Talk:Abortion

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Including all of abortion's names

The way that Climategate is referred to as "CPU research hacking incident", "abortion" should also be called by its other equally legitimate name, "baby murder". From a pro-life POV this is baby murder and we should not be oppressed by the leftist academic/government class. We should be able to include (after "abortion") the term we use to refer to abortion, baby murder. —Preceding unsigned comment added by 71.109.157.245 (talk) 12:46, 15 April 2010 (UTC)

I have no objection to the basic argument here, because it is general WP policy to lay down redirects to an article under all terms which are commonly and unambiguously used to refer to the subject of said article. Thus, "Climategate" is a common and unambiguous moniker for what would be called (more precisely) the "CRU research hacking incident". Closer to home, WP applies the same principle in the case of partial-birth abortion (precise article title: "intact dilation and extraction," a phrase which, while hideously Orwellian, is also inarguably more precise than "partial-birth abortion").

However, while I see your general point, 71.109.157.245, I don't think it applies here. As an active pro-lifer, I very rarely see my fellow pro-lifers call it "baby murder" in public. They certainly liken it to baby murder, and abortion is certainly morally equivalent to baby murder, but they don't actually call it that. They call it, simply, "abortion." Maybe they shouldn't surrender that piece of rhetorical ground; maybe they should call it unbornicide. But they don't, and WP would be wrong to adopt an alternate name for abortion that isn't in common use.

Nor would the term "baby murder" be unambiguous, referring, as it often does, to infanticide rather than feticide. My two cents. --BCSWowbagger (not signed in on 24.245.45.254 (talk) 19:06, 18 April 2010 (UTC))

Well, for something to be called "baby murder" one would think it should have some direct connection to either babies or murder (or even both!). Unfortunately, whether elective or spontaneous, abortion is not murder, nor does it have anything to do with the death of a baby. This is not an ideological platform, it's fact. In many cases we are talking about some kind of feticide, as mentioned above, but this is far from the only aspect of abortion that is (and should be) addressed in the article. In any case, "killing" + "fetus/embryo" is a far cry from "murder" + "baby"... Let's not start clogging a surprisingly well-balanced article with inaccurate (and more than a little silly) terminology. 66.41.65.237 (talk) 21:48, 14 May 2010 (UTC)

Agreed, the very usage of the word "baby" for an unborn human (or other animal) is itself POV-dependent. George Orwell taught us, through mis-use of a language, to be careful! So, we don't count chickens before they hatch, because some eggs don't hatch. Similarly, we shouldn't count babies before they are born, because some are born dead not alive, and therefore a too-early count would be incorrect. V (talk) 15:40, 12 June 2010 (UTC)

Wikipedia is not a forum, and it is ESPECIALLY not a political forum! So all posters in this section need to chill out immensely. The term I use to refer to Nazis is "Russian target practice" but I don't think that should be in the article about it. Baby murder is a completely and utterly POV term that is not even widely used. I agree with BCSWowbagger that it should really be called partial-birth abortion since it is more commonly used (see Talk:East Germany for a similar discussion on the names of articles), but I feel I need to point out that the term "intact dilation and extraction" is the polar opposite of Orwellian. In 1984, Newspeak shortens words so that they are as refined as possible to limit any possible interpretation other than the Party-defined one. As opposed to lengthening it for scientific/euphemistic purposes (depending on your view) which is the opposite.

Also, to the IP who started this section, it shows a complete lack of good faith and neutrality to assume that because a Wikipedian disagrees on whether or not we should call it baby murder, you are being oppressed by some vast left-wing conspiracy. Furthermore, you actually said you speak from a pro-life POV and not a neutral POV, in complete contradiction of the tenets of good editing and just plain common sense. I'm sure I don't need to remind you that as a Wikipedian, your POV is meaningless here. Commissarusa (talk) 20:59, 21 May 2010 (UTC)

Maybe we shouldn't feed trolls (or continue forum-y conversations from over a month ago ;P ) -Andrew c ^[talk] 21:16, 21 May 2010 (UTC)

Header change

Should the section with the header containing the words "female infanticide" be changed to female foeticide, for clarification? (ie. pre-birth not post-birth) —Preceding unsigned comment added by InternetGoomba (talk • contribs) 19:59, 20 May 2010 (UTC)

Safer than childbirth

There's a sentence in this article that says: "Early-term surgical abortion is a simple procedure which is safer than childbirth when performed before the 21st week." There was previously a lot of discussion about this, because some editors felt that it denies abortion is unsafe for the embryo or fetus. So, there have been times when the sentence instead said: "Early-term surgical abortion is a simple procedure which is safer for women than childbirth when performed before the 21st week."

There was a big discussion about this in September 2007. I was not involved, being otherwise occupied. It's in Archive 29, here and here. Another option, instead of including "for women" in this sentence, would be to modify the heading so it's clear we're talking about health risks for the woman (though Andrew c has just reverted that approach). I don't really care which way it's done. Maybe there's a third way ("maternal health risks"?). But it does seem to me that something should be done.

If you like, I can go back through the history of this article, and figure out how this particular sentence and/or the heading has been phrased over the years. I do seem to recall that there has been a pretty firm consensus at some points in the past for including "for women" in this sentence (and some admins reverted changes with some pretty emphatic edit summaries).Anythingyouwant (talk) 04:50, 25 May 2010 (UTC)

I've looked into this some more, and the person who put it best was the editor ElinorD: "Those two words don't push anything, but leaving them out does."[1] That phrase ("safer for women than childbirth") appears in reliable sources. For example, see:

McLain, Linda. The place of families: fostering capacity, equality, and responsibility, page 237 (2006): "safer for women than childbirth".

Goldstein, Leslie. Contemporary cases in women's rights, page 21 (1994): "safer for a woman than childbirth".

These sources are not implying that there's someone else who may be unsafe, but merely using the word "woman" because it fits well in the sentence. I realize that there will be objection to using the word "mother" or "maternal" (which are normal medical terms), so why not use the word "woman"?

Here’s what our third cited source (Grimes DA (1994). "The morbidity and mortality of pregnancy: still risky business". Am. J. Obstet. Gynecol. 170 (5 Pt 2): 1489–1494. PMID 8178896) says:

The three leading causes of maternal death today are pregnancy-induced hypertension, hemorrhage, and pulmonary embolism. Although comprehensive data on pregnancy-related morbidity are lacking, about 22% of all pregnant women are hospitalized before delivery because of complications. Women of minority races have much higher risks of death than do white women, and the same holds true for older women and those with limited education. For most women, fertility regulation by contraception, sterilization, or legal abortion is substantially safer than childbirth.

Also see:

Goldstein, Laurence. The Female body: figures, styles, speculations, page 61 (1991): "abortion is safer for the mother than childbirth".

Senderowitz, Judith. Adolescent health: reassessing the passage to adulthood, page 17 (1995): "safer than childbirth for women age 15-19".

Anythingyouwant (talk) 07:38, 25 May 2010 (UTC)

Your "reliable sources" google search is deceptive. You listed the ONLY two books that contain your desired phrase. Yes, there are a total of two hits on google books for your preferred wording (in all fairness I've found two additional sources that have a similar wording "Abortions are statistically safer than childbirth for the mother during the first trimester" and "early abortion is 24 times safer than childbirth for women age 15-19". But, how many hits are there for "safer than childbirth" without such modification? If none of these sources feel it is necessary to add such a qualification, I feel like we are supporting a minority view, and thus violating weight, by going with the minimal sources we could google to support our preferred wording... We say in the first sentence that abortion results in the death of an embryo/fetus. DO we also need to say that health considerations for women undergoing the procedure are excluding the outcome of the POC? I think not, and the majority of "reliable sources" based on a google book search agree. -Andrew c ^[talk] 14:46, 25 May 2010 (UTC)

Please note that WP:MEDRS calls for a better standard than just WP:RS in cases like this. Journal articles describing the authors' research are treated as primary sources. We look for recent reviews, and where possible, recent systematic reviews. I would suggest PMID 18319189 and PMID 19201657 as providing a more WP:WORLDWIDE perspective than the above developed world focused sources. The vast majority of maternal deaths clearly occur in developing countries. Limiting the focus to rich countries misses the point entirely. LeadSongDog come howl! 15:47, 25 May 2010 (UTC)

Andrew c, sure there are a lot of sources that also use the phrase "safer than childbirth". Likewise, there are a zillion sources that use the term "maternal health" and yet this article leans over backward to never use the word "mother" or "maternal", though this issue would be easily solved by writing "maternal health" in the heading instead of "health." One way we could preserve the phrase would be to write: "Early-term surgical abortion is a simple procedure which is safer than childbirth for most women, when performed before the 21st week."

Can we at least please track the cited sources? Abortion is safer than childbirth for "most women". Saying so in the article cannot conceivably imply anything "pro-life." You can even say the "vast majority of women" or "almost all women" or "women in most countries" or "women in almost all countries", et cetera. The point is to be less categorical (per the sources), while also not denying (or affirming) that there may be health risks for someone else.

Mifepristone is contraindicated with adrenal failure, hemorrhagic disorders, inherited porphyria, and anticoagulant or long-term corticosteroid therapy. Surgical abortion is contraindicated in patients with hemodynamic instability, profound anemia, and/or profound thrombocytopenia. In some cases childbirth is safer (and LeadSongDog is correct to point out that the degree of relative safety also depends on what country a woman lives in).

You're correct that this article starts out by mentioning death of the fetus or embryo, but that doesn't mean it would be okay to say much later in the article that "abortion is a completely harmless procedure for everyone involved." Which is how some people will reasonably read the sentence in question.

According to pro-lifers, the phrase "abortion is safer than childbirth" is a mantra for abortion advocates.[2] Can't we use a phrase that is a mantra for neither side, and that is more accurate too?

We might also consider using the word "slightly" given that (in the U.S. anyway) the risks from both early abortion and childbirth are vanishingly small. There is less than .01% risk of maternal death from childbirth in the United States and Europe. Additionally, perhaps we should also mention that early abortion is extremely unsafe relative to being nonpregnant? Let's not deceive readers into thinking that early abortion is risk-free.Anythingyouwant (talk) 16:40, 25 May 2010 (UTC)

When a woman becomes pregnant, she has a choice to terminate the pregnancy or carry it to term. Therefore, the comparison generally made by reliable independent sources is between abortion and full-term pregnancy/childbirth. If you're aware of reputable sources making the comparison you suggest, please point them out.

In an absolute sense, the risks of death from childbirth and from (legal) abortion are both extremely small. In a relative sense, in the US, childbirth (7.06 deaths per 100,000 live births) is about 14 times riskier than abortion (0.567 deaths per 100,000 procedures, figures from PMID 16389015). So it would be accurate to say that abortion is safer than childbirth, that it is ~14 times safer, and that both childbirth and abortion are very safe in an absolute sense.

It might also be appropriate to note that these figures assume that abortion is legal and readily available. In countries where abortion is illegal, or where it is legal but access is restricted by various extralegal means, unsafe abortions are a significant cause of death (e.g. PMID 17126724).

I don't think anyone is trying to "deceive" readers into thinking abortion is risk-free. MastCell ^Talk 04:21, 26 May 2010 (UTC)

I agree with a lot of what you said, MastCell. I agree that we would be accurate to say that both childbirth and abortion are very safe in an absolute sense (which the article does not currently say). I agree that it would be appropriate to note that the figures about the relative safety of abortion and childbirth assume that abortion is legal and readily available (which the article does not currently do). And I'll AGF and assume that no one is trying to "deceive" readers into thinking abortion is risk-free (I hope that Andrew c would AGF and assume that my Google search was not meant to be "deceptive").

Also, we should not omit that there are risks associated with early abortion even in countries where abortion is legal, like the U.S. (as the article currently does). By putting in your factor of fourteen, we could accomplish that.

But here's what I think you haven't addressed: why can't we put "most women" somewhere in the sentence that says abortion is safer than childbirth (or alternatively put the word "maternal" in the section heading)? Merely saying that abortion has minimal health risks is really a lopsided method of expression.Anythingyouwant (talk) 05:09, 26 May 2010 (UTC)

I'm a little agnostic about how to best present the risk level. Going back to WP:MEDRS-friendly sources, PMID 15096333 (a review from Annals of Internal Medicine) states:

Abortion is one of the safest procedures in contemporary practice. However, in some developing countries where safe, legal abortion is not available, 50,000 to 70,000 women die of unsafe abortion each year.

Which is sort of what I was getting at above, although more concisely put. That same review compares the safety of abortion favorably with that of penicillin. (The risk of dying from an anaphylactic reaction to a dose of penicillin is 2 per 100,000, about 4 times higher than the risk of death from abortion). Whether that is a useful comparison to cite in this article would be a matter for discussion; I have no strong position.

It is generally understood that abortion is safer than childbirth at any gestational age. UpToDate says as much ("Overall, elective abortion at any gestational age is safer for the mother than carrying a pregnancy to term.") although I don't think it's an ideal source, and I'd rather cite the actual literature if we choose to include that fact. I'm not quite clear on what the proposed addition of "most women" refers to - is it meant to cover situations where abortion is illegal or otherwise inaccessible, where the risk of abortion is demonstrably higher? If so, IMO we should probably just come out and say as much, in the interest of clarity. MastCell ^Talk 18:06, 26 May 2010 (UTC)

If elective abortion at any gestational age is safer for the mother than carrying a pregnancy to term, then where the heck did the "21 week" figure come from in the present article? My understanding was that abortion gets riskier as time goes by, and eventually gets riskier than childbirth. If what the article presently says is flat wrong, then I hope someone corrects it.

As for including new info, I hope someone will insert that both childbirth and early abortion are very safe in an absolute sense, given that maternal mortality in developed countries is less than .01%. This is essential for NPOV. Also, if we say that our statistics apply for "most women in developed countries where abortion is legal" then we needn't necessarily get into details about what happens in other countries, or details about the women for whom the statistics might be different (e.g. women with contraindications). All of those details could be in footnotes or via footnotes. Additionally, we need to mention that even for those "most women" there is some risk involved (which is where your factor of fourteen would be helpful assuming it's accurate), and again this seems necessary for NPOV.

Using a term like "for most women" would kill two birds with one stone, if you will. It would not only help achieve the NPOV goals described above, but would also help us to avoid saying the equivalent of "abortion is very safe," which may not be quite accurate from every point of view (i.e. death of a tiny human being is involved, so something unsafe must be going on).Anythingyouwant (talk) 20:23, 26 May 2010 (UTC)

Hmm. Re: 21 weeks, it appears to be based on a Guttmacher Institute fact sheet, which is in turn based on PMID 15051566 from the CDC. Figure 1 of that article shows mortality by gestational age, but the abscissa only goes up to 21 weeks - presumably because abortions after 21 weeks are extremely rare and data is lacking. I assume that the "21 weeks" figure was inserted here out of caution, since the cited source only shows data through 21 weeks. On the other hand, the UpToDate authors were probably willing to extrapolate existing data beyond 21 weeks, but as best I can tell that is a matter of expert opinion rather than hard data. MastCell ^Talk 22:08, 26 May 2010 (UTC)

Well, we seem to have consensus that it would be okay to fix up this section of the article in one way or another. Do we need a draft at the talk page first, or shall one of us just go ahead and edit the article, subject to change? And which editor would like to take the lead? There's no sense having multiple first drafts.Anythingyouwant (talk) 22:12, 26 May 2010 (UTC)

I'm not sure we're agreed on what needs to be fixed. In any case, I'm going to step back - it might be good to hear from some other editors on the topic. MastCell ^Talk 22:29, 26 May 2010 (UTC)

Okay, maybe Andrew c or others have some thoughts about it.Anythingyouwant (talk) 22:34, 26 May 2010 (UTC)

I'm all for making revisions based on better, medical sources for the purpose of accuracy and WP:MEDRS. I consider the initial issue raised here unimportant, and I don't think we need to give a nod to the view that "while abortion may be safe for pregnant women, abortion isn't safe for the tiny human being" anywhere in this section. That is not to say that I may not be convinced otherwise based on new, significant WP:MEDRS. But I really don't think it is a good practice to come to an article with a POV, then go looking for sources. We should be following sources, and representing majority views, and taking not of weight were applicable. All that said, I'm all ears to proposals. And feel free to make bold changes to the article as well (anyone!) As it stands, it seems like there is basic agreement that there may be some technical adjustments needed to the figure concerning safety, and perhaps a clause added about relative safety of both procedures. This is a bit technical, and I haven't looked into any of the sources, and have been busy with other matters, so I'm probably not a good candidate for a re-write. -Andrew c ^[talk] 23:25, 26 May 2010 (UTC)

Andrew c, if I were to insert into this section that, "abortion has a low risk for everyone involved, relative to childbirth" then that would be fine with you? It implicitly denies that there is any significance to the death that occurs. Arent' we supposed to be NPOV? I think we should steer as far from such statements as possible. Anyway, I'll go ahead and try some bold changes when I get a chance.Anythingyouwant (talk) 23:30, 26 May 2010 (UTC)

I think we can give the reader a minimal degree of credit and assume that they understand the impact of abortion on the fetus. It seems awkward and repetitive (at best) or polemical (at worst) to belabor this point in the "health risks" section. MastCell ^Talk 23:44, 26 May 2010 (UTC)

Nor should we go out of our way, at all possible opportunities, to use phraseology that denies anyone is involved but the woman. Neutral phraseology should be acceptable.Anythingyouwant (talk) 23:53, 26 May 2010 (UTC)

I agree with that principle, but I do not agree with your application of it here, nor with your concept of "neutral" language in this instance. I don't believe that an objective (or even minimally literate) reader, reviewing this article, would conclude that it "denies" that abortion harms the fetus. I will withdraw and await additional input. MastCell ^Talk 23:58, 26 May 2010 (UTC)

Been a while since I've weighed in an abortion discussion, has it ever been outlined/debated when we draw the line in the sand for the fetus' health matters, if ever? I regard the fetus as a welcome parasite, meaning that in the end indeed it is the host that matters, and that is what we write towards. On the other hand, acknowledging the "death" of the fetus is appropriate, but that doesn't seem to be a health risk, rather a result. Also, obviously an abortion is for a women, not a fetus. So grammatically that follows, I think. - RoyBoy 04:07, 27 May 2010 (UTC)

Looking a 4th time found an issue, every"one" involved, determines the fetus is an individual. That is not the case, a fetus has the elements of an individual, but they are in development. There is a difference. - RoyBoy 04:22, 27 May 2010 (UTC)

The initial point here seems to include women on the phrase, it's reasonable and I don't see the problem of making that change. Although it should be already implied to most of the readers that abortion causes the death of the baby other consequences can't be suddenly ignored when saying it's safer, otherwise it may imply the fetus has the same chances from dieing during the pregnancy process compared to the successfulness of the abortion procedure in killing the fetus.

Another point raised is that abortion is only safer when done in specific conditions.

RoyBoy, your position that the "fetus is not an individual" is not a NPOV, others disagree. From the medical POV human fetuses are usually cared as humans with individual characteristics and needs. Most individuals are also "in development" during a large part of their lives after childbirth--Nutriveg (talk) 12:36, 27 May 2010 (UTC)

It's closer to NPOV than the alternative. An individual is a separate entity, a fetus is not (attached to mother-to-be). Disagreement does not alter this. Medical POV is merely a reflection of their individual characteristics (elements mentioned above). If I am missing something I'd be curious to know, but to even infer a fetus is an individual is less NPOV than clarifying they are not yet. - RoyBoy 20:05, 29 May 2010 (UTC)

No. The opening of the lead paragraph makes it clear that the death of the foetus is involved. It's not an implication but an explicit statement. That is nowhere hear on the same level as an implication - in your opinion - that because we do not explicitly refer to the woman, that the foetus might be as likely to survive the abortion process as to survive pregnancy. The longer I think about this point, the more it sounds like a pro-life talking point. I can imagine the sneering tone, "Yeah, abortion is safer... for the mother." That's the problem I see with it. SHEFFIELDSTEEL^TALK 13:36, 27 May 2010 (UTC)

Well I do hear claims like " in the first days there's low probability that an embryo/fetus will result in a successful childbirth", some methods described in the intro (like herbal abortifacients, the use of sharpened tools, physical trauma, and other traditional methods) aren't very much effective and an unskilled reader may not know the significant efficacy difference between those methods. So mentioning the woman should avoid other implications by some readers.--Nutriveg (talk) 13:52, 27 May 2010 (UTC)

I removed two sources from the Guttmacher Institute that supported the phrase because that's not a neutral source, I'm unaware of who Grimes is, the author of the other source, so I can't say anything about. That 1994 article conclusion does not support the text, it's a US review, it says "for most women" and can be used only to compares risk of mortality, not other health risks.--Nutriveg (talk) 14:15, 27 May 2010 (UTC)

• To go back to a request for sources from Anythingyouwant regarding the relative safety of abortion vs. childbirth: Elective Abortion] from eMedicine states: "At every gestational age, elective abortion is safer for the mother than carrying a pregnancy to term." MastCell ^Talk 20:48, 27 May 2010 (UTC)

Okay, thanks, I will get around to re-working this section of the article in "due" time. If you have further sources regarding the other issues we've discussed in this talk page section, please feel free to share.Anythingyouwant (talk) 21:38, 27 May 2010 (UTC)

Having thought about this a bit more, I don't think it's appropriate to insert into this article a comparison of the risk of death from childbirth relative to the risk of death from abortion. To be NPOV, it would also be necessary to include a comparison of the risk of death from contraceptives, for example. Likewise, it would be inappropriate to insert into the childbirth article a comparison of the risk of death due to abortion. The place to include all of these comparisons would be in the family planning article, and I have done so.Anythingyouwant (talk) 17:26, 8 June 2010 (UTC)

It's not about being completely neutral, and giving all possibly views equal weight. It's about presenting all notable views with due weight. I believe it has been established through multiple reliable sources, and google search results :), that this comparison IS notable in the context of abortion. Is it notable in the context of the much more broad and general topic pregnancy? That's really not something worth discussing on this talk page, but perhaps something to consider elsewhere. -Andrew c ^[talk] 17:30, 8 June 2010 (UTC)

Given that multiple editors do not find the comparison particularly useful for this article, why not just have a Seealso at the top this section pointing to the pertinent section in the family planning article? I really don't think that the comparison is any more suitable for this article than it would be in the childbirth article.Anythingyouwant (talk) 17:42, 8 June 2010 (UTC)

With all due respect, I'm always wary of editors finding sources useful or not, so could I suggest that we go back to our sources for abortion, especially reviews? If the comparison is made within such sources, then it's a good indicator that something about the comparison should be included in this article – if not, then we can see it is not relevant. --RexxS (talk) 17:58, 8 June 2010 (UTC)

I'm not suggesting that the comparison to childbirth is non-notable. It definitely is notable, and reliable sources say so. The only issue is putting it in the correct Wikipedia articles. If it were to go into this article, then I don't see why it wouldn't also belong in the childbirth article. Comparisons like this belong in a Wikipedia article that compares different family planning methods. It's much more relevant there.Anythingyouwant (talk) 18:15, 8 June 2010 (UTC)

Sorry I wasn't clearer. There are many sources that deal specifically with abortion. I was hoping that consulting those would give us the indication about whether those writing in the field made use of the comparison. If the writers on childbirth also made the comparison, then I could see a good reason to include it there. I'm no expert on this topic, so I'll always prefer to follow the lead of our sources. I must admit – and it's probably a cultural phenomenon – that I've never considered abortion as a family planning method, but if reliable sources on the topic say it is, I'm certainly not going to disagree. --RexxS (talk) 19:10, 8 June 2010 (UTC)

Looking at the universe of reliable sources on abortion, I don't think they're requiring us to include the comparison to childbirth (and not the comparison to contraceptives) in this particular Wikipedia article, as opposed to a more general Wikipedia article like the family planning article. If you search on Google Books for abortion, you get 1,920,000 hits. But then search for abortion and childbirth: only 143,000 hits. And then search for abortion and childbirth and death: 36,400 hits. These results are not determinative, but they do perhaps suggest that the pro-choice mantra "abortion is safer than childbirth" does not have to be documented in this particular Wikipedia article, while omitting the comparison to contraceptives. A few days ago, I was willing to support inclusion of the mantra in this article, because it does have a factual basis. But since then other editors have persuaded me otherwise, though my mind is still open about the matter.Anythingyouwant (talk) 19:27, 8 June 2010 (UTC)

A "Google search" is not WP:RS, we can certainly cite that as pro-choice mantra, but I'm not sure it should belong to the health section since we should cite other POVs as well which can turn that section lengthy.--Nutriveg (talk) 19:51, 8 June 2010 (UTC)

I was not suggesting that this article mention or cite a Google search. A Google search "is helpful in identifying sources, establishing notability, checking facts, and discussing what names to use for different things (including articles)." See WP:Search engine test.Anythingyouwant (talk) 19:57, 8 June 2010 (UTC)

Thank you, AYW, I understand better now. I had honestly not made the connection between "pro-choice" and the phrase until now. Perhaps because I live in the UK, such polarised positions have never impinged on my perception of abortion; I don't think I've ever interacted with anyone expressing a strong "pro-life" stance in real life. I can understand that those subscribing to the different viewpoints would be sensitive to statements that seem to favour one side and perhaps react as a "red flag to a bull". Apologies for my cultural near-sightedness. Nevertheless, I'd still urge editors to go back to the reliable sources and reflect only what they say. I accept that there is a vast literature on this topic, but it's not unique in that respect. The solution that Wikipedia recommends to us is to forget our own beliefs and concentrate on reporting sources, as best we can. I know that can be difficult. --RexxS (talk) 20:01, 8 June 2010 (UTC)

Well, I'm not pro-life (I seem to be repeating this a lot lately), not that you necessarily implied I am. It's important for this article to stay on topic. See Wikipedia:Writing_better_articles#Stay_on_topic (this is a good explanation that I recommend).Anythingyouwant (talk) 20:06, 8 June 2010 (UTC)

Contraception substitute

This edit was reverted under claims of "The cited article really doesn't say that at all." but the information is mentioned in the top of the reference.--Nutriveg (talk) 14:39, 26 May 2010 (UTC)

I read the whole article but - due to being unfamiliar with the formatting - didn't notice the "pull-out" at the top. I don't know who added the pull-out or why, but it doesn't sum up the rest of the piece. The article provides hard figures about abortions but does not mention use of abortion as an alternative to contraception, even at the very end of the article where a spokesman for the Family Education Trust provides a conservative interpretation of the figures:

“ But Norman Wells, from the Family Education Trust, which researches the reasons behind family breakdown, said that the high abortion rates were an “inevitable consequence of a society that has made an idol of sexual pleasure”. He added: "It is not ignorance of contraception that leads to alarming rates of teenage abortions. "The contraceptive culture has made girls feel they have a right to have babies to order and to do away with any that would interfere with their chosen lifestyle." ”

In other words, the article doesn't say what you said it says - no mention of abortion as an alternative to contraception - and it doesn't even say what it says it says. It certainly doesn't refer to some abortions as being "inadequate." It just has an attention-grabbing sub-headline. SHEFFIELDSTEEL^TALK 17:25, 26 May 2010 (UTC)

Guttmacher purge

I'd like to discuss this further. How specifically does a peer reviewed journal like Perspectives on Sexual and Reproductive Health not meet WP:MEDRS, feel free to quote the specific portion of the guideline. Many places we are even clearly attributing the publisher, which we don't do with many other sources, which I think help qualifies the source. I think deleting sources, without replacing them with a substitute source is a form of disruption. Is this content inaccurate at all? Is it simply guilt by association, or do we have bad content in the article? I'd like to discuss the specifics of these edits, and work together to improve the article, and find suitable replacement sources, if that needs to happen, or argue that our current content and sourcing is accurate and within policy. -Andrew c ^[talk] 19:45, 27 May 2010 (UTC)

What is even more alarming is a source from The Lancet was removed because of the authors association with the GI. When do we ban citing The Lancet? Maybe I'm missing something here, which is why we have talk pages, but I'm concerned by the purge, and thus reverted it until further discussion. -Andrew c ^[talk] 19:48, 27 May 2010 (UTC)

Removal of sources as non-MEDRS

Nutriveg has been removing citations to publications from the Guttmacher Institute on the grounds that they are not MEDRS compliant. I have questioned this on their user Talk (composite diff:[3]), since I feel this is a user conduct issue, but they asked that it be discussed here. SHEFFIELDSTEEL^TALK 19:47, 27 May 2010 (UTC)

Perspectives on Sexual and Reproductive Health is a journal published by the Guttmacher Institute which is an advocate group supporting abortion, so a questionable source in this article context because its lack of neutrality in this matter. I also removed primary sources replacing with tertiary sources as possible, as well text that was not clearly supported by the source conclusions. I might have accidentally removed sources from other Journal (The Lancet) that were just stored in the Guttmacher website, I'll check for that. Let's try to use WP:MEDRS compliant sources from now.--Nutriveg (talk) 20:13, 27 May 2010 (UTC)

The lancet source is a primary research for the calculation of unsafe abortion, the article was also produced by Guttmacher Institute employees. Can't we find better WP:MEDRS compliant sources?--Nutriveg (talk) 20:27, 27 May 2010 (UTC)

This is a mistaken and wrong-headed application of WP:MEDRS. I'm not aware that the accuracy or validity of data published in Perspectives has ever been seriously called into question. It is a respectable, well-cited, peer-reviewed journal - in fact, one of the leading scholarly journals on family planning and contraception. Since our goal is to create a serious, respectable reference work, it seems misguided to exclude a significant amount of scholarly literature on the topic. MastCell ^Talk 20:31, 27 May 2010 (UTC)

Fine, find a secondary/tertiary source citing that Perspective article and we can cite that secondary/tertiary source as defined in WP:MEDRS. I've never objected to that and it wouldn't be that hard.--Nutriveg (talk) 20:38, 27 May 2010 (UTC)

MEDRS doesn't actually say that we can only use secondary sources, and it always pains me to see it abused to justify the knee-jerk removal of any "primary" source. The guideline says that we need to use primary sources carefully and avoid abusing them to undermine or "rebut" the conclusions of expert bodies and reputable secondary sources. MastCell ^Talk 20:43, 27 May 2010 (UTC)

Well, WP:MEDRS says:

"Ideal sources for these aspects include general or systematic reviews in reputable medical journals, widely recognised standard textbooks written by experts in a field, or medical guidelines and position statements from nationally or internationally reputable expert bodies. "

I was trying to improve the article in that sense. If Perspectives is as reputable as you say it's NO PROBLEM to cite another source citing that article.

