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)

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)

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.[3]

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)

Sorry if it was already there in Abortion and mental health that's fine, but the edit comment implied the insertion was yet to be done. LeadSongDog come howl! 19:37, 14 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 [4])-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)

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)

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 [5] 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.[6] Doc James (talk · contribs · email) 19:59, 8 June 2010 (UTC)

(undent) Uptodate also makes the comparison to completed pregnancy. [7]

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 [8]

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.[9] 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.[10] 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'.

[11] 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. ([12], 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.[13] 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:[14]

• "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.[15] 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 [16]. 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)

When we start discussing in a section we should be on topic with the discussion subject of that section, this one being "comparing a global rate of maternal death from safe abortion with a comparable rate of general maternal death" the main contendious point discussion in this article. If you want to discuss other stuff, like unsafe abortion, open a different discussion section!

Yes it's different to say "safer" than presenting something as having a lower mortality rate. "Safer" implies an analysis was performed, a lower data rate is just lower raw data rate. We should present information as by the source. And I always need to rember you Laube is US centric

If a study doesn't attribute the source for some claim, and that claim can't be found in any source, we should threat that claim as primary research.

Whether a source is regarded as primary or secondary in a given context may change, depending upon the present state of knowledge within the field. For example, if a document refers to the contents of a previous but undiscovered letter, that document may be considered "primary", since it is the closest known thing to an original source, but if the letter is later found, it may then be considered "secondary"

If you did not find contradiction beteween the sources then we should base the contendious text in (Lloyd,2005) and that should be enough

We first look for sources and later write text, after having a source we could use, I made my first suggestion based on that source we finally had (Lloyd, 2005)

• AIW clearly points to be satisfied by (Lloyd,2005). Satisfied in the sense a need was fullfilled and it wasn't necessary "other sources regarding the childbirth comparison". He sees everyone the same way, except for you, the only one asking to use other sources
• Mastcell, said why he saw a problem with the text "Your proposed text doesn't work for me, because it incorrectly singles out the Guttmacher" so if he agrees with the text but not with the Guttmacher attribution
• Schrandit after I agreed (Lloyd,2005) was reliable and updated he said: "it would still be worth it to give the 1 more reliable, recent number to give the reader an idea" later he commented about the suggested text saying he supported keeping the Guttmacher attribution in the text, opposing MastCell "Keep in mind who Guttmacher is and where their money comes from. We should probably mention it in the article."

"Fact" has a whole different meaning use the appropriate words to reflect your ideas, in Wikipedia we usually use words like "view" and "information" to represent what you're talking about

Can't you separate the "developing world" "unsafe abortion" discussion from this one? In a diferent discussion section or after we finish this "develop world" issue? That would be helpful since everyone else is having no problem discussing these different topics separatedly.

I'll ask other editors on their talk page to make clear if they are satisfied or not by (Lloyd,2005) and the text derived from it.--Nutriveg (talk) 03:46, 14 June 2010 (UTC)

Assessing the current agreement status

I earlier pointed that me(Nutriveg), MastCell, Anythingyouwant and Schrandit agreed with my first suggestion. While MastCell expressed a problem in attributing Guttmacher Institute and Schrandit expressed a problem in not attributing. Other editors remained silent which I understood that they had agreed or didn't care about the outcome.

Rexxs questioned that interpretation so I need to ask editors to explicitly express their current opinion so we can continue from that point.--Nutriveg (talk) 04:52, 14 June 2010 (UTC)

Question 1

Do you agree the following (Lloyd, 2005) quote satisfies our needs for sources about "comparing a rate of maternal death from safe abortion with a rate of general maternal death" in the sense that, in that context it fairly represents other sources so far mentioned here and so the use of these other sources is not necessary in this same context?

"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)"

Answers to question 1

yes

1. Nutriveg (talk) 04:52, 14 June 2010 (UTC)
2. Doc James (talk · contribs · email) 05:56, 14 June 2010 (UTC) To clarify I do not see that agreeing to this excludes the use of further sources. Yes it "satisfies our needs for sources" but we can do better than.
3. Anythingyouwant (talk) 06:33, 14 June 2010 (UTC)
4. LeadSongDog come howl! 17:27, 14 June 2010 (UTC)

no

1. It fails to address significant factors by arbitrarily limiting the issue. --RexxS (talk) 15:53, 14 June 2010 (UTC)
2. Wording is awkward and redundant. Fails the basic test of good writing, in that it takes simple and clear facts and obscures them. Needlessly unclear (should cite specific mortality rates for childbirth, or at least a relative risk - otherwise it's uselessly vague). It is OK to use the US, or another developed country, as an example here, especially since rates are so uniform. That would be preferable to completely vague, innumerate statement about "low" risks. Substitutes a Wikipedia editor's framing for that of innumerable scholarly sources. MastCell ^Talk 17:08, 14 June 2010 (UTC)

Mu

1. This question presupposes that the sentence above is the best way to pass the relevant information to the reader. To me, it seems like the worst. Finding sources to justify what you want to say isn't writing an encyclopaedia but sourced POV-pushing. SHEFFIELDSTEEL^TALK 14:41, 15 June 2010 (UTC)

Question 2

If you answered yes to question above or didn't answered that question which text based on the above quote should be used in the Abortion article?

