Since Lotus did not produce a center seat S2 car, interior parts including the dash are not off the shelf items.  We have been able to modify existing parts and then throw in a couple of our sillSACKs to get closer to a finished look. The AiM MX2E comes with a binnacle cover that we tweaked to fit.

We have trimmed two passenger side airbag covers to fit on both sides.

The dash and sills will be covered in a marine-grade suede material.  This will give a nice upgraded look with out being too blingey...

Roll call! What do you think was GM’s first hybrid? It’s not going to be the Chevy Volt, as that hit the market in 2010. Nor was it the Saturn Vue from 2007, as while the Vue was offered with a Green Line mild hybrid version, there were earlier hybrids from GM. In fact, GM’s first hybrid passenger vehicle sold to the buying public, outside fleet use or prototypes, was the Chevy Silverado/GMC Sierra Hybrid, which was launched in 2004 and sold to retail buyers between 2005 and 2007. It was a mild hybrid setup with an electric motor inside the transmission’s flywheel housing.

However, if we also take prototypes and studies into account, the first hybrid GM ever displayed was the Stir-Lec. The vehicle bearing that futuristic and mysterious name was an Opel Kadett coupe with a very weird experimental hybrid set-up, in 1968. In the mid-1960s, severe smog became a public health crisis, and since General Motors had put many polluting cars on the roads, it directed funds into researching alternative means of propulsion other than regular gas or diesel.

The Basic Car Was Good Looking

The Opel Kadett was one of those perfectly ordinary European family cars. The Kadett name was already used in the 1930s on a small and basic car that later spawned a Soviet copy, the Moskvich 400, that was produced until the mid-1950s. In the early 1960s, the Kadett was reborn. You might recognize the Kadett A as the “Oliver” car from Top Gear’s Botswana Special. These are small and friendly-looking cars, and while the Kadett B introduced just a couple of years later was somewhat larger, it was still compact enough to be sold as a small car at Buick dealers in the United States. That was also the Kadett, which Bob Lutz famously put on its roof.

The following generation, the Kadett C, was largely the same car as the Chevrolet Chevette, the Vauxhall Chevette and the Isuzu Gemini/I-Mark, as it was built on GM’s T-Body platform.

Stir-Lec For Stirling-Electric

In the late 1960s, General Motors let journalists behind the wheel of its experimental vehicle, built by GM’s Research Laboratories. Clothed in a production car body, the Stir-Lec was an early EREV prototype designed in the face of the growing smog situation in the United States. How about a commuter car that didn’t emit any meaningful exhaust gases?

A bunch of small European cars of the time had the engine in the back, while the Kadetts were front-engined. The Stir-Lec changed that, as the car’s engine was located in the trunk, and attached to the differential was a three-phase, 20-horsepower electric induction motor, small and compact, powering the rear wheels via batteries mounted in the front.

The rear-mounted engine, running at a constant 2,800 rpm, had the sole job of keeping the car’s batteries charged, and had no connection to the driven wheels. And it didn’t run on gasoline, as it was a Stirling engine that could even run on kerosene. Mind-boggling stuff, especially for the late ’60s.

What’s a Stirling engine, you may ask? It mustn’t be confused with a Sterling engine, which is a 2.7-liter Honda V6 fitted in a Rover 800-series exported to the US.

The Stirling engine was invented by its namesake, the Scotsman Robert Stirling, and it’s a closed-cycle regenerative heat engine, also called a hot air engine, patented by Stirling already in 1816. As The College of Science and Mathematics at Fresno State explains the basic premise:

Stirling engines are more efficient forms of generating power from heat energy than standard combustion engines. The greater the temperature difference between the interior and exterior, the more efficient the generation. The two pistons of the engine are connected via a pressure chamber that allows air to flow between them. The ‘hot-side’ of the piston is exposed to the flame and heats up while the ‘cold-side’ is cooled by the ambient air temperature. Thermal expansion causes the heated air to push the hot-side inward, forcing the cool-side up. The air moves into the cool-sides chamber, where it cools and condenses. This condensation causes the cool-side’s piston to contract, the momentum of which draws the cooled air into the hot-side and forcibly compresses it further. The flame then again heats and expands the air, forcing the piston back inward, repeating the cycle.