Current use of those primary sources go beyond the WP:MEDRS when it says "should only describe the conclusions of the source" that's not the case for example of that first Perspectives article and it ommits informations found in other articles, like this other study that point to still high abortion between blacks and the unaccounted number of "early medical abortion". So let's use secondary/tertiary sources and avoid those problematic primary sources.--Nutriveg (talk) 21:06, 27 May 2010 (UTC)

Yet another conflicting source "Among the 46 areas that reported data consistently during 1996--2006, decreases in the total reported number, rate, and ratio of abortions were attributable primarily to reductions before 2001. During 2005--2006, the total number and rate of abortions increased". So let's keep citing unreliable primary sources?--Nutriveg (talk) 21:21, 27 May 2010 (UTC)

These sources don't conflict with each other, so I'm not sure why you consider any of them "unreliable". This one says US abortion rates declined through 2005. This one says the US abortion rate declined through 2003, which is clearly consistent. This one says that US abortion rates dropped through 2005 (see Fig. 1, again, consistent with the earlier studies) but took an upturn in 2006 (a year not addressed in the earlier studies). Note also that in 2006, although the number of abortions increased, the ratio of abortions to live births did not. In other words, there were more pregnancies across the board in 2006 - more live births, and proportionately more abortions as well. I think this points up the need - spelled out in WP:MEDRS - to read primary sources carefully. MastCell ^Talk 21:32, 27 May 2010 (UTC)

Less reliable would be a better word when comparing primary and secondary/tertiary articles, primary sources may occasionally be used with care, we shouldn't base articles on them.

By WP:MEDRS we don't interpret primary articles as you're doing above, we only cite their conclusions.

Citation of Perspectives go beyond the article conclusion, and BTW is naive to take chinese official numbers for granted.

Perspectives, omits high abortion between blacks and the influence of unaccounted number of "early medical abortion" cited in the conclusion of this other study

The conclusion of the CDC source says: "decreases were attributable primarily to reductions before 2001" which was as well omitted by Perspectives that had data from data time. The same CDC conclusion says "During 2005--2006, the total number and rate of abortions increased" so current data shows that the trend is inversed.

So when we mention primary source studies "Abortion incidence in the United States declined 8% from 1996 to 2003." a lot of information is missed which usually is not the case for secondary/tertiary studies that compare multiple studies to avoid inaccuracies including of the primary articles methodology and data selection.--Nutriveg (talk) 22:19, 27 May 2010 (UTC)

... in terms of secondary sources, this summary from the World Health Organization goes through 2003 at least. MastCell ^Talk 22:08, 27 May 2010 (UTC)

Would you cite a pamphlet in a scientific work of yours? I don't know to which Journal would accept that. This doesn't fit WP:MEDRS--Nutriveg (talk) 22:26, 27 May 2010 (UTC)

You asked for a MEDRS-style secondary source. I gave you one (an information page from the WHO, which is an international expert body). So now you have peer-reviewed journal articles, supported by information from an international expert body. That's sort of what MEDRS was designed to encourage. And by the way, if I were writing a manuscript for journal submission, I would cite primary sources - other journal articles - exactly like those described above, which you found unsatisfactory. MastCell ^Talk 22:50, 27 May 2010 (UTC)

No, that informational pamphlet is not a secondary source by WP:MEDRS. "Literature reviews, systematic review articles and specialist textbooks are examples of secondary sources, as are position statements and literature reviews by major health organizations. A good secondary source from a reputable publisher will be written by an expert in the field and be editorially or peer reviewed".--Nutriveg (talk) 11:04, 28 May 2010 (UTC)

I disagree, not only with your specific interpretation of this source (which I think falls under synthesis of evidence by a reputable expert body), but also with your general approach to interpreting WP:MEDRS. I'll leave it at that to give others a chance to comment, if they wish. MastCell ^Talk 17:46, 28 May 2010 (UTC)

As yourself pointed above that source is a summary, a brief note, it's not even published it's just a one page (double sided) pamphlet. If you still have a problem understanding it's not a secondary source by WP:MEDRS definition we can bring the discussion about it somewhere else.-Nutriveg (talk) 19:21, 28 May 2010 (UTC)

There is no doubt that the WHO fact sheet is a secondary source. It explains in the last column that it is a version of a larger, fully annotated version, available from a link at http://www.who.int/reproductivehealth/en/ and that lists the sources it summarises. The principal survey used is described at http://www.who.int/bulletin/volumes/88/2/08-057828-ab/en/index.html, which in itself is a secondary source. The data on the fact sheet is completely relevant to this article, and the WHO is a reliable publisher. There can be no valid reason for objecting to the use of the fact sheet here. --RexxS (talk) 00:35, 2 June 2010 (UTC)

Identification in footnotes of affiliation or position for sources

Generally speaking, I'm not for removing Guttmacher sources in the footnotes. However, I do think it would be appropriate in each one of those footnotes to append a very brief statement like "This organization is a pro-choice group" or (if being pro-choice is not part of their primary mission) "This organization takes a pro-choice position." Same for pro-choice individuals, and same for pro-life organizations and individuals, in this article. The readers can then make of it what they will. A disclaimer was previously discussed at this talk page here.Anythingyouwant (talk) 21:43, 27 May 2010 (UTC)

A great deal of the scholarly literature on family planning and abortion is produced by groups that "take a pro-choice position" on some level. For example, the World Health Organization (among other major bodies) lists "improving access to safe abortion and high-quality postabortion care" among its public-health goals. The American College of Obstetricians and Gynecologists (the relevant US expert body) and its UK counterpart both support access to safe, legal abortion as part of family planning. The American Medical Association supports individual doctors in their choice to perform or not perform abortion, and has repeatedly filed amicus briefs on behalf of groups seeking greater access to abortion ([4]). The New England Journal of Medicine frequently publishes editorials and news items critical of the US pro-life lobby's efforts to restrict access to abortion. I don't think it makes sense to start footnoting these and other reputable, scholarly sources in a way that seems designed to push the reader in the direction of skepticism of their findings. MastCell ^Talk 22:25, 27 May 2010 (UTC)

The WHO doesn't promote abortion or its legalization, Guttmacher does. "The Institute works to protect, expand and equalize access to information, services and rights that will enable women (...) exercise the right to choose abortion" The WHO has many goals, Guttmacher has specific ones. It's clearly an abortion advocate group. We can't take their data or analysis for granted.--Nutriveg (talk) 22:37, 27 May 2010 (UTC)

"Improving access to safe abortion" (WHO) and enabling women to "exercise the right to choose abortion" (Guttmacher) are semantically equivalent to me. Anyone else? MastCell ^Talk 22:52, 27 May 2010 (UTC)

Both WHO and Guttmacher have pro-choice positions, and ought to be identified as such in the respective footnotes. See, for example, Ruth Ann Dailey who is a columnist for the Pittsburgh Post Gazette (January 21, 2008): "contrary to the Guttmacher/WHO study's squishy estimates and ideologically driven claims, legalizing abortion can dramatically affect its numbers."[5] Readers of this article need to be aware of the sources' potential leanings. Additionally, since we're talking about primary versus secondary sourcing, there's another significant distinction to be made: sources that are available online and those that aren't, and we need to use less of the latter (because only certain editors have easy access to them, and readers cannot easily fact-check our interpretations of the offline sources).Anythingyouwant (talk) 23:03, 27 May 2010 (UTC)

(EC)It's clearly an abortion advocate group. We can't take their data or analysis for granted. And why is that? Can you cite specific Wikipedia policy or guidelines? Do you have sources which question the validity of our cited sources, or is this entirely based on Nutriveg's personal opinion? Seems like original research. As for semantics, I agree with what MastCell wrote directly above this post. As for the topic header, I think it is a terrible idea to attempt to label all our sources and add disclaimers of sort. If we are using bad sources, we should consider changing them. If we have conflicting sources, we should describe the conflict, if notable, in prose. Anything's proposal above seems unnecessary.-Andrew c ^[talk] 23:04, 27 May 2010 (UTC)

MasterCell, the WHO may be interpreted as pro-abortion but it doesn't say that clear, access is different of right. WHO main goal is defined as "reduce unsafe abortion". While Guttmacher defines abortion as a right and has a mission to expand the exercise of such "right".

Andrew c, Controversies or areas of uncertainty in medicine should be illustrated with reliable secondary sources describing the varying viewpoints. The use and presentation of primary sources should also respect Wikipedia's policies on undue weight; that is, primary sources favoring a minority opinion should not be aggregated or presented devoid of context in such a way as to undermine proportionate representation of expert opinion in a field"

I've no objection in using secondary/tertiary sources that cite the Guttmacher (pro-abortion POV) sources but by WP:MEDRS I disagree of the current use of such POV oriented sources in this article.

The Guttmacher Institute itself defines its mission as "expand (...)(the) exercise (of) the right to choose abortion". Abortion is not qualified as right in a large part of the word if you're unaware of, Guttmacher Institute mission of expanding the exercise of such "right" isn't equally neutral. Does anyone here really disagree it's a pro-choice organization?--Nutriveg (talk) 11:32, 28 May 2010 (UTC)

In some ways, I would prefer if we would cite research papers from NARAL than from Guttmacher, because readers would more easily recognize that NARAL has a bias. This is a short article, so we should be able to find sources that are not sketchy.Anythingyouwant (talk) 14:13, 28 May 2010 (UTC)

I don't believe that scholarly, peer-reviewed literature from Perspectives is "sketchy", nor do I think that material from the World Health Organization is "sketchy". On the contrary, I think such sources form an essential part of any serious, scholarly treatment of abortion (as opposed to a basic he-said, she-said reiteration of political talking points). MastCell ^Talk 17:43, 28 May 2010 (UTC)

Textbooks, newspaper reports, and scholarly articles in publications that guarantee neutrality are not "he-said-she-said".Anythingyouwant (talk) 17:50, 28 May 2010 (UTC)

And I don't object to those, of course. I'm saying that we should not exclude a substantial portion of the scholarly literature on abortion (without which I don't think we can write a serious, scholarly overview). MastCell ^Talk 17:53, 28 May 2010 (UTC)

MEDRS is clear: "Controversies or areas of uncertainty in medicine should be illustrated with reliable secondary sources describing the varying viewpoints", so secondary sources that fill that definition should be used, not primary sources, specially those supporting a specific point of view.--Nutriveg (talk) 19:04, 28 May 2010 (UTC)

I have no objection to marking sources as suboptimal in this article, if everyone agrees that the same information in another source would be okay.

Nutriveg, any reason why the Trupin source has been removed? I thought it had some good info about contraindications for both medical and surgical abortion. And the Tchabo source had some interesting info about overall risk of maternal death.Anythingyouwant (talk) 19:59, 28 May 2010 (UTC)

I don't like the idea of marking sources if they aren't good enough they shouldn't be used to support article text.

We may add information about contraindication, but I prefer to use better sources, will try to find some.

I added the information about maternal death.--Nutriveg (talk) 20:10, 28 May 2010 (UTC)

Marking the sources may not be the best way, but it may be an acceptable compromise between yourself and MastCell.Anythingyouwant (talk) 20:20, 28 May 2010 (UTC)

Nutriveg's interpretation of MEDRS has been questioned by quite a few editors, not just myself. I would rather wait for more input than have this turn into a contest of who-can-shout-the-loudest or who-can-post-the-most-often. Also, tagging sources with our editorial impression of their "bias" is an extreme and (I believe) unprecedented attempt to editorially lead the reader. I don't think that a "compromise" involves meeting these positions halfway, since I think both are rather extreme. MastCell ^Talk 20:25, 28 May 2010 (UTC)

It is completely inappropriate to add our editorial opinion about a perceived bias in sources, because that is our opinion, and nothing more. We only report what reliable sources say. If sources conflict, we simply present both viewpoints in a neutral way with a weight according to their prevalence – that's what WP:NPOV requires. It is a serious mistake to try to exclude a reliable source because it is a minority viewpoint; it is an equally serious mistake to attempt to characterise the POV of a source according to our own view. If a reader wants to learn about the POV of a particular institution, then the Wikipedia article on that institution is the place for that (and such information will also be cited to reliable sources which describe that POV). --RexxS (talk) 00:52, 2 June 2010 (UTC)

Undue weight to "mental health"

I'm confused as to why the section on "mental health" risks is so much longer than the section on general health risks. It is unanimously agreed by reputable expert bodies that abortion does not cause mental health problems. I think we could say this is in a sentence or two, or a paragraph at most. Right now, our section on health risks gives substantial undue weight to this issue, well in excess of that given by independent, reliable sources. Is there any interest in trimming this section down to a more proportionate representation of available information? MastCell ^Talk 17:50, 28 May 2010 (UTC)

Agreed. Go for it. The same might be said for the section titled "Selected issues of the abortion debate."Anythingyouwant (talk) 19:13, 28 May 2010 (UTC)

It doesn't carry mental risks for most but it has exceptions. The WP:UNDUE is not about size, but content. The problem is that the remaining of the health risk section is so small. I improved the mental risk section a little bit---Nutriveg (talk) 19:36, 28 May 2010 (UTC)

Terminology

The Associated Press and Reuters encourage journalists to use the terms "abortion rights" and "anti-abortion", which they see as neutral.

The above is from the article Pro-choice. I'd like to see this article (Abortion) use the more neutral terms oftener, and reduce the use of the pro- terminology, which so obviously is political framing. ("Pro-choice" implies that the alternative viewpoint is "anti-choice", while "pro-life" implies that the alternative viewpoint is "pro-death" or "anti-life").

I've met Europeans who laugh at the pro- terminology. Reducing the use of it will make the article more global.

I'll make a couple such changes. --Hordaland (talk) 22:16, 28 May 2010 (UTC)

I'm pleased to see someone taking this stand. Yes, the pro- words are pure, manipulative POV tools. Go for it. HiLo48 (talk) 22:22, 28 May 2010 (UTC)

Agreed.--Nutriveg (talk) 22:24, 28 May 2010 (UTC)

Thanks for immediate support. When I started this thread there were 6 instances of "pro-choice" and 8 instances of "pro-life". Now there are 4 of each. --Hordaland (talk) 22:36, 28 May 2010 (UTC)

Makes not much difference to me. Generally, I don't like stupid euphemisms, and vague modifiers, so there's something to be said for using the word "abortion" to describe people who take a position about it. On the other hand, self-identification is important too. Anyway, you're removing a lot of wikilinks. Maybe you could use a piped link: anti-abortion, pro-abortion.Anythingyouwant (talk) 22:42, 28 May 2010 (UTC)

I believe that wikilinking a term once in an article is enough. Sometimes the term will be wikilinked in a caption as well as the first occurrence of it in the text.

Let's not introduce a term "pro-abortion" as people don't advocate for more abortions than they believe are desirable/necessary, as that term could be construed. Reproductive rights people usually say that the woman/girl involved must make the final decision about abortion. Hordaland (talk) 14:37, 29 May 2010 (UTC)

WP:Euphemism is reasonably clear, but we do generally accept that the names by which groups self-identify should be respected. I think Hordaland has found a reasonable compromise between the two. Given that redirects are free, I would suggest all the various names can redirect to whatever target title is accepted. Perhaps Abortion debate is a sufficiently neutral target? I suggest that direct language could simply explain terminology, such that

Supporters and opponents of a right of access to lawful abortion are groups that respectively have characterized their positions as "pro-choice" and "pro-life". These groups strongly correlate to - but are significantly different from - the groups that support or oppose a right of lawful access to effective contraception.

(with suitable refs)LeadSongDog come howl! 16:46, 29 May 2010 (UTC)

Like I said, this terminology thing is no big deal to me. But I would like to point out that the terms "pro-abortion rights" and "anti-abortion rights" (or "anti-abortion") would be somewhat misleading. Everyone supports people exercising their rights, and the question here is not whether anyone should exercise their rights, but rather whether the right exists. So, if it were me, maybe better names would be "abortion rights believers" and "abortion rights nonbelievers". That's not how they characterize themselves, but if we go by how they characterize themselves then we'd be sticking with "pro-choice" and "pro-life". Of course, no matter what two terms we use, it will be an oversimplification.Anythingyouwant (talk) 17:05, 29 May 2010 (UTC)

While most people support the exercise of their own rights, many are not so enthusiastic about other people doing so, particularly when those rights have an associated cost to them (individually or, in the case of insured medicine, collectively). However, I would agree that it is essentially a question of oversimplied terminology. I suspect that few care so much about natural rights as about legal rights in this discussion, but that is just a guess. LeadSongDog come howl! 18:52, 29 May 2010 (UTC)

Even in a legal sense, there are non-believers (i.e. people who think that Roe v. Wade is unconstitutional). But whatever terminology people use is pretty much okay with me (within reason!).Anythingyouwant (talk) 20:21, 29 May 2010 (UTC)

Does anyone know if the terms pro-choice and pro-life are very common in English-speaking countries other than the USA? I know that American groups self-identify with these terms, but I wonder if they are immediately understandable for all others? I suspect not. Hordaland (talk) 04:56, 30 May 2010 (UTC)

Yes, common enough in Australia, but used by the bodies thus described as political tools through making the opposite side seem less reasonable when the prefix anti- is added. The terms are out and out POV in themselves. HiLo48 (talk) 05:10, 30 May 2010 (UTC)

Well, now "pro-abortion" has been introduced and as I have said, there is no such thing. People can be pro- the legality and availability of abortion, without being pro-abortion. No one welcomes a rise in the portion of induced abortions in a country where they are readily available. No one who is pro-choice is obliged to welcome abortion in her/his own family. Surely everyone agrees that avoiding any need for abortion is the ideal.

Anti-abortion seems to me to be a correct term, while pro-abortion is not. Most people who are anti-abortion are against its availability in all or nearly all circumstances. --Hordaland (talk) 12:28, 3 June 2010 (UTC)

"Pro-abortion" implies a belief that abortion is a good thing that should be encouraged. Contrast this with being "pro-choice" (being in favour of the woman's right to choose) and "pro-abortion-rights" (being in favour of the right to have an abortion). Ultimately a pro-abortion position may be associated with eugenics programs and forced abortions for e.g. the very young or mentally subnormal. It is not a belief altogether without adherents; rather, it is an extremist position. That in itself - plus the term's use by anti-abortion groups - ought to demonstrate that "Pro-abortion" is a pejorative term. SHEFFIELDSTEEL^TALK 12:46, 3 June 2010 (UTC)

What was wrong with self-identity again? Yeah, the AP has decided to use it's own terms, and there can be arguments that both are somewhat misleading, but still... self-identity seems more in line with Wikipedia policies, it isn't proscriptive or trying to right some perceived wrong. And it had been the longterm standing consensus on multiple articles. The recent edits to the article show that the change was controversial, and perhaps lacked consensus yet. I think self-identity is better than using homegrown, awkward phrasing such as pro-abortion availability which is the current state of the article. -Andrew c ^[talk] 13:31, 3 June 2010 (UTC)

Those "pro-x" self-identity terms violate WP:WEASEL if nothing else. It won't harm the article to actually use English descriptive clauses rather than spin-doctor's labels. At worst it will add a few dozen words. It also allows discussion of nuanced positions. Not everyone supporting access to family planning supports access to abortion. Not everyone opposing abortion is so literally "pro-life" as to eschew using antibiotics. LeadSongDog come howl! 13:50, 3 June 2010 (UTC)

eschew using antibiotics, I'm sorry, what are you talking about? Sounds like a strawman argument. The "Catholic Church" is not necessarily the one, universal Christian church. Many arguments could be made that choosing such a title for itself is weasely. What about the Palestine Liberation Organization or the Symbionese Liberation Army? Surely arguments could be made that these are weasel terms for terrorist organizations. What about vegetarian? Surely, people still consume food that isn't vegetable based. Fruits, grains, legumes, fungus, not to mention all the microbs. I mean, these arguments seem ridiculous to me. I read WP:WEASEL and I don't see hot it applies. If we say "survey X found 46% of Americans consider themselves 'pro-life'", it is entirely clear what it means, just as if it said "26% of Americans consider themselves 'catholic' or vegetarian". If we say "pro-life organizations hold that...." we know what it means. It isn't weaselly in any sense, IMO... -Andrew c ^[talk] 13:23, 4 June 2010 (UTC)

We could avoid this whole debacle by just sticking to pro-choice/pro-life. - Schrandit (talk) 06:06, 4 June 2010 (UTC)

Let's not confuse organizations with positions. If the "Pro-x Alliance of Inner Outer Slobovia" says something in its literature or on its website, of course we use that name in the attribution. But points of view are graduated in various subtle ways. Our language should not introduce further polarization. We would not say "26% of Americans consider themselves 'catholic' or vegetarian", but rather that "Such-and-such a source estimated that 26% of Americans consider themselves 'catholic' or vegetarian". When a statement is clearly dubious but notable, we alway seek to attribute it in text. The antibiotic comment is fairly self-evident, not a strawman at all. Life is inherently a competitive phenomenon. One organism lives only at a cost to other organisms. To "respect life" as the slogan goes really means to "respect the life of an embryo" not "respect all life", which would include the lives of various organisms that might threaten the life of that embryo or its mother. LeadSongDog come howl! 13:48, 4 June 2010 (UTC)

Before everybody spends too much time debating what we think about terminology, we should first acknowledge the two elephants in this particular room. The section where these terms are used principally is Abortion debate. It claims (using the {{main}} template) to be a summary of the articles Abortion debate, Pro-choice and Pro-life. If that template is to remain, then the section needs to accurately reflect those. At present, I think it is rather short of that goal. Secondly, and more importantly, the section has four paragraphs and one source. If the text had been written with reference to reliable sources, then no-one would be in any doubt about what terminology the preponderance of sources use. My suggestion is to go back to the sources. The three articles to be summarised have plenty of sources – some of them even reliable sources. Why not use the experience of the long-term editors of this article to set out here the reliable sources that relate to the Abortion debate section? Then you can agree the sources to use and the text for the section. It needs to be done anyway, and a by-product would be it would settle the debate about what terms to use. --RexxS (talk) 14:20, 4 June 2010 (UTC)

RexxS probably has the best idea, you know, following sources. Schrandit's last edit is disruptive because people here specifically objected to "pro-abortion", yet Schrandit re-instated it. Seriously, does consensus and working with other editors not mean a thing? Hordaland and SheffieldSteel strongly objected to "pro-abortion". So why on earth put in the article, despite (or in the face of) this ongoing discussion. Perhaps it's best to restore the longstanding version pro-life and pro-choice, as there hasn't been consensus to change anything yet. Someone made a bold edit, we tried to fiddle with it, yet haven't come to a compromise we can all agree with yet. I objected to "pro-abortion availability" because it is awkwardly phrased, and gets very low google hits, so it's a self-coined, perhaps neologism, which we should avoid. I instead restored the phrasing that the AP used, and is cited above in the first post, as it seems like more people on this talk page were into that then using the terms of self-identity (my preference). I mean, I'm trying to work with y'all, and I'm down for a compromise, but lets NOT use terms which multiple editors object to, OK? Can we agree on that at least? And then perhaps restore the old version while we work this out further? -Andrew c ^[talk] 20:16, 4 June 2010 (UTC)

Using neither and just sticking with the previouw pro-choice/pro-life sounds dandy to me. - Schrandit (talk) 20:27, 4 June 2010 (UTC)

I agree that it would be best to restore the longstanding pro-choose/pro-life terminology for the time being, as Andrew c and Schrandit said.Anythingyouwant (talk) 21:07, 4 June 2010 (UTC)

You seem to have very strong opinions, but are not participating in the discussion. In light of what I said above, would you consider reverting yourself, as you introduced a term clearly which lacked consensus? Then, would you like to put forth arguments why you'd prefer "pro-abortion", or instead revert back to the self-ID terms? Building consensus only work if you are an active participant in a discussion :) -Andrew c ^[talk] 20:40, 4 June 2010 (UTC)

I don't see any terms in the fray that gather more consensus and at the same time I am unprepared to allow one side on the debate to be described in positive terms while the other is described in negative terms. - Schrandit (talk) 20:47, 4 June 2010 (UTC)

Sources for Abortion debate

• Goldstein, Norm, ed. (2007). The Associated Press Stylebook. Philadelphia: Basic Books. - page needed.

Health risks rewrite

I've taken a shot at rewriting the section on health risks. The previous section had several shortcomings (IMHO):

• Numerous one-sentence paragraphs
• Spotty overview of health risks, with focus on isolated factoids and no clear summary
• Written in a somewhat opaque style
• Did not address the difference in risks between "safe" and "unsafe" abortions, which is of great importance to a worldwide (as opposed to Western) overview

I'll leave it open for comments and changes. I think the new version is a bit better (obviously), in that it clearly delineates the difference in risk between "safe" and "unsafe" abortion. It also provides a more organized overview of risk - both the absolute risks and relative risks for abortion and childbirth are given, and they are juxtaposed (as they are in virtually all scholarly sources on the topic) rather than presented in isolation. I think I've emphasized that there are actual risks associated with abortion, to address the charge (above) that the article made it sound like abortion was entirely risk-free as opposed to merely very safe.

I've tried to avoid sourcing material from websites of organizations like Planned Parenthood and Guttmacher. While these websites have ample and high-quality information, their association with the pro-choice viewpoint in the US always renders them problematic. I've tried to go for review articles, WHO material, etc supported by some key primary sources which illustrate the conclusions of secondary sources.

There are still some areas that need work. For example, the specific health risks of medical abortion (at least those that differ from surgical abortion) remain to be spelled out, pending a good source. Additionally, the "mental health" section should be condensed and probably conflated with other non-risks like breast cancer. I'd welcome any updates, new sources, or comments. MastCell ^Talk 23:47, 1 June 2010 (UTC)

Looks pretty good and thorough and sourced. I thought you had devoted a good amount of space to medical abortion. Thanks for taking the time and effort. Kodus. That said, I found it a little awkward to have the parenthetical phrase (requiring surgical abortion) twice in the same paragraph. And now we have two sections in the article called "unsafe abortion" so direct linking will break (and should we be discussing the health risks of unsafe abortion before discussing the topic of unsafe abortion more generally?) I may have some more comments later, but overall, an improvement for sure. -Andrew c ^[talk] 01:30, 2 June 2010 (UTC)

I haven't got time right now for a detailed critique, so this will be brief.

I do not see any need for this article to contain two separate subsections titled “unsafe abortion”. Much of this newly overhauled section is redundant. For example, the new material says: "Medical abortion with mifepristone and misoprostol is effective through 49 days of gestational age." But the article already says, "When used within 49 days gestation, approximately 92% of women undergoing medical abortion with a combined regimen completed it without surgical intervention." Why so much redundancy?

I do not see any reason to completely exclude information about contraindications, especially for medical (i.e. non-surgical) abortion. We have previously discussed a source that details the contraindications for both medical and surgical abortion.[6]

I support the statement that for most women abortion is safer than childbirth, when performed according to recommended protocols. But why now omit that the risk of maternal death is slight even for childbirth? This hugely slants the article. We've discussed this at this talk page repeatedly, so should we conclude that the omission from the article is deliberate? All of this material was in the NPOV (but reverted) edit I made to this section of the article, including the statement that abortion is safer than childbirth (not just early abortion or surgical abortion). Now that material is omitted. This is not just a matter of emphasis, but of complete omission.

Additionally, we're not writing a textbook here, so I would think you would be able to find accurate sources that are available on the internet for free, via Google Books or Google News Archive, or Google Scholar, so that other editors can look at them. Did you look and were unable to find them? If so, doesn't that say something about the non-notability of the information being cited?

When saying that abortion is safer than childbirth, I would prefer if we hedge a little bit, as our frequently cited author (Grimes) does. He says: "For most women, fertility regulation by contraception, sterilization, or legal abortion is substantially safer than childbirth" in his article "The morbidity and mortality of pregnancy: still risky business", Am. J. Obstet. Gynecol., Vol. 170, pages 1489–1494 (1994), pmid 8178896. Is there some reason to depart from what Grimes says here?

I object that this article devotes so much space to rebutting notions that could easily be rebutted in much less space (health risks, breast cancer, fetal pain, effect on crime rate), while not addressing a primary reason why women may decide not to get an abortion, namely the alleged indicia of humanity in the embryo or fetus.Anythingyouwant (talk) 01:43, 2 June 2010 (UTC)

You guys both identified the duplication of "unsafe abortion", which I have to admit I missed. I agree that we should streamline and combine those two sections, though I'm not sure at a glance how best to do so. I do think that a discussion of health risks needs to detail the distinction between "safe" and "unsafe", but perhaps we can shorten/merge somehow.

Anythingyouwant identified duplication of the timeframe for medical abortion. I admit that I missed that redundancy as well; it's not essential to repeat the timeframe for a discussion of health risks, so it could probably be excised from the "Health risks" section.

Contraindications are not the same as health risks. In fact, there is no health risk to someone with a contraindication, because they won't be eligible to have an abortion. That's not to say that there is no room for a discussion of contraindications to various methods of abortion, but it didn't seem to fit properly in "health risks", since contraindications to the procedure are clearly distinct from health risks caused by the procedure.

I don't think I have omitted information about the small risk of maternal death from childbirth. In fact, I gave precise and properly sourced figures for the exact magnitude of the risk, just as I did for the risk of abortion. The reader can see (rather than simply take our word for it) that both absolute risks are slight. If anything, I've emphasized the safety of both childbirth and abortion by providing absolute risk estimates, while also mentioning the relative risks of the two (as reliable sources do).