• The first suggestion:

"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"

• or the second suggestion:

"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."

Answers to question 2

first suggestion

second suggestion

1. Nutriveg (talk) 04:52, 14 June 2010 (UTC)
2. Doc James (talk · contribs · email) 05:59, 14 June 2010 (UTC) I recommend we use simplier wording. Rather than "lower than the general maternal death rate" how about "lower than the death rate from pregancy and childbirth"
3. Hordaland (talk) 06:19, 14 June 2010 (UTC) Even simpler, more direct, and avoiding "maternal": In developed countries, few women die in childbirth and even fewer (below 1 in 100,000 procedures) die as a result of abortion.
4. Anythingyouwant (talk) 06:39, 14 June 2010 (UTC) I would change the word "relatively" to "already".
5. I would go along, but prefer simpler yet, "A safe abortion has far less risk than continued pregnancy and delivery". Any exact numbers will always be misleading if not outright wrong. LeadSongDog come howl! 17:27, 14 June 2010 (UTC)

Neither

1. I don't understand why we're going to such great lengths to avoid a concise, clear representation of the content of numerous reliable sources. This is a simple and well-documented fact - that abortion is numerically safer than childbirth in the developed world - and we seem to be doing our best to render it opaque. I don't see how this serves the general reader, nor do I see how it serves the goal of accurately and clearly representing the state of scholarly knowledge in the field. MastCell ^Talk 17:08, 14 June 2010 (UTC)
2. The sentence is written backwards. It should start with the main point (abortion is safer than childbirth), provide the best statistics we can find, and then follow up with any qualifications that are felt to be necessary(in countries offering legal access to abortion, etc). SHEFFIELDSTEEL^TALK 14:46, 15 June 2010 (UTC)

---

I was invited on my Talk page to comment on this portion of the overall discussion, even though I had not participated in that Section. Skimming it, though, leads me to no particular opinion about the phrasing specified above. The data is quite clear that for most of the world's population, childbirth is more dangerous than standard/recognized/medically-accepted abortion procedures. It can of course be true that a significant fraction of the world's population does not have access to those procedures, in which case abortion might be as dangerous as, or even more dangerous than, childbirth. It may also be true that in the most medically advanced countries the danger is about the same for either event --but this means, to me(!), because of the costs associated with bringing the whole world up-to-the-most-advanced-medical-level, compared to the costs associated with bringing the whole world up-to-the-safest-available-abortion-level, that we need to concentrate on accomplishing the latter NOW, and worry about the former as it can be afforded, to save the lives of the most women sooner rather than later. Not to mention that I do not see any reason to automatically prefer childbirth over abortion, if the danger is the same, even in the most medically advanced places. V (talk) 05:26, 14 June 2010 (UTC)

DocJames and AYW, I think we can accommodate your suggestions if no one (further) disagrees with that, the only problem I see with DocJames suggestions is the lack of easily accessible data about maternal death from childbirth as we have for general maternal death (pregnancy), so that claim would have a problem standing by itself which could lead to problems in the future about people questioning that information with primary sources, I my self would be inclined to add the so exceptional cases like Finland. Hordaland I need to remember you that Maternal death is associated with pregnancy in general and your rewrite give more emphasis to childbirth than the article topic (abortion).--Nutriveg (talk) 13:23, 14 June 2010 (UTC)

LeadSongDog, your suggestion have some problems: it lacks "developed countries" so it would be advancing a point the sources took care to restrict, "far less risk" also carry the same problem of not being supported by the sources, it doesn't solve the problem of citing an abortion mortality risk number and pointing the mortality from pregnancy is already low.--Nutriveg (talk) 17:49, 14 June 2010 (UTC)

MastCell, if you think (Lloyd, 2005) is so problematic I don't see your point in further criticizing how we should rephrase that source in the section bellow. You criticized (Lloyd, 2005) so much that I got confused about your earlier position about the first suggestion when you questioned only the Guttmacher attribution--Nutriveg (talk) 18:01, 14 June 2010 (UTC)

Rexxs, please mention those "significant factors" so other editors can better understand your point.--Nutriveg (talk) 18:07, 14 June 2010 (UTC)

Sure, if it's not clear enough for anyone, they are: the relative paucity of statistics for developing countries, compared with developed countries; the low risk of both abortion and maternity in developed countries; the greater risk for both abortion and childbirth in most developing countries; the greater risk for unsafe abortion; the increasing rate of mortality from abortion as pregnancy develops; the mortality figures for abortion and maternity; the comparison made between those figures.