The “cool side” in the Stir-Lec was water-cooled with a rear-mounted radiator and fan setup, with a separate blower for the combustion air. The working gas, hydrogen in this specific case, is permanently retained in the engine.

The downside is a low power-to-weight ratio. However, for keeping 6 kWh worth of batteries charged, it’s fine, and the Stir-Lec’s engine produced just eight horsepower. The engine was produced by the Dutch company Philips, which had been producing Stirling engines to be used as power generators, like the one in the above video. While that generator doesn’t run silently, I guess it would make a lot less noise clothed in a car body, even inside a 1968 Opel Kadett.

It Wasn’t Fast

Under the hood, the radiator’s place was taken up by the modulating inverter and 14 completely conventional, commercially available lead-acid batteries. Running on battery power only, the car would have a range of just 15 to 30 miles depending on how much the throttle pedal was pressed, but the Stirling engine setup (which did its own mashing of the gas) worked as a range extender, giving it a usable range of 150-200 miles out of 4.75 gallons of kerosene. As much as 42 mpg with barely any exhaust pollution isn’t bad at all, but it’s not like you would cover ground very fast.

The entire experimental vehicle weighed some 3,100 lbs with the front seats occupied, which is heavy for a Kadett.

Since the Stir-Lec was widely shown in 1969 magazine ads, it’s often noted to have been unveiled that year, but Popular Science test-drove the first version, the Stir-Lec I, already in 1968. The magazine said it wasn’t fast, as acceleration to 30 mph took “10 to 20 seconds”, which is an interestingly wide span, but the take-off was said to be very smooth.

During the test, the Stirling engine was fueled using kerosene. The article also says that 30mph is the “break-even” speed, where the car can travel without draining the batteries faster than it can recharge them. A second version, the Stir-Lec II, followed in 1969, which swapped the AC motor for a DC one, and the electronics were simplified further. Range wasn’t improved, but the car was slightly faster. The prototypes had both the trunk and the frunk full of stuff, and GM never developed the Stir-Lec cars to the production phase.

In 1973, Ford was developing a 170-hp Stirling engine together with Philips, reportedly to replace the 351 Cleveland in the Ford Torino, but it doesn’t seem to have been significantly more economical.

In 1971, GM also showed the XEP-1a experimental vehicle, which was based on a similar Opel Kadett as the Stir-Lec cars. It was a more conventional electric car prototype, just full of batteries without a range extender, and it worked as a test mule for Opel’s record-breaking Elektro GT.

The Opel GT-based prototype reached a top speed of 188 km/h (116.8 mph), with 1630 lbs of Varta nickel-cadmium batteries providing power. The entire car weighed as much as an Opel Blitz truck, or over 3700 lbs. When you know how small an Opel GT is, it puts that into proper context.

While the 1968 Stir-Lec was GM’s first hybrid prototype, GM also showed another hybrid prototype the next year. That was the XP-883, a tiny fiberglass nugget with a plug-in hybrid system. The engine was a 35-cubic-inch two-cylinder, coupled to a DC motor and six 12-volt batteries in the rear. Setting off, the car would run on electric power until it reached 10 mph, after which the engine turned on. The XP-883 would accelerate all the way to 60 mph, taking a whole 28 seconds to do that; 40mph was attainable in a more palatable 12 seconds.

Like the Stir-Lecs, the XP-883 remained an experimental prototype, and it took until the 1990s for GM to actually provide an electrified car for regular customers, with the EV-1 – which was strictly limited in the way it was distributed, too, as you could only lease them. The 2010 Chevrolet Volt, again championed by Bob Lutz, was a moonshot when you consider how long it took for GM to sell hybrids to people who wanted to save a bit of fuel and run on electricity when it suited them.

Correction: The original version of this story said that the Stirling engine runs on helium. The fuel is actually kerosene. We have corrected the error.