Quality of information is not synonymous with its free availability. Any overview worthy of a serious, respectable reference work will necessarily be based on the scholarly literature. In many cases, the scholarly literature is not freely available online - although it is generally freely available at any halfway-decent library, thanks to our tax dollars at work. I looked for the best available sources - as in those in high-quality journals, those that dealt with the topic at hand directly, and those that are frequently cited by reputable authorities - and this is what I came up with.

Most sources don't "hedge" at all when saying that abortion is safer than childbirth - I actually hedged by saying "through 21 weeks", because a lot of expert sources make a blanket statement that abortion is safer at any gestational age. I don't think it is an accurate representation of Grimes' article, or of the scholarly literature in general, to excessively hedge here - if anything, we're understating the degree to which reliable sources hold that abortion is safer than childbirth.

As to space, we go where the sources go. For awhile, there was a lot of literature addressing the (non-)link between abortion and breast cancer. Likewise with the supposed mental-health sequelae of abortion, and fetal pain. I'm not as familiar with available sources on the impact of views on the humanity of the fetus on the decision to have or not have an abortion, but I agree that this would be a relevant topic for this article to discuss. If you have some decent sources in mind, please lead the way. MastCell ^Talk 04:20, 2 June 2010 (UTC)

This edit has several problems.

• There are specific articles for Unsafe abortion and Medical abortion so much of that edit belong to other articles. ::::* Concerning surgical abortion it gives undue balance to mortality risk as a health risk, since that risk is minimal, but the first paragraph only talks about it.
• The statement that complications is rare is not supported by updated sources, complication risk is low but they are common due to the high number of abortions. Botha, Rosanne L.; Bednarek, Paula H.; Kaunitz, Andrew M. (2010). "Complications of Medical and Surgical Abortion". In Guy I Benrubi (ed.). Handbook of Obstetric and Gynecologic Emergencies (4 ed.). Lippincott Williams & Wilkins. p. 258. ISBN 978-1605476667. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Complications are not well represented and the presented solution is deceptive. (Botha, 2010)
• Procedures details, like: description of aspiration, places where they are performed and antibiotics should belong to the procedures section.

So I'm reverting that major change. Please add unrelated text to specific sections/articles and make other changes incrementally.--Nutriveg (talk) 14:21, 2 June 2010 (UTC)

I reverted your major change as well, as MastCell's first 3 bulletted points above discuss the shortfalls of your version. I'm not going to talk down to you and ask you to make changes incrementally. Bold edits are to be encouraged, and I think MastCell's went a long way to improve that section. The section is how it was for quite a long time before the recent edits. It is the longstanding consensus version. There is no consensus for any change (Nutriveg or MastCell's) so we revert to default. What can we do to address everyones concerns and perhaps find a harmony between the two versions?-Andrew c ^[talk] 14:42, 2 June 2010 (UTC)

Or we can continue to edit wildly and pray out edits don't get reverted, in lieu of discussing our differences :Þ -Andrew c ^[talk] 15:23, 2 June 2010 (UTC)

I've addressed the issues raised by MastCell and moved unrelated content elsewhere. That previous version (where I started from today) is closer to that older version where incremental changes were made since then. Beyond that I don't like putting specific numbers to maternal death since that number varies yearly, IIRC it's currently around 0.4 for abortion and 2.5 to live births. I refuse making straight comparisons of maternal death because those are not statistically adjusted (age, risky pregnancies,...), both numbers are very low and comparing near "zeros" is stupid.--Nutriveg (talk) 15:28, 2 June 2010 (UTC)

Andrew c's deletion edit note implies this is going somewhere else, but that doesn't seem to have happened.LeadSongDog come howl! 16:51, 2 June 2010 (UTC)

Abortion and mental health already mentions the Johns Hopkins University's 2008, as is information regarding economic and decision issues. Did I delete any content which isn't covered already at Abortion and mental health in more detail? Or am I missing your point entirely?-Andrew c ^[talk] 17:01, 2 June 2010 (UTC)

← To address Nutriveg's concerns:

• I agree that we should avoid duplication of content. But I don't see how we can accurately discuss the health risks of abortion without drawing some sort of distinction between safe and unsafe procedures (I think there was general agreement on that). Do you have any suggestions about how to cover this distinction in the "health risks" section? That might be more useful than reverting.
• Mortality is the most prominent health risk, both as a matter of common sense and as a matter of weight in reliable sources, so I think our coverage reflects that weight (whatever Nutriveg's personal opinion of it might be).
• If you want to add information on non-lethal complications, feel free. The rate is very low. The source you favor (Botha 2010) states: "Fewer than 0.3% of abortion patients experience a complication that requires hospitalization." If you'd like to include that sort of information, be my guest.
• If you wish to use different language to discuss the frequency of side effects, then propose some rather than reverting the entire edit. For example, it might be more precise to say that the complication rate after abortion is very low (perhaps citing the numbers given by Botha in my bullet point above). We could add that although the rate of complications is low, abortion is a common procedure and therefore it is "not uncommon" for gynecologists to encounter women who have had complications from abortion. Personally I think this is a bit silly - the article should probably be written from the perspective of the individual reader rather than the practicing gynecologist - but whatever.
• I'm not sure what you consider "deceptive"; elaboration might be useful.
• If you want to move specific details of the procedure, please feel free (doing so does not require a blanket revert). I think some minimal level of detail is necessary, since the risks may vary depending on which procedure is used, but I agree that most detail should be in the "procedures" section.
• I'm interested in the comparisons made by reliable sources. Those sources repeatedly and commonly compare the risk of abortion to that of childbirth, and so this is the appropriate comparison for article, regardless of whether Nutriveg personally finds it "stupid".

Thoughts? MastCell ^Talk 18:15, 2 June 2010 (UTC)

Answering

• Your separation of safe vs unsafe was already incorporated to introduce the specific articles.
• Mortality is not the most prominent health risk in this case, it's negligible so there's no reason to be lengthy about that.
• That source said despite the low risk of complications incidence is common due to the high number of abortions not rare as you early said. The current text uses the same terms of that source "low".
• I didn't revert the whole edit, you that rewrote the whole section. I incorporated those relevant changes in this an other specific articles. I'm against citing numbers since they vary from country, year, source and method. Most of the sources, like Botha is US centric.
• Your text mentioned only one trivial medical procedure that would be necessary in case of abortion complications.
• I may not be the most appropriate person to move those procedure descriptions to the appropriate section or article, the article is already big and it doesn't need to repeat itself.
• As I said those comparisons weren't statistically adjusted (for age, risky pregnancies, ...) and dividing anything to zero results in a large number. According to your 0.56 per 100000 maternal death number, abortion would be almost 3 times more deadly than vaginal birth. These comparisons don't carry relevant death risk to worth comparing, less a direct (unadjusted) one.--Nutriveg (talk) 19:29, 2 June 2010 (UTC)

Have you read the article you mention in your last bulletpoint (PMID 18455140)? It notes a maternal death rate of 6.5 per 100,000 births, which is very close to the figure we cite. You must be looking at the rate of maternal death causally related to mode of delivery, which for vaginal birth was 0.2 per 100,000. That statistic reflects only deaths which (in the authors' opinion) could have been avoided by going to C-section. It does not represent the overall maternal death rate. You're comparing apples to oranges.

Do you understand the difference? It's a subtle point, but it nicely points up the reason why WP:MEDRS urges against cherry-picking primary sources. You've gone to a primary source which has nothing to do with abortion and pulled out a number. As it turned out, you've incorrectly interpreted the paper, which is a risk when you employ papers to make a point that the authors themselves don't make. If we didn't double-check your assertion carefully, we might have made a similar error.

That's why I'm citing papers which specifically address the safety of abortion as it relates to childbirth. The numbers are actually quite consistent if you read carefully. But even that issue becomes superfluous if we choose sources which directly address the questions at hand, rather than trying to pull numbers from unrelated publications to buttress our personal viewpoints. MastCell ^Talk 20:56, 2 June 2010 (UTC)

First of all I'm not trying to use that source, I just used it as an example it's not worth to compare such near zero numbers. ::::I just read the article abstract, I don't have access to the whole article but it says "The rate of maternal death causally related to mode of delivery was 0.2 per 100,000 for vaginal birth" not "The rate of preventable maternal death causally related (...)" as you stated above. Sure there are other causes but it's just an example we can't make a direct comparisons (without adjust) since the causes of maternal death are restricted to specific factors. --Nutriveg (talk) 21:11, 2 June 2010 (UTC)

I still don't expect to use comparisons in the article but just as an information see what I've found "After the 19th week of pregnancy the maternal death rate due to abortion is greater than that of childbirth"

Jones, Richard Evan (2006). Human Reproductive Biology (3 ed.). Academic Press. p. 429. ISBN 978-0120884650.--Nutriveg (talk) 22:19, 2 June 2010 (UTC)

You don't need full-text access. See the abstract, first sentence under "Results": Ninety-five maternal deaths occurred in 1,461,270 pregnancies (6.5 per 100,000 pregnancies.) This is not an "example" of anything except the danger of using primary sources without reading them carefully.

As to the Human Reproductive Biology book, it doesn't describe the basis for its claim that abortion is riskier than childbirth after 19 weeks. Nonetheless, if you'd prefer to provide various expert interpretations of the risk at late time points, we could cite it as part of a full discussion, along with sources such as eMedicine and UpToDate, which argue the opposite (that abortion is safer at any gestational age). It seems a bit excessive, since extremely few abortions are performed after 19 weeks, but I'm fine either way. MastCell ^Talk 22:32, 2 June 2010 (UTC)

Please don't read problematic content without discussion, ignoring the problems reported before, like making Division by zero to imply a high risk from maternal death from child birth when it's actually very low, using unadjusted correlation, adding content that belong to other specific articles and making major changes that can't be individually reverted.--Nutriveg (talk) 01:43, 8 June 2010 (UTC)

One of the changes repeatedly made by you is replacing maternal death with mortality rate, please use the correct naming definition by WP:MEDMOS. Abortion is pregnancy management.--Nutriveg (talk) 02:18, 8 June 2010 (UTC)

Since those US statistics were so important to you I moved them to the specific article and created a link for it. I also would like to remember the same was already done for Medical abortion long before.--Nutriveg (talk) 02:52, 8 June 2010 (UTC)

About medical abortions, and the four 2005 deaths due to infection. From my recollection of those events, and their media coverage, the deaths were related to an off label application of misoprostol. Misoprostol was not recommended to be taken vaginally, yet all 4 cases were related to the off label application. I personally feel that if we are to mention the deaths, perhaps we should also mention that it was off label usage? But then again, the RS we are citing doesn't think it is important enough to mention, so maybe I should be quite as I clearly don't know better than published scientists... (quick google search found something like [7])-Andrew c ^[talk] 02:51, 8 June 2010 (UTC)

This is likely a issue for the Medical abortion#Health risks article.--Nutriveg (talk) 03:03, 8 June 2010 (UTC)

Contraindications

The info about the risk of childbirth was in a parenthetical that was not apparent on a first read, so I fixed it.

Regarding the assertion that contraindications do not involve health risks, I disagree. If a person with contraindications for medical abortion gets a medical abortion then the risk is abnormally great, just like if a person gets an abortion in an unsafe operating room the risk is abnormally great (or gets an abortion where they are illegal). Also, I have not suggested hedging any more than Grimes has.

Regarding the idea that I would take the lead on writing a section that addresses alleged indicia of humanity that cause some women to not get abortions, I would need some kind of assurances that doing so would not inspire accusations of POV pushing. That's why I would prefer if someone else would get started on it.Anythingyouwant (talk) 05:10, 2 June 2010 (UTC)

Can you suggest any sources that you would consider appropriately encyclopedic, to assist in writing it? MastCell ^Talk 06:04, 2 June 2010 (UTC)

No, I usually accumulate sources in the process of writing a section. But I think it's common knowledge that many people find significance in such things as when unique DNA is formed and/or when the heart starts beating and/ or when the shape and form become characteristic of humans and/or when movement begins and/or when the first electrical activity can be detected in the brain and/or when the chance of survival to birth becomes very probable and/ or when the mother can feel kicking and/or when survival outide the womb could be possible. These seem like the primary alleged indicia of humanity that cause many women (and men) to either completely oppose abortion (of their own offspring or offspring of others), or alternatively encourage abortion sooner rather than later in pregnancy. There are zillions of reliable sources out there. I feel like I would be just as susceptible to accusations if I named sources, as if I drafted the section myself.Anythingyouwant (talk) 14:48, 2 June 2010 (UTC)

"unsafe" v. "safe"

In short, what? Is "unsafe" a type the same way surgical is? What is "safe" abortion? Even under the best of circumstances an abortion is an invasive medical operation and the mother does incur risks. This section is stange, illogical and contradictory, I think there should be a link to the article Unsafe abortion at the end of this article but the two section should be removed. - Schrandit (talk) 05:22, 3 June 2010 (UTC)

I included the definition of unsafe abortion in the edits I made. This is a categorization used by the World Health Organization, and one that is prevalent in the scholarly literature on abortion, so you might want to take it up with them. I think everyone agrees that abortion carries a small but finite risk (as does childbirth). What exactly do you find contradictory? MastCell ^Talk 05:32, 3 June 2010 (UTC)

No MastCell, everyone does not agree that abortion carries a small but finite risk. In fact, a pretty sizable majority of the American people believes that the later in pregnancy an abortion is performed, the greater the risk that it is equivalent to homicide. Speaking in shorthand at this talk page might not be so bad, if the article itself avoided such shorthand, and did not totally fail to discuss the reasons why this risk is thought to exist. The article starts out by acknowledging that death is involved, but people are justifiably comfortable with death. Thousands of sperm die every time a male masturbates. What this article avoids like the plague is any description of the reasons why so many people believe that not just death may he involved, but something equivalent to homicide, as pregnancy advances into it's later stages. Am I missing something, or is this a big oversight in this article?Anythingyouwant (talk) 06:01, 3 June 2010 (UTC)

Not exactly what is being discussed here, but I guess you can keep bringing it up in every single discussion here if you want. We currently clearly states the anti-abortion position argues that a human fetus is a human being with a right to live making abortion tantamount to murder. Would you be happier if we changed "murder" to "homicide"? I guess you want more detail than just that? I just don't think we need to mix ethical and political banter in with the medical explanations and details. Compartmentalize them, if you will. Also, I don't think interjecting the same argument over and over on the talk page is helpful. Keep it in one discussion header. (and I'm not helping, I know, by continuing this discussion in an offtopic location).-Andrew c ^[talk]13:39, 3 June 2010 (UTC)

If anyone is undecided about which word to use in a particular context, simply look at the words used by the reliable sources specifically discussing the issue. If the preponderance of sources use one of those words, then we use it. We shouldn't be imposing our preconceptions on what the sources say. --RexxS (talk) 14:18, 3 June 2010 (UTC)

"Safe" is a politicized definition, it describes an activity that is inherently risky (not outrageously dangerous, but by no stretch safe) as safe for the sake of political expediency, not fact and I think we're above that. It might make sense to discriminate between abortions that take place in a medical context and ones that don't but it doesn't make sense to pander to these definitions. It also doesn't make sense to include these distinctions in with a list of abortion methods. - Schrandit (talk) 06:19, 3 June 2010 (UTC)

"Unsafe abortions are characterised by the lack or inadequacy of skills by the provider, hazardous techniques and unsanitary facilities." World Health Organization page 3. If you'd read the source, you'd have known that. This talk page is for discussing improvements to the article, not a forum for expressing personal opinions: "an abortion is an invasive medical operation ..."; "everyone does not agree ..."; "a pretty sizable majority of the American people believes that ..."; "so many people believe that ...". First read reliable sources - there's plenty of them. Then neutrally summarise what the sources say. If there's uncertainty about what the sources are saying, bring it to this talk page and discuss those sources. There's no place for unattributed assumptions and speculation here. --RexxS (talk) 07:14, 3 June 2010 (UTC)

I have looked at the source, a political body has decided to take something that is red and call it blue. This is not the WHO making a numeric or otherwise verifiable claim, in this instance they have decided to give one category of abortions a politicized name and that name is far from unassaliable. "Safe" is neither a accurate or helpful description and we are under no obligation to use it. - Schrandit (talk) 08:35, 3 June 2010 (UTC)

Do not use this page for voicing your own opinions on the subject (e.g. "is red"). Instead, discuss how this article can best provide a neutral summary of what reliable sources say. It isn't just a good idea, it's policy. SHEFFIELDSTEEL^TALK 12:27, 3 June 2010 (UTC)

It's not your place to look at a reliable source and decide that that it is being made by a political body or that the author is making unverifiable claims. Those sort of assertions and opinions about sources carry no weight, and for good reason. Articles are not made by writing your opinion and then cherry-picking sources to match it, while rejecting those that don't for spurious reasons. If your point is that WHO is not a reliable sources for health information, take it to the reliable sources noticeboard and get some consensus for that supposition. --RexxS (talk) 12:50, 3 June 2010 (UTC)

Perhaps my last edit will address some of the concerns? I didn't like that we had two section headings in the article for "unsafe abortion", and I didn't like having one/two sentence, short paragraphs. So I combined two really short sections into one, which acts as an introduction to the health risks section. Seems relatively elegant to me, and it gets rid of the "safe abortion" header, which some found problematic. But make it clear, I made my edits to try to improve flow and readability, and not because I think the WHO has politicized a significant public health issue "unsafe abortion" or that I find the WHO unreliable or anything like that. -Andrew c ^[talk] 13:57, 3 June 2010 (UTC)

That looks a good deal better to me, thanks. - Schrandit (talk) 06:06, 4 June 2010 (UTC)

Why Not Have a Section on "Dependency of attitudes on developmental stage" ?

Most people are neither purely pro- life nor purely pro- choice. There is a whole range of positions and reasons for those positions, most of which are linked to the biological condition of the embryo or fetus. This is true of the positions that governments take, and it is true of the positions that individuals take. Fighting about which two terms to use for the extreme positions dumbs down and polarizes this article, absent an intelligent description of why many women seek to get abortions earlier rather than later: the desire to do no harm.Anythingyouwant (talk) 16:41, 3 June 2010 (UTC)

I'll assume most of you editors agree this is a glaring omission from this article. That being so, I wonder if the admins who are long-time caretakers of this article would be interested in WP:Writing for the opponent. If not, I'll get started on a draft section in a few days.Anythingyouwant (talk) 04:45, 4 June 2010 (UTC)

I really have no idea what you are talking about, so I look forward to seeing what you mean. If you give me a couple sources as an example of what you mean, I might be able to come up with something, but "Dependency of attitudes on developmental stage" does not compute to me. Sorry. -Andrew c ^[talk] 13:14, 4 June 2010 (UTC)

I don't see how my initial comment in this section could be clearer. That it reads like gibberish may have more to do with how it's read than how it's written. What is unclear about the idea that many men and women avoid or discourage later abortions as compared to earlier abortion because of the more life-like characteristics that appear as gestation progresses?Anythingyouwant (talk) 16:16, 4 June 2010 (UTC)

So that's a "No" on giving me a couple example sources....? -Andrew c ^[talk] 18:54, 4 June 2010 (UTC)

The POV I described is extremely well-known. If you don't realize or acknowledge that it exists or acknowledge that it is comprehensible, then I don't see how providing sources to you would help. Part of WP:Writing for the opponent is finding reliable sources. If I were to give you sources, then I would doubtless become a target for picking a bad set of sources. I'll just draft a section in a few days with lots of sources, and then the usual editors can attack it, I'll go for an RFC, et cetera, et cetera.Anythingyouwant (talk) 20:02, 4 June 2010 (UTC)

"No" it is! Thanks for nothing :P -Andrew c ^[talk] 20:18, 4 June 2010 (UTC)

Another possibility would be, as soon as you find the sources that you are going to work from, cite them in the subsection below and we can all join in a collaborative effort to write some text from them. Establishing consensus beforehand rather than having an edit war is usually a better route. --RexxS (talk) 21:25, 4 June 2010 (UTC)

Sounds interesting, I'll wait to see how it turns out. - Schrandit (talk) 06:06, 4 June 2010 (UTC)

I'd like to point out a shortcoming of this text in the "Abortion Debate" section, which is relevant to this section of the discussions here. "Generally, the anti-abortion position argues that a human fetus is a human being with a right to live making abortion tantamount to murder. The pro-abortion availability position argues that a woman has certain reproductive rights, especially the choice whether or not to carry a pregnancy to term." The second sentence fails to bring up the importance of the word "person". Note that the U.S. Constitution does not use the phrase "human being" anywhere, but it does use the word "person" a great deal. And there is a very significant piece of evidence that the two things, "human being" and "person", are not always the same thing, legally speaking: The U.S. Constitution requires that a Census of all "persons" be conducted every 10 years --the Founding Fathers were directly responsible both for that part of the Constitution and for the specification of what data should be collected in the very first Census of 1790. Unborn human beings have never been counted as persons in any Census!, including the current Census of 2010. It should be very clear, then, that just as one should not count one's chickens before they hatched, the attitudes of the writers of the U.S. Constitution did not include the notion that unborn human beings qualified as persons. Reference: http://www.census.gov/history/www/through_the_decades/index_of_questions/ V (talk) 16:57, 4 June 2010 (UTC)

You might want to bring that up at the Roe v. Wade article, since that article deals with U.S. legal issues more than this one does. And you might want to keep in mind that dogs and cats are not persons, and yet that does not mean all laws are unconstitutional that prevent cruelty to animals.Anythingyouwant (talk) 17:07, 4 June 2010 (UTC)

Do note that the SPCA kills more non-farm animals than anyone else (not counting environmental destruction). Certainly they do it as humanely as possible, and I'm sure that even an anti-abortionist would agree that if an abortion must be done (such as if a pregnancy is ectopic), then it should be done as humanely as possible. But the main abortion argument is not about how to do an abortion, but whether. --And that's why various other issues are introduced, such as the faulty concept of claiming that unborn human beings automatically always qualify as legal persons, without ever at any developmental stage qualifying as mere animal bodies. V (talk) 17:46, 4 June 2010 (UTC)

Wikipedia is world-centric not specific to the US, it's not a legal forum neither, the fetus has a complete individual human DNA, so it does qualify as human, at least for those who see it that way, so the definition is OK when describing their POV.--Nutriveg (talk) 19:17, 4 June 2010 (UTC)

What? A cell scraped off the inside of my cheek has "a complete individual human DNA"; so do the white cells in a tube of blood; but no one would consider them "human". I don't think you're correctly parsing the pro-life argument, which is that a fetus has not only a human genome, but the capacity to develop into a human given the right gestational environment. MastCell ^Talk 21:37, 4 June 2010 (UTC)

The "capacity" argument is inherently flawed. You have the capacity to fall down a stairway and break your neck. Does the fact that that capacity exists mean it must become realized? I think you will say "NO!". Just as there are in actual fact no sorts of capacity at all that absolutely/inherently must be realized. There are many types of capacity that human people might want to be realized (capacity to obtain next meal, for example). But none that must, for the Universe to continue to exist. V (talk) 08:01, 5 June 2010 (UTC)

A scraped cell of your cheek doesn't have an individual human DNA, it has the same DNA as yours, it's part of you, if you want to cut your arm instead of scrap your cheek that's your problem, that's not the case of a fetus that carries the individuality of a human not of "any animal" as pointed above. I won't further discuss when life starts or how other governments around the world define it starts at conception, since this is not a place to debate. I just pointed to someone which wanted to disqualify fetuses as mere animals, where I pointed to the individual complete human DNA and the definition used by those involved in the phrase.--Nutriveg (talk) 22:22, 4 June 2010 (UTC)

It is quite factual that human bodies are animal bodies, similar in many ways to a large variety of other animals in the world, and almost all of which are each as biologically unique in its own way as each human is biologically unique in its own way. The thing that makes humans more than only animals is the magnitude of their minds' abilities. Have you ever contemplated what human society would be like if every human being had an animal-level IQ? In what way would such a human species qualify as more than just another variety of animals??? The fossil record plainly shows us ancestral hominids that were indeed more animal than otherwise; they didn't start to control fire until less than 2 million years ago. How much brainpower does it take to dare to control fire? Brain sizes of large gorillas peak at about 700 cubic cm; the first hominids to use fire had an average adult brain size of at least 800cc. http://www.stanford.edu/~harryg/protected/chp22.htm Meanwhile, a modern human baby typically starts out with less than 400cc of brainpower (and therefore every fetal stage has even less, including zero at conception). http://hypertextbook.com/facts/2001/ViktoriyaShchupak.shtml There is no way a human fetus qualifies as more than a mere animal, in terms of both body and mind, with respect to every moment of its existence as a fetus. V (talk) 08:01, 5 June 2010 (UTC)

Several animals have bigger brains than humans have. Anyway: (1) size is not determinative, (2) a laptop computer is a lot smaller than a 1960s era mainframe computer but can do much more, (3) when people are sleeping the performance of their brains is unimpressive (we can have nightmares!) but that doesn't mean it's fine to kill sleeping people, and (4) most important of all Wikipedia is not a forum.Anythingyouwant (talk) 14:53, 5 June 2010 (UTC)

Agreed, Wikipedia is not a forum. Neither it is a place for people to make remarks that are nonsense, such as "having human DNA automatically means an animal is more than just an animal". Bad Joke: Man-eating tigers have human DNA inside them...(temporarily, of course). At least I was size-comparing only-primate brains; it is not sensibly reasonable to directly size-compare them to other animal families, which you appear to be trying to do. And your remark about sleeping people has a basis in nonsense, too. Do you say that a professional piano player is not any such thing when not seated at a piano? The sleeping person has actual more-than-animal mental abilities that simply aren't being used while asleep. A human fetus has no actual mental abilities that are more than merely animal abilities. And the Courts have indicated that a brain-dead adult human on life-support can be disconnected because of having utterly lost all actual abilities to be more than merely animal (indeed, because of being on life support, such a human has less mental abilities than an ordinary animal).

Asking a question (even if perhaps rhetorical) is probably not a very intelligent way of ending a conversation.  :-). Anythingyouwant (talk) 17:54, 5 June 2010 (UTC)

Ah, ok. By "individual", you meant "unique". Got it. MastCell ^Talk 22:39, 4 June 2010 (UTC)

Unique would be ideal, but it seems several editors do consider a fetus a full individual, hence the entire "abortion is safe for whom /everyone?" meme in the first place. I repeat it is incorrect to find a fetus to be an individual as it is not separate entity. DNA, brain, heart beating, soul(s) / life force are all moot by this prima facia reality. What footprint that leaves upon NPOV assessment of abortion safety is a little tricky. - RoyBoy 02:30, 8 June 2010 (UTC)

Sources for "Dependency of attitudes on developmental stage"

• Crock, Rosemary (2007). "Abortion decision-making attitudes of adolescents attending Roman Catholic schools" (PDF). PhD Thesis. Manhattan, Kansas: Kansas State University. pp. 93–97. – This study doesn't really address the effect of stage of pregnancy on making a decision about abortion, but does contain a sizeable list of references that may contain some information immediately relevant to the issue. --RexxS (talk) 23:55, 4 June 2010 (UTC)
  • Funny. I actually came across that study when I was doing my search, and didn't give it a second glance because I don't think it is what Anything is getting at... but that doesn't mean it may not be useful for this article! -Andrew c ^[talk] 02:57, 5 June 2010 (UTC)
    • Yes, I nearly discarded it until I spotted the references which may give some leads. While reading it, what then struck me was the analysis on page 86 "There will be no interaction effects on the four scenario dimensions predicting students’ attitudes about abortion. - Rejected". It shows that each of the factors affecting the abortion-decision were inter-related. That implies we are very likely going to find difficulty in extracting data concerning just the "stage of development" from any study which discusses it. --RexxS (talk) 14:29, 5 June 2010 (UTC)
• Abortion in the United States#By trimester of pregnancy has three references that give some raw data on public opinion, but only for the USA.
• Societal attitudes towards abortion has a number of references with data on attitudes to abortion, with the Urugayan survey specifically referencing the right to abortion in any circumstances in the first trimester. --RexxS (talk) 00:27, 5 June 2010 (UTC)

Proposal on the labels. Drop them completely

Lots of angst above on the use of pro-choice, pro-life, pro-abortion, anti-abortion, etc. I propose using no labels at all.

I've been looking at the article on the musical group the Bee Gees. Yes, music, nothing to do with this complex moral issue, but it had a problem with where the members, or the band, came from. Musical articles like to say things like "Joe Bloggs was an American entertainer", explicitly stating where he was from. But the members of the Bee Gees were born in the Isle of Mann (not part of the UK), began their musical careers as kids in Australia, went to the UK to live, and also lived in the USA for a while. And that's what the article now says. It doesn't try to give them a simplistic label. That's what we should do here. Describe positions as briefly as we can, but avoid the politically and morally loaded labels completely.

It may be worth saying that some people, particularly those with extreme views, like to use the labels, but apart from that not use them here.

HiLo48 (talk) 21:33, 4 June 2010 (UTC)

I'd like to explore this possibility further but I do think that there is utility in describing the two sides as we have articles on both that expand on the topic. - Schrandit (talk) 21:56, 4 June 2010 (UTC)

Aspects of prenatal development relevant to abortion decision

Okay, as mentioned earlier at this talk page, I think this Wikipedia article is unduly weighted to the pro-choice and pro-life extremes, whereas most people are in the middle, and those people link their opinions to particular aspects of fetal development (presence of heartbeat, presence of electrical activity in the brain, presence of human form, fetal movement, et cetera). This article mentions none of those biological aspects, except for fetal pain, which seems like undue weight for fetal pain. And I don't think it's adequate to merely link to the embryo and fetus articles, which do not distinguish between fetal characteristics that are relevant or not relevant to the abortion decision. Anyway, I did some web-surfing today, and can give you the following partial draft. Again, I would prefer to have some of our more enthusiastic pro-choice editors and admins do some work on this, in the spirit of WP:Writing for the opponent (I'm not pro-life myself, but am not pro-choice either)....