Let me now put on record that I object very strongly to your refactoring of my contributions to this section. You started this request without any agreement between us on the questions to be asked, and unilaterally decided on the scope of the request to favour your position. In addition, the notifications you put out, and the follow-up notices that I posted referred only to this section, so anyone following the notices would be mislead. This is one of the clearest examples of gaming the system that I've ever encountered, and if you should choose to move any of my contributions off to another section again, on the grounds that they are a different discussion, when we have no agreement on the scope of the discussion, I will not hesitate to request sanctions against you for disruption. --RexxS (talk) 19:04, 14 June 2010 (UTC)

Just because the 2005 source is good and we could technically exclude others I do no think we should. The 2003 and 1998 reviews are also excellent and should be kept. I think the second suggestion is better than the first but even better wording than both can be created.Doc James (talk · contribs · email) 19:34, 14 June 2010 (UTC)

Rexxs, the question says "about "comparing a rate of maternal death from safe abortion with a rate of general maternal death" in the sense that, in that context it fairly represents other sources so far mentioned here ". It doesn't restrict the use of sources not already mentioned in the talk page about that context, like one "for developing countries". The question is just about that context "maternal death from safe abortion with a rate of general maternal death", it has no influence in other issues you raised like "the greater risk for both abortion and childbirth in most developing countries; the greater risk for unsafe abortion; the increasing rate of mortality from abortion as pregnancy develops".

I created this discussion to assess your criticism that my former suggestion had no support, so we could move on from that point: using it as a stable version for further improvements or addressing its problems with other suggestions.--Nutriveg (talk) 19:40, 14 June 2010 (UTC)

DocJames, in the current setting we need to move somewhere before reaching a solution everyone thinks is ideal.--Nutriveg (talk) 19:45, 14 June 2010 (UTC)

SheffieldSteel, the question is if (Lloyd, 2005) a commonly agreed source as updated and reliable by WP:MEDRS fairly represents the other sources so far presented in the context we were discussing. The question is not if it's the one everyone believe is "the best" but if that's the best we can commonly agree. If you don't think so it would be helpful if you point what consistently supported information is not fairly represented by (Lloyd, 2005) and how it disagrees with that information.--Nutriveg (talk) 15:41, 15 June 2010 (UTC)

SheffieldSteel, in the other section we are not discussing an ideal text (from our head) for the sentence, but a rephrase of (Lloyd, 2005). I think both phrases fairly represent the two earlier concerns you mentioned as well as the third: developed countries, since we can't use information that can't be verified.--Nutriveg (talk) 15:54, 15 June 2010 (UTC)

The question that you want to discuss is neither here nor there, and attempts to structure the discourse in your favour have gone far enough. The purpose of this page is to discuss improving the article. To do so, we should consider all reliable sources that have written on the subject, not just the one that you want to cite. SHEFFIELDSTEEL^TALK 16:18, 15 June 2010 (UTC)

The question is there and answers are supposed to be based on that question, not by implying it means something else. If you insist to assume bad faith that's a kind of behavior that disrupts consensus building. If you think that source doesn't fairly represent some issue consistently supported by other sources, in that same context, please let us know what's that issue and how it disagrees with that source. There's no pointing in continuing a discussion about (unreliable/outdated) sources if those sources are already fairly represented by a source we commonly agreed to use. --Nutriveg (talk) 17:03, 15 June 2010 (UTC)

The question is there, and the answer is pretty clear. Multiple sources would be better than one. SHEFFIELDSTEEL^TALK 20:18, 15 June 2010 (UTC)

Questions raised by Rexxs

It was pointed out by me (RexxS) that Nutriveg's first suggestion was questioned by each of the editors who commented. I also objected to the method of picking a single source from the many offered, as a single source rarely covers all the issues raised by the literature examined. Having examined the sources, I looked for material that was relevant to the health risks of abortion, in particular when a comparison was made and found the following factors: the mortality rates for abortion; the mortality rates for childbirth and the comparisons made; the increasing mortality rate as pregnancy progresses; the large difference between mortality rates between developed and developing countries. I then requested that all of these factors expressed by the sources should be reflected in the article per WP:RS. I do not believe it is justifiable to arbitrarily limit the scope of Health risks by only addressing developed countries (where the minority of abortions take place), and also ignoring the increasing rate by stage, when we have spent the time examining plenty of reliable sources that give us the information we need to write about those factors. Why replace one piece of problematical text with another piece of problematical text, when we can do a proper job? --RexxS (talk) 15:53, 14 June 2010 (UTC)

Question 3

Do you agree that the section on Health risks should address the issues of developing countries with at least as much weight as developed countries?

yes

1. RexxS (talk) 15:53, 14 June 2010 (UTC)
2. It should distinguish between safe and unsafe abortion (as defined by the WHO and others), and address both. MastCell ^Talk 17:08, 14 June 2010 (UTC)
3. So far as practicable. LeadSongDog come howl! 17:27, 14 June 2010 (UTC)
4. as long as we have reliable sources in the same context where those developed countries are differentiated, so far in "maternal mortality from safe abortion versus other causes of maternal mortality". I don't see the point of creating this question if those sources weren't already presented to a discussion of sources we already have.--Nutriveg (talk) 17:39, 14 June 2010 (UTC)
5. Definitely. We should mirror what is done by reliable sources. Doc James (talk · contribs · email) 19:29, 14 June 2010 (UTC)

no

1. There is a separate section in this Wikipedia article already devoted to unsafe abortions.[17] Do other medical articles discuss how the procedure is frequently botched in underdeveloped countries? Even if that's a normal thing in medical articles, I feel that we already have a section in this article for such info.[18]Anythingyouwant (talk) 17:26, 14 June 2010 (UTC)