Top graphic images: Opel; Popular Science

The post GM Built An Ingenious Hybrid In The 1960s And Then Everyone Forgot About It appeared first on The Autopian.

We needed a longer gear shift transmission cable for the install now that the shiftR is position on the right side of the car.  Our trusty supplier sent us one in the length we specified.  Jorge installed it and it was the perfect length.  

We temporarily refit the dash that we know will need to modified for the instrument cluster binnacle.  Though it appears the modifications won't be too terrible.  We will eliminate the speakers and likely cover it all in Alcantara.

We decided to fit our shiftr 2.0 in this car to highlight the latest version of our much loved product.  The 1.0 version that we removed and offered up for sale.

For years, Microsoft and OpenAI have fought to keep certain information out of the public eye in their fight with news organizations that have accused the AI firms of teaming up to violate copyright laws by stealing tons of news content to train AI.

However, now the details that should never have been marked confidential are starting to leak. In a motion for summary judgment that was unsealed Thursday from news plaintiffs led by The New York Times, internal documents are exposed that news groups alleged show exactly how Microsoft and OpenAI viewed the threat to news before unleashing new AI products like ChatGPT and Copilot.

Perhaps most explosively, Microsoft Director of Applied Science Brent Hecht repeatedly warned in documents that scraping news for AI training was “an astonishing theft of unprecedented proportions,” calling it perhaps the “largest theft of labor in human history,” news orgs said. In another document, Hecht contradicted Microsoft and OpenAI’s argument that training AI on news content is fair use, suggesting that the plan to widely scrape news made “a complete mockery of the idea of ‘fair use.’”

Over at OpenAI, ChatGPT head Nick Turley wrote in an internal message that publishers would face an “existential threat” from commercial products trained on news content that can be used to substitute news providers. One Microsoft document even described a “doom loop,” news orgs said, “that will hurt the performance of our models and the entire web at the same time.”

“It is highly unusual that an end-product threatens the economic foundations of its essential suppliers, but that is the situation we have created for our LLM business with respect to its ‘content supply chain,’” that document said.

Data from both firms shows that this prediction was accurate. Microsoft recorded 83–93 percent drops in click-through rates for some news plaintiffs, and 51–94 percent drops for others. Add to that reporting on low click-through rates from ChatGPT search results and news organizations’ own reporting on traffic declines. Suddenly, it becomes easier to see how declining news revenue could ultimately rob chatbots of the abundant streams of reliable information that supposedly makes them such groundbreaking tools.

Meanwhile, “almost no one intended for content they created to be used in this fashion, nor are they compensated for its use,” Hecht acknowledged in a Microsoft document.

News organizations say they’re ready to go to trial because there’s so much “compelling evidence of substitution.” If they can prove that chatbots are replacing them in their own markets, while serving to spit out excerpts of articles verbatim, they think that one-two punch may eviscerate Microsoft and OpenAI’s fair use arguments.

“The future not just of journalism but of responsible AI too depends on preserving incentives for humans to produce the creative works on which a healthy society depends,” news groups argued.

Chatbots are “largely substitutive, period”

Under oath, Microsoft CEO Satya Nadella testified that AI companies shouldn’t be violating news sites’ terms of use by dodging paywalls. But over at OpenAI, internal messages showed that when a staffer, Nick Ryder, informed President Greg Brockman that “a hack” was found for OpenAI crawlers “to get around” the NYT paywall, Brockman replied, “Ah, nice.”

Nadella also acknowledged that chatbots have served as substitutes for news platforms, describing the chatbot as stealing clicks from news sites by “giving you the information right there on the website on the AI platform versus needing to go to the underlying source.”

There’s consensus on that at OpenAI, where a software engineer said in an internal message that “no matter how prominently we show the links, users won’t click.”

OpenAI’s Turley agreed that there is “no good reason to click” when the chatbot provides information, the motion said. He also seemingly suggested that the doom loop was already in motion, describing chatbots as “largely substitutive, period” and predicting that they “will get more and more substitutive as they get better.”

News groups argued that insiders' own statements should be damning.