Most people favor increasing legal protection for an embryo or fetus as it becomes increasingly developed, so that abortions will be performed sooner rather than later.[1][2] Additionally, women often prefer to abort “a formation of cells, rather than this fetus that was so developed.”[3][4] According to this type of viewpoint, which is neither strictly pro-choice nor strictly pro-life, some aspects of fetal development are more relevant to the abortion decision than other aspects. The relevant ones are suggested by informed consent laws, which may also encompass additional information such as risks to the woman.

Some informed consent laws have been criticized as using “loaded language in an apparently deliberate attempt to ‘personify’ the fetus,”[5] but their information mostly “comports with recent scientific findings.”[6] That information about fetal development goes beyond the possibility of fetal pain, and may include the following:

Blah, blah, blah (heartbeat, brainwaves, movement, shape).

[1](ref)Gallup, George. The Gallup Poll: Public Opinion 2003, page 20 (2003).(/ref)

[2](ref)Wardle, Lynn. The abortion privacy doctrine: a compendium and critique of federal court abortion cases, page 110 (1980): “the more developed the fetus is, the greater the percentage of interviewed subjects who would not permit an abortion for non-therapeutic reasons.”(/ref)

[3](ref)Kushner, Eve. Experiencing abortion: a weaving of women's words, page 164 (1997).(/ref)

[4](ref)See also Shrage, Laurie. Abortion and social responsibility: depolarizing the debate, page 57 (2003): “A woman who aborts later than she could have imposes death on a creature that is more developed and sentient.”(/ref)

[5] (ref)Gold, Rachel and Nash, Elizabeth. State Abortion Counseling Policies and the Fundamental Principles of Informed Consent, Guttmacher Policy Review, Fall 2007, Volume 10, Number 4.(/ref)

[6] (ref)Richardson, Chinue and Nash, Elizabeth. “Misinformed Consent: The Medical Accuracy of State-Developed Abortion Counseling Materials”, Guttmacher Policy Review

Fall 2006, Volume 9, Number 4.(/ref)

Anythingyouwant (talk) 01:29, 7 June 2010 (UTC)

Good research. I've only had time so far to study the first two references and I would advise that since the Wardle book relies for its conclusion on the 1979 Gallup Poll data, you might as well just use 2003 Gallup Poll. Although the book has the advantage of being a secondary source, it's very out of date (1980) to use to support a statement about public opinion. The 2003 Gallop Poll will need some care, as it's a primary source. It's interesting that it shows how the question distorts the answers, since 24% thought abortion should be legal in any circumstances, but only 10% thought it should be legal in the third trimester! It seems that at least 14% changed their minds when asked to focus on a particular factor. But that's the danger of us trying to analyse a primary source. We should note, of course, that the poll only measured opinion in the USA. For the first sentence, how about:

• When asked if abortion should be legal in the first trimester, two-thirds of Americans were in favor. However, in the case of the second trimester, only a quarter agreed. Approval dropped below one fifth for the third trimester.[1]

I don't know whether readers would have a preference for approximate fractions or raw percentages, as polls with sample size of about 1,000 have confidence limits around ±2%. I'll take another look tomorrow. --RexxS (talk) 00:27, 7 June 2010 (UTC)

The advantage of Wardle is that it is not a primary source, and it extracts a sensible conclusion from poll data. I would prefer not to descend into minutae about trimesters and such. The point is: the earlier the better, according to the respondents, and there's no indication from their responses that they support the trimester framework or think in terms of trimesters. It should not be difficult to find further secondary sources that address the point that Wardle addressed.Anythingyouwant (talk) 01:36, 7 June 2010 (UTC)

This thread shows promise IMO. I've read the Norwegian Wikipedia article(s) on abortion. They use quite a bit of space on the results of opinion polls internationally and in Norway including trends from the 1960s to today. It's interesting reading; most of the references are to newspapers.

(Norway: abortion legal from 1964 by application to a committee. From 1978, abortions have been freely available through the end of the 12th week, and that is when "97-98%" of them happen. After that there still is a committee which since 1978 has been allowed to use social indications. Between 20 and 25% of women have at least one abortion in their lives. An unreferenced claim: Chile, Nicaragua, Oman og Malta are the only countries in the world where abortion is not allowed under any circumstances.)

Perhaps, too, there might be information about why the low percentage of late-term abortions, happen at all. They are extraordinary, and availability can't be the only reason for them. This seems to be "covered" in Abortion in the United States, but not more generally. --Hordaland (talk) 04:16, 7 June 2010 (UTC)

The disadvantage of Wardle is that it's analysing 30 year old data on public opinion. Also it's worth remembering that Gallop phrases the questions as "in the first/second/third three months of pregnancy", so the data that Wardle looks at is compartmentalised by trimester. Nevertheless, if you want to avoid the primary source, I'd suggest:

• In 1979 a large majority of Americans considered the stage of fetal development to be a significant factor affecting the decision to abort. As the fetus develops, support for allowing abortion decreased.[ref Wardle, referencing 1979 Gallop Poll ISBN:9780842021708]

I think there's a problem with your quote from Kushner. It's a huge leap from a source narrating one woman's (Annika) experience to the generalisation "women often prefer ..." - I hope you'll agree. I'm also unhappy that picking one woman's story does not accurately characterise the source. What about Melba, a doctor, who said "women who believe a seven-week old fetus is the equivalent of a baby have been fed a line of bull about the level of development of the child"? --RexxS (talk) 15:55, 7 June 2010 (UTC)

Thanks for the comments. The several sources that I listed barely scratch the surface of the sources that support the draft text I wrote. So, I'm not just looking for the best way to summarize those few sources I listed. I'll list more as I have time. I'm most curious about whether other editors agree (based on their own experience and any further sources they'd like to add) with the main point I was making, regarding undue weight. Also, I don't think that the viewpoint of "Melba" that you mention is really pertinent, because it doesn't contradict (or even address) that women generally want to obtain or allow abortions before a lot of prenatal development occurs ("Annika" didn't say that a lot of development occurs by 7 weeks).Anythingyouwant (talk) 16:13, 7 June 2010 (UTC)

Here's a source that addresses your concern about use of the Gallup poll data:

(ref)Saad, Lydia. Abortion Views Reviewed as Alito Vote Nears (2006-01-20): "When Gallup asked the public about the legality of abortion according to the stage of the development of the fetus rather than the specific circumstances involved, nearly two-thirds say abortion should be legal in the first three months of pregnancy. Two-thirds or more say it should be illegal in the second and third trimesters."(/ref)

Anythingyouwant (talk) 18:17, 7 June 2010 (UTC)

• This seems to be coming at the question by asking why women choose not to have an abortion, and it seems to focus largely on public opinion in the US (perhaps making it more appropriate for abortion in the United States). I'm a bit wary of starting with a thesis (the developmental stage of the fetus is a key factor in decision-making) and then looking for sources to support it, although I recognize that good material can emerge that way.

  If we want to follow where the sources lead, and address the factors that influence a woman's decision to have (or not have) an abortion on a less US-centric basis, then we could start with something like PMID 19517213 (a 2009 review of the published literature on the topic). Also see PMID 18637178 (which is freely available thanks to your tax dollars at work); this review does mention that experiences "are related to gestational age, for example, in one study a medical termination before any symptoms of pregnancy were perceived was described as involving a 'loss' whereas a surgical termination was described as a 'death'." Although it hardly emphasizes the point among many other factors, which makes me wonder a bit about undue weight. MastCell ^Talk 16:49, 7 June 2010 (UTC)

Thanks for the additional sources. Those are valid points you make, but there are countervailing considerations. This article recognizes two extreme POVs (pro-life and pro-choice) while not recognizing a third and more common POV that is linked to prenatal development; this is a distinct issue from what factors are relevant to women who get abortions. And regarding the latter, this article mentions a bunch of factors but omits prenatal development. Since prenatal development is relevant here in multiple ways, and since it is a subject of informed consent laws, and since aspects of prenatal development that are relevant to abortion are not described in any WIkipedia article, there may be a problem that we can solve. Anyway, it will be interesting to see what more editors think. In the mean time, I'll continue to investigate as time permits.Anythingyouwant (talk) 18:26, 7 June 2010 (UTC)

Thanks for the responses, AYW. You say above that Melba's view isn't pertinent because it doesn't address that women generally want to obtain or allow abortions before a lot of prenatal development occurs. Can you see the problem there? You're starting with a thesis and looking for support for it. When you read that section of Kushner, it doesn't say precisely at what stage Annika's abortion occurred (5 weeks after the test); it reports her feelings and those of Toni (12th week termination), but balances them by saying "some women have looked at the same pictures and felt the opposite way", going on to relate Melba's views which imply no discomfort with the concept of abortion in the early stages. In other words, the source is presenting differing views on first trimester abortions. The source presents two opposite views, and we mustn't present just one of them.

The Saad reference is just what I was looking for, thank you. Wouldn't that support almost exactly what I had proposed from a reading of the 2003 primary source? --RexxS (talk) 18:20, 7 June 2010 (UTC)

The Saad reference also seems to support the draft language that I provided (and note that your version didn't mention "development of the fetus" which is the concept that I was writing about and that the 1980 source emphasized). Anyway, regarding Kushner, perhaps we can get rid of that in favor of MastCell's source(s).Anythingyouwant (talk) 18:26, 7 June 2010 (UTC)

As has already been mentioned more than once, this is the global Abortion article. Most of this section is about the USA alone. Please move this issue to the article on that nation, or just stop wasting time and space here. HiLo48 (talk) 21:17, 7 June 2010 (UTC)

If you read the draft I provided above, there is nt one word that is US-specific. Do you know of any sources indicating that it's only applicable to the US? Some of the sources discussed so far involve studies and surveys conducted in the US, and I'll see about getting some more non-US sources too.Anythingyouwant (talk) 21:46, 7 June 2010 (UTC)

(edit conflict) I wouldn't agree that time and space spent here looking at sources is wasted, but I agree that much of what we've found so far would be more germane to Abortion in the United States. That's ok - it's easy to copy & paste or provide a link on that talk page for interested editors. In any case, there seem to be fewer quality sources with a global outlook than US-specific ones, probably because of the high profile the abortion debate has in the US. Of Mastcell's two suggested sources (likely to be the most up-to-date and comprehensive), the narrative review by Lie et al admits difficulty in finding any more than 18 suitable studies world-wide, and the US is strongly represented; while the review of the literature by Kirkman et al was confined to English language publications. However, IMHO, they are likely to be the best starting points for the issue this section addresses in both this article and the US-specific one.

@AYW: I understand better now what you are looking for. I suspect that Saad has made the translation from 'stages of pregnancy' (the Gallop Poll primary source that is being analysed) to 'development of the fetus'. I don't see a problem in that - it's a slight shift in emphasis, but the secondary source is making that correlation, so we can use it. I didn't, of course, for the obvious reason that I was reporting the Gallop source as verbatim as I could without plagiarism, and that was the terminology used in the Analysis section of Gallop. --RexxS (talk) 21:52, 7 June 2010 (UTC)

It seems worth pointing out that, worldwide AFAIK, no government that has legalized abortion has done so thru all 9 months, which suggests that they have tied it to fetal development, except in countries like the US where fetal development has been deemed legally irrelevant once viability is determined. So, given that fetal development has been deemed relevant worldwide in at least these abortion decisions of governments, it seems like somewhere on Wilipedia there ought to be a description of which aspects of fetal development have been deemed most relevant in the abortion decisions of individuals and nations.Anythingyouwant (talk) 22:01, 7 June 2010 (UTC)

If it's any help, in the UK abortions in the third trimester are legal if "there is grave risk to the life of the woman; evidence of severe foetal abnormality; or risk of grave physical and mental injury to the woman". It is possible that Canada may be the only country where there is no criminal regulation of abortion. There's a survey at http://pewforum.org/Abortion/Abortion-Laws-Around-the-World.aspx --RexxS (talk) 22:36, 7 June 2010 (UTC) Oops - probably China as well. --RexxS (talk) 22:37, 7 June 2010 (UTC)

It's pretty much the same as the UK in Australia HiLo48 (talk) 02:32, 8 June 2010 (UTC)

I cannot agree that the shift from stages of pregnancy to development of the fetus is slight. Both the woman and the fetus go through a lot of changes. If the woman is going to have an abortion, it is to her advantage both physically and psychologically to have it done before all the hormone changes, "showing", swelling breasts etc. are underway, as much as possible. --Hordaland (talk) 22:54, 7 June 2010 (UTC)

Unfortunately, it doesn't matter whether we agree or not. The shift was made by Lynda Saad (senior editor at the Gallup Organization and recognised as expert in interpretation of opinion polls) in an analysis of the Gallop Poll data, reported in a reliable secondary source - and apparently without reliable commentary criticising that transformation. The review clearly states "When Gallup asked the public about the legality of abortion according to the stage of the development of the fetus ...", although the data shows that the questions asked were based on trimester (i.e. stage of pregnancy). If the source makes that connection, all we can do is present another equally reliable source that contradicts that. Much as I'd like to agree with you, we mustn't start cherry-picking sources simply because we don't agree with their conclusions. --RexxS (talk) 23:19, 7 June 2010 (UTC)

Edit warring

I have place this notice on the talk page of Nutriveg (talk · contribs · deleted contribs · page moves · block user · block log):

Please do not edit war. If your change is reverted, do not revert back, but engage in discussion on the talk page. I checked the talk page for discussion of the three sources you removed: Bartlett 2004; Trupin 2010; Westfall 1998. No reason has been stated on talk why they should not be in the article. Removal of reliable sources is disruptive editing, particularly when you revert instead of discuss in the BRD sequence. --RexxS (talk) 02:21, 8 June 2010 (UTC)

Please get yourself aware of what is happening in the article talk page and in the article history before assuming bad faith and making attacks to resolve content issues. I just reverted a major change that was simple redone by MastCell despite the many problems pointed about that edit.--Nutriveg (talk) 02:29, 8 June 2010 (UTC)

I see no valid reason to revert all the work of MastCell. There may be one or two ongoing disputes, but a blanket revert was not necessary. Try improving the content, or commenting out the disputed pregnancy comparison. There is no consensus for your version either. I tried, but failed, to restore the longstanding health risks section from a couple weeks ago, but of course you had to revert back to YOUR version. Watch out for ownership issues. I'd be glad to revert back to the longstanding version again, while we work out our differences even more. MastCell, IMO, was acting in good faith, based on the discussions above, to improve the section. Going back to your version over and over is problematic in my eyes. Try contributing, building, working together, and compromising! -Andrew c ^[talk] 02:46, 8 June 2010 (UTC)

MastCell made a major change, he didn't change one or two phrases as I have been doing from that older version, in a single edit he deleted a lot of content and added a lot of the same text reported as problematic ignoring those issues. It's completely natural to revert as I did when such large changes are made in a single edit. As before I've been [8] adding his suggestions incrementally despite his desire for large changes --Nutriveg (talk) 03:01, 8 June 2010 (UTC)

I find the version by mastcell puts the issue of risk into better context. Stating the risk of abortion without referring to the risk of no abortion for a pregnant woman does not give the proper context needed to interpret the risk of abortion.Doc James (talk · contribs · email) 05:45, 8 June 2010 (UTC)

I think thats what the rest of the article is for. An section on the risks of owning firearms would not need to also have a paragraph on the risks of not having firearms, etc. - Schrandit (talk) 08:43, 8 June 2010 (UTC)

I tend to agree with Schrandit on that. Also, it doesn't seem NPOV to dscuss the risks of childbirth here in this article without discussing, for example, the risks of using contaceptives. And are we also going to have to insert onto the pregnancy article a comparison to the risks of abortion?Anythingyouwant (talk) 15:01, 8 June 2010 (UTC)

This article seems to have a history of ownership and edit warring. I am not prepared to play those games. Nutriveg has now removed reliable sources three time and Scrandit once against the advice of three other editors. The sources are:

• Bartlett LA, Berg CJ, Shulman HB; et al. (2004). "Risk factors for legal induced abortion-related mortality in the United States". Obstet Gynecol. 103 (4): 729–37. doi:10.1097/01.AOG.0000116260.81570.60. PMID 15051566. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Trupin, Suzanne (May 27, 2010). "Elective Abortion". eMedicine. Retrieved June 1, 2010. At every gestational age, elective abortion is safer for the mother than carrying a pregnancy to term.
• Westfall JM, Sophocles A, Burggraf H, Ellis S (1998). "Manual vacuum aspiration for first-trimester abortion". Arch Fam Med. 7 (6): 559–62. PMID 9821831.{{cite journal}}: CS1 maint: multiple names: authors list (link)

I therefore request that a link be provided to where these 3 sources were discussed; or failing that, a justification from Nutriveg and Schrandit why they removed reliable sources. --RexxS (talk) 10:49, 8 June 2010 (UTC)

Despite what you're appearing to look my edit was not an edit that removed sources, it was an edit that reverted a large change made by mastcell, that himself removed referenced text and added problematic text, I incrementaly addressed his changes where they were relevant, this issues are discussed in a specific section of this talk page and on edit summaries.

Answering your question detailed statistics specific to the United states were added to that Abortion in the United States#Maternal death, (Westfall,1998) is old and primary

Doc James, those statistics are US based where the number of risky (late) abortion is low and pregnant women have lower access to public health than other developed countries, I also pointed how that direct comparison without using appropriate statistics is problematic, some of those detailed statistics were added to a specific article you also need to be aware, when reverting content, that MastCell single edit was a large change that deleted a lot of text and had many issues instead of one.--Nutriveg (talk) 12:59, 8 June 2010 (UTC)

Despite what you either believe or are trying to convince others of, this edit removed the sources listed above, just as RexxS has stated. It would be best if you were to self-revert and restore the reliably sourced material which you were edit warring to remove, otherwise you may be blocked from editing. Note that I'm posting this here for all involved editors to see, rather than on your talk page, because you seem to believe that this is an issue of content, rather than user conduct. SHEFFIELDSTEEL^TALK 13:10, 8 June 2010 (UTC)

I need to remember you that MastCell edit also removed a lot of sources, and a lot of text, so simple redoing that large change clearly isn't the way to restore the article content:

• Botha, Rosanne L.; Bednarek, Paula H.; Kaunitz, Andrew M. (2010). "Complications of Medical and Surgical Abortion". In Guy I Benrubi (ed.). Handbook of Obstetric and Gynecologic Emergencies (4 ed.). Lippincott Williams & Wilkins. p. 258. ISBN 978-1605476667. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Studd, John; Seang, Lin Tan; Chervenak, Frank A. (2007). Progress in Obstetrics and Gynaecology. Vol. 17. p. 206. ISBN 978-0443103131.

I've already referenced yesterday those mentioned sources [1][2] and others included by MastCell, while still rewriting text to better address his recurrent changes, so you're assuming bad faith here despite of those edits, but I readded that (Westfall,1998) old primary study since that's so important to you.--Nutriveg (talk) 13:24, 8 June 2010 (UTC)

I have not presumed bad faith on your part. In turn, I ask that you not make assumptions about me. What is "important" to me is that this page is used for civil discussion on how to improve the article, and that editing the article takes place without disruptive activity such as vandalism or edit warring. SHEFFIELDSTEEL^TALK 14:17, 8 June 2010 (UTC)

Well if you asked to readd it that sounded like you thought that recently added primary source was necessary despite of the tertiary source already present in the article. Since you made your point clear that will be taken into account when deciding if that primary source should really be kept or if that issue was just noise in the background.--Nutriveg (talk) 14:25, 8 June 2010 (UTC)

(undent) As I said previously I think the comparison to the risk of normal pregancy is important. Presenting numbers without a control group does not give any context in which to interpret it. WRT to other precdures or medicines rates are ideally given as greater than or less a control group. The rates of side effects with placebos may be up to 10% and benefits from placebo are as great as 50%. Life is not risk free as many assume. Thus the risk of a precedure should be compared against the risk of not having the procedure.Doc James (talk · contribs · email) 14:58, 8 June 2010 (UTC)

WRT Firearms I think information on the risk of not having firearms would be exceedingly useful. You occasionally hear conservatives in the US claim that the risk of not having firearms is less than having them. Doc James (talk · contribs · email) 15:05, 8 June 2010 (UTC)

We don't have worldwide reliable statistics to use here as I said before health care access for pregnant women in the United States, where those "statistics" came from, is worse than many developed countries and the number of late abortions is low, maybe due to easy access to test methods, high education level and right awareness of the young. And as someone pointed above by that argument we should also compare the risk of death for using condoms or other preconception methods, which is as well negligible due to the rare (if any) incidence, so irrelevant.--Nutriveg (talk) 17:09, 8 June 2010 (UTC)

We do not have reliable statistics for what? Mortality from abortions or mortality from pregancy? Late term abortions are rare everywhere as very few patients or physicians are interested in having them or doing them. Discussion of the effects of condom use on population mortality would be interested so I am not sure how this is irrelevant.Doc James (talk · contribs · email) 17:53, 8 June 2010 (UTC)

Worldwide reliable data of statistically supported comparisons (like age, income, risky pregnancies, matched). The United States number only show the disparities of how those health issues are handled differently in that country, with easy access to abortion but not to Prenatal care#Prenatal Care and Race and other pregnancy health services.--Nutriveg (talk) 18:01, 8 June 2010 (UTC)

• This seems to have gone off the rails a bit. The reason we compare abortion risk to childbirth risk is because that is the comparison made by reliable sources. It doesn't matter whether I, or Nutriveg, or Schrandit, or Anythingyouwant believe these are the optimal comparisons. Our goal is not to accurately reflect the beliefs and prejudices of a handful of anonymous Wikipedians, but to reflect the content of expert, reliable sources. So let's focus on that.

  The distinction between abortion risk in "safe" and "unsafe" environments is an important one, and one that I made in my proposed text. We do, of course, have reasonable statistics available from reliable sources. Nutriveg's personal doubts about the conclusions of those sources is not sufficient reason to drop them.

  I'm pretty disheartened by the quickness to revert and the accusations. Obviously, I believed that I had addressed the objections brought forth by Nutriveg when I made my edit. I recognize that my edit can certainly be improved upon, but I think it's a clear improvement, stylistically, in WP:MOS terms, in readability, and in informative content, over what preceded it. That's why I made the edit. I am willing to address reasonable concerns, but I'm pretty deeply convinced that some of Nutriveg's objections are based on misunderstandings or selective and inappropriately doctrinaire interpretations of snippets of policy. More fundamentally, I'm concerned that people are arguing about whether they personally agree with a given comparison, rather than simply representing the context and comparisons made by expert reliable sources. How should we fix this? MastCell ^Talk 19:22, 8 June 2010 (UTC)

We do have sources but they are US centric that's why I moved that comparison to the Abortion in the United States article, while adding a link to that article. Despite of your good intentions the problems your major change caused were basically the same as the previous one.--Nutriveg (talk) 19:46, 8 June 2010 (UTC)

And which problems are those for us new to the debate?Doc James (talk · contribs · email) 19:59, 8 June 2010 (UTC)

I believe they were reported in this same section (which also links to Talk:Abortion#Health risks rewrite and edit summaries).--Nutriveg (talk) 20:11, 8 June 2010 (UTC)

The data is from more places than the USA. This ref refers to a rate of 0.7 per 100,000 in developed countries.[9] Doc James (talk · contribs · email) 19:59, 8 June 2010 (UTC)

(undent) Uptodate also makes the comparison to completed pregnancy. [10]

Legal pregnancy termination 0.567 per 100,000 terminations

Miscarriage 1.19 per 100,000 miscarriages

Live birth 7.06 per 100,000 live births

They than go on to say "Moreover, the overall death rate from all legal abortions (0.6 per 100,000 operations in 1997) is far less than the United States maternal mortality rate of 7.5 per 100,000 live births [73-75]. In 2002, a total of nine women died as a result of legal induced abortions in the United States, and none died as a result of illegal induced abortions [76]." Doc James (talk · contribs · email) 20:19, 8 June 2010 (UTC)

I agree we have maternal death numbers from other countries, like the 0.7 one. The 0.567 one is exactly the same of the US one (already cited in the article), so I wonder where they got it. The problem is that simple comparing those numbers is WP:OR less to say without adjusting for confounding factors, like age, income, access to prenatal care, ... That would be the same as comparing unsafe abortion in the same bag of safe abortion, simple as abortion.--Nutriveg (talk) 20:29, 8 June 2010 (UTC)

No it would not be original research as we could reference Uptodate which makes this exact comparison.Doc James (talk · contribs · email) 20:37, 8 June 2010 (UTC)

The Uptodate numbers you posted to far are US numbers, not worldwide.--Nutriveg (talk) 20:41, 8 June 2010 (UTC)

(edit conflict) Of course it wouldn't be original research. Not only UpToDate, but numerous other sources (e.g. Grimes) make that comparison. The issue seems to be that Nutriveg personally believes that those sources have not adequately controlled for confounding factors. So if we're talking about original research... have any reliable, independent sources made those criticisms? If not, then Nutriveg is pushing his own beliefs over the content of reliable sources, which does in fact violate WP:OR.

Worldwide numbers are readily available. I think it's reasonable to use US numbers as an example of abortion risk in developed countries, since the US numbers are very close to those from other such countries. MastCell ^Talk 20:45, 8 June 2010 (UTC)

I've already cited the US comparison in that specific article, but this article is not US centric. The problem is we don't have a worldwide comparison to cite here, making one from raw numbers is WP:OR. There are problems with health care access for pregnant women in the United States, like Prenatal, so we can't ignore that factor and apply the same numbers worldwide.--Nutriveg (talk) 21:01, 8 June 2010 (UTC)

We have references that say rates in developed countries are below 1 in 100,000. Thus we can keep first sentence broad. We should than include a comparision such as in the US this compares favorable with normal pregancy which has a mortality of 7.7 see page 150. This is by the way widely taught in medical school. Douglas W. Laube; Barzansky, Barbara M.; Beckmann, Charles R. B.; Herbert, William G. (2009). Obstetrics and Gynecology. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 150. ISBN 0-7817-8807-2.{{cite book}}: CS1 maint: multiple names: authors list (link) Doc James (talk · contribs · email) 20:48, 8 June 2010 (UTC)

Yeah we can use that first sentece instead of the current. But we shouldn't cite US centric maternal death associated with childbirth numbers since a significant percentage of women in that country have poor access to pregnancy health services.--Nutriveg (talk) 21:01, 8 June 2010 (UTC)

Any claimed "global" figures that show miscarriage statistics separately from legal abortions do not include Australia. Such information is not collected. HiLo48 (talk) 21:06, 8 June 2010 (UTC)

Perhaps these can provide better global perspective?

• Safe abortion : technical and policy guidance for health systems. Geneva: World Health Organization. 2003. ISBN 9789241590341. OCLC 52709442. Retrieved 2010-06-08. and
• "Maternal Mortality". World Health Organization. 2010. Retrieved 2010-06-08.

I'm quite sure anyone reading these will understand how wrong it is to focus on the developed world. For those too busy, I'll quote a bit from the latter:

A total of 99% of all maternal deaths occur in developing countries, where 85% of the population lives. More than half of these deaths occur in sub-Saharan Africa and one third in South Asia. The maternal mortality ratio in developing countries is 450 maternal deaths per 100 000 live births versus 9 in developed countries. Fourteen countries have maternal mortality ratios of at least 1000 per 100 000 live births, of which all but Afghanistan are in sub-Saharan Africa: Afghanistan, Angola, Burundi, Cameroon, Chad, the Democratic Republic of the Congo, Guinea-Bissau, Liberia, Malawi, Niger, Nigeria, Rwanda, Sierra Leone and Somalia.(1)
Because women in developing countries have many pregnancies on average, their lifetime risk more accurately reflects the overall burden of these women. A woman’s lifetime risk of maternal death is 1 in 7300 in developed countries versus 1 in 75 in developing countries. But the difference is more striking in Niger, where women’s lifetime risk of dying from pregnancy-related complications is 1 in 7 versus 1 in 48 000 in Ireland.(1)
In addition to the differences between countries, there are also large disparities within countries between people with high and low income and between rural and urban populations.
(1) Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva, World Health Organization, 2007 (http://www. who.int/reproductive-health/publications/maternal_mortality_2005/index.html, accessed 14 August 2008).

LeadSongDog come howl! 23:03, 8 June 2010 (UTC)

I would be fine with more focus on the developing world. In fact, my initial proposed revision for this section included far greater detail on the burden of unsafe abortion in the developing world. There were objections that the material was redundant to that in our unsafe abortion article, but I'm still open to more coverage here. MastCell ^Talk 23:19, 8 June 2010 (UTC)

Reference to settle the debate

This ref states [11]

Death following legal abortion induced in appropriately equipped and staffed medical settings is very rare, with rates ranging from zero to two deaths per 100,000 procedures in the 13 countries for which accurate statistics are available (3). The aggregate mortality rate for these countries is 0.6 deaths per 100,000 legal abortions; this rate is lower than that of tonsillectomy and makes induced abortion about ten times safer than pregnancy carried to term.