   Unsafe abortion is closely linked to the legality and accessibility of abortion, rather than simple resource availability (a point made in numerous sources). Thus the issue takes on a dimension beyond that of, say, a "botched" appendectomy in a developing country. MastCell ^Talk 20:56, 14 June 2010 (UTC)

• This Q&A style discussion is sort of wonky to me (plus I don't have much time to contribute to this in the first place). But I did want to say I agree with AYW above, as that in itself may be notable ;) Mentioning something about unsafe abortion in the health risk section seems prudent. But I was not a fan of having two sections on unsafe abortion, and I don't see articles on, say, tooth extraction which devote a lot of space to poor dental care in developing countries (though I also don't want to undermine the significant world wide, public health issue of unsafe abortions).-Andrew c ^[talk] 18:38, 14 June 2010 (UTC)

Question 4

Do you agree that the section on Health risks should address the issue of increasing rate of mortality from abortion as the pregnancy progresses?

yes

1. RexxS (talk) 15:53, 14 June 2010 (UTC)
2. Yes, at least in a single sentence. MastCell ^Talk 17:08, 14 June 2010 (UTC)
3. LeadSongDog come howl! 17:27, 14 June 2010 (UTC)
4. Yes, once reliable sources are found that everyone can agree on. Surely such sources must exist. And in the mean time, I don't think this should be a precondition for mentioning the childbirth comparison. Additionally, I'd like this article to also mention that abortion is increasingly controversial as pregnancy progresses and the fetus develops.Anythingyouwant (talk) 17:32, 14 June 2010 (UTC)
5. I don't see the point of creating this question when, in the discussion section no one opposed to that, and there's already some sort of text covering this. --Nutriveg (talk) 17:39, 14 June 2010 (UTC)
6. Yes once again supported by reliable sources Doc James (talk · contribs · email) 19:30, 14 June 2010 (UTC)

no

Question 5

Do you agree that the following text addresses the issues related to health risks of abortion better than the proposal above?

• "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. 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."

yes

1. RexxS (talk) 15:53, 14 June 2010 (UTC)

no

1. If I were a general reader and came across that paragraph, it would be opaque and largely incomprehensible Struck; I apologize. I'm getting too cranky. It mixes "developed world" with US statistics in an unclear way. There are one or two simple facts to be communicated, so I think we can do better. Let's start with a general overarching statement and then add more detail as the paragraph progresses. Example: Abortion, when legally performed in developed countries, is among the safest procedures in medicine. For example, in the US the risk of maternal death is approximately 0.7 per 100,000 procedures [19], as compared to a maternal death rate of 7.7 per 100,000 live births. The risk of abortion increases with increasing gestational age, but remains lower than that of childbirth through at least 19 weeks' gestation. ¶ In contrast, the risk of death or injury from abortion in the developing world is significantly higher, and is linked to a high rate of unsafe abortion (defined by the WHO as...) That at least has the advantage of being more concise and organized, and is arguably a better representation of the content and emphases of available sources as well. MastCell ^Talk 17:08, 14 June 2010 (UTC)
2. We should not isolate developing nations' women's elevated risk due to unsafe abortion from their elevated risk in ongoing pregnancy and delivery, it is nonsensical to do so. LeadSongDog come howl! 17:27, 14 June 2010 (UTC)
3. by the reasons already explained. And if you want to use other sources you should get an agreement on them first.--Nutriveg (talk) 17:39, 14 June 2010 (UTC)
4. If risks due to botched abortions in developing countries are mentioned in this article, it ought to be in the section already devoted to unsafe abortion.[20] As for increasing rate as pregnancy progresses, if everyone agrees on adequate sourcing then fine, but if not let's insert into the article the stuff that everyone agrees on, rather than holding some stuff hostage to the increasing risks stuff. Anyway, I think the increasing disapproval of abortion as pregnancy progresses (and the fetus develops) ought to be mentioned too.Anythingyouwant (talk) 17:41, 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)

I'd suggest a read of:

• Ronsmans C, Graham WJ (28 September 2006). "Maternal mortality: who, when, where, and why". Lancet. doi:[https://doi.org/10.1016%2FS0140-%0A6736%2806%2969380-X 10.1016/S0140-

6736(06)69380-X]. {{cite journal}}: Check |doi= value (help); line feed character in |doi= at position 15 (help) LeadSongDog come howl! 20:57, 14 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)

This article is "Abortion", not "Safe abortion", nor "Induced abortion", nor even "Human abortion". It is rather silly to focus it solely on "Safely induced abortion in humans in regimes where such practice is legally available" while maintaining that title. However, I seem to be the only editor bothered by that. So far as legal criteria for induced abortion (in humans) are based on the maternal danger in continuing the pregnancy, measures of that danger seem like eminently pertinent things to include. LeadSongDog come howl! 05:01, 14 June 2010 (UTC)

I think people agree with you (I do, anyway). If we talk about health risks, the #1 health risk (worldwide) is the prevalence of unsafe abortion, which is closely tied to restrictive abortion laws and societal attitudes. That risk dwarfs any risk associated with safe, legal abortion in the developed world. We should say something about the safety of abortion under safe, legal circumstances, both because developed-world statistics deserve at least a mention and because it points up the enormity of the disparity with unsafe abortion.