“With respect to outputs that are substantially similar to training or grounding sources, courts have rejected claims that copying news articles to provide a product that substitutes for demand for news is fair use,” news groups argued.

Microsoft disclaims exec's comments

News groups tried many different tactics to test if Microsoft and OpenAI products would output their news articles verbatim. Their motion shows they went further than early strategies where they would ask chatbots to provide access to entire news stories by repeatedly asking “what’s the next line?”

In some cases, news organizations found that chatbots would generate long excerpts of articles when users requested summaries of articles. Other flagged outputs were generated by asking for key bullet points of articles. Particularly successful were prompts requesting that chatbots “rate the bias” of news articles. Chatbots also reproduced portions of articles if users asked them to pick any article off a certain site’s homepage.

In their motion, news plaintiffs have only asked the court to rule on infringed articles where outputs “demonstrate extensive verbatim overlap,” because they’re confident that the “substitutive purposes of defendants’ copying weigh against fair use.” Legal concerns with other articles will be raised at trial, they said.

OpenAI did not immediately respond to Ars’ request to comment.

However, a Microsoft spokesperson defended Microsoft’s AI products as a transformative fair use that don’t substitute for news sites. The spokesperson said that Nadella’s testimony touched on “broad principles and changes underway in how people find and consume information,” which were merely “observations” that “should not be confused with conclusions about copyright questions before the Court, which Microsoft addresses in its filings.”

Regarding Hecht’s comments, the spokesperson claimed that those documents only “reflect one employee’s individual perspective, are not a legal analysis, and do not represent the company’s views.”

Steven Lieberman, counsel for the New York Daily News and seven of its sister papers, disagrees. He told Ars that “the evidence revealed here for the first time shows that OpenAI and Microsoft knew that what they were doing was wrong.”

“Throughout this case Defendants insisted that these documents be treated as confidential so that the public could not see them,” Lieberman said. “Well, now the cat is out of the bag. Finally, the world can see what OpenAI and Microsoft thought all along about the fairness of their own behavior.”

Microsoft exec described "accidental cover up"

News plaintiffs have argued that regardless of the individual expressing the views, the internal documents make clear that firms anticipated that verbatim outputs would harm news sites. Further, they alleged that instead of preventing the outputs, the firms tried to make it harder for news groups to test chatbots by creating a filter that Hecht suggested could be perceived as an “accidental cover up” because it would result in “people who have a right over the content having less visibility into what was used for training."

News groups are also upset that instead of listening to insiders warning that scraping news was theft, Microsoft and OpenAI never chose to license content, allegedly usurping them in another market in ways they couldn't anticipate.

Specifically, their motion accused Microsoft of violating “industry norms” by selling a dataset purchased for Bing as training data for OpenAI, allegedly doing so without consulting news groups that would not have approved of that repurposing of their consent to basic search engine crawling. Further, OpenAI allegedly “acted improperly” by obtaining a NYT dataset with 1.8 million articles from a third party that was bound to an agreement that the data wouldn’t be used for commercial purposes. OpenAI’s employees knew it “would not be appropriate” to use that data “to train a model,” but they did it anyway, news groups alleged.

For news groups, the problem isn’t just Microsoft and OpenAI, but all the AI firms that are following their lead in "free-riding" on their content, the motion said. Most notably, after ChatGPT’s launch, Google’s AI Overviews was quickly introduced and started absorbing even more traffic that previously went to news sites.

If courts don’t clarify that AI firms must license news content, both news publishers and AI firms could be doomed, news plaintiffs argued. One Microsoft internal document agreed that “there is a ‘real risk’ that GenAI could ‘significantly disrupt’” the “employment of the very people who generated the data on which the foundation model was trained,” they noted. Microsoft even included a cartoon illustrating the problem of LLMs destroying their own supply chains, they said:

Cartoon in a Microsoft internal document. Credit: via News Plaintiffs

“AI companies remain powerless to break out of this ‘doom loop,’ because, while the industry as a whole would benefit if every company paid to sustain the continued production of the creative works their technology depends on, each individual company is better off taking content for free while others pay,” news groups argued.