I propose summarizing this as: "In 13 countries with proper facilities and legally allowed abortion the average mortality was 0.6 per 100,000 procedures which was ten fold safer than a live birth." Doc James (talk · contribs · email) 21:25, 8 June 2010 (UTC)

Why would you leave out the words "for which accurate statistics are available"? They are significant. Does the source tell us which countries? HiLo48 (talk) 21:35, 8 June 2010 (UTC)

We would not be quoting it if these statistics were not accurate so in the context of Wikipedia it seems a little redundant.Doc James (talk · contribs · email) 22:20, 8 June 2010 (UTC)

That source is pretty dated and in any case only pertains to the developed world, which grossly misses the point. Pregnancy, childbirth and illegal abortion are all vastly more dangerous for poor women in developing countries. They are also vastly more common there. LeadSongDog come howl! 22:32, 8 June 2010 (UTC)

This page is about both legal and illegal abortions. No one disagrees that illegal abortions are way more dangerous.Doc James (talk · contribs · email) 22:52, 8 June 2010 (UTC)

I assume that James is proposing we use this language/ref to address safe abortion. We would still have separate language addressing unsafe abortion (the majority of which takes place in the developing world), I presume. As LeadSongDog notes (and I don't think anyone disagrees), the risks of unsafe/illegal abortion are exponentially greater. MastCell ^Talk 23:00, 8 June 2010 (UTC)

Please note that there was already a long discussion above about whether to get into a comparison to childbirth. Several editors have objected to doing that. I initially had no objection (and even inserted it into the article myself), but the arguments the other way have persuaded me that it's best not to include it. This article needs to stay on topic, and not digress into tonsillectomies or childbirth, or what have you. It's fine to give the death rate for abortion, but giving it for certain other procedures is problematic. We already refer readers to Family_planning#Risk_of_death which gets into the risks not just of childbirth but of other family planning methods (e.g. contraceptives). So, let's please stick with the earlier consensus according to which we don't compare to childbirth in this article, until we reach consensus to include it. Thanks.Anythingyouwant (talk) 23:03, 8 June 2010 (UTC)

(ECx2)We already refer readers to Family_planning#Risk_of_death Ok, let's refer to a section of another article that was created today (which, BTW, I still oppose and would still like to remove) for the purposes of bolstering an argument to exclude content here. If that section "Risk of death" is deleted from that article, what then... Just saying the argument seems a bit circular (or the conditions cleverly orchestrated to support one side)-Andrew c ^[talk] 23:12, 8 June 2010 (UTC)

Ah, I see that a certain admin has just edit-warred this back into the article.[12] Not surprising. Per WP:BRD, "If an issue is already under discussion or was recently discussed, people may take offense if you boldly ignore the discussion, especially if you make a change away from a version arrived at through consensus, to an earlier or suggested non-consensual version. Ignoring earlier consensus is generally not a wise approach!" So, if a revert cycle is to be broken, it is best to break toward the earlier consensus. The edit-warring admin has not said one word at this talk page about staying on topic or the family planning article, both of which I've mentioned repeatedly above (and in edit summaries).Anythingyouwant (talk) 23:09, 8 June 2010 (UTC)

The comparison to childbirth is explicitly made by numerous expert, reliable sources as a key element of contextualizing the risk of abortion. It is thus "on topic". The objection to our mention of it seems to be based on personal opinions and viewpoints of anonymous Wikipedians. Perhaps you could elaborate on a policy-based reason for excluding this comparison, which numerous expert sources deem appropriate and relevant? MastCell ^Talk 23:16, 8 June 2010 (UTC)

It is redundant to what is at the family planning article. It also omits the comparison to tonsillectomy (at the top of this talk page section), and omits the risk of contraceptives, presumably to advance the POV that women should opt for abortion instead of childbirth. More importantly, you're edit-warring, MastCell. You slap a bad faith label on everyone who disagrees with you about this, and disparage us as "anonymous" (as if your identity is known to all). I cited Google search results above that indicate only a very small fraction of books about abortion compare its risks to those of childbirth. The Wikipedia guideline about staying on topic instructs us to avoid redundancy between articles. This has nothing to do with personal opinions and viewpoints, at least at my end. You blasted me a few days ago for including the comparison to childbirth in this article, and now you're blasting me (and other editors) for taking it out; this seems unfair.Anythingyouwant (talk) 23:22, 8 June 2010 (UTC)

Correction: Andrew c has now removed all the information about risk from the family planning article.[13] I must say, that's not surprising either.Anythingyouwant (talk) 23:28, 8 June 2010 (UTC)

I could easily find 20 references the makes the comparison between child birth, abortion and maternal mortality. How many review articles does one need? This point is mentioned in the exact context of this articles subject in top quality recent reviews, governmental sources, and textbooks. It is not controversial within the field of obstetrics and gynecology. I do not understand why it is controversial here. None of the reasons for removal make any sense. It does not matter if it is discussed elsewhere it should still be discussed here.Doc James (talk · contribs · email) 23:34, 8 June 2010 (UTC)

There is a HUGE amount of information about abortion in reliable sources. We have to be somewhat selective here. Just because something is in 20 references does not mean it belongs here in this article. In fact, if it's only in 20 out of the many thousands of reliable sources on this subject, then that might be a very good reason for not including it. In any event, I was for including it in another more appropriate article, and linking from this article. I'm not going to argue about this further today, since arguments are not addressed, and material is jammed into this article regardless.Anythingyouwant (talk) 23:41, 8 June 2010 (UTC)

I do not see any good arguement to exclude it. Uptodate makes the comparison so there is no reason why we should not. Providing numbers without context is close to meaningless. We need to provide context.Doc James (talk · contribs · email) 23:47, 8 June 2010 (UTC)

The Geneva Foundation for Medical Education and Research (1993) source predates widespread access to mifepristone in many of the developed countries. If that point does need making can we at least find something more current to get more accurate numbers? LeadSongDog come howl! 23:55, 8 June 2010 (UTC)

We have it referenced with the article from the US in 2006. The The Geneva Foundation for Medical Education and Research is part of the World Health Organization. I have added a 2009 medical text.Doc James (talk · contribs · email) 23:57, 8 June 2010 (UTC)

I've a problem with this source, I can't find a pubmed or ISBN for it, looks like self-published

• "Induced abortion". Geneva Foundation for Medical Education and Research World Health Organization.

Doc James, GFMER doesn't belong to the WHO, it's a non-profit organisation focused in "Sexual and reproductive health" that collaborates with the WHO, it's alike of "The Guttmacher Institute"--Nutriveg (talk) 03:50, 9 June 2010 (UTC)

Mastcell reverted my edit saying the WHO published that document, please provide the source supporting that information.--Nutriveg (talk) 04:10, 9 June 2010 (UTC)

You removed it as a "self-published sources", which is clearly inappropriate. Material published by the WHO, or by GFMER, is not "self-published" in the Wikipedia sense, just as scholarly material from the National Cancer Institute, the American Cancer Society, or the US Surgeon General is not "self-published". GFMER is a non-profit associated with Geneva University, and works in close partnership with the WHO. The authors of that particular source are from the WHO. It appears to be a reasonably expert body, and certainly qualifies under WP:MEDRS. MastCell ^Talk 04:18, 9 June 2010 (UTC)

Make yourself clear, the authors work for the WHO or it was published by the WHO? If the later is true please provide a source (like a PMID or ISBN) supporting that information. The only source supporting it was ever published is the GFMER website itself.--Nutriveg (talk) 04:24, 9 June 2010 (UTC)

The publication series is listed as being in the NLM (NLMID 9602354) OCLC 34525562 and a few other libraries, but not a great many. Perhaps someone with ready access to NLM, BL, or CISTI can check the details agree with the gfmer website's version of the title page.LeadSongDog come howl! 05:20, 9 June 2010 (UTC)

I think that doesn't matter any more, that data is too old, from 1990, and so doesn't respect WP:MEDRS#Use up-to-date evidence.--Nutriveg (talk) 05:26, 9 June 2010 (UTC)

Yes it does look like it is just a collaboration of the WHO rather than the WHO my mistake.Doc James (talk · contribs · email) 06:21, 9 June 2010 (UTC)

The rate hasn't changed at all, really. It's been remarkably consistent from the 1990 ref through the mid-to-late 2000's, so I don't see that we're providing out-of-date information. We are using up-to-date evidence, by the way - note the other 3 cites attached to that sentence. I'm a bit confused as to why we seem to be throwing everything in MEDRS against the wall to see what sticks, all in the name of keeping out a piece of information that reliable expert sources clearly deem relevant. The spirit of MEDRS is to help us create high-quality, informative medical coverage that accurately reflects scholarly knowledge. For all the citations of the guideline, I think we're actually moving away from its intended goal. I'll leave it to others to comment further, because I'm finding Nutriveg's objections increasingly arbitrary and unreasonable. MastCell ^Talk 06:25, 9 June 2010 (UTC)

The other sources don't support the previous text. So far this is just an old study self-published by a NGO. It's not my problem if respected epidemiologists don't make such poor comparisons as the one that has been tried to be included in the article and the only worldwide source you can find is an old one, so old that it doesn't comply with WP:MEDRS#Use up-to-date evidence.--Nutriveg (talk) 12:37, 9 June 2010 (UTC)

You mean like UpToDate (which directly compares abortion risk to childbirth risk)? The cited reliable sources make the comparison, so I'm not sure why you believe that respectable sources don't make it. You've rejected Grimes 2004 as "US-centric" (which is a reason to balance our coverage with more worldwide perspectives, not a reason to simply delete an otherwise informative and reliable source). You've rejected Grimes & Creinin because... why, exactly? You've rejected Beckmann 2009 (the standard OB/GYN textbook)... why, exactly? (It draws the comparison on p. 150). You've rejected the GFMER source because it's "self-published" (incorrect), and because it's "out of date" (although the rate has not changed since the paper was published, so its information is not in fact out of date). Perhaps you could clarify, because it's a waste of time to keep finding good sources in this sort of environment. MastCell ^Talk 16:59, 9 June 2010 (UTC)

As pointed before, Uptodate uses US numbers when comparing those two: 0.567, so it's not a worldwide source, the same problem of Grimes.

Doc James presented Beckmann as a US source "We should than include a comparision such as in the US this compares favorable with normal pregancy which has a mortality of 7.7". Later, when I didn't realize that was the same source being used, I couldn't find the citation in Beckmann since I was searching for the word "safer" which in fact it doesn't have. Now I have found the text but it doesn't say it's safer, it only present the numbers. I doesn't say where that 7.7 number come is from, but that whole section only references US data and facts, the is book published by the " American College of Obstetricians and Gynecologists" and this 7.7 number has been reported as a US one "To discern possible trends in maternal mortality, data were divided into two 5-year periods (1987-1991 and 1992-1996). The national MMR was 7.7 for each time period."

So repeating sources that were already debunked as US centric won't resolve this issue doing original research to apply US numbers to the world or to making comparison where it wasn't made.

GFMER is a 17 old source when WP:MEDRS#Use up-to-date evidence says "Look for reviews published in the last five years or so, preferably in the last two or three years" which is an obvious thing since a review of still older studies is useless. The publishing status of that source can not be checked as it is not properly formatted as such

Stop searching for data you can't find, no respectable epidemiologist would make such poor comparison and deaths caused by abortion are usually counted in general maternal death, by the WHO/ICD definition of maternal death, so that number will always be higher and incomparable by respected scientists.--Nutriveg (talk) 18:45, 9 June 2010 (UTC)

It's a bit frustrating to have you repeatedly assert things that are clearly incorrect, and to persist in making untrue statements despite correction. Numerous reliable and scholarly sources make this comparison. It is untrue to say that no respectable source would do so, unless you're trying to illustrate the No true Scotsman fallacy.

Also, calling a source "US-centric" doesn't "debunk" it, and I'm not sure where you got that idea. It does mean we should try to balance it with more global sources, but the fact that a study was performed in the US does not render the source's content untrue or "debunked". MastCell ^Talk 22:15, 9 June 2010 (UTC)

I didn't insist in anything after evidence were provided if that looks different is because discussion of a single source is often broken between different sections of this talk page, while you often insist in using sources without addressing their reported problems. As I've said numerous times my problem with US centric sources is mainly the one of applying them in a worldwide context.--Nutriveg (talk) 22:53, 9 June 2010 (UTC)

You keep claiming that "no respectable scientist" would compare abortion risk to childbirth risk. You've been provided with nearly a dozen examples in which respectable scientists do exactly that (and there are more). Yet you keep making the same assertion, as recently as two posts above this one. Do you see what I mean? MastCell ^Talk 23:17, 9 June 2010 (UTC)

To make myself clear that was mortality risk, and (mainly) epidemiologist. I pointed that because I have not seen so far data to support such comparison in a worldwide level since, maybe due to how ICD defines it, maternal death data isn't so stratified to allow such epidemiological study, so what most are doing is directing comparing which is also clear by their presentation of those numbers. I do think those who may do such direct comparison do a poor job, but I don't oppose citing them I just don't believe their work is easily available in editorially reviewed publications.--Nutriveg (talk) 23:37, 9 June 2010 (UTC)

(undent) I have provided another 4 references for people perusal.Doc James (talk · contribs · email) 17:24, 9 June 2010 (UTC)

Thanks, I'll comment those in the section you created.--Nutriveg (talk) 19:15, 9 June 2010 (UTC)

I think the above source is fine for use on Wikipedia. We also have many other great sources which confirm these conclusion.Doc James (talk · contribs · email) 19:44, 9 June 2010 (UTC)

I see you have a personal opinion, maybe you should first change WP:MEDRS to reflect the use of unreferenced phrases (and rounded numbers) from two decades old, poorly cited (no pmid or isbn) source with no signs of editorial review.--Nutriveg (talk) 19:53, 9 June 2010 (UTC)

(Sigh) Let see the GFER has a peer reviewed journal

'Reproductive Health' - the official journal of GFMER As a peer reviewed, online, open-access journal, 'Reproductive Health' offers a platform for scientists to publish results of good quality research in human reproduction. The journal is supported by an international editorial board experienced in reproductive health and peer review thus ensuring the quality of the journal. Published articles are freely and universally accessible online and are indexed in PubMed. Information about submitting a manuscript can be found at 'instructions for authors'.

[14] The problem with pubmed is it is very US centric. Much of the rest of the world is not on pubmed as it is run by the US NIH.

The rest of the title says

Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, 1211 Geneva 27, Switzerland

It mentioned the World Health Organization in the title. Doc James (talk · contribs · email) 19:58, 9 June 2010 (UTC)

I got that wrong at first as well, James - the attribution of WHO is actually to the authors, both of whom work for WHO. --RexxS (talk) 20:31, 9 June 2010 (UTC)

Misrepresenting sources

I've removed a sentence on contraindications from the article, and wanted to register a concern here. Please compare the actual source to our representation of it:

• Our article: Women who have uterine anomalies, leiomyomas or had previous difficult first-trimester abortion are contraindicated to undertake surgical abortion.
• Source: Abortion should not be undertaken for women who have known uterine anomalies or leiomyomas or who have previously had difficult first-trimester abortions, unless ultrasonography is immediately available and the surgeon is experienced in its intraoperative use. ([15], emphasis mine)

This is a real problem, because we've misrepresented the source pretty badly. It does not list "contraindications" to abortion. It lists factors which may complicate the procedure, and which may prompt a referral to an experienced surgeon, which is quite different. Can I put in a plea for everyone to spend a few extra minutes double-checking the actual content of the sources they cite? MastCell ^Talk 23:35, 8 June 2010 (UTC)

I did not insert that material, and I have no idea whether there was an innocent mistake by another editor, or an intentional misrepresentation according to your accusation of bad faith. However, I would urge you, MastCell, to include something about contraindications in this article. You've repeatedly removed all such information over the past several days. Surely you can find some way to include info about contraindications.Anythingyouwant (talk) 23:38, 8 June 2010 (UTC)

I assumed it was an unintentional misrepresentation. That's why I encouraged greater care going forward. If I thought it was intentional, I'd take a different approach. I don't remember removing any material on contraindications previously; perhaps you could supply a diff to clarify your concern? I do think that a contraindication is distinct from a "health risk". After all, if a procedure is contraindicated, then it will not be performed, and thus carries no health risk whatsoever. MastCell ^Talk 00:03, 9 June 2010 (UTC)

The word "misrepresent" connotes lying.[16] You would do well to use another word if you don't want to piss people off. As far as removing mention of contraindications, you did that here for example. Good night, MastCell.Anythingyouwant (talk) 00:11, 9 June 2010 (UTC)

Misrepresenting means "representing badly" (def. #2), as in "we have represented this source badly". In any case, since that was my meaning, please accept this as a post hoc correction if you prefer. I'm not sure I can apologize for removing an unsourced lead-in about contraindications 10 days ago, but I remain open to a discussion of them that involves concrete sources. MastCell ^Talk 00:20, 9 June 2010 (UTC)

Stop misrepresenting. The erased material was sourced concretely: "For women without [[contraindication]]s,<ref name=Trupin>Trupin, Suzanne. [http://emedicine.medscape.com/article/252560-overview "Elective Abortion"], Medscape (updated 2010-05-27).</ref>...." Sheesh.Anythingyouwant (talk) 00:29, 9 June 2010 (UTC)

(edit conflict) I can't see the Google books ref, but that obviously doesn't disqualify it. Trupin gives:[17]

• "Absolute contraindications are virtually unknown ... Surgical abortion is contraindicated in patients with hemodynamic instability, profound anemia, and/or profound thrombocytopenia. The conditions should be managed and the context of pregnancy continuation must be considered."

PubMed finds 35 records for a search on contraindication+surgical+abortion but I've found nothing so far discussing contraindications to surgical abortion there.

For contraindications to medical abortion, may I suggest:

• "Medical management of abortion". The National Guideline Clearinghouse. October 2005. Retrieved 9 June 2010.

as a reliable secondary source? --RexxS (talk) 00:41, 9 June 2010 (UTC)

Trupin also describes contraindications for medical abortion (not just surgical abortion): "Medical abortion is contraindicated in patients with clotting disorders, severe liver disease, renal disease, cardiac disease, and chronic steroid use. Medical abortion is also contraindicated in women with no access to emergency services and no partners or family to be with the patient during the heaviest bleeding times." May I suggest that the subject does not warrant elaborate treatment, and that it would be more than adequate to simply mention the word "contraindications" with a footnote to Trupin for the interested reader?Anythingyouwant (talk) 01:45, 9 June 2010 (UTC)

I suspect that not everyone will agree that Trupin is the best source to use if we have alternatives. To some extent, I'm inclined to that view, since she summarises without giving us the leads to her own sources. If you look at the NGC page I cited above, they lay out their sources and methodology clearly, which is why I offered it as an potentially unimpeachable source for the medical abortion part. --RexxS (talk) 01:54, 9 June 2010 (UTC)

MastCell already recommended the Trupin source for other purposes.[18] If another good source is used instead, I have no objection.Anythingyouwant (talk) 02:07, 9 June 2010 (UTC)

The emedicine ref mentioned by anything says

Absolute contraindications are virtually unknown. If abortion presents a medical risk to the patient, then continuation of the pregnancy presents an even greater risk. The type and timing of an abortion procedure or method may be contraindicated based on the medical, surgical, or psychiatric condition of the patient.

Doc James (talk · contribs · email) 00:44, 9 June 2010 (UTC)

I have no serious issue with it being used.Doc James (talk · contribs · email) 04:07, 9 June 2010 (UTC)

The source is fine so long as it is accurately represented; that's been the sticking point, repeatedly. As James notes, the source emphasizes that contraindications are "virtually unknown", so an accurate representation of the source would probably convey that. The source also emphasizes that for any given risky situation, abortion is safer than the alternative of proceeding to childbirth. Again, an accurate discussion of contraindications, or an accurate representation of the source, would convey that.

My view is that since a) contraindications are "virtually unknown", and b) contraindications are distinct from "health risks", we should not discuss them in the "Health risks" section of this article. They might be more appropriately discussed in articles on specific procedures (vacuum aspiration, dilation and extraction, etc). MastCell ^Talk 04:11, 9 June 2010 (UTC)

You'll have to correct my understanding, but I thought that 'relative contraindications' described factors that significantly increased risk, but not enough to completely rule out the drug/procedure, so that judgement is required in making a decision (or the relative contraindications eliminated before treatment). If that's so, I would expect expect to find some mention of contraindications somewhere in the article. Again, I'll gladly be corrected, but my reading of the literature gives me the impression that surgical abortion is effectively free of any contraindications of any kind, while medical abortion has relative contraindications for a number of factors relating to interactions of the two drugs used. As the article grows, is there a point at which it should be switched to summary style, spinning off a daughter article something like 'Abortion (medical procedure)' which would describe in more detail surgical and medical abortion in the same way as other medical procedures/treatments/drugs (I'm thinking of Brachytherapy (GA) and Sertraline (FA) as templates for the layout)? Or are the sociological aspects too closely tied into this topic for that to be realistic? --RexxS (talk) 11:36, 9 June 2010 (UTC)

There's already a Medical abortion article we can create a Surgical abortion one. The original source sounded like a relative contraindication for me so I don't understand why so much noise, it would be easier simply add the word "relative" or complement that citation with the mitigative measures.--Nutriveg (talk) 13:29, 9 June 2010 (UTC)

Ok. The Medical abortion article is only start-class and would benefit from expansion (we have a lot of sources here that could be used) as well as a copyedit to transform much of the list-style information into prose. It would benefit from a structure similar to Sertraline, imho. There's no point in condensing this article until the daughter articles are at least as complete, so I'll put my suggestion hold for now. --RexxS (talk) 14:11, 9 June 2010 (UTC)

After the lesson on "Misrepresenting sources", do we now need a lesson on using your own words, plagiarism/copyvio, and using quotes when you are copying verbatim text? -Andrew c ^[talk] 14:45, 9 June 2010 (UTC)

No, we need helpful people who can fix those minor mistakes instead of creating catch-22 discussions: "misrepresentation" or "too much alike".-Nutriveg (talk) 15:04, 9 June 2010 (UTC)

Can someone propose a change to avoid the copyvio? Then we can make an editprotected request.-Andrew c ^[talk] 23:19, 11 June 2010 (UTC)

Use of MEDRS

WP:MEDRS, by consensus, has the force of WP:RS when considering sources that make medical claims. It imposes a higher standard of reliability for those claims than does WP:RS. However, it has to be read in full and used carefully, as a superficial reading can lead to reliable sources being removed because of a misunderstanding of the guidance it gives.

In the case of WP:MEDRS#Use up-to-date evidence, it contains a "rule-of-thumb" to help us decide between multiple sources. If we don't have recent secondary reviews on the topic concerned, we should not use this section as a tool to delete sources simply on the grounds of age, until more recent sources are found.

In the case of WP:MEDRS#Respect secondary sources, it contains the following points: We cannot use primary studies to contradict reliable secondary sources such as reviews. This does not mean that primary sources are forbidden. Indeed, they may be the only sources available and may be used, albeit carefully, mentioning the study in the text and avoiding any analysis. However, once reviews or other reliable secondary sources are published, those should be substituted for the primary source. The only occasion where removal of a source is clearly indicated is when reviews in the area have been published which ignore a particular primary source – in that case the study is deemed "unimportant" and should be removed. quotes from WP:MEDRS removed per suggestion

I hope editors here will subscribe to my summaries and abide by what WP:MEDRS actually says. In particular, I'm asking that the likely debate on the current addition and removal of sources confines itself to discussing how the actual principles of MEDRS should apply here. --RexxS (talk) 13:57, 9 June 2010 (UTC)

It's better to discuss problematic sources individually in the sections of the talk page where they were brought to and are currently discussed. Text from WP:MEDRS is available for every user so copying it here brings no help, use links as everybody else, pasting large amounts of text here doesn't improve your argument. Create an essay if you want to express your personal views about MEDRS this is not the appropriate place for that.--Nutriveg (talk) 14:24, 9 June 2010 (UTC)

Thanks for taking the time to discuss this issue. As you obviously prefer to be dismissive, let me explain that I placed it here to try to help you could understand how you have misused the guidelines and policy.

The source that you removed here (edit summary: Self published source) is not a self-published source:

• "Induced abortion". Geneva Foundation for Medical Education and Research. World Health Organization.

The publisher is the World Health Organization: per WP:RS a "reliable, third-party, published sources with a reputation for fact-checking and accuracy". Take it to WP:RS if you don't believe me.

In this diff (citing the original source f), you change the text which was based on a secondary source to reflect a primary source - exactly what WP:MEDRS#Respect secondary sources tells you not to do.

In this diff (despite being self-published this is too old and so doesn't respect WP:MEDRS#Use up-to-date evidence), you remove a secondary source that is available in two forms:

• "Induced abortion". Geneva Foundation for Medical Education and Research. World Health Organization. 1993. Retrieved 2010-06-07.
• . Frontiers in Endocrinology. Vol. 2. Rome: Ares Serono Symposia Publications. 1993. OCLC 34525562. {{cite book}}: |work= ignored (help); Missing or empty |title= (help); Unknown parameter |editors= ignored (|editor= suggested) (help)

After tagging the latter with {{failed verification}} despite the fact that a quick Google search shows that it has been cited by others. From {{failed verification}}: "Use this tag only if a source is given, you have checked the source, and found that the source says something other than what is contained in the text, or for whatever reason is illegible or unreadable. Explain in detail on the talk page (my emphasis). MEDRS does not give you the right to just delete sources simply because they are old. You need to be replacing them with newer reviews.

In this diff (removing primary old source by WP:MEDRS#Use up-to-date evidence and WP:MEDRS#]Respect secondary sources), you remove a retrospective chart audit of 1677 medical charts:

• Westfall JM, Sophocles A, Burggraf H, Ellis S (1998). "Manual vacuum aspiration for first-trimester abortion". Arch Fam Med. 7 (6): 559–62. PMID 9821831.{{cite journal}}: CS1 maint: multiple names: authors list (link)

It's a primary source, but you don't suggest why it contradicts a secondary or that it has been excluded from later reviews - the reasons required by MEDRS.

If you are having problems in understanding Wikipedia's sourcing policies and guidelines, please discuss here first, rather than presenting other editors with a fait accompli by removing numerous sources without taking the time to find a consensus for your actions first. You know your removals are contentious, and acting before discussion is inviting others to edit-war. --RexxS (talk) 16:45, 9 June 2010 (UTC)

That first NGO source was discussed in this section where we reached consensus it was not published by the WHO. I described that reference was not found due to lack of a pmid, isbn and results of some basic search, which is still the case since no one was able to check it maybe the template used before was not the best, but it's not being used due to other problems with that source better described in that discussion. Feel free to discuss those issues in the appropriate section now you know where it is.

The other is an old primary source. It's primary, the doctor evaluates the safety of the procedures performed in his own office. Currently it supports no unique information in the text to worth citation, it's too old (1998) to not have been cited in a secondary/tertiary source we could use. And the removal strictly follows WP:MEDRS as an example: "Prefer recent reviews to older primary sources on the same topic".--Nutriveg (talk) 17:17, 9 June 2010 (UTC)

I'm commenting here because of a note left on my User Talk page. Note also that I have previously warned Nutriveg regarding the removal of sources or sourced material using MEDRS as a justification. This ought to be obvious without being explicitly stated, but here it is: MEDRS provides supplementary guidance as to which sources are to be preferred assuming that multiple sources are available. MEDRS should not be used to justify removal of sources or sourced material that, while reliably soured according to WP:RS, is nevertheless not of the very highest standard possible. Again, I note that Nutriveg started removing sources from this article after being told on this talk page that their source was not up to MEDRS standards (though that was not the only problem with their addition) and I reiterate my concern that this course of conduct is disruptive and intended to make a point. SHEFFIELDSTEEL^TALK 18:29, 9 June 2010 (UTC)

(edit conflict) Thanks for the helpful response, Nutriveg. If you don't mind though, I'd rather keep this particular discussion together. I can see the debate about the publisher of the "Induced abortion" source, but I can't see where consensus was reached that it is not a reliable source or is unsuitable for other reasons. Your view seems to be that it's published by the GFMER, rather than the WHO. In that case, why is GFMER not a reliable source? It has articles cited 164 times in Google Scholar, and 7 times in PubMed. I know that's only an indicator (not a guarantee) of a reliable publisher, but what is the rationale suggesting that it isn't RS? Should I make a post at WP:RSN to get some other opinions?

The 1998 primary source was supporting the sentence "Possible complications include hemorrhage, incomplete abortion, uterine or pelvic infection, ongoing intrauterine pregnancy, misdiagnosed/unrecognized ectopic pregnancy, hematometra (in the uterus), uterine perforation and cervical laceration." If you're happy that the Handbook of Obstetric and Gynecologic Emergencies p.258 supports that list, I'll gladly withdraw my objection to the removal of the primary source. I now see that Doc James has been providing more sources, so hopefully much of this will become moot. --RexxS (talk) 18:33, 9 June 2010 (UTC)

SheffieldSteel, you should be aware of your former involvement as an editor in this article. It's not because a source was removed before that it can't ever be removed again, all those changes where justified and explained, stop making unecessary out-of-context warnings on content disputes. I see the message Rexxs left on your talk page but he was the only that made any noise about the removal of a 1998 study which is not used to support any wikipedia article text not supported by the other tertiary sources in the article. His unjustified call for the use of that source is what looks disruptive for me.