We've spent a lot of time arguing about the precise wording about abortion risk in the developed world (which seems a bit silly, since ample sources exist to handle it in a short paragraph). But don't take that to mean that there is no interest in discussing the risk of unsafe abortion - in fact, the pathetic under-representation of such material was one of the major factors that motivated me to attempt a rewrite. MastCell ^Talk 17:43, 14 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 ([21]). 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)

Is there some evidence that the usually reliable bodies (e.g. the CDC) using Guttmacher's statistics are wrong to do so? While some points of view may disagree with their motivation, the GI still hold as their goal the provision of accurate information to enable women to make informed choices. It would be self-defeating for them to knowingly provide inaccurate information. I have not seen any WP:MEDRS reviews that seriously challenge their figures accuracy. Why should we? LeadSongDog come howl! 15:07, 15 June 2010 (UTC)

LMP?

Hi, first caption has this initialism as a pipe. I think it should be spelled out so high up in the article ... but what does it stand for? Can someone fix it? Tony (talk) 09:39, 14 June 2010 (UTC)

Last Menstrual Period. It is a very common way of dating pregnancy (Gestational age). I would change it, but page is protected. I mean, if there is consensus for a change, I'd be glad to implement it, but I'd rather an uninvolved admin edit this particular protected page.-Andrew c ^[talk] 13:39, 14 June 2010 (UTC)

It's no longer full protected so that change can be made. By the way the article was earlier partial protected but that protection was removed as well when full protection finished, someone should restore partial protection.--Nutriveg (talk) 14:22, 14 June 2010 (UTC)

OK, I've spelled it out. I also fixed the second caption, which was pretty chaotic. Please check it. I'm just passing through, so probably won't watchlist this article. Tony (talk) 14:37, 14 June 2010 (UTC)

Removal from the lead paragraph

I've reverted this edit [22] as it was made without consensus and apparently without reading either the preceding sentence or the source. Compare the edit summary with the source's summary... In recent years, more countries experienced a decline in legal abortion rates than an increase, among those for which statistics are complete and trend data are available. The most dramatic declines were in Eastern Europe and Central Asia, where rates remained among the highest in the world. The highest estimated levels were in Armenia, Azerbaijan and Georgia, where surveys indicate that women will have close to three abortions each on average in their lifetimes. The U.S. abortion rate dropped by 8% between 1996 and 2003, but remained higher than rates in many Northern and Western European countries. Rates increased in the Netherlands and New Zealand. The official abortion rate declined by 21% over seven years in China, which accounted for a third of the world's legal abortions in 1996. Trends in the abortion rate differed across age-groups in some countries. I trust that this revert will meet either with consent or discussion, rather than an edit war. SHEFFIELDSTEEL^TALK 15:00, 15 June 2010 (UTC)

I removed the phrase because I don't see why it should be in lead. The article is about abortion not abortion in the USA and the lead is meant to introduce and summarise the main points of the article. More fundamentally Wikipedia articles should present a worldwide view, the worldwide trend is mentioned - appropriately - so why single out one country for mention in the lead? If the USA statistic is kept in the lead why not have a sentence describing abortion trends in China or the UK or Slovenia or any other individual country? I am not arguing that the sentence is not reliably sourced or verifiable I just think that it is inappropriately placed. The sentence may have a place in the article (it would almost certainly belong in Abortion in the United States) but not the lead. Guest9999 (talk) 16:32, 15 June 2010 (UTC)

I think the information should be kept, since many countries were mentioned, but it should be updated at least, since the trend has inverted: 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--Nutriveg (talk) 16:50, 15 June 2010 (UTC)

That source is specific to the US. I'm sure I don't need to say anything further :) SHEFFIELDSTEEL^TALK 16:53, 15 June 2010 (UTC)

I've partly self-reverted and removed the sentence that Guest9999 removed. The preceding sentence, and the source, remain. If we agree that other information from that source would make a good addition to the lead, we can re-add something. SHEFFIELDSTEEL^TALK 16:56, 15 June 2010 (UTC)

The edit you undid removed not just the example, but more importantly it also removed the reliable source that supported the previous sentence, so I'm bound to agree with your revert. The lead is quite compact for an article this size, and I can't see any problem when summarising incidence to give a worldwide overview followed by a not untypical example citing figures. I'm a native Brit, but I still find using the example of the US quite appropriate for the English Wikipedia. --RexxS (talk) 17:14, 15 June 2010 (UTC)

Afterthought: if the example is dropped, it leaves the lead a little bare on an important topic, perhaps the variation in trends between counties might be briefly noted instead, as a prelude to a more detailed discussion in the Incidence section. --RexxS (talk) 17:27, 15 June 2010 (UTC)

I apologise, it was wrong of me to remove the source, I should have been more careful in checking what it covered. As a general rule the lead usually covers information mentioned - and sourced - later in the article, I assumed this would be the case considering the how much scrutiny this article gets. Still the BRD cycle seems to be working nicely. Guest9999 (talk) 17:38, 15 June 2010 (UTC)

Facts first, or qualifications first?

