Like, how do the sperm and egg get outside the womb?? And how do they then like, still work to make a baby? Can ectopic pregnancies ever survive? I’m assuming that, if they can, they’d have to be birthed via c-section, right?
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I think a brief rundown of the female reproductive system is helpful here. [Take a look at this diagram](https://images.everydayhealth.com/images/sexual-health/female-reproductive-system-722×406.jpg?w=1110) and you can see all the major parts. The uterus, or what you call the “womb,” is organ that’s meant to hold the fetus. The fertilized egg implants into the side of the uterus and then grows into a blastocyst and later a fetus. On each side of the uterus is an ovary. The overies are where the eggs come from. The ovaries are connected to the uterus via the Fallopian tubes. The eggs are released from the ovary and travel through the Fallopian tubes to the uterus. Finally, at the bottom of the uterus is the cervix, which is the canal that connects the cervix to the vagina and ultimately, the outside.
Now normally what’s supposed to happen is that the fertilized egg implants into the wall of the uterus. Sometimes though, the egg can implant into wrong place, such as inside the Fallopian tube, the ovary itself, or the cervix. That’s what an ectopic pregnancy is. These places are not meant to be where the fetus grows and develops. Ectopic pregnancies are never viable. It will always lead to the death of the fetus and in some cases, the death of the mother as well, because the fetus can grow too large and rupture the organs and cause severe internal bleeding.
In an ectopic pregnancy, the egg is fertilized normally but implants outside of the uterus. This most often happens in the Fallopian tubes, though it can also occur in the ovary, cervix, or even the abdominal cavity (the ovaries and Fallopian tubes are not connected, the Fallopian tubes are built to “sweep in” the egg). Any ectopic pregnancy is nonviable, and moreover, if left untreated, it can lead to lethal bleeding and organ damage. An ectopic pregnancy must be terminated to save the mother’s life.
I think other people have done a good job of explaining how ectopic pregnancies happen.
I will say that very, very, very rarely, ectopic pregnancies do survive. Most of the time, ectopic pregnancies implant in the Fallopian tube, where there is no room to grow. Occasionally, they will completely escape the reproductive system altogether, though, and implant somewhere else. This is called an abdominal pregnancy and it’s *fantastically* dangerous. Almost everyone with an abdominal pregnancy simply dies unless they get immediate treatment, and often die even with treatment. An embryo trying to implant is just going to shred your spleen, for example, and you will bleed to death.
The world is big, though, and once or twice a decade lightning strikes and someone shows up at the hospital in terrible pain and discovers their fetus is viable but not where it should be. This mostly happens in countries or areas where ultrasounds are not routine. An immediate surgery can *sometimes* save both mother and child. I can’t emphasize enough how rare and dangerous this is, though.
Here’s [a case study of this](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158531/).
I’d wager every living survivor of an ectopic pregnancy could split a single large pizza, assuming they manage to agree on toppings.
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