RexxS, GFMER is being discussed in that section, there is a whole section about it, I will discuss it there as everybody else. The consensus I pointed was about it not being published by the WHO, you're welcome to join that discussion. I'm glad you finally recognized how useless that 1998 source was.--Nutriveg (talk) 19:06, 9 June 2010 (UTC)

I am quite aware of my involvement in editing this article. My last edit was to revert an edit - by you - which misrepresented its source (a newspaper) in order to push a particular POV. Administrators routinely revert edits which are uncontestably detrimental to Wikipedia; such actions do not render us "involved" to the point where we cannot subsequently use our admin tools. SHEFFIELDSTEEL^TALK 19:52, 9 June 2010 (UTC)

Please refer where is administrative role to get involved in this discussion about content--Nutriveg (talk) 20:03, 9 June 2010 (UTC)

The 1998 primary source probably isn't as useless as you may think: It's been cited at least 60 times :) --RexxS (talk) 20:24, 9 June 2010 (UTC)

It was useful to those articles, don't know in which context (good or bad), but at Wikipedia we don't make science so we prefer secondary/tertiary sources like the one already supporting that same text.--Nutriveg (talk) 20:31, 9 June 2010 (UTC)

Perhaps a little light can be shed on the credibility of the "Induced abortion" source by pointing out that, whoever "published" the book, there were no fewer than eleven WHO contributors listed for various chapters amongst the contributors listed here. The title page shows five editors, one of whom, J. Villar, is listed as "Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, 1211 Geneva 27, Switzerland". The specific chapter is listed as being authored by Van Look P (63 pubmed hits) and von Hertzen H (46 pubmed hits, 13 together), both of whom are listed as from the same organization. According to pubmed, their collaboration spans from PMID 8324605 (in 1993) to PMID 20159186 (in 2010), almost entirely focussed on medical abortion and emergency contraception, and including four review articles. GFMER lists their terms of reference as collaborating experts to the WHO. Now does anyone seriously contend this source is a hoax played out by someone claiming to be Aldo Campana, in Geneva, under the very noses of the WHO, simply because they made an online copy available in apparent accord with those terms of reference, or is the sole remaining objection that it is out of date? A refined citation if used, would thus read:

• Van Look PFA, von Hertzen H (1993). "Induced abortion". In Campana A, Dreifuss JJ, Sizonenko P, Vassalli JD, Villar J (eds.) (ed.). Frontiers in Endocrinology. Vol. 2. Reproductive Health. Rome: Ares Serono Symposia Publications. ISBN 9788885974128. OCLC 34525562. Retrieved 2010-06-07. {{cite book}}: |editor= has generic name (help); Missing or empty |title= (help)CS1 maint: multiple names: editors list (link)

The NLM ID 9606196 maps to a longer malformed title, "Reproductive health : postgraduate course for training in reproductive medicine and reproductive biology / Faculty of Medicine, University of Geneva and Special Programme of Research, Development, and Research Training in Human Reproduction, World Health Organization ; editor, A. Campana ; co-editors, J.J. Dreifuss ... [et al.]." LeadSongDog come howl! 20:06, 9 June 2010 (UTC)

Thanks for your effort now we have checked that reference and solved that specific problem. It's not unusual for people which work for an organization to write articles not reviewed by such organizations while still using their work correspondence address that's why I raised that point. I needed to check if it was actually published to confirm if that 1993 book was editorial reviewed.--Nutriveg (talk) 20:22, 9 June 2010 (UTC)

More reliable references

I have added more reliable references to support the comparison to child birth in the developed world:

• A Lance review from 1996: Kulczycki A, Potts M, Rosenfield A (1996). "Abortion and fertility regulation". Lancet. 347 (9016): 1663–8. PMID 8642962. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• A medical text from 2004 Danielle Mazza (2004). Women's health in general practice. Oxford: Butterworth-Heinemann. p. 93. ISBN 0-7506-8773-8.
• Another medical text from 2007 Eric Sokol; Andrew Sokol (2007). General gynecology. St. Louis: Mosby. p. 238. ISBN 0-323-03247-8.{{cite book}}: CS1 maint: multiple names: authors list (link)
• A third medical text from 2005 Lloyd, Cynthia B. (2005). Growing up global: the changing transitions to adulthood in developing countries. Washington, D.C: National Academies Press. p. 215. ISBN 0-309-09528-X.
• Returned a 2009 medical text Douglas W. Laube; Barzansky, Barbara M.; Beckmann, Charles R. B.; Herbert, William G. (2009). Obstetrics and Gynecology. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 150. ISBN 0-7817-8807-2.{{cite book}}: CS1 maint: multiple names: authors list (link)

I hope this addresses the concerns regarding the previous references being old and question about if they were peer reviewed and from a reliable source.Doc James (talk · contribs · email) 17:20, 9 June 2010 (UTC)

It would be helpful if you added the quote to those references, it's problematic to search for that book to find it uses US data or don't make a comparison (safer) as in the Wikipedia text.--Nutriveg (talk) 17:36, 9 June 2010 (UTC)

Just pull it up using google books. If you wish to type out the text though feel free.Doc James (talk · contribs · email) 17:48, 9 June 2010 (UTC)

Yes, the lancet 1996 review does support the text "In developed countries, mortality associated with childbirth is 11 times higher than that for safely performed abortion procedures". It doesn't follow WP:MEDRS#Use up-to-date evidence since it is 14 years old but I will check the other sources first.--Nutriveg (talk) 19:29, 9 June 2010 (UTC)

We have used many other sources of this age. It is sufficiently uptodate and before making claims it is not you should request comments at WP:MEDRS. I am fine with saying 1996. The other references mainly say that child birth is more dangerous than abortion in developed countries. Thus we can either clarify with the date "1996" or the "11 times". I do not have any strong opinion either way. Doc James (talk · contribs · email) 19:42, 9 June 2010 (UTC)

You should try to change WP:MEDRS#Use up-to-date evidence to reflect that.--Nutriveg (talk) 20:06, 9 June 2010 (UTC)

(edit conflict) If it's any help:

• The Kulczycki 1996 review seems to be cited in other texts and supplies data on abortion rates and maternal death from unsafe abortions across the globe;
• Mazza 2004: "Mortality associated with pregnancy is 30 times higher than that associated with abortion prior to 8 weeks gestation" - a comparison made on page 93;
• Sokol 2007: (aside: pages 233- overview of surgical abortion; useful if that article is created?) search for 'mortality' brought up some results in termination section that I wasn't allowed to view;
• Lloyd 2005: "Mortality and morbidity related to pregnancy and childbirth (particularly in sub-Saharan Africa and South Asia, where levels of early childbearing remain high) and as a direct consequence of unsafe abortion across all developing regions remain among the most significant risks to young women's health." (p.5) - factors juxtaposed, but no direct comparison; "Maternal deaths are those that occur during pregnancy and up to 42 days after birth. About 80 percent of these are due directly to maternity; the most common cause is hemorrhage, followed by sepsis and complications of unsafe abortion ..." (p.191); 3 more pages that I can't see;
• Laube 2009: "Risk of death from abortion during the first 2 months of pregnancy is less than 1 per 100,000 procedures, with increasing rates as pregnancy progresses (versus 7.7 maternal deaths per 100,000 live births)." (p.150) - makes a comparison.

It seems clear that some reliable secondary sources make a comparison. There should be enough in the sources there to produce a supportable piece of text. --RexxS (talk) 20:13, 9 June 2010 (UTC)

(edit conflict)Reading what you posted.

• (Kulczycki, 1996) is the one we just cited
• (Mazza, 2004) is just citing (Kulczycki, 1996), using exactly the same phrase so it doesn't qualify as a new review just a copy
• (Sokol, 2005) missing the quote
• (Lyond, 2005) missing a quote comparing both
• (Laube, 2009) it's Beckmann we previously discussed as US data, it just presents both the numbers.--Nutriveg (talk) 20:52, 9 June 2010 (UTC)

Absolutely wrong. You are not qualified to draw conclusions from your own opinion of a reliable source. That's the single biggest problem you bring here. Mazza 2004 is a secondary source and your opinion that "it doesn't qualify as a new review just a copy" is pure nonsense. You have no way of knowing what primary sources were used by Mazza in compiling the book, and it is contrary to all established policy for you to start making your own guesswork analysis of a reliable source. You are also totally wrong to think that Laube 2009 "just presents both the numbers". By using the "versus" phraseology, it is abundantly clear to everyone else that it is a comparison. This is not the first time that it's been pointed out to you that you cannot pick and choose which references you want depending on whether they fit your own preconceptions. --RexxS (talk) 23:00, 9 June 2010 (UTC)

Yeah, I can only opine from what I see if I'm wrong it's up to other more informed people to clear that misunderstanding. The phrases from both articles are the exactly same but I don't know why you're bringing the issue of (Mazza, 2004). Do you expect to use it in a different way than it's currently being used?

Comparing data is not the same thing of presenting both to the reader compare. Compare is using words like "higher", "safer", we usually just cite the source, without advancing it by making such comparisons of different subjects especially when we don't know where those numbers came from... As usual I don't see how you raising that semantic issue will result in a change in the article text.--Nutriveg (talk) 23:14, 9 June 2010 (UTC)

Okay, I can sympathise with the frustration of "knowing that text is wrong" - I often feel the same when editing scuba articles. But I've had to learn that whatever expertise I may have outside Wikipedia is worth zilch inside it, unless a reliable source has already made that point. Even then, sometimes it's not clear-cut and two different views have to be presented; but that's ok as well, as long as I don't give undue weight to my own personal opinion.

I think we'd go mad if we had to track down and analyse the source of every piece of numerical data that shows up in sources. At some point we have to just say "It's a good quality reliable source: I trust it".

Finally, I'm willing to be corrected if I'm wrong, but I thought the issue with the comparison of mortality rates was not "what the text said", but whether the text should even be in the article? I thought that we were trying to settle the point that secondary sources used such a comparison, and therefore it is appropriate for our article to do so. If I've misunderstood, please accept my apologies - it's quite possible that I'm not up-to-date on all of the debates here. --RexxS (talk) 00:05, 10 June 2010 (UTC)

Yanda

• I have found an even better reference. Which I will add Yanda K.; et al. (2003). "Reproductive health and human rights". International journal of gynecology and obstetrics. 82 (3): 275–283. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help). Is 2003 recent enough? Here is the wording they use "Studies of medical abortion since the 1980s in Europe and in 2000 in the United States, in addition to studies in various other countries, have shown the method to be extremely effective and significantly safer than childbirth."Doc James (talk · contribs · email) 20:48, 9 June 2010 (UTC)

It's a newer source but that claim is about Medical abortion so it belongs to that article.--Nutriveg (talk) 20:58, 9 June 2010 (UTC)

Look the answer is no. You must start getting consensus for your deletion of excellently sourced material. Obviously nothing no matter how good a reference will ever be ever good enough for you. This has become silly. Doc James (talk · contribs · email) 21:04, 9 June 2010 (UTC)

The source looks good, but it didn't supported the claim, since the quote is clearly about Medical abortion--Nutriveg (talk) 21:11, 9 June 2010 (UTC)

The answer is still no. The rest of the references support the rest of the claim. Sokol 2007 "In developed countries the mortality rate from induced abortions is less than 1 in 100,000 procedures making the procedure safer than pregnancy and childbirth"Doc James (talk · contribs · email) 21:13, 9 June 2010 (UTC)

And on that note, I will add that this was "a revert too far" in my opinion also. Hence, I have asked an outside admin to take a look at this. SHEFFIELDSTEEL^TALK 21:21, 9 June 2010 (UTC)

DocJames, well you didn't provide the quote to that 2007 article when I requested trying to figure what text it was supporting, and said "Is 2003 recent enough?" as if you had based your last edit on that 2003 source you just added and previously quote here, where the quote indeed reflected your edit. You can use that Sokol,2007 phrase if you think it's better, but the other one is clearly about Medical abortion.--Nutriveg (talk) 21:25, 9 June 2010 (UTC)

SheffieldSteel, what's the ongoing problem you're seeing? This was newly added content, you can't evaluate an edit during the editing process you need to wait few minutes for the outcome.--Nutriveg (talk) 21:30, 9 June 2010 (UTC)

Having most additions of references I have added in an attempt to solve the ongoing debate removed I have posted at WP:3RR [19]. I will stop further editing of the main article / looking for references until this matter is resolved. I see no reason to search the literature in this environment. BTW that sentence is based on 6 excellent sources and the information is in all 6 of the sources. Doc James (talk · contribs · email) 21:40, 9 June 2010 (UTC)

I feel sad about that but good look searching for sources if you think they are not good enough or they directly don't support the text. As opposed of what you're saying most of the references you added are still in the article. If you don't like to have your changes reverted you should discuss them first instead of editing and waiting to see if someone will revert them. Despite of how good you think they are some people may not agree with you.--Nutriveg (talk) 22:05, 9 June 2010 (UTC)

Usually you should see if you can find two people who disagree rather than just one.Doc James (talk · contribs · email) 22:10, 9 June 2010 (UTC)

Nutriveg, take a look at Wikipedia:Ownership of articles#On revert. You've demonstrated nearly all of the examples of inappropriate ownership listed there. MastCell ^Talk 22:11, 9 June 2010 (UTC)

Doc Jones, if you don't care about being reverted I don't care if you do bold edits, but if you do care about being reverted your advice also applies to you: get agreement before making a change.

MastCell, I don't identify with those points since we have added a lot of content so far and the problems we are having is mainly one of inappropriate use of sources, except in what concerns your edits, that remove a lot of sourced content.--Nutriveg (talk) 22:32, 9 June 2010 (UTC)

I agree with Doc (although I don't think it's necessary to include all of the sources he's turned up, since a few should suffice for any reasonable interpretation of verifiability). I think several other editors also agree. The thing is that you're sort of drowning them out, both here on the talk page and by your ready recourse to edit-warring (which I don't really see from other editors). The other thing I see is about 4 or 5 editors working hard to find and vet sources, and one editor (you) simply shooting down that work and reverting (with increasingly odd rationales).

Here's an idea - self-impose 1RR. If people agree with your edits, they'll stick without the need for your rapid-fire reverting. If people don't agree with your edits, it will become apparent once you've given other editors a tiny bit of room to breathe and work. I've done this before myself and it helps (in fact, I decided to limit myself to 1RR here, although I broke my own rule to fix your error about contraindications since it seemed fairly serious). MastCell ^Talk 23:10, 9 June 2010 (UTC)

Cites cleaned up

I've cleaned up the cites Doc James offered above:

• A Lancet review from 1996: Kulczycki A, Potts M, Rosenfield A (1996). "Abortion and fertility regulation". Lancet. 347 (9016): 1663–8. doi:10.1016/S0140-6736(96)91491-9. PMID 8642962. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• A medical text from 2004 Danielle Mazza (2004). Women's health in general practice. Edinburgh; New York: Butterworth-Heinemann. p. 93. ISBN 9780750687737. OCLC 52515824.
• Another medical text from 2007 Eric R. Sokol; Andrew I. Sokol (2007). General gynecology. St. Louis, Missouri: Elsevier Mosby. p. 238. ISBN 9780323032476. OCLC 70663738.{{cite book}}: CS1 maint: multiple names: authors list (link)
• A third medical text from 2005 National Research Council (U.S.). Panel on Transitions to Adulthood in Developing Countries (2005). Lloyd, Cynthia B. (ed.). Growing up global: the changing transitions to adulthood in developing countries. Washington, DC: National Academies Press. p. 215. ISBN 9780309095280. OCLC 57529038.
• Returned a 2009 medical text Douglas W. Laube; Barzansky, Barbara M.; Beckmann, Charles R. B.; Herbert, William G.; American College of Obstetricians and Gynecologists (2009). Obstetrics and Gynecology (6th ed.). Baltimore, Maryland: Lippincott Williams & Wilkins. p. 150. ISBN 9780781788076. OCLC 567310751.{{cite book}}: CS1 maint: multiple names: authors list (link)

Most of these have google previews available.LeadSongDog come howl! 03:06, 10 June 2010 (UTC)

Thanks LeadSongDog You missed one Yanda K.; et al. (2003). "Reproductive health and human rights". International journal of gynecology and obstetrics. 82 (3): 275–283. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help) and yes all of these were visible by google books from were I come from.Doc James (talk · contribs · email) 03:48, 10 June 2010 (UTC)

(undent) To continue this above paper states "Studies of medical abortion since the 1980s in Europe and in 2000 in the United States, in addition to studies in various other countries, have shown the method to be extremely effective and significantly safer than childbirth." It describes world wide statistics for medical abortions in developed countries. I see that the US does primarily procedural abortions which is different than up north. The other refs provide the comparison for procedural abortions so I think we should changed the wording to "significantly safer than childbirth" and drop the 1996 as there is no evidence that this has in any way changed.Doc James (talk · contribs · email) 05:44, 10 June 2010 (UTC)

I checked the text of those references:

• (Kulczycki,1996) sounded too informal and counseling "When women ask about the safety of abortion it is also worth pointing out that in developed countries, mortality associated with childbirth is 11 times higher than that for safely performed abortion procedures and 30 times higher than for abortions of up to 8 weeks gestation" Not the kind of text I would expect to see in an epidemiological analysis, sounds more like advice for those supporting a specific POV so they can have an argument to get handle of insecure mothers.
• (Mazza, 2004), is in a section called Surgical abortion (not general abortion) as expected it was just a plain citation of (Kulczycki,1996)
• (Sokol, 2007) "In developed countries, the mortality rate from legal, induced abortion in the first trimester is less than 1 in 100,000 procedures, making the procedure safer than pregnancy and childbirth." "First trimester" was an important omission from what Doc James previously quoted.

That book chapter "Pregnancy Loss and termination" was written by Allison Cowett, which is a pro-abortionist and E. Steve Lichtenberg who serves on several committees of the Board of Directors of the National Abortion Federation. NPOV anyone?

• (Lloyd, 2005) is not a medical book so not a good source by WP:MEDRS#Books standards and it says: "In representative developed countries, the risk of dying is no more than 1 in 100,000 procedures lower than the relatively low risks associated with pregnancy and childbirth in these countries (The Alan Guttmacher Institute, 1999)" Even when making poor comparisons they took care to "quantify" the risk. Guttmacher is the one which promote abortion and its legalization: "The Institute works to protect, expand and equalize access to information, services and rights that will enable women (...) exercise the right to choose abortion"
• (Laube, 2009) seems to use US data in the whole section, not worldwide, as previously discussed. It says "Risk of death from abortion during the first 2 months of pregnancy is less than 1 per 100,000 procedures, with increasing rates as pregnancy progresses (versus 7.7 maternal deaths per 100,000 live births)." same 7.7 number of "To discern possible trends in maternal mortality, data were divided into two 5-year periods (1987-1991 and 1992-1996). The national MMR was 7.7 for each time period."
• (Yanda, 2003) says "Studies of medical abortion since the 1980s in Europe and in 2000 in the United States, in addition to studies in various other countries, have shown the method to be extremely effective and significantly safer than childbirth." It's about a specific procedure, medical abortion, which has its own article.

Good luck finding good sources next time.--Nutriveg (talk) 03:17, 11 June 2010 (UTC)

These are all good via WP:MEDRS. I am not sure what you mean by next time as this time I think I have already done very well. You do not get to say "sounded too informal and counseling" as a means to dismiss a reference. This page is about both medical and surgical abortions thus we are not going to exclude everything that does not specifically deal with both.

I recommend we change it to: "Abortions are safer than child birth in developed countries." referenced to the 1996 paper. No this is not too old as nothing new has come along to refute it.Doc James (talk · contribs · email) 03:29, 11 June 2010 (UTC)

That's your interpretation, and since it was you who suggested those sources as reliable I wasn't expecting to hear anything much different.

To you it1s not informal when someone brings a number in a phrase which point was how to address insecure mothers? And that number (11) can't be found (previously) anywhere else so we just don't know if the author took an aesthetic decision to summarize numbers during the editing process since that phrase was directed to (insecure) lay people where an strong (but poor) comparison would sound better to convince those insecure people than presenting individual numbers and letting them do that (poor) "high school math" (as opposing to serious epidemiological analysis) in their head?

Even by bad sources that phrase you suggested is inappropriate. Even those bad sources say "first trimester" and they make clear the risk is low for both procedures.

Using that 14 years old source clearly contradicts WP:MEDRS#Use up-to-date evidence "Look for reviews published in the last five years or so, preferably in the last two or three years." beyond the problems of the context where that argument was used in that old source.--Nutriveg (talk) 03:53, 11 June 2010 (UTC)

Wow so the cut off is 5 years but preferably within the last 2 to 3 years? No reviews before 2005 are sufficiently uptodate for use on Wikipedia.Doc James (talk · contribs · email) 04:05, 11 June 2010 (UTC)

We are not talking about the whole wikipedia, but to support medical claims which WP:MEDRS#Use up-to-date evidence is about.

I wouldn't have a problem if it was just a few years older, but that's not the case here, specially when we think a review is about even older studies. And the problem of the context where that claim was made, that doesn't help neither.--Nutriveg (talk) 04:10, 11 June 2010 (UTC)

"Up to date" implies "not superceded by more recent sources of similar or better quality". Are there any such more recent sources that you would care to suggest? LeadSongDog come howl! 04:40, 11 June 2010 (UTC)

I don't know why you quote text without pointing their source, I pointed the source for quote that mentioned the years. It's not hard to find people that are careless enough to make bold claims without appropriate scientific support that's why the burden of evidence lies with the editor who adds or restores material, not me in this case.--Nutriveg (talk) 05:06, 11 June 2010 (UTC)

(edit conflict) Please try to understand that your characterisation of a source is not an argument. Just because you feel a source is bad doesn't make it so. Your insistence on presenting your own analysis is disrupting the discussion on how best to use these sources.

Your objection to Kulczycki is that it's not the kind of text you'd expect to see?

Your objection to Mazza is that it's a plain cite. It's not any sort of cite. This is a secondary source and you've already been told that none of us know if the source was X,Y or Z unless the author specifically attributes it to another source. Our job as editors is to neutrally report what sources say, not play detective with where the secondary might have got its data from.

Your comment on Sokol that it refers to first trimester is useful and will helps the editors in using that source accurately. However, you completely misunderstand WP:NPOV - that prescribes the way in which editors have to report sources. It is nothing whatsoever to do with authors, publishers, or the words used in a source. The only opinion about the POV of a reliable source is one which is stated in other reliable sources. You cannot dismiss a source on the grounds that you feel it (or its authors or editors) have a POV. It's not our job to do that.

Your objection to Lloyd is that it isn't a medical book. MEDRS says medical books are excellent sources, but you make the logical fallacy of thinking that non-"medical books" are therefore not "excellent sources". I agree that Lloyd certainly isn't a medical book. It's a report on a project undertaken by the National Research Council, drawing from the National Academy of Sciences, the National Academy of Engineering and the Institute of Medicine (as it states on its first page). It's a quality piece of research undertaken by some of the most eminent institutions. It is inconceivable that anyone else could think it was not a reliable source. The fact that it quotes another reliable source is not an objection to its reliability.

There's an essay at WP:TE that gives good advice on how to avoid these sort of problems. You have the capability to make good points – the limitations of sources discussing only part of the issues, for example. But you are drowning that out by insistence on trying to "debunk" all of the sources that don't suit, by repeated arguments that rely only on analyses that are beyond the competence of any editor to make. --RexxS (talk) 04:46, 11 June 2010 (UTC)

I agree with RexxS. A good-faith effort has been made to address Nutriveg's objections, with several editors going above and beyond the call of duty producing a raft of good sources. At this point these are simply not reasonable objections, as RexxS has explained in more detail, and I think it's time to stop wasting effort addressing them. None of us are infinitely patient, and we need to refocus our efforts on actually improving the article with the many sources that we've accumulated, rather than trying to satisfy endless goalpost-moving obstruction. We are at the point where we're going to lose editors who have a lot to contribute (if we haven't already) because of this, so let's not let that happen. MastCell ^Talk 05:04, 11 June 2010 (UTC)

RexxS, I didn't merely characterized the sources, I pointed the problems they had, detailing those issues.

I've said much more about Kulczycki than that out of context word you picked, curiously the same out of context way as that Kulczycki text is trying to be used. It's mainly a problem of taking an unreferenced informal "how to advice" as scientific fact. I've already pointed unreferenced claims by sources saying that abortion could be riskier than childbirth but you didn't see me supporting the use of such text. Do we want to lower the level of the sources used in this article just because some people want to make a comparison? Kulczycki is also older than defined by WP:MEDRS

I later checked the source and Mazza explicitly cites that whole Kulczycki phrase (with the advice part) attributing that claim to him. Don't play detective with me so.

I didn't say WP:NPOV, but NPOV which is short for "neutral point of view", Wikipedia don't have exclusive rights over acronyms. The authors of that text are biased since they are abortion lobbyists and even sue the government for defending that minors should commit abortion without their parents consent. It's appropriate to clarify who was making those (again) unreferenced claims. WP:NPOV applies to text presentation not to WP:Verifiabilty or the selection of reliable sources. Source selection is decided by Wikipedia editors. External criticism about a source would only be required if we decide to include text criticizing that source.

MEDRS in its definition also says "Ideal sources for these aspects include (...) widely recognised standard textbooks ", "specialist textbooks are examples of secondary sources" and "A good secondary source from a reputable publisher will be written by an expert in the field". I initially noticed that problem of not being ideal as that book wasn't categorized as medical, but now, looking further at least some parts of (Lloyd, 2005) seems to have been written by experts, so we can use it.

MastCell, try to really address those issues instead of just saying "Oh, that was already addressed" that kind of participation doesn't help to solve those issues.--Nutriveg (talk) 06:52, 11 June 2010 (UTC)

Having reviewed this, I see no problem with what RexxS, MastCell etc are proposing. Verbal chat 07:48, 11 June 2010 (UTC)

First suggestion by Nutriveg

It looks that Schrandit, by the description he makes, apparently agrees with me about that one source selection: "give the 1 more reliable, recent number".

Verbal, I see you read fast but so far in this current discussion I didn't see what text they (RexxS, MastCell) were proposing or in which source it was mainly based.

I propose we use (Lloyd, 2005) "In representative developed countries, the risk of dying (from abortion) is no more than 1 in 100,000 procedures, lower than the relatively low risks associated with pregnancy and childbirth in these countries (The Alan Guttmacher Institute, 1999)" we may also attribute that claim to their original author Guttmacher Institute, since (Lloyd, 2005) did that attribution and given this is not an "ideal source" as discussed above.

So an early version would look: "According with the Guttmacher Institute maternal death from abortion in developed countries is bellow 1 in 100,000 procedures, lower than the relatively low risks associated with pregnancy and childbirth in these same countries "--Nutriveg (talk) 13:31, 11 June 2010 (UTC)

Arbitrary break 1

Nutriveg, I understand your objections to Kulczycki, but refute them. Your criticisms were "sounded too informal and counseling"; "Not the kind of text I would expect to see ..."; "sounds more like advice for those supporting a specific POV ..." Can you not see that such objections are wholly inappropriate concerning a "review of abortion-related issues", (i.e. a secondary source) published in the The Lancet. It simply doesn't get any better than that.

I was mistaken when I said that Mazza does not cite Kulczycki. I retract that and have struck it from my previous comment. Nevertheless, you still miss the point about Mazza - it's a secondary source; when we use it, we rely on it's own authority. We accept that the author made the judgements and conclusions based on earlier sources – that's what makes it a secondary source – but anyone who wants to contradict those judgements needs to have their contradiction published in a reliable source to have any weight. There is the source you pointed to (Jones, Richard Evan (2006). Human Reproductive Biology (3 ed.). Academic Press. p. 429. ISBN 978-0120884650.) and I simply don't understand why you aren't suggesting a caveat expressing a minority opinion. I'd suggest something like '... although Richard Jones concludes that "[a]fter the 19th week of pregnancy the maternal death rate due to abortion is greater than that of childbirth"(ref)'

Again however, you make the mistake of confusing fact with opinion. The fact is that in developed countries the mortality rate from abortion during at least the first trimester is an order of magnitude lower than the rate of mortality from childbirth. That fact is attested in several reliable sources and you have to understand that the POV of the authors is not our concern. Read again WP:MEDASSESS:

"Assessing evidence quality" means that editors should determine the quality of the type of study. Editors should not perform a detailed academic peer review. Do not reject a high-quality type of study because you personally disagree with the study's inclusion criteria, references, funding sources, or conclusions.

I can't make it any clearer for you than that. --RexxS (talk) 15:27, 11 June 2010

No, that's not my argument, that's part of one of the conclusions (informal/unscientific context) about that reference (the others being unreferenced claim and old source by MEDRS standards) I took from my arguments. So we are going nowhere if those arguments are just ignored and you (again) just pick some words and restrict this discussion as if baseless personal opinion were being discussed. That Kulczycki claim was made under an informal context (how to address doubtful women) where scientific rigor is not expected, during the editing or reviewing process, since that phrase was directed to a lay audience and in that context other features of the message like easiness to read and clarity may outweigh scientific reliability. That claim has no reference in that text and is too old by WP:MEDRS#Use up-to-date evidence standards since it is 14 years old.

I don't want to use and reject the use of (Evan, 2006) since it shares the same problem of making claims without citing the sources. That was just an example of how sources can be problematic in both ways.

I do see the way Mazza cited Kulczycki as a caution measure: This guy, not me, is saying that. It does cite Kulczycki the same way I quote it here, so it doesn't solve those reported problems.

I suggested the text above based on a respectable source, there's no point in further discussing (Kulczycki,1996) (or Mazza which cites exactly that same quote) if those sources aren't being used to support a change in that text or they disagree with it.

That's not a fact, some people here do see it that way and so may show little care about problematic sources supporting that claim. It's likely mortality from induced abortion is lower in many countries and undoubtedly that's the case of the United States. But to make bold claims, especially when mentioning numbers (like you did in "one order of magnitude"), we need good sources. We don't compare apples with oranges, so far I haven't seen worldwide epidemiological reviews, we and others could cite, comparing both cases or data from where those studies could be made: are they more poor? they have less access to good health services? do they have a specific condition? do they decide to continue pregnancy even when advised that carries a death risk? Are those just exceptional cases that generally don't apply? Does it carry statistic relevance when comparing to abortion? Another problem is that around the world women who die from abortion are generally counted as death from pregnancy, by ICD-9/WHO definition, so, in most places, distinction is not done even in the most basic raw data.

But that doesn't stop some people from seeing two different numbers, one higher than other, and saying: "Oh, this number is higher than the other, let's make a simple math", "It's late night and I'm reviewing what I previously wrote, let's make this minor change to make this argument stronger". So when citing those studies we need to make sure they are about real epidemiological analysis and not a case of someone, in a review article/book, presenting original research as if it was a result of such epidemiological analysis that hasn't been done.--Nutriveg (talk) 19:30, 11 June 2010 (UTC)

You've just illustrated the behavior that RexxS' green-colored quote specifically warns against. Again. MastCell ^Talk 23:47, 11 June 2010 (UTC)

Exactly about what source? RexxS said:

"The fact is that in developed countries the mortality rate from abortion during at least the first trimester is an order of magnitude lower than the rate of mortality from childbirth."