This discussion regards this revert (edit comment: reverting, by the sources). But two sources, not one, are provided for the sentence:-

• Unsafe abortion: the preventable pandemic [23]
• Induced abortion: an overview for internists [24]

It should be clear from the title alone that the first source is making a specific point about unsafe abortions, and therefore emphasises the importance of the country and the legality of the procedure. The review, on the other hand, states the facts much more simply (Abortion remains one of the safest procedures in contemporary practice, with a case-fatality rate less than 1 death per 100 000 procedures.). It is far clearer to make the point of the sentence before listing any necessary qualifications. SHEFFIELDSTEEL^TALK 17:33, 15 June 2010 (UTC)

Does anyone disagree with this? SHEFFIELDSTEEL^TALK 14:00, 16 June 2010 (UTC)

I didn't see this before because the section title was not clear. We should follow the same order used by the source "legal abortion in industrialised nations has emerged as one of the safest procedures in contemporary medical practice",[25] So I disagree with your change.--Nutriveg (talk) 14:12, 16 June 2010 (UTC)

The source? Which source? Did you read my comment above? more to the point, does anyone else have an opinion on this? SHEFFIELDSTEEL^TALK 16:50, 17 June 2010 (UTC)

Sorry, I've busy recently, but I'll offer an opinion. As a matter of style, it is always better to give the generalities first, then discuss the qualifiers next - unless it's a crucial exception of great significance. Editors need to lead the reader through a subject progressively, and facts first, qualifications next is the natural way to write to achieve this. The editor's job is write about what the sources say, in as neutral and engaging way as they can; the fundamental principle is to make the text as intelligible as possible. The sentence structure in sources doesn't need to override that, as long as we represent their message accurately. --RexxS (talk) 18:14, 17 June 2010 (UTC)

Same here, been busy. I do not think it matters greatly what order it is in. One often changes the order / wording to avoid plagiarism. Just make it understandable. The say on minor issues like this should go to the user who added the content. This is a little like the issue over American versus British spelling IMO. Doc James (talk · contribs · email) 18:47, 17 June 2010 (UTC)

"in developed countries" is qualifying "abortion (procedure)", not "safest procedures in contemporary medical practice" which already carries a qualifier in itself "in contemporary medical practice". So the qualifier should be placed closer to the object of qualification, in the same order is the one used by the indicated source: "legal abortion in industrialised nations has emerged as one of the safest procedures in contemporary medical practice",[26]--Nutriveg (talk) 15:09, 18 June 2010 (UTC)

Assessing the current agreement status(2)

These three are excellent sources:

• 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)

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

• A 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.

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)

• A 2003 journal article Yanda K, Smith SV, Rosenfield A (2003). "Reproductive health and human rights". International journal of gynecology and obstetrics. 82 (3): 275–283. PMID 14499974. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

The availability of safe, affordable abortion

services in any country is determined by the legal status of induced abortion, compounded with how laws are interpreted.Thus, a country with strict policies could have an exception for the life of the mother, while one with liberal laws could place a series of restrictions w19x.When abortion is legal, available, and carried out under modern aseptic conditions, mortality is extremely low; abortion is one of the safest surgical procedures w17x.Deaths from obstructed labor and abortion are extremely rare in the United States and other developed countries, where mortality per 100 000 abortions is 0.2–1.2 w18,20x.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.

These can be summarizes: The risk of abortion in developed countries is less than 1 in 100,000 per procedure making it significantly safer than pregnancy and childbirth.— Preceding unsigned comment added by Jmh649 (talk • contribs)

Agree

1. Doc James (talk · contribs · email) 18:01, 15 June 2010 (UTC)
2. I would still prefer to cite actual numbers for childbirth, to make the absolute and relative risks clearer. But this text at least accurately and honestly conveys the content and emphases that are consistently presented in the scholarly literature. MastCell ^Talk 18:51, 15 June 2010 (UTC)
3. LeadSongDog come howl! 19:13, 15 June 2010 (UTC)
4. Agree. I also think that, as when dealing with any low risk, stating absolute risk is pereferable to stating a relative risk. SHEFFIELDSTEEL^TALK 20:22, 15 June 2010 (UTC)
5. That summary is okay, except that you don't need to say "pregnancy", and it also needs to be mentioned that the risk of childbirth is itself low (per Lloyd 2005). I agree with omitting lots of numbers, and they can be explicitly put in a footnote, or in the wikilinked article about childbirth.Anythingyouwant (talk) 20:29, 15 June 2010 (UTC)
6. Disagree, because the sentence is not good English. By itself, the phrase "The risk of abortion" is much more about having an abortion than about the risk of complications (including death) associated with having an abortion. See? V (talk) 19:09, 18 June 2010 (UTC)

Suggestion based on the so far most commonly agreed suggestion

I fell sad about this newly created suggestion when we had a former one which five people agreed in its basic form, so we could evolve from that taking those editors opinion into account. But I'll take this new section as an opportunity to present that earlier suggestion with the improvements suggested there. With that I expect we can get more support than that former one and this newly created discussion section fits any purpose.--Nutriveg (talk) 18:58, 15 June 2010 (UTC)

From the following medical book

• 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. 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)

Suggested text

"In developed countries the maternal death rate from abortion is below 1 in 100,000 procedures, lower than the rate for childbirth and general pregnancy, which is already low."

