is 2%. Again, in your instance, it was 100%. I mention this only as a caution to avoid over-emphasizing statistics and to balance them properly.

To that end, here are some “balancing” statistics:

• After a pregnancy is detected (i.e., the developing unborn child is embedded in the uterine lining), 15-16% of pregnancies will end in a miscarriage.
• There is around a 14% chance that a pregnant woman would develop gestational diabetes (a type of diabetes that first appears during pregnancy and causes higher‑than‑normal blood sugar levels in the mother).
• In the United States, a pregnant woman has about a 6.5% chance of developing preeclampsia (a potentially fatal pregnancy complication characterized by high blood pressure and organ damage typically occurring after 20 weeks’ gestation; having preeclampsia doubles the mother’s lifetime risk of death from cardiovascular disease).
• The maternal mortality rate in the United States from a pregnancy is 17.9/100,000 live births (2024).
• The chances of post-partum depression are around 13% (130 mothers/100,000 live births attempt suicide in their depression, and 2-4/100,000 succeed).

Everything about bearing children in a sinful world seems full of risk. The full impact of Genesis 3:16 is not that bearing children might be a bit painful. The Hebrew suggests that the entire process, from conception into adulthood, would be fraught with danger, grief, anxiety, loss, and toil. Certainly, statistics support this reality.

Perspective: Statistics are valuable tools when doing things in the world and for the world. Because we also live in the world, we pay attention to statistics. Most of us cannot cite exact percentages, but we have a general sense of statistics. For example, as we approach the end of winter and the beginning of spring, ice fishermen realize that the statistical odds of safely walking on lake ice increase as the days get warmer. We recognize that setting speed limits is based on statistical analysis for safe driving. We instinctively run the odds in our heads over how long to hold on to leftovers until they become unsafe to eat.

Not everything we do in this world, however, is driven by statistics. The most obvious example is living as a child of God. We are told:

In fact, everyone who wants to live a godly life in Christ Jesus will be persecuted. (2 Timothy 3:12)

This reality is well-supported elsewhere in the Scriptures (Matthew 10:38-39; John 16:33; 2 Corinthians 4:8-11; 1 Peter 4:12; Hebrews 11:35-38). Yet, despite the odds (certainty) favoring persecution and suffering, we are encouraged to boldly face the odds (Isaiah 43:2; Romans 5:3-4; James 1:2-4). This does not mean reckless abandonment. The Scriptures also call for us to be prudent (Proverbs 22:3; Proverbs 27:12; Matthew 10:16).

A Christian’s worldview, however, begins vertically with his/her relationship with God. Our very reason for existence is defined by our Creator. That reason is to glorify God in all things (Isaiah 43:7; 1 Corinthians 10:31). We do this audibly in the way we talk (Psalm 29:2; Psalm 99:9; 1 Peter 4:11), in the way we act, which distinguishes us as being different than others in the world (Matthew 5:16; 1 Peter 2:12), and in the way we respond to the God’s wishes (John 15:5-10; 1 John 5:2).

This Christian perspective makes us strikingly different than the world (Isaiah 8:12; Matthew 5:43-44; Romans 12:2; Philippians 2:14-15).

Our actions, however, do not earn us anything with God, for we have that in Christ (Isaiah 64:6; 2 Corinthians 5:21; Ephesians 2:8-9). Our faith (our convictions about our relationship with God) is on display through what we do (Matthew 7:20; Romans 14:23; 1 John 2:3). Faith itself is something miraculous and often illogical by the world’s standards (Proverbs 3:5; 1 Corinthians 1:18; 1 Corinthians 12:3; 1 Thessalonians 1:5; Hebrews 11:1).

For this reason, believers are willing to walk through the greatest of challenges without fear (Psalm 23:4). Even the greatest challenge in this world (death) is not an obstacle or a deterrent when the believer is living by faith (John 11:25; Romans 8:38-39; 1 Corinthians 15:54-55; Revelation 12:11).

What Does This Mean: To answer the time-honored Lutheran question: “What does this mean?” I will put these pieces together:

It is God’s will to have children (Genesis 1:28), even with so much danger associated with childbearing (Psalm 127:3; 1 Timothy 2:15). Prudency in our approach is done not out of a fearful clinging to life in this world, but as a responsible steward over God’s many blessings (Matthew 25:14-30; Luke 9:24; Ephesians 5:15-17).

Prudency means you take the statistics that quantify the dangers in childbirth and you leverage them into God-pleasing action. You seek second opinions and exercise additional vigilance to protect all involved lives, clearly understanding that lives come into existence and end first according to the will of God (Deuteronomy 32:39; Psalm 31:15; Acts 17:26). We are flawed stewards, and we will make mistakes. That is why actions emanate from faith rather than from the pursuit of earning our salvation. Even our most grievous errors find forgiveness before God (2 Samuel 12:13; Isaiah 1:18; 1 Timothy 1:13-16).

Practical Advice: Find a doctor who shares your high regard for God’s gift of life. Find a doctor who understands you have a vision for eternity, and that you are not living just for the here and now. To find that doctor, here are some resources:

• Reach out to the WELS District President
• Reach out to the ELS President
• Reach out to the LCMS District President
• Reach out to Minnesota Citizens Concerned for Life (MCCL): When I was a student at Bethany Lutheran College in the seventies, MCCL was premier, and I think they still are, and I would imagine they keep a list of pro-life doctors and OB/GYN physicians.
• Reach out to the Christian Medical & Dental Associations: They have a search feature where you can find Christian medical/dental professionals in your area:
  https://cmda.org/member-search/ (search link)

Having had an ectopic pregnancy means that getting pregnant again subjects you to closer scrutiny – which is a good thing. Though you are at an increased risk of another ectopic pregnancy. 20-25% does not have to seem prohibitive.

A pro-life and Christian physician will understand your stewardship perspective on life and that you do not wish to take action to end a life. However, there are very, very rare circumstances where either one life must be taken, or you stand to lose two lives. Our perspective is that we seek to save the lives we can. You can read more about that in our abortion position statement here.

We also addressed the matter of pitting a child’s life against the mother’s life in a Life Challenges podcast episode here.

I have given you a lot of stuff to think about. Read through it all carefully and spend a lot of time talking to God about it.