I contradicted that argument of him not a source. Right as the opposite, if that was the case I wouldn't have agreed to use (Lloyd, 2005)

Again you show up here to question the editors instead of the content being discussed.---Nutriveg (talk) 23:59, 11 June 2010 (UTC)

There's nothing difficult about this process. Doc James finds six reliable sources. I look for what they said about the comparison between mortality rates for abortion and for childbirth:

Kulczycki is a 1996 secondary review in Lancet, cited 44 times, and as recently as 2009 according to Google Scholar.

Mazza is a 2004 medical text from a quality publisher and says "Mortality associated with pregnancy is 30 times higher than that associated with abortion prior to 8 weeks gestation"

Laube is a 2009 medical text from a quality publisher and says "Risk of death from abortion during the first 2 months of pregnancy is less than 1 per 100,000 procedures, with increasing rates as pregnancy progresses (versus 7.7 maternal deaths per 100,000 live births)"

I put forward the fact that in developed countries the mortality rate from abortion during at least the first trimester is an order of magnitude lower than the rate of mortality from childbirth. I also mention Jones which says that by the 20th week, the mortality rate from abortion has overtaken the rate for childbirth.

Other editors put information from sources that address geographical factors, or the second trimester, or contradict what I assert as a fact, or contradict Jones. Eventually a form of words is agreed and it becomes the article text. That's how collaborative editing reaches a consensus.

Now I'll ask if you can see where this process is being derailed? Instead of looking for sources that add to the process, you have repeatedly sought to analyse the sources put forward, attempting to "debunk" or smear them. That is destructive, not constructive debate. "Kulczycki is too old per MEDS#up-to-date, therefore Mazza isn't acceptable because it uses Kulczycki" – well, read "up-to-date":

Here are some rules of thumb for keeping an article up-to-date while maintaining the more-important goal of reliability. These guidelines are appropriate for actively researched areas with many primary sources and several reviews, and may need to be relaxed in areas where little progress is being made and few reviews are being published.

What are the later reviews in the area and in what way do they differ from what Mazza or Kulczycki say? We have no reason to throw out older secondary sources, in the absence of equally authoritative recent ones that modify their conclusions. What "up-to-date" is telling us, is that we should seek to replace older conclusions as newer ones supersede them. Are you confusing it with "Respect secondary sources"?

If an important scientific result is so new that no reliable reviews have been published on it, it may be helpful to cite the primary source that reported the result ... After enough time has passed for a review to be published in the area, the review should be cited in preference to the primary study. If no review is published in a reasonable amount of time, the primary source should be removed as not reporting an important result.

That tells us we may use a fresh primary source in the absence of a secondary one; that such primary sources should be replaced by secondary ones when available; and that the primary should be removed if no secondary emerges after a time. That's a procedure for discarding primary sources, not secondary.

Where did you get the idea that secondary sources have to reference their claims? A secondary source is either a reliable source or it's not. If it is a reliable source, then we do not attempt to deconstruct it, relying on our own assessment of what it says or who the authors are. And we most certainly do not attempt to "mine-down" to its sources (be they primary or secondary) and quote them instead of the secondary. The authority of a secondary source to support a piece of text rests on that source itself. You merely weaken the support by trying to tie it to the primary sources used by the secondary. I really hope your intention of sourcing your suggested text to Guttmacher 1999, instead of Lloyd 2005 wasn't to deliberately weaken it. I'll make a counter-proposal for some suggested text:

• Maternal death from abortion in developed countries is below 1 per 100,000 procedures when performed during the early stages of pregnancy. The corresponding mortality rate for childbirth is 7.7 per 100,000 live births.(Lloyd 2005) However, Richard Jones in 2006 concluded that "[a]fter the 19th week of pregnancy the maternal death rate due to abortion is greater than that of childbirth."(Jones 2006)

I have no attachment to that or to any other form of words. Feel free to do with it what you will. Now, please review what I'm asking you to do here: to engage in a process of consensus-building, and please do your best to avoid what I clearly believe to be spurious criticism of reliable sources.

We have a reliable sources noticeboard. I've made use of it recently to garner outside opinion on "Geneva Foundation for Medical Education and Research". I'm going to suggest that to enable debate to focus here, when anyone feels that a source is unreliable, they take their objections to RSN (feel free to use my request as a template), and make just a courtesy note here. Perhaps we could try that for a period of two weeks?. Is that an acceptable way to move forward? --RexxS (talk) 02:47, 12 June 2010 (UTC)

Rexx, although you were addressing Nutriveg, I just want to briefly mention that, if the comparison to childbirth is included in this Wikipedia article, then I think it would be essential to say that the risk of death from childbirth is "low", citing Lloyd 2005. Merely reciting numbers is not adequate, because lay readers may not understand that those numbers for childbirth really do reflect a low risk in the big scheme of things. I think MastCell has agreed that we can explicitly say that the risk of dying in childbirth is "low".Anythingyouwant (talk) 03:39, 12 June 2010 (UTC)

That sounds eminently sensible to me, and I follow your rationale. I think LeadSongDog also makes a valid point that will need to be addressed below in Worldwide, so chop away at what I suggested, or suggest something else. Thanks to James, we have enough sources! I have no expertise in this area at all – you're the experts. --RexxS (talk) 04:19, 12 June 2010 (UTC)

There's something difficult about this process, when people defend the use of problematic sources even when those sources won't add anything to the text, just for the sake of doing so. Me, MastCell, Anythingyouwant and Schrandit likely agreed to use (Lloyd, 2005) with the only problem being to attribute or not Guttmacher Institute. But you came back here and say: "We need to use all those six sources" when I see no gain from that.

Except for one point, its age, we aren't analyzing (Kulczycki, 1996) as a whole article but one phrase from that article, so it's pointless to count how many people cited that article if you don't know what or how they cited it. That counting doesn't solve the reported problems with that phrase/source: informal/unscientific context, unreferenced claim and old source by MEDRS standards.

That Mazza whole book also isn't being critized, but the mere citation of (Kulczycki, 1996)

Laube, 2009 is a medical text about US data, not worldwide representative, although, you want to use that number in a worldwide context.

You're trying to put forward original research, we only cite what reliable updated sources say.

Richard Jones is an awful source and I don't believe you'll get support for its use, so I'll wait and see before spending my time.

Collaborative editing reaches consensus when the reported problems are listened and addressed.

I'm not forced to search for sources supporting comparison, that WP:BURDEN lies to those trying to add such text, I did some search before and didn't find anything reliable in a worldwide context. We already have agreed on (Lloyd, 2005) so I have even less motivation to do a search.

If the sources don't respect WP:MEDRS they shouldn't be used to support medical claims, that's my point. If such source doesn't exist I won't blind eye to add that content by anyway, this is simple WP:V compliance, there's nothing about being constructive or destructive. On the other hand insistence in adding such content when the sources are problematic looks like a WP:V and WP:MEDRs violation.

I didn't see your point in citing that MEDRS phrase, there are many recent reviews about abortion, it's an actively researched area, so there's no reason to not follow Look for reviews published in the last five years or so, preferably in the last two or three years, if that information is important it will be mentioned in recent reviews otherwise it became outdated, simple like that. WP:BURDEN lies to those trying to add such text.

I didn't suggest to reference (Guttmacher, 1999) but to attribute Guttmacher as the author cited by (Lloyd, 2005). That was an initial suggestion, we can make some changes from it but I expect to respect what the sources said.

Your counter-proposal has the problem of using a US source "7.7 per 100,000" (Laube, 2009, which you referenced as Lloyd, 2005) a bad source (Jones, 2006) using a text/restriction I don't know where you got "is below 1 per 100,000 procedures when performed during the early stages of pregnancy", and not qualifying the risks involved "low", since the lay reader isn't an specialist in getting "a per 100,000" and qualifying that number by comparing it to other risks that may affect him.

We can go to the RSN if you insist in using a specific (all) sources, but I was expecting to stop when we've got just the necessary ones so we should be able to already have finished this discussion by using Lloyd, 2005.--Nutriveg (talk) 05:21, 12 June 2010 (UTC)

Have you considered this: Wikipedia articles should be based on reliable, published sources, making sure that all majority and significant minority views that have appeared in reliable, published sources are covered? Of course I want you to make use of all the reliable sources that have been brought forward! But there's no way you are going to be accepted as judge and jury of what is a reliable source. All of the sources Doc James found are reliable sources, and all of them need to be considered when writing article text.

Once again, you're not qualified to criticise what a RS says. I've demonstrated that Kulczycki is a RS (published in Lancet) - looking at how many times it has been cited is an indicator of its quality: it's high quality. MEDRS has no definition of "old source", and certainly does not forbid older sources from being used For example, Genetics might mention Darwin's 1859 book On the Origin of Species as part of a discussion supported by recent reviews.

Mazza is a RS. It makes a statement about this issue. Any RS putting forward a view should be included unless it's so much a minority view among the sources that it is not significant. Mazza is not a minority view, so should be included.

Laube is a RS and its view needs to be included for the same reasons. It's US data, so the article needs to say something about US data; we have a RS. You want world-wide data? You go find the sources for word-wide data.

Is Jones a RS? Probably. Is the view expressed a minority view? Probably. Is it such a minority view that it's not significant? I don't know, and I'd welcome debate on that point.

The "1 per 100,000 procedures" is given by Lloyd, Sockol and Laube, as you noted above at 03:17, 11 June 2010 (UTC). So, do the sources support "is below 1 per 100,000 procedures when performed during the early stages of pregnancy" or not?

The point of the MEDRS quote was to give context. "Up-to-date" is a rule of thumb for keeping an article up-to-date, not a "bright line" that automatically disqualifies reliable sources over five years old. Hope that's clearer now.

I agree that it would be good to further contextualise the mortality rates for the lay reader, but not at the expense of the figures that the reliable sources use. Perhaps they should also be characterised as "low", or "very low" - what do the sources say?

I note your accusation that I'm performing original research. I'm not, since I'm only reporting what reliable sources say, but I'd be very interested to hear why you think so. Back it up with some explanation, that will be a help.

Naturally, I agree with your statements concerning WP:BURDEN and WP:V. Naturally, I reject your implied assertion that you should be the judge of when the sources are problematic. Once we've got past the stage where you think you can cherry-pick just the sources you are prepared to accept, I'm hopeful we can start to make some progress with the article. --RexxS (talk) 07:31, 12 June 2010 (UTC)

RexxS, the text you point (without the source, so I can't understand the context) mentions "all (...) views" it doesn't say we should include mention "all the content" or "all the sources". WP:MEDRS let's us find the most approriate sources. (Lloyd, 2005) follows that criteria and represents that view. Your insistence in pushing for the inclusion of all sources, what won't make any significative improvement to the text, is delaying this process we should have already resolved

Kulczycki article is a RS, but that claim was used in a different context from the remaining of the article, so we can't just take that phrase as strict scientific knowledge and use it as so. Yes, it is 14 years old, and so outdated by Look for reviews published in the last five years or so, preferably in the last two or three years. The example you cited was described as exceptional, it was a seminal source, it was a primary source. Reviews, like Kulczycki, aren't supposed to be seminal they just cite other people work, I wonder from where he got that data. Epidemiologic data are representative to a specific population, we can't use old epidemiologic data an present is as current.

As I've said before, Mazza just copy Kulczycki, it doesn't add anything more and doesn't solve it's problems.

About Laube, this is not a US centric article as Abortion in the United States#Maternal death is, so far we've been searching for world representative sources if you didn't notice.

I don't think Jones is a RS. I don't think a source that doesn't provide references to its claims is a RS. If you think otherwise open a separate discussion for that source so it will be clear for you no one is supporting its use.

There's no individual source saying "is below 1 per 100,000 procedures when performed during the early stages of pregnancy" you were making WP:SYNTH by combining sources.

That's not my view of Look for reviews published in the last five years or so, preferably in the last two or three years. when we are talking about a 14 year old epidemilogic review using data from no one knows when.

(Lloyd, 2005) does say "low" did you mind to check my suggestion?

You're doing original sources when you say "the fact that in developed countries the mortality rate from abortion during at least the first trimester is an order of magnitude lower than the rate of mortality from childbirth" There's no updated reliable source saying that and just because a source say something that doesn't mean we should support that as a "fact". We just cite the sources, we don't defend them as true or make further conclusions about what they say.

I only pointed the problems I saw with the sources by WP:MEDRS, while most of those essential problems have been unadressed just because some people personally agree with what those problematic sources say.--Nutriveg (talk) 23:28, 12 June 2010 (UTC)

I'm sorry I forgot to quote the source of the text I drew your attention to. It's in the lead of WP:RS, our fundamental guideline for determining reliable sources. I hope the context is clearer now. You're quite right we don't include "all the content", and I never asked that we should. But WP:RS does insist that we include mention of all the views that reliable sources express. I am, unsurprisingly, pushing for us to consider what all of the sources say when we write the text. What basis do you have for believing that considering all reliable sources will not make a significant improvement to the text? There's no deadline, and taking short-cuts with the sourcing process is contrary to how we work on wikipedia.

Kulczycki is a reliable secondary, agreed. It's also on-topic for the subject of health risks of abortion. So the only question is: have its conclusions been modified by later reliable secondary sources? If not, then its views need to be included. I agree it's inappropriate to write our text to give the impression that old epidemiological data is current. Is there any evidence that the figures or the conclusions have changed significantly in the last 14 years? I'm sorry if I missed that.

The same goes for each of the sources Doc James provided. You're the one who suggested Jones - is it a reliable source you want us to consider, or not?

I had noticed we'd been searching for world-wide data, but not found much. We have found more data relating to the USA and other developed countries, and I see that the sources indicate that there's a significant difference between the data for developed countries and the rest of the world.

I read the three quotes you provided: "In developed countries, the mortality rate from legal, induced abortion in the first trimester is less than 1 in 100,000 procedures" (Sokol 2007); "In representative developed countries, the risk of dying is no more than 1 in 100,000 procedures" (Lloyd, 2005); and "Risk of death from abortion during the first 2 months of pregnancy is less than 1 per 100,000 procedures" (Laube, 2009). I suggested "Maternal death from abortion in developed countries is below 1 per 100,000 procedures when performed during the early stages of pregnancy". Do you seriously believe that is WP:SYNTH?

You propose 'just because a source say something that doesn't mean we should support that as a "fact".' Nobody is asking you support what the source says. But WP:RS, WP:MEDRS and WP:MEDASSESS require you to respect secondary sources; to include all significant views; and not to reject reliable sources because of your personal opinion of them. On Wikipedia, a "fact" is what a reliable source says it is (absent a contradiction from an another reliable source), regardless of whether you think it is wrong or not. Your disagreement with what a source says does not make it "problematical".

RexxS, everyone seems to be satisfied with the Lloyd 2005 source, and from the perspective of expedience and practicality we only need one reliable source to support inclusion of content. Is there any content that is not covered by Lloyd 2005 that we need from other sources regarding the childbirth comparison?Anythingyouwant (talk) 18:55, 12 June 2010 (UTC)

Is expediency a useful factor when writing text? Isn't that coming to the process from the wrong direction? Surely we're not writing text, then finding a source to support it. Anyway, as for your specific concern, if the text you're going to propose includes the views of all the reliable sources (duly weighted of course), then the editors here have done their job. If that text can be cited with just one source, that's a bonus. If it's any help, my feeling is that the following points related to the comparison are reflected in the sources:

1. More data is available for developed countries than for the rest of the world;
2. Both abortion and childbirth carry low risk in developed countries;
3. The risk for both abortion and childbirth is greater in most non-developed countries;
4. The risk for unsafe abortion is much greater than for "safe" (is that the right word?) abortion;
5. The mortality rate for abortion is greater in the later stages of pregnancy that in the earlier stages;
6. In developed countries, in the early stages of pregnancy, the mortality rate for childbirth is around 7 to 11 (an "order of magnitude" if you prefer words to numbers) times greater than the mortality rate for childbirth;
7. In developed countries, in the early stages of pregnancy, the mortality rate for safe abortion is somewhere around 1 per 100,000 procedures;
8. In developed countries, the mortality rate for childbirth is somewhere around 8 per 100,000 live births.

That's not proposed text, just my impression of what I've seen in the sources. Is there anything that you think I've missed, or misrepresented?

The current section on Health risks has an introduction of just four sentences. Are you thinking of replacing it or expanding it? One small point: the subsections that have a level 2 section as parent should be level 3; at present Physical health is level 4. --RexxS (talk) 20:05, 12 June 2010 (UTC)

Nutriveg, do you think that the points just described by RexxS are adequately supported by Lloyd 2005 (and any other sources that you think are Wikipedia-compliant)? If so, perhaps you could start a subsection here at this talk page with some draft content for this article?

RexxS, I usually try not to use the word "misrepresented" due to it's connotations; "mischaracterized" might be a better word, and I'd like to reserve judgment on that until there's some concrete draft language. I think expediency is a worthwhile goal, in the sense that we ought to accomplish what we can agree on now, and discuss the rest later.Anythingyouwant (talk) 22:01, 12 June 2010 (UTC)

Thanks, AYW, I appreciate your sensitivity on the use of terms that could be pejorative, but I hope you'll allow me a little leeway when I'm describing my own contributions. As I've said, I'm have no expertise in this topic. I can only offer what I've learned about sourcing and editing. As a result, I freely acknowledge that I may inadvertently misrepresent/mischaracterise what a source is really saying. The part of the process where editors fine tune text to go in the article is best left to those who understand the background and nuances, so at that point, I'll step aside. --RexxS (talk) 22:38, 12 June 2010 (UTC)

AIW, To my understanding (Lloyd 2005) does represent that view we need to represent. About the points RexxS is concerned:

• The first and second points are addressed by (Lloyd 2005). :The third and fourth are out of the scope of the problem we are discussing "the comparative mortality of safe abortion vs average maternal death in developed countries" We may open that discussion when we finish this one.
• The fifth is also off-topic but since it's simple I'll comment: We can point that maternal death by itself (not associating with anything), is greater in later pregnancy, but I believe that's already represented by "major complication"
• About the sixth: there's no updated data supporting that number, the source that support it are old (so are the numbers), those numbers are presented in an informal/unreferenced context and you can not combine numbers to create another (numeric representation).
• About the seventh: That's original research, we can use terms "early stage" that weren't used by the sources. That's redundant if the average number is the same.
• About the eighth: By what updated source? Those numbers are always changing to use old data or an undated number and I need to remember you that abortion is included in maternal mortality numbers by the WHO/ICD definition. We should present maternal mortality rate in its relevant context: mortality rate from safe abortion in developed countries is lower than the average maternal mortality rate in these same countries.
• The discussion so far is about "the comparative mortality of safe abortion vs average maternal death in developed countries" discuss other issues in another discussion section but a lot of people are expecting this discussion, where you remain the only opposing voice, to end so we can change that problematic text.--Nutriveg (talk) 00:58, 13 June 2010 (UTC)

Have you now decided that we should limit the text that goes into the article to just developed countries? You suggested rejecting Laube less than six hours ago because it was US-centric and you were looking for worldwide sources.

1. If Lloyd addresses "More data is available for developed countries than for the rest of the world", why doesn't your proposed text mention non-developed countries?

3. How can "The risk for both abortion and childbirth is greater in most non-developed countries" be out-of-scope of a comparison between the risks for abortion and childbirth?

4. The risk of unsafe abortion is massively different from safe abortion. How can explaining that any comparison depends on the conditions under which abortion is performed be out-of-scope?

5. If the mortality rate changes with stage of pregnancy, how is that "off-topic" for a comparison using that rate? Where is the phrase "major complication" and how does it address this?

6. Laube (2009) gives 7.7 per 100,000 for US and makes the comparison directly. Looking back in time Clarke (2008) gives 6.5, while CDC (1999) gives "approximately 7.5" and 7.7 for the US. I don't see any significant variation over the time period you object to. Laube is a 2009 source and does the comparison of rates, not me. Do you think WP:SYNTH applies to reliable secondary sources?

7. If one source uses "first trimester", another "first 8 weeks", another "first two months", what is the problem with me summarising that as "the early stages of pregnancy"? I utterly reject the notion that we are disallowed from using terms synonymous to those used by the sources. The whole process of writing for an encyclopedia is to neutrally summarise what the sources say in a manner understandable to our audience. An article written by simply stringing together quotes from sources is unlikely to be much of an article. Please remember that too close a paraphrase of a source is plagiarism.

8. see 6

The sole voice derailing the consensus process is yours. You are the only voice that's proposing a change of scope at this late stage, and the only voice that's proposing to reject all but one source. Everybody else has accepted the other sources as reliable. I still don't see how we can make progress when you unilaterally change the terms of the discussion, and insist on cherry-picking a single source to work from. --RexxS (talk) 04:46, 13 June 2010 (UTC)

1,3,4 The very issue we are discussing here is "comparing a global rate of maternal death from safe abortion with a comparable rate of general maternal death". That's the problematic text, if you came up wanting to discuss unsafe abortion in the same discussion that's off-topic of this discussion, so you should create a separate discussion for that

5, Why you didn't mind to check the article? "rate of major complications (...) varies depending on how far pregnancy has progressed" It's offtopic when that's a isolate point from that discussion above.

6,You said "In developed countries, in the early stages of pregnancy, the mortality rate for childbirth is around 7 to 11" but presented US data to support that

7,Lloyd 2005 doesn't say early stage, if all sources say lower that 1 in 100000, no matter the stage they used, there's no need to differentiate a specific period unless another source puts a higher number for other period.

We have analyzed those sources and the one which was mutually accepted by WP:MEDRS standards was (Lloyd, 2005), (by AIW, Mastcell, Schrandit[2] and me/Nutriveg) which fairly represents the other sources view. So far you're the only one disagreeing with that demanding the use of all sources even knowing they have several problems by WP:MEDRS and don't carry any other consistently or representative information.--Nutriveg (talk) 01:50, 14 June 2010 (UTC)

I made it clear that That's not proposed text, just my impression of what I've seen in the sources.

1,3,4: The exact issue we're discussing is "comparison of the health risk of abortion with that of childbirth", nobody but you has suggested it has to be confined to just developed countries or only safe abortions.

5: That's a statement about complications, and it only refers to surgical abortions. How does it address what we know the sources have to say about mortality from abortions in general?

6: So if I quote the sources that show the US is typical of developed countries, and the MMR is around 7 to 11 for other developed countries, you'll agree that the issue should be included in any text we write?

7 Kulczycki uses the phrase "up to 8 weeks gestation"; Mazza uses the phrase "prior to 8 weeks gestation"; Sokol uses "first trimester"; Laube uses "the first 2 months of pregnancy"; Lloyd doesn't qualify the stage. We're sure of the figures for the early stages, but guessing that they are the same later on is pure speculation.

We don't analyse secondary sources; we report them. Lloyd does not cover the all of the views presented in the other sources. The other secondary sources are no less reliable than Lloyd and the issues they raise cannot be excluded, no matter how much you claim they are old, inconsistent, unrepresentative, unsourced, perform synthesis, cite another source, or any of the other spurious reasons that you've advanced. --RexxS (talk) 02:59, 14 June 2010 (UTC)

Another source

Sorry if this has been examined and rejected earlier, but isn't this the recent, relevant review that we've been looking for? It seems to specifically address the issue we wanted – at least for the USA:

• Christiansen LR, Collins KA (March 2006). "Pregnancy-associated deaths: a 15-year retrospective study and overall review of maternal pathophysiology". American journal of forensic medicine and pathology. 27 (1). National Association of Medical Examiners: 11–9. PMID 16501342.

I can only see the abstract, but it looks promising. Does anyone have Swets or other access to the full text? --RexxS (talk) 05:04, 12 June 2010 (UTC)

I have full access. Anything specific you want me to look for? It doesn't appear to address abortion.-Andrew c ^[talk] 22:10, 12 June 2010 (UTC)

Thank you Andrew. If it doesn't address abortion then there's nothing else needed. It won't be relevant here, other than to confirm a recent estimate for maternal mortality in the USA. I think we already have that from the existing sources. --RexxS (talk) 22:38, 12 June 2010 (UTC)

Rephrasing my earlier suggestion

Earlier I've said:

I propose we use (Lloyd, 2005) "In representative developed countries, the risk of dying (from abortion) is no more than 1 in 100,000 procedures, lower than the relatively low risks associated with pregnancy and childbirth in these countries (The Alan Guttmacher Institute, 1999)" we may also attribute that claim to their original author Guttmacher Institute, since (Lloyd, 2005) did that attribution and given this is not an "ideal source" as discussed above.

So an early version would look: "According with the Guttmacher Institute maternal death from abortion in developed countries is bellow 1 in 100,000 procedures, lower than the relatively low risks associated with pregnancy and childbirth in these same countries"

Likely me(Nutriveg), MastCell, Anythingyouwant and Schrandit agreed with that version. While MastCell expressed a problem in attributing Guttmacher Institute and Schrandit expressed a problem in not attributing. So far RexxS disagreed and proposed another version. Other editors remained silent so I understand they agree or don't care about the outcome.

Expecting to address Mastcell and Schrandit concerns I'll remove the attribution while rephrasing that text. I expect others will maintain their position despite of this change (otherwise we can return to the previous suggestion) and RexxS will make an effort so we can get at least a stable version even if he thinks that's not complete enough.

So this is the new proposed version:

"In developed countries the maternal death rate from abortion is bellow 1 in 100,000 procedures, lower than the general maternal death rate, which is relatively low."

By the linked "maternal death" definition it's clear that's associated with pregnancy and we avoid direct associations that some understand as erroneous or not consistently supported by updated reliable sources.--Nutriveg (talk) 01:57, 13 June 2010 (UTC)

Let's be clear then what you're proposing. You're asking us to discard consideration of all of the sources except the one that doesn't compare the figures for mortality in childbirth, and then use a quote from that source. What part of the current text are you proposing to remove in order to insert that text? --RexxS (talk) 02:52, 13 June 2010 (UTC)

I'm using a source that fairly represents a view and all the editors who had opinion to express agreed with that except for you.

I'm using the scientific technical terms to represent that source, so I'm presenting that data as what it is and in a neutral way, not advancing a position that's WP:SYNTH and not giving more emphasis to it than the one given by the source itself.

The main focus here is to replace the text which was focus of the recent problems "by 1996, mortality from childbirth in developed countries was 11 times greater." The earlier part of the sentence "risk of maternal death is between 0.2-1.2 per 100,000 procedures" should also be replaced since that would became redundant and a range that varies that much doesn't give an idea of the data distribution within that range.--Nutriveg (talk) 18:00, 13 June 2010 (UTC)

I have no problem with writing text that accurately and neutrally reflects the views of all of the reliable sources, including Lloyd, so let's be clear: None of us are objecting to Lloyd - you are the only one objecting to also including what is written in other reliable sources.

So you want to replace the sentence:

• "In such settings, risk of maternal death is between 0.2-1.2 per 100,000 procedures[33][34][35][36] in comparison, by 1996, mortality from childbirth in developed countries was 11 times greater.[37][38][39][40][41][42]"

with:

• "In developed countries the maternal death rate from abortion is bellow 1 in 100,000 procedures, lower than the general maternal death rate, which is relatively low. (Lloyd 2005)" (or is it to be cited to Guttmacher?)

You've not used the figures for maternal death rate, avoiding the comparison that Laube 2009 makes. That is despite the previous lengthy discussions at #Safer than childbirth and #Reference to settle the debate asking for the comparison to be made because it's a comparison made accurately in reliable sources.

You've ignored mention of the fact that the "1 in 100,000 procedures" varies significantly between different stages of pregnancy. Is it not misleading to leave that out? --RexxS (talk) 18:46, 13 June 2010 (UTC)

Yeah (Lloyd,2005) is global, better fits WP:MEDRS, including by being update and fairly represents the other sources in a consistent way, meaning some of these (worse by MEDRS) sources make claims not supported by the others, like using the word "safer", presenting (different) comparative numbers, or not citing which global epidemiological study reached that conclusion. While none of these (worse by MEDRS) sources refute (Lloyd,2005) claims in a relevant way.

(Laube, 2009) is US centric and doesn't detail its numbers (date, source).

The proposed text gives due representation to those issues you mentioned when it compares: "Maternal death rate from abortion is lower than maternal death rate from general causes" where a link to "maternal death" is provided to make sure the reader understand the association with pregnancy.

Adding further terms is an issue first because (Lloyd,2005) is a better but not an ideal source by WP:MEDRS and rely on a single primary source (Guttmacher) for his claims. Secondly because this and the other (worse) sources don't agree with a common clearly understandable medical term "pregnancy", "childbirth", "live birth", "pregnancy or childbirth", "brought to term" like the standardized WHO definition of maternal death. The WHO term is not just standardized, but also is the one statistics are based on and so readily available, where the reader can also further check for himself instead of trusting a claim from a single author or weak sources.