Agree

1. Nutriveg (talk) 18:58, 15 June 2010 (UTC)
2. Anythingyouwant (talk) 20:38, 15 June 2010 (UTC) I don't see a problem with this.

Comment

The most commonly agreed suggestion is Doc James' above, having 5 agreements (3 with reservations) versus 1 disagreement. Talk:Abortion#second suggestion had 5 in favour (4 with reservations) versus 2 against, and was phrased ("If you answered yes to question above or didn't answered that question") to exclude those (including me) who disagreed with the first question. It would be better to try to find consensus based on Doc James' suggestion, addressing the comments there. --RexxS (talk) 19:51, 18 June 2010 (UTC)

The answer to this misplaced commentary is on the discussion section below.--Nutriveg (talk) 21:15, 18 June 2010 (UTC)

Other suggestions

---

You're not assessing the current status, you're making a new proposal and asking for "votes". And I see this as problematic when you created this discussion when the former one which you and four other users basically agreed (about the second suggestion) was still in discussion and the few opposing voices didn't clearly express their concerns in a way that those opinions could be properly addressed.

The sources don't consistently say "significantly safer", the only one who does so is one about a specific procedure: Medical abortion which indeed has lower rate of maternal mortality, at least in the US, even than abortion itself. Your suggestion also fails to qualify the risk of general maternal death which is low, giving the impression that risk is somewhat considerable. --Nutriveg (talk) 18:23, 15 June 2010 (UTC)

A huge number of reliable sources consistently make clear that abortion is significantly safer than childbirth (many are listed on this talk page). If you either do not understand that or are unwilling to acknowledge it, then I think it's a waste of time to continue this circular discussion, because you are ignoring the reality of available sources. MastCell ^Talk 18:49, 15 June 2010 (UTC)

MastCell, safer is an interpretation, an analysis. When the compared subjects are different (one group performing abortion and other group of pregnant women not performing abortion) such analysis requires epidemiological criteria, for example by searching for possible confounding factors (like income, age, education status, access to health care, regional issues, ...) often misrepresented by a single number and verifying statistical significance after those factors were adjusted. Sources consistently present "lower data rates", so presenting that as an analysis (safer) is WP:SYNTH and WP:UNDUE. Beyond the point of uncharacterizing the actual maternal death from childbirth and general pregnancy, which the sources support as "low" so further breaking WP:NPOV. --Nutriveg (talk) 19:02, 15 June 2010 (UTC)

We don't need another lecture on your personal ideas about epidemiology. We need a commitment to actually respect available sources, instead of making up frivolous and idiosyncratic reasons to reject them. It not WP:SYN, because numerous high-quality sources explicitly compare abortion to childbirth and conclude that the former is safer. If you don't understand that, then my time is better spent finding ways to limit the damage you cause rather than talking in circles. MastCell ^Talk 20:59, 15 June 2010 (UTC)

Turning "lower data rate" into "safer", using a claim about a "specific procedure" (medical abortion) to apply to "all procedures" is WP:SYNTH. My points about epidemiology were to show how you're doing the "science in between" by yourselves.--Nutriveg (talk) 21:19, 15 June 2010 (UTC)

Do you see the numerous sources explicitly using the word "safer"? If yes, then you should be clear that it is not WP:SYN to say it's safer. If no, then, well... MastCell ^Talk 21:38, 15 June 2010 (UTC)

Do you? From DocJames quotes above, I only see in Yanda using the word "safer" in a phrase that talks about medical abortion, the others talk about mortality rates. If such source is out there that claim is not consistent--Nutriveg (talk) 22:15, 15 June 2010 (UTC)

Since I'm a bit tired of watching you move the goalposts, I'd like you to do a bit of the legwork. Start on this page with #Safer_than_childbirth, perhaps scroll through to #More reliable references, peruse eMedicine, UpToDate, this review from Annals, Grimes 2006, and so forth. Then please come back and let us know whether you see any sources stating explicitly that abortion is safer than childbirth. MastCell ^Talk 22:42, 15 June 2010 (UTC)

I agree the sources are good and relevant but disagree with the summary: "These can be summarizes: [This makes no grammatical sense] risk of abortion in developed countries [this sounds like it means risk of abortion occurring, I assume it means risk of death caused by an abortion] is less than 1 in 100,000 per procedure [the sources don't seem to support this statement "the risk of dying is no more than 1 in 100,000" and "where mortality per 100 000 abortions is 0.2–1.2 (emphasis added)] making it significantly safer than pregnancy [significantly is not stated in the snippets] and childbirth [no objections]." Guest9999 (talk) 18:48, 15 June 2010 (UTC)