As evidence of this blind greed, their motion emphasized that Brockman wrote that he was “deeply motivated by the gazillions” that could be gained by commercializing OpenAI’s technology.

“Finding that copying news for AI is not fair use would solve this prisoners’ dilemma by putting all AI companies, OpenAI and Microsoft included, on an even footing,” news organizations said.

This story was updated with a quote from New York Daily News counsel Steven Lieberman. 

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The number of women who died after an ectopic pregnancy has spiked in recent years, a ProPublica analysis found. The mounting deaths in Centers for Disease Control and Prevention data have drawn little scrutiny or response.

Such deaths typically occur in the first trimester, after a pregnancy fails to properly implant in the uterus and begins to develop elsewhere, most commonly inside a fallopian tube. The embryo grows until it causes the organ to rupture, triggering catastrophic bleeding. 

With prompt and appropriate medical care, maternal health experts say, women should not die. Yet ProPublica’s analysis found a stark and baffling increase: Almost 200 women with the condition died from 2020 to 2025, compared with about 100 in the previous six years.

“A death related to ectopic pregnancy should really be a never event,” said Dr. Alice Abernathy, an OB-GYN in Philadelphia.

While chaos and access issues at hospitals during the COVID-19 pandemic likely contributed to at least some of the deaths, the surge has persisted, raising serious questions about the role of the most significant disruption to maternal healthcare in the years since: state restrictions on abortion. 

To treat an ectopic pregnancy, which is almost never viable, doctors must terminate it. But lawsuits and federal complaints have alleged that some medical providers are hesitating or flat-out refusing to do that in states where they face criminal penalties for performing an abortion. Patients described their terror. 

“I genuinely thought I was going to die,” said Kyleigh Thurman, whose right fallopian tube ruptured after she struggled to get ectopic care in Texas in 2023.

“There were a few times I asked my husband if I was going to die,” Leitaea Lowrimore of Oklahoma said in a lawsuit after being denied treatment for an ectopic pregnancy at multiple hospitals in February. “I kept thinking about our kids.”

To determine whether these issues go beyond anecdotes, ProPublica analyzed the data collected from every state by the CDC to look for patterns. The analysis shows a growing divide for women in states with strict abortion bans compared with those without.

While the uptick in ectopic deaths occurred nationwide, the climb has been much steeper in states that banned abortion after the Supreme Court overturned Roe v. Wade in 2022. 

ProPublica shared its analysis with more than a dozen maternal health experts, including leaders in the field, who were unaware of the spike; early pregnancy complications are chronically underresearched.

While they cautioned that abortion bans alone can’t explain the national rise, maternal health experts said any examination of the spike should include the documented delays in care caused by the laws, including for ectopic pregnancies. 

In Thurman’s case, despite clear signs of an ectopic pregnancy, two emergency departments sent her home without resolving the complication. Regulators in 2025 found that one of the hospitals, Ascension Seton Williamson, failed to properly screen Thurman for a suspected ectopic pregnancy and did not call in an OB-GYN, in violation of the hospital’s own policies and federal law that requires emergency departments to treat and stabilize patients before discharging them. Thurman has an ongoing lawsuit against Ascension Seton Williamson and the other hospital, Ascension Seton Highland Lakes, for medical malpractice.

Thurman had to have her fallopian tube removed after it ruptured. (Thurman is not related to Amber Thurman, who died in Georgia, which also has an abortion ban, after doctors delayed treating different pregnancy complications in 2022.) 

“I’ve never been in a situation where I didn’t get healthcare when I needed it,” Thurman told ProPublica, comparing the condition to having “a time bomb you can’t control.”

A spokesperson for the Ascension Seton hospitals said in a statement, “When a patient experiences a serious or life-threatening condition during pregnancy, our clinicians provide medically indicated treatment, including treatment for an ectopic pregnancy.” The hospital has denied Thurman’s malpractice allegations in a court filing.