The increased risk of major complications is already expressed in the section bellow, we may repeat it as a separate phrase.--Nutriveg (talk) 20:57, 13 June 2010 (UTC)

For comparison, I'll suggest that the paragraph should look more like:

"Abortion, when legally performed in developed countries is among the safest procedures in medicine.[31][32] (remains the same) Maternal death from abortion in developed countries is below 1 per 100,000 procedures performed during the first eight weeks of pregnancy, with the rate increasing in the later stages; while for childbirth in the USA - itself very low risk - the mortality rate is 7.7 per 100,000 live births.(Laube 2009, p.150)(Lloyd 2005) In the developing world, much higher mortality rates from abortion and childbirth can be found, and they remain some of the most significant risks to young women's health.(Lloyd 2005, p.5) (possible new text) Unsafe abortions (defined by the World Health Organization as those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities) carry a high risk of maternal death and other complications.[43] For unsafe procedures, the mortality rate has been estimated at 367 per 100,000.[44]" (remains the same)

If you felt it essential to specifically reference the "much higher mortality rates from ..." then Okonofua 2006 (full text, p.7)ought to suffice, but I would have expected the rest of the paragraph would supply the context. Thoughts? --RexxS (talk) 20:31, 13 June 2010 (UTC)

Perhaps there is an over-emphasis on the comparison with childbirth, so the last sentence of the possible text could have 'childbirth' removed, to read:

• Maternal death from abortion in developed countries is below 1 per 100,000 procedures performed during the first eight weeks of pregnancy, with the rate increasing in the later stages; while for childbirth in the USA - itself very low risk - the mortality rate is 7.7 per 100,000 live births.(Laube 2009, p.150)(Lloyd 2005) In the developing world, much higher mortality rates from abortion can be found, and it remains one of the most significant risks to young women's health.(Lloyd 2005, p.5) (possible new text)

It less close to what Lloyd wrote, but may balance concerns of undue weight. --RexxS (talk) 20:55, 13 June 2010 (UTC)

RexxS the very issue we are discussing here is comparing a global rate of maternal death from safe abortion with a comparable rate of general maternal death. We don't compare one world data with a US one, we don't cite data from every country here when they have their own abortion in <named country> article, we don't combine data to advance a position, we don't present inconsistent data between sources, we choose the sources that better fit WP:MEDRS, we don't give more attention to a issue than the sources themselves did in a similar context. Your suggestion suffer from all these problems, while every other editor showed support or had no disagreement with my suggested text. Let's commonly agree on something. Even if you think that's not complete it's better than nothing.

Unsafe abortion is not the issue here, open a different discussion section if you want to this discuss that.---Nutriveg (talk) 21:15, 13 June 2010 (UTC)

If we're back to comparing a global rate of maternal death from safe abortion with a comparable rate of general maternal death, then your proposal doesn't address it. I used a comparison directly from Laube, making it clear that he was using US data. I didn't "combine" the data, Laube did - we don't call reliable sources "inconsistent" on the basis of nothing more than our own opinion, particularly when multiple other sources reach the same conclusion. Unlike you, I have no position to advance, other than to ensure our core standards of respecting secondary sources is complied with. We don't exclude relevant summary from a parent article just because a daughter article exists. We do assemble the views of multiple sources in a neutral manner to produce article text. We don't cherry-pick a single source from many and completely disregard the other equally reliable sources. We don't leave out issues that are covered in multiple reliable sources, by spuriously claiming that they are undue weight - are you claiming that health risks is given too much weight appropriate to its significance to abortion, or that five sentences devoted to data and comparison in a section containing eight paragraphs and two subsections is giving too much weight appropriate to the significance of data to health risks?

Nobody's expressed agreement with your proposed text. Why are you so wed to it, despite its obvious short-comings? Is it simply that Lloyd's phrasing is least inimical to your own point of view?

Unsafe abortion is an issue here. Are you trying to tell us that unsafe abortion is not an issue relevant to the health risk of abortion? You seen a dozen reliable sources that say otherwise. --RexxS (talk) 22:06, 13 June 2010 (UTC)

Why my proposal doesn't address "comparing a global rate of maternal death from safe abortion with a comparable rate of general maternal death"? As far as I'm concerned "developed countries" is not country specific, unfortunately we don't have a mortality from safe abortion rate encompassing more countries.

You compared "Maternal death from abortion in developed countries" with mortality "for childbirth in the USA"

(Laube, 2009) is a US source it says nowhere: "Maternal death from abortion in developed countries is below 1 per 100,000 procedures performed during the first eight weeks"

As I've said other sources are inconsistent because they "make claims not supported by the others, like using the word "safer", presenting different comparative numbers or not citing which global epidemiological study reached that conclusion"" beyond the terminology used. They don't reach the same conclusion but their general view is fairly represented by (Lloyd,2005)

Well I expect to follow WP:MEDRS when writing medical claims but I don't think that's advancing a position since that's exactly MEDRS purpose.

We try to represent a global view not giving more emphasis to a specific country whose statistics is already included in the represented global view, otherwise we would have to include every single country which has such data but this article is already too big. If you think bellow 1 per 100000 is not representative enough we can include a abortion mortality table.

We give WP:DUE to these issues, there's a single, updated source that fits MEDRS, making such claim in a global base (while we have thousands of sources talking about abortion mortality) and it do that shortly compared to the remain of its text. On the other hand we have a small intro section and you want to combine information from several (worse by MEDRS) sources giving more emphasis to this issue than the original source did.

We only have one source fitting WP:MEDRS because we have few sources about this issue! So far the discussion is: "comparing a global rate of maternal death from safe abortion with a comparable rate of general maternal death"

AIW did support, so did Mastcell, as Schrandit[2] and me (Nutriveg). We only have the issue of atributing or not (Guttmacher) since that (Lloyd,2005) information relies and is attributed to that single source, the only problem we are trying to address. The only one disagreeing is you. I'm only trying to find a stable due version supported by updated reliable sources by WP:MEDRS, if it was just for me I wouldn't have accepted Lloyd,2005 since it's not an ideal source, but I made that concession. While you want to add anything that you believe is true, which you call "fact".

I'm only trying to say unsafe abortion is outside of the problem we are trying to solve, so you should discuss it in a new discussion section--Nutriveg (talk) 00:30, 14 June 2010 (UTC)

When did we decide that we were going to only address health risks of safe abortion in developed countries? The vast majority of abortions occur in developing countries, and many of those in unsafe conditions.

One source says 'safer' and another says 'the risk is lower' or compares '1 per 100,000 with 7.7 per 100,000' and you call that inconsistent. Humpty Dumpty would have been proud of that.

It's not your place to reject a reliable secondary source because you don't know where gets its data from; it has the authority to analyse and perform synthesis from its author, its publication, and its peer-review; you don't get to apply your own filtering criteria to reliable secondary sources.

We have half a dozen or more sources that "fit" MEDRS, but as a concession to your demands for stringent application of the rule-of-thumb "Up to date", I only cited the most recent secondaries, although I did weigh what was in the earlier ones, but found no contradiction.

• AIW did support?: "everyone seems to be satisfied with the Lloyd 2005 source ... Is there any content that is not covered by Lloyd 2005 that we need from other sources regarding the childbirth comparison?" - yes, support for including Lloyd. I see no support for your text.
• so did Mastcell?: "Your proposed text doesn't work for me ... " - that's strange support.
• Schrandit[2]?: "Keep in mind who Guttmacher is and where their money comes from. We should probably mention it in the article.", "Over here I've got Guttmacher saying its around 1,100 a year. I also hear that most of those state bans are very, very weak.", "Yeah, intuitively it didn't make sense to me either but I usually hear abortion classified as family "planning". To AYW's earlier point about linking to a more expanded article - I think it would still be worth it to give the 1 more reliable, recent number to give the reader an idea and then link to the main article if they want to know the rest." - Where's the support for your text in that?

It seems more like everybody is questioning your text. On Wikipedia, I call "fact" what can be sourced from reliable sources. Here, I have no beliefs other than that following Wikipedia's policies and guidelines is the only acceptable route to writing an article. Do I need to repeat Wikipedia articles should be based on reliable, published sources, making sure that all majority and significant minority views that have appeared in reliable, published sources are covered?

And I'm only trying to say that we have sources discussing the health risks of abortion in the developing world (the vast majority), and addressing only abortion in developed countries is surely a violation of WP:UNDUE.

Both of seem to be repeating the same objections without persuading the other. Let me make an offer. Get the clear support for your text of the other editors who have contributed heavily to this debate: Andrew, AYW, LeadSongDog, James, Mastcell, Schrandit (have I missed any?) and I will certainly support it as well, despite my reservations. Optionally, let's go to dispute resolution (3O, mediation) or open an RfC to decide. --RexxS (talk) 01:48, 14 June 2010 (UTC)

Sources comparing other risks

Nutriveg, you have looked at a lot more sources about this issue than I have. Have you found any sources --- either US centric or not --- that put the risk of death from abortion in PROPER context by comparing it to other risks, or explaning that the risk of death from childbirth is also very low? We do need context in this Wikipedia article, but IMHO the bare comparison to risk of death during childbirth is insufficient and potentially misleading.Anythingyouwant (talk) 19:44, 11 June 2010 (UTC)

There are a boatload of reliable sources listed on this talkpage, which makes "proper context" obvious. When you say "PROPER context", you have in mind not the context provided by experts in the field or by scholarly sources, but the context you personally think is best. You are asking Nutriveg to cherry-pick available sources to find one that agrees with your personal viewpoint. I would strongly suggest (not for the first time) that we follow where the sources lead instead. MastCell ^Talk 20:11, 11 June 2010 (UTC)

No, I am asking if Nutriveg has come across a contextualization of the abortion death risk that HE THINKS would be proper to cite somewhere at Wilipedia according to what he perceives to be Wikipedia policy. Your constant stream of accusations against me is most tiresome MastCell.Anythingyouwant (talk) 20:27, 11 June 2010 (UTC)

Anythingyouwant, worldwide (Lloyd, 2005) does say risk from childbirth is also "low". What other risks are you talking about? There a lot of US centric sources out there but I didn't mind to check because I'm not challenging that information despite the low quality of/access to (pregnancy) health care for poor women in the United States and how those studies usually ignore that when comparing both. Sources presented in Abortion in the United States#Maternal death may be a start for you.

MastCell, assuming bad faith: " You are asking Nutriveg to cherry-pick available sources to find one that agrees with your personal viewpoint" doesn't help. And so what if he finds the sources he's searching? Isn't you the one saying he should follow what sources say? Let's let him find such sources then.--Nutriveg (talk) 20:36, 11 June 2010 (UTC)

I'm not "assuming" anything. We have dozens of high-quality sources on this talk page alone. Yet Anythingyouwant has declared that these sources don't put things in "PROPER context", further mentioning his personal opinion that the sourced comparisons are "insufficient and potentially misleading." It remains a source of deep concern to me that discussion on this talk page revolves around whether certain editors personally agree with the comparisons used by a given expert reliable source. MastCell ^Talk 21:03, 11 June 2010 (UTC)

I explained what I meant by "proper" above. You can ignore that if you want MastCell. And yes, to the extent that this article mentions the risk of childbirth without mentioning that it is a "low" risk, that is potentially misleading. Reliable sources confirm that it is a "low" risk.Anythingyouwant (talk) 21:15, 11 June 2010 (UTC)

Way back, I had proposed including the absolute risks of both abortion and childbirth in addition to the relative risks. This approach has several benefits: a) it makes clear that both risks are very low in an absolute sense in the developed world, b) it does not editorially tell the reader what to think (one can see that the risks are low for oneself, rather than being editorially informed that they are "low"), and most importantly c) it is the approach used by many, if not most, expert scholarly sources. Should we reconsider that approach? MastCell ^Talk 21:26, 11 June 2010 (UTC)

This article currently says that abortion has one of the lowest risks of any medical procedure. I don't think that's editorializing any more than is the statement that the risk of dying in childbirth is also low. You're suggesting that we keep the first but omit the second?Anythingyouwant (talk) 23:03, 11 June 2010 (UTC)

The first is a direct quote from a recent review article appearing in a major medical journal. Thus it's not us editorializing. If you want to describe the risk of death from childbirth as "low", I don't really have a problem with it. I just think that using the actual numbers to illustrate the low risk is more consistent with the content of actual reliable sources, but whatever. MastCell ^Talk 23:37, 11 June 2010 (UTC)

Ok, so if we mention the low risk of childbirth, citing Lloyd 2005, then we may have a deal. I prefer not overwhelming the reader with numbers, and would therefore prefer a summary in words (perhaps with the numbers in a footnote), but whatever.Anythingyouwant (talk) 01:58, 12 June 2010 (UTC)

And later you complain the discussion process isn't evolving... Why didn't you opine on the text I suggested in the section above instead of going back in the process to propose the very same text, with the same problems (US centric) as explained before? I also need to remember the main issue here so far is comparing mortality with childbirth so I extracted that text:

"In the US, the risk of death from abortion is 0.567 per 100,000 procedures, making abortion approximately 14 times safer than childbirth (7.06 maternal deaths per 100,000 live births).(primary source about US) The risk of abortion-related mortality increases with increasing gestational age, but remains lower than that of childbirth through at least 21 weeks' gestation.(Other primary source about US) and ( Suzanne R Trupin, emedicine source).

At first look that emedicine source the following useful information: "At every gestational age, elective abortion is safer for the mother than carrying a pregnancy to term." But, it doesn't cite references for those claims, the author owns a clinic that provides abortion services which advertises as safe since 1973 and doesn't require parental consent and that reference doesn't add up anything to what is already said by (Lloyd, 2005), least it has the benefit you mentioned: "a) it makes clear that both risks are very low in an absolute sense in the developed world," .--Nutriveg (talk) 22:22, 11 June 2010 (UTC)

Your proposed text doesn't work for me, because it incorrectly singles out the Guttmacher Institute as claiming that abortion is safer than childbirth. In fact, this view is universally held by experts in the field, as demonstrated by a plethora of sources, and is in no way unique to Guttmacher. MastCell ^Talk 23:51, 11 June 2010 (UTC)

So the only problem with it is the Guttmacher attribution?--Nutriveg (talk) 00:25, 12 June 2010 (UTC)

Keep in mind who Guttmacher is and where their money comes from. We should probably mention it in the article. - Schrandit (talk) 02:13, 12 June 2010 (UTC)

(undent) I came across a comparison to taking antibiotics and to appendectomy. It was safer than both of these if I remember correctly.Doc James (talk · contribs · email) 22:30, 13 June 2010 (UTC)

Relevance of comparing to childbirth

Whether the comparison to childbirth is supported by reliable sources or not, I believe that including a comparison to chilbirth (and only chilbirth) unnecessarily skews this article and is off topic. It would be much more appropriate to put that info in an article like family planning, with a wikilnk from this article to that one, where the risks of other family planning procedures and the like can be presented too (e.g. the risk of oral contraceptives). We cannot put everything into this article that reliable sources say about abortion, or else this article would become too big. Although both Andrew c and Nutriveg have conspired together (heh) to remove my insertion of this material into the family planning article, I intend to pursue the matter, and when I do so it will be noted here at this talk page. Also, note that way more reliable sources do not make this comparison, than those that do.Anythingyouwant (talk) 05:11, 11 June 2010 (UTC)

We've amply (excessively) established that this comparison is commonly used by scholarly sources as a central aspect of contextualizing abortion risk. Now we can either choose to follow the lead of reliable sources and accurately reflect their presentation of abortion risk, or we can choose to substitute our own personal ideas of how abortion risk should be contextualized. I think our guidelines and policies are clear that the former is preferable. MastCell ^Talk 05:23, 11 June 2010 (UTC)

No, it has nothing to do with personal preference. I presented search results above from Google Books that show only a small minority of reliable sources on this topic make this particular comparison. Some sources make other comparisons (e.g. to tonsillectomy). By homing in on this particular comparison, and avoiding other comparisons, this article goes off topic to childbirth in such a way as to give great emphasis to what is undoubtedly a pro-choice mantra. It would be preferred if this article would steer clear of both pro-choice and pro-life mantras. The effect of highlighting this particular comparison in this particular article is pretty clear: many readers will conclude that it would be wiser to get an abortion than give birth. Well, if all family planning options are presented together with an overview of their risks, then the impression readers get will be more NPOV.Anythingyouwant (talk) 05:36, 11 June 2010 (UTC)

We don't decide on an accurate, scholarly representation by counting Google Books hits. We do not provide medical advice - but if we did, and if a woman's decision about abortion was predicated solely on the relative safety of the procedure compared to childbirth (which is entirely implausible), then you think we should conceal the accurate and well-sourced facts on the topic to prevent that choice? Isn't that an example of a Wikipedia editor substituting their own personal value system for the content of scholarly, reliable sources, and abusing this site as a venue for advocacy? MastCell ^Talk 05:47, 11 June 2010 (UTC)

See WP:Search engine test. If you prefer, I could make a list for you of all the reliable sources on abortion that do not make this particular comparison.

As for the absurd charge of concealment, putting info in another more pertinent article is not concealment, especialyy if it is wikilinked from here. A better example of concealment would be complete removal from Wikipedia of all information regarding contraindications for various types of abortion, but I guess that's another subject. Generally speaking, it would be nice if people would tone down the rhetoric a notch.Anythingyouwant (talk) 06:03, 11 June 2010 (UTC)

WP:Search engine test specifically cautions against your approach. For example, it warns that search engine results cannot "guarantee that little mentioned or unmentioned items are automatically unimportant." But that seems to be the argument you're making. MastCell ^Talk 20:15, 11 June 2010 (UTC)

Search engine results do not automatically establish anything. That does not mean they are useless however.Anythingyouwant (talk) 20:35, 11 June 2010 (UTC)

No one is saying that they're useless. I'm saying that your specific use of search engine results in this discussion is both meaningless and specifically cautioned against by the very guideline that you're citing. MastCell ^Talk 21:05, 11 June 2010 (UTC)

I never said that search engine results automatically establish anything, so your objection does not seem well taken.Anythingyouwant (talk) 21:18, 11 June 2010 (UTC)

Let's stop being silly and culturally biased about this. Once a woman is pregnant, other means of contraception are irrelevant. There are two choices. Childbirth or abortion. This has been a reality in many place over many years. Places where contraception choices are very limited. Places unlike those where anti-abortion movements are strong. Probably places with fewer Wikipedia editors to argue that position too. HiLo48 (talk) 05:54, 11 June 2010 (UTC)

HiLo48, I initially thought the same thing, and that's why I myself inserted the childbirth comparison into this article a week or so ago (ironically reverted by MastCell with all kinds of charges of personal bias). On further reflection, I realized I was wrong to insert it. Suppose the risk of abortion were one in ten trillion, and the risk of chilbirth were one in a trillion. Wouldn't it be silly for us to note how hazardous childbirth is compared to abortion? What we're doing here is similar, and we're not showing readers the whole picture; whether it's abortion or childbirth, the risks are so small that they're on a par with the risks of oral contraception. Anyway, like I said, I'll give people a heads up if there's a big debate at the family planning article.Anythingyouwant (talk) 06:16, 11 June 2010 (UTC)

If we've got reliable sources I say give it a go for inclusion. The comparison doesn't seem unreasonable to me. - Schrandit (talk) 06:34, 11 June 2010 (UTC)

How about including it at a more pertinent article (e.g. family planning), and wikilinking from here?Anythingyouwant (talk) 06:48, 11 June 2010 (UTC)

Well sourced, common in academic literature, therefore we must include it. Verbal chat 07:42, 11 June 2010 (UTC)

Anythingyouwant - I'm not sure this is really about family planning Well, only in the fairly brutal sense of "Shit, I'm pregnant. What am I going to do now?" That's hardly planning. HiLo48 (talk) 08:00, 11 June 2010 (UTC)

It's a form of family planning in the sense that it ensures all births will be planned instead of unplanned. Thus, organizations like "Planned" Parenthood promote it. I've found lots of reliable sources that say it's an aspect of family planning, plus some opinion pieces that say it shouldn't be used for family planning or for any other purpose. Whether you or I think it should be used for family planning or not, it is. But if you think there's a more appropriate Wikipedia article, I'm all ears.Anythingyouwant (talk) 08:18, 11 June 2010 (UTC)

Oh well, if there are sources calling it family planning, that's what it is to the creators of those sources. The English language is wonderful. I love being educated by Wikipedia. HiLo48 (talk) 08:36, 11 June 2010 (UTC)

Yeah, intuitively it didn't make sense to me either but I usually hear abortion classified as family "planning". To AYW's earlier point about linking to a more expanded article - I think it would still be worth it to give the 1 more reliable, recent number to give the reader an idea and then link to the main article if they want to know the rest. - Schrandit (talk) 11:13, 11 June 2010 (UTC)

"In the US, about 60% of all pregnancies are unwanted or mistimed and about 50% are aborted." (Kulczycki, 1996). This suggests that the comparison is likely to be at least as relevant to this article as it is to Family planning. I mean that, at present, the Family planning article mentions pregnancy termination once (in the lead), and thereafter focuses mainly on the policies, resource implications, and methods related to population control. This article covers the surgical and medical procedures of abortion, and as such covers the associated risks. The fact that any reliable secondary source makes the comparison means that it is significant enough to warrant consideration for inclusion in the Health risks section. Mastcell argues that using the comparison to give context to the mortality rate is relevant because secondary sources have made that comparison and drawn that conclusion. I would add that because this is an encyclopedia for the lay reader (like myself), putting something like a mortality rate into a context is a fundamental necessity to aid understanding. --RexxS (talk) 14:31, 11 June 2010 (UTC)

Whoa, those numbers are crazy old. The number I hear most these days is 1 in 4 pregnancies in the US end in abortion. - Schrandit (talk) 22:29, 11 June 2010 (UTC)

I need to remember you that in general articles Wikipedia tries to represent a worldwide view not a country centric one, this article is not about United States on the other hand Abortion in the United States is. Let's try to focus on sources here, it has been hard to find a reliable medical source about abortion making such comparisons, less to say about finding a "family planning" one, where abortion role is not very clear since it's about "planning" not "oh my good what we gonna do now?". Please discuss the relevance to that topic there before bringing it to the discussion here.--Nutriveg (talk) 14:42, 11 June 2010 (UTC)

(undent) We are editing here not family planning, if people want to have that discussion there I have no problem with that. Having this information there however has no bearing on our decision to have it on this page. The references make the comparison to abortions and delivery / pregnancy. I have not seen the comparison made to family planning but did not search for that. All one needs is one reliable third party source to justify inclusion. We do not need to show that the majority of sources discusses an exact point before we mention it. I could just image the work that would require. Google books does not allow us to search many textbooks. Many publishers have pulled their books. Doc James (talk · contribs · email) 15:58, 11 June 2010 (UTC)

I have found one that makes reference to the comparison in family planning "Current Diagnosis & Treatment Obstetrics & Gynecology - 10th Ed. (2007) Chapter 36" Doc James (talk · contribs · email) 16:16, 11 June 2010 (UTC)

Worldwide

Why is it so hard to focus people? The developed world statistics don't matter. Almost every woman survives. The mortality (in both pregnancy and in abortion) is almost entirely in poor, densely populated third-world countries, particularly in sub-Saharan Africa. No matter how closely we look at the studies of Europe or the US we won't see anything useful. Focussing on those few is a gross neglect of WP:WEIGHT. LeadSongDog come howl! 02:11, 12 June 2010 (UTC)

Stats from both the developed and developing world are important and as these assertions are back up by lots of current high quality literature I hope we can settle things and move on to more productive editing.

It is useful to state that legalized abortion are very safe, non legal abortions are very dangerous. We can leave the logical conclusion from this to our readers.Doc James (talk · contribs · email) 23:31, 12 June 2010 (UTC)

In a medical context we should follow the WHO definition of safe abortion, legal status is a different matter, abortion is legalized in India but not safe.--Nutriveg (talk) 23:44, 12 June 2010 (UTC)

About half of the 343,000 maternal deaths worldwide in 2008 occurred in six countries — India, Nigeria, Pakistan, Afghanistan, Ethiopia and the Democratic Republic of Congo, according to the study published in The Lancet. Mothers’ deaths were highest in Afghanistan (1,575 per 100,000 live births) and lowest in Italy (4 per 100,000). And perhaps 'one death per 63 births' would be easier to understand than '1,575 per 100,000 live births'. --Hordaland (talk) 04:53, 13 June 2010 (UTC)

I don't know why you pointed that number here, we have specific articles about Maternal death or Unsafe abortion since you didn't make clear how those numbers should be specifically used.--Nutriveg (talk) 17:51, 13 June 2010 (UTC)

The difference birth makes

The "abortion debate" section seems rather skimpy on the list of arguments used by the two sides of the issue. One such argument involves the question, "What is the difference between a newborn and the fetus just prior to birth?" Such a fetus is (usually) fully viable and the main-reason-presented it is not equal to a newborn is that it hasn't actually been born yet, though it might be about to do so. I'm sure even most die-hard proponents of late-term abortions would be a bit uneasy about the notion of turning labor into an abortion, should the woman change her mind at that point. Therefore might it be appropriate to discuss this a bit, and include something of the discussion in the article? V (talk) 16:25, 11 June 2010 (UTC)

I agree. This is the reason why most places in the world will not perform abortion after 20 weeks based on a mothers wishes and basically no centers in Canada will do abortions after 23 weeks. In Canada less than 0.5% of abortions occur after 20 weeks of gestation primarily because the fetus is gravely or fatally impaired, or the woman's life or physical health is at risk, or both (Statistics Canada, 2003; http://www.arcc-cdac.ca/action/bill_c338.html#facts). I assume most of the developed world is the same. Doc James (talk · contribs · email) 16:33, 11 June 2010 (UTC)

In the UK, abortion was legalised in 1967 with a limit of 28 weeks. This was reduced in 1990 to 24 weeks (iirc, since improved care of preterm infants showed viability from that age), with similar provisos to those you quote. In 2008 a reduction to 22 or 20 weeks was debated, but not implemented. We have an article on Abortion law, but I believe Canada does not legislate on the issue. In any case, all that I've read recently indicates that abortions after 20 weeks or so are only a tiny proportion of the total and that you're right about the case being similar in most developed countries. --RexxS (talk) 18:14, 11 June 2010 (UTC)

The government has not made any official law however it is understood among the profession that abortions will not be performed electively after viability.Doc James (talk · contribs · email) 18:32, 11 June 2010 (UTC)

There actually is one very significant difference, besides not actually being born yet, between a full-term fetus and a newborn. This difference involves its modus operandi of survival. All during pregnancy, including just-before-birth, a fetus is biologically equivalent to a parasite, in its means of acquiring food and eliminating wastes. It does what it does without any regard whatsoever for the host it inhabits, and regardless of whether or not a woman wants to be pregnant. That is, even if a woman wants to be pregnant, the biological modus operandi of the fetus is still parasitic not symbiotic (any euphoria associated with pregnancy can be traced to hormones dumped into the blood by the fetus, expressly to discourage pregnancy termination). An unborn human is the only biological parasite in all of Nature that has its existence tolerated or even encouraged by a host that has the conscious power to free itself (no other mammal has that power, although some, when the environment is unfavorable, can do fetal resorption unconsciously). Note that even for humans, such real social-not-biological parasites as are called "criminals", and such fictional (biological!) parasites as are called "vampires" are very far from tolerated, much less encouraged!

For anyone wondering about what sort of abortion procedure might be practical-to-do just before a normal birth, or even during labor (if it was allowed!!!), consider using a fiber-optic line and a laser to cut/cauterize the umbilical cord. This stops the supply of oxygen, likely leading to fetal unconsciousness and death within 5 to 10 minutes. And it is well known that labor can take hours --the result, of course, could be called a "still birth". V (talk) 06:27, 12 June 2010 (UTC)

After birth, a living newborn's survival depends exclusively on gifts. The very first such gift could be called "cutting the umbilical cord after a delay", since it is now known that a newborn can benefit significantly from from a non-immediate cord-cut. The Chinese supposedly have a custom involving saving someone's life: If you do that, then you become responsible for the person you saved. With respect to newborns, this custom is universal across humanity. For example, if a woman wishes to have her newborn adopted, the baby will become someone else's responsibility to breast-feed, and likely it will be taken away immediately after birth. Even ancient Romans, who would examine newborns for defects and allow the declared-unworthy to die of exposure, accepted responsibility for caring for the babies that passed inspection. Today we can scan the unborn for defects and make such decisions well before birth, but we should not forget that the ultimate form of a late-term "abortion", exposure of a newborn, has in various times and places been socially acceptable. Also, today, a semblance of the "other side of the coin" is revealed whenever a newborn is dumped into a trash can; the mother is in-effect refusing to save its life and become responsible for it by offering it gifts. (Note I've tried to present facts without injecting opinion. Some facts, like the current oil gusher in the Caribbean Sea, are unpleasant but still true.) V (talk) 20:11, 11 June 2010 (UTC)

Third trimester abortions can happen legally in Australia. In Melbourne, Australia, a few years ago a legal, but not surprisingly very controversial, third trimester abortion was performed. It was for a woman from an immigrant culture who discovered that her foetus had dwarfism. This was regarded as an extremely bad omen in her culture and she was deemed to be at severe risk to her mental health if she gave birth to that baby. Many moral issues there which I won't dare try to comment on, but just be aware that the situation did arise in an advanced country in very recent times. HiLo48 (talk) 21:42, 11 June 2010 (UTC)

You're good to go for third trimester abortions in most American states as well, they happen not infrequently. - Schrandit (talk) 22:29, 11 June 2010 (UTC)

That's multiply incorrect. First of all, most American states (38) have laws against elective third-trimester abortion ([20]). These laws have exceptions only for the life and (rarely) the health of the mother. You're also incorrect about their frequency - third-trimester abortions are extremely rare in the US. They constitute ~0.01% of all abortions in the US (according to Fox News). There are about 100 performed annually in the US (for comparison, there are about 400-600 lightning strikes per year in the US). The only sense in which late-term abortions are "common" in the US is as a talking point in the political debate. MastCell ^Talk 00:20, 12 June 2010 (UTC)

Over here I've got Guttmacher saying its around 1,100 a year. I also hear that most of those state bans are very, very weak. - Schrandit (talk) 02:13, 12 June 2010 (UTC)

yes in 1992 Doc James (talk · contribs · email) 04:12, 12 June 2010 (UTC)

Your source is nearly 20 years old and is put out by the PRO-ABORTION Guttmacher Institute, and thus fails WP:MEDRS. Don't believe me, I'm sure we could argue about it for days on end and get nothing else accomplished here! all in good fun ;) -Andrew c ^[talk] 04:16, 12 June 2010 (UTC)

I think MEDRS specifically excludes the latter reason: Do not reject a high-quality type of study because you personally disagree with the study's inclusion criteria, references, funding sources, or conclusions. However, there does stand a good chance that the conclusions reached by an 18 year old source will have been superseded by a later, secondary source. Does anyone know what the later sources conclude on the issue? --RexxS (talk) 04:37, 12 June 2010 (UTC)