Ectopic pregnancies, while rare, have long been recognized as the leading cause of maternal deaths in the first trimester. The condition impacts up to 2% of pregnancies in the U.S. Because government agencies don’t require hospitals to track or report overall ectopic diagnoses, it is impossible to know whether the condition itself is becoming more common.

While rates for other pregnancy-related deaths also increased during the pandemic, those climbs have largely subsided. 

Experts aren’t sure why ectopic deaths have continued to rise. Ectopic pregnancies are more common among older women, but the increase in deaths has been even more stark among younger women, the analysis showed. 

Anti-abortion groups have suggested that the use of abortion pills prescribed online is leading to more undiagnosed ectopics because telehealth patients don’t receive an ultrasound. But studies have found that ectopic rates are far lower among people who seek medication abortions than in the general population. Telehealth clinics ask questions that filter out patients at higher risk of ectopic pregnancy and follow up with those they treat to screen for symptoms, said Ushma Upadhyay, a researcher at the University of California, San Francisco, who studies telehealth abortion administration.

Experts told ProPublica that more research is required to determine the role of the abortion bans in the rise of ectopic-related deaths. Many states with bans, which generally provide less Medicaid funding and coverage to low-income women, have long had poorer maternal outcomes. “It’s a real challenge to try and tease out one thing out of the array of factors that undermine women’s health in these states,” said Eugene Declercq, a public health researcher at Boston University.

But experts said ProPublica’s data analysis, along with stories about delays in ectopic care, underscores the need to find out what is driving the deaths.

“Reproductive health is unusual across medicine when we consider how swiftly policy changes affect the care patients can receive,” said Dr. Courtney Schreiber, a professor of obstetrics and gynecology. 

Caitlin Myers, an economist at Dartmouth College who studies abortion policy, said the deaths should be investigated: “This is a potentially profound consequence of the regulation,” she said. 

How Abortion Bans Interfere With Ectopic Care

Many state abortion bans include exceptions for ectopic pregnancies. But experts have worried that doctors are hesitating to offer treatment without an ironclad diagnosis, which clinicians say can take time and increase risks to the mother.

Ectopic pregnancy symptoms often begin with abdominal pain and bleeding, which send women to emergency rooms. There, doctors use ultrasounds to locate where the pregnancy has implanted. 

However, embryos are often not visible on an ultrasound early in pregnancy. That could mean the pregnancy is ectopic, but it may also be a miscarriage or normal pregnancy that’s too small to see. Doctors can also assess whether the pregnancy is likely ectopic through blood tests over multiple days.

If the pregnancy is ectopic, the risk of rupture increases the longer treatment is delayed. In a state without a ban, a patient could decide at any point that that risk is not worth taking and opt to terminate the pregnancy.

In a state with a ban, however, that option may not exist. If doctors can confirm the pregnancy is ectopic through an ultrasound, they can protect themselves from having their decision to terminate questioned, perhaps by a zealous prosecutor. But waiting for this can delay treatment by days or even weeks. 

“Seeing a mass is not the only reason to have high suspicion for an ectopic pregnancy,” said Dr. Rebecca Nerenberg, an emergency medicine doctor in New York and the clinical director at Access Bridge, which educates ER doctors on reproductive healthcare and has released evidence-based guidelines for diagnosing possible ectopic pregnancies.

Experts say that doctors should be able to offer treatment when other symptoms are present, such as plateauing pregnancy hormone levels, bleeding and abdominal pain. Patients can be treated with a procedure or a cancer drug that stops cells from growing.

But for women in states with abortion bans, getting that treatment can be difficult.

Lowrimore, who lives near the state border in Oklahoma, sought care at an Arkansas emergency department in February after experiencing abdominal pain and significant bleeding. She was sent home and told to return for more tests after being diagnosed with a “pregnancy of unknown location,” because an ultrasound could not show where her pregnancy had implanted, according to a lawsuit. 

Lowrimore visited three different hospitals across both states over the following week as she began passing blood clots and the pain intensified, radiating up the left side of her body, according to the lawsuit.

The fact that the states’ abortion bans make exceptions for ectopic pregnancies did not help her, even though doctors acknowledged that was a possible diagnosis. In each visit, they didn’t treat her for that condition. One told her that intervening in her pregnancy could land him jail time — “10 years in the poky,” according to the suit. “I felt like my life was a risk he couldn’t afford,” she said in the lawsuit filing.

After consulting a lawyer, Lowrimore finally drove to a hospital in Kansas, where abortion is legal, and got an injection of the cancer drug called methotrexate within hours of arrival. 

Lowrimore’s lawsuit, in which an OB-GYN and six women who were denied care are seeking to block the Arkansas abortion ban, is ongoing. Lowrimore also filed complaints under the same emergency medicine law as Thurman against the three hospitals. Regulators cited Mercy Hospital in Fort Smith, Arkansas, for failing to provide care during the eight hours Lowrimore waited to be seen. The other two hospitals were not found to have violated that law, and they did not respond to requests for comment.

A spokesperson for Mercy Hospital declined to comment on the case, saying that, “in tragic situations when a mother suffers from an urgent, life-threatening condition during pregnancy, Mercy provides all medically indicated treatment to save her life.” 

Many experts predicted that ordeals like the ones Lowrimore and Thurman described would occur when abortion bans took effect. To see if more women with ectopic pregnancies are experiencing severe health outcomes, ProPublica analyzed hospital data from Texas, the most populous state to ban abortion.

In this new analysis, ProPublica found that 310 more patients in Texas experienced substantial blood loss after an ectopic pregnancy in 2023 and 2024 compared with 2018 and 2019, an increase of about 29%. Similar to ectopic deaths, the rise appeared to begin during the COVID pandemic, but the rate of complications remained elevated after hospital systems stabilized and the state passed its restrictive law. ProPublica is working to acquire similar data from states without abortion bans.

In response to ProPublica’s reporting on the deadly impacts of Texas’ abortion ban, the state passed the Life of the Mother Act in 2025, which attempted to clarify what kinds of abortions are allowed by the state’s law, explicitly adding ectopic pregnancies to the list. 

But new guidance from the Texas Medical Board includes only a case study with an ectopic pregnancy that can be seen in an ultrasound, remaining silent on the difficulty of early ultrasounds to detect where a pregnancy has implanted. This leaves open the possibility that a prosecutor could question whether such a case was really ectopic, in a state where doctors face up to 99 years in prison for performing illegal abortions.

A spokesperson for the Texas Medical Board said the course is not intended to cover all scenarios and that it “explains that imminent harm is unnecessary and specifically states that physicians who follow evidence-based medicine, standard emergency protocols, and proper documentation face minimal risk.” Asked whether a conclusive ultrasound image is necessary for an ectopic diagnosis, the spokesperson said, “The Board has consistently stated that providing commentary on every possible situation would be impractical.”

But Michelle Maloney, an attorney who represents Thurman and 13 other Texas women or their families who say they were denied care — including seven with ectopic pregnancies — said she still gets frequent calls from women who say they were denied care for pregnancy complications. “I don’t think specific exemptions address the massive gray areas that arise in pregnancy,” she said. 

Solutions are unlikely to come from the states themselves. A previous ProPublica investigation found that states with strict bans are not studying whether their laws are contributing to maternal deaths. And others have not followed Texas in attempting to amend their bans.

Gaps in Research, Training and Awareness 

One of the biggest challenges to reducing ectopic pregnancy deaths nationwide is the lack of awareness, research and data. 

No one, for example, is tracking whether women who experienced ectopic pregnancies also had one or more common risk factors, like a history of ectopic pregnancies, infertility or use of hormonal intrauterine devices, according to ProPublica’s review of maternal health statistics and interviews with experts. 

Nor has any published research addressed the connection between recent ectopic pregnancy death rates and untreated infections like gonorrhea and chlamydia, which increased substantially during the first years of the pandemic before declining again. Those infections can cause pelvic inflammatory disease, which causes fallopian tube scarring and raises the long-term risk of developing an ectopic pregnancy.

It is unclear why the CDC and other federal agencies across two administrations have failed to publicly respond to the increase in deaths despite having access to the same information ProPublica analyzed. But experts say the country’s capacity to respond to it has been greatly reduced under President Donald Trump.

Robert F. Kennedy Jr., secretary of the Department of Health and Human Services, told Congress in April that improving maternal health outcomes is a priority. But the Trump administration has eliminated much of the staff devoted to researching the topic and cut hundreds of millions of dollars in government funding for healthcare research. 

The CDC’s Division of Reproductive Health, for example, lost most of its 100 employees, according to a lawsuit filed by more than a dozen states’ attorneys general last year. The entire team that ran the Pregnancy Risk Assessment Monitoring System, a significant source of data for state and local governments as well as maternal health researchers, is on paid administrative leave. That includes many researchers who would have been responsible for investigating the rise in ectopic pregnancy deaths, according to current and former CDC employees.

“You’re losing the capacity to know what’s going on with pregnant women,” Lee Warner, the former chief of the Women’s Health and Fertility Branch at the CDC, said of the cuts at the division. “It’s going to take decades to build this capacity back.”

Funding cuts have also impacted efforts to raise awareness about the condition. Because ectopic pregnancies usually cause complications before standard prenatal care begins around 10 weeks, patients often rely on emergency departments, where doctors don’t typically have specialized training in pregnancy care. Experts say more training on high-risk early pregnancy conditions could help combat rising maternal mortality rates.

The CDC in 2025 also stopped funding a partnership with the American College of Obstetricians and Gynecologists to educate emergency medicine doctors about reproductive healthcare. The initiative, “Obstetric Emergencies in Nonobstetric Settings,” offers resources for emergency departments on caring for pregnant patients with cardiovascular disease, hypertension and eclampsia. An ACOG spokesperson said its foundation now funds the project, and that the organization is working on a set of guidelines for diagnosing and managing tubal ectopic pregnancies in the emergency department.

A spokesperson for HHS said the agency continues to track maternal mortality trends, investigate their causes and provide funding for research. “This important work is being accelerated across the Department to support healthy mothers, healthy babies, and strong families,” the spokesperson said.

The United Kingdom’s response to a similar spike in ectopic deaths during the pandemic shows just how much the U.S. is failing to do. 

Researchers and officials there identified a surge in deaths in 2021 and 2022 in the U.K. and Ireland; 12 women died of an ectopic pregnancy during those years, which, as in the U.S. during this period, represented a near doubling of the death rate compared with previous years.

They investigated the causes and found a range of culprits, including overstretched emergency services and inadequate early pregnancy screenings, says Marian Knight, a professor at the University of Oxford who leads the U.K.’s maternal mortality reporting.

In 2024, Knight co-authored a maternal mortality report that focused on those deaths and offered policy recommendations. Knight worked with policymakers and a U.K. charity to raise awareness and help doctors and the general public recognize ectopic pregnancy symptoms. Officials also changed how patients experiencing ectopic pregnancy symptoms are prioritized when they call for an ambulance, leading to faster response times.

But the first step, said Knight, was identifying and investigating the issue. “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.

The U.S. doesn’t do national maternal mortality reviews, said Boston University’s Declercq, who serves on the Massachusetts Maternal Mortality and Morbidity Review Committee. Instead, CDC epidemiologists review death and birth records to establish accurate national totals of pregnancy-related deaths, largely leaving state and local maternal mortality committees to take an in-depth look at individual cases and make recommendations to lawmakers and medical providers.

Declercq said his committee has not identified a notable increase in deaths from ectopic pregnancies in Massachusetts in recent years. In most states, these deaths are sporadic enough that they don’t, in isolation, show a notable trend.

It’s only at the national level that this increase in avoidable deaths becomes visible. 

ProPublica’s analysis “raises concern that young women are dying from a preventable cause at an increasing rate,” Schreiber, the professor of OB-GYN, said. “That is not what we should be seeing in the United States of America.”

The post Ectopic Pregnancy Deaths Have Nearly Doubled. It’s Worse in States With Abortion Bans. appeared first on ProPublica.