I can't find "safer" in the "Annals" article. I can't further check "Grimes,2006" but it's a US centric primary study. I can see UptoDate uses US data (citing grimes, the same author of Annals btw), oh wait there's something about "safer" in eMedicine but the author (Suzanne Trupin) owns a [clinic that provides abortion since 1973, not reliable and certainly WP:UNDUE to give such exposition to a POV (safer) supported by a minor number of sources, let's keep lower mortality rate, then everyone is happy and no Wikipedia policy (WP:SYNTH and WP:NPOV) had to be breached.--Nutriveg (talk) 00:03, 16 June 2010 (UTC)

(the comment below was moved from the space reserved to the suggestions Nutriveg (talk) 19:43, 15 June 2010 (UTC))

Comment I find the wording a little choppy. I do not think we need to state maternal death rate twice. Doc James (talk · contribs · email) 19:24, 15 June 2010 (UTC)

I reworded that to address your concerns.--Nutriveg (talk) 19:48, 15 June 2010 (UTC)

Why not just pregnancy rather than general pregnancy. And below has one l not two :-) People already realize that the mortality is low from child birth repeating "already low" at the end I think is not needed.Doc James (talk · contribs · email) 20:03, 15 June 2010 (UTC)

Abortion is pregnancy management, the woman needs to be pregnant to perform an abortion, childbirth is also associated with pregnancy. The association is defined in the WHO definition of maternal death. So "general" is necessary to represent the general data. But I can remove that if that's your only problem.

The already low is to qualify the risk of general maternal death which is low, so the reader can balance the actual risk. Such term was used by sources in the same context, was in the last most approved suggestion, AIW also expressed direct concerns about it several times.--Nutriveg (talk) 20:24, 15 June 2010 (UTC)

I need to remember that Wikipedia:Polling is not a substitute for discussion so I expect the same way of respect for raised concerns as I didn't further use a majority position before to ignore those few opposing voices despite their silence over the problematic parts of the source supported text.

I can only laugh when seeing so much votes to something like this:

"The risk of abortion in developed countries is less than 1 in 100,000 per procedure (...)"

that doesn't even say what that risk is about.--Nutriveg (talk) 20:48, 15 June 2010 (UTC)

Agree and fixed that.Doc James (talk · contribs · email) 21:24, 15 June 2010 (UTC)

I reverted because you already received votes for that and don't know which term "maternal death", "death", "of abortion death in early stages of pregnancy", "risk of death from medical abortion" was presumed by those "careful" voters.--Nutriveg (talk) 21:29, 15 June 2010 (UTC)

The collaborative approach is to discuss concerns with editors, and evolve the proposal into something which will gain more support. Reverting another editor's good faith attempt to improve a proposal... really isn't constructive. This sort of thing can leave other editors feeling that it would be easier to work here without your input. SHEFFIELDSTEEL^TALK 21:39, 15 June 2010 (UTC)

That's your interpretation, you can't change a question after you received votes after it. Such conclusion ("significantly safer") was extracted from a phrase about medical abortion, by the quoted text, so it's not clear where that came from, as Guest9999 also pointed. Other editors have insisted several times that lower risk was about early abortion. DocJames can't decide by himself.--Nutriveg (talk) 21:49, 15 June 2010 (UTC)

I tell you what. Why don't you specify exactly which hoops you want all the other editors to jump through, in order to produce a proposal that you will accept, and we can take it from there. SHEFFIELDSTEEL^TALK 22:08, 15 June 2010 (UTC)

If WP:SYNTH, mainly, and WP:UNDUE were taken out of the game we would be playing fair. I've done several suggestions and addressed many concerns, so that's not me who is lacking effort towards a good solution here.--Nutriveg (talk) 22:22, 15 June 2010 (UTC)

Actually, there's no need for any of this silliness. I just realised that we actually have consensus support for Jmh649's proposal at the top. The fact that one editor does not recognise that consensus, for whatever reason, does not stand in the way of improving the article. I'll start a new proposal addressing the concerns of those editors who've made productive suggestions above, and get confirmation of support for it. Moving forward, and all that. SHEFFIELDSTEEL^TALK 13:41, 16 June 2010 (UTC)

Silliness is you that rejected my second suggestion lacking any arguments that could be addressed is now the one defining consensus, when that former suggestion had a similar degree of approval. There are two editors above disagreeing with DocJames suggestion, clearly pointing their reasoning, I hope your new proposal addresses those issues.--Nutriveg (talk) 13:48, 16 June 2010 (UTC)

(un-dent) The more I look, the more it seems that there's no consensus that the article text needs changing at all. SHEFFIELDSTEEL^TALK 14:05, 16 June 2010 (UTC)

This article was earlier protected in the middle of changes to this very sentence, so it could be previously discussed, if you think that version is the better one, please suggest it as everyone else did with their suggestions.--Nutriveg (talk) 14:22, 16 June 2010 (UTC)

(text below was moved from Talk:Abortion#Suggestion based on the so far most commonly agreed suggestion: )--Nutriveg (talk) 17:17, 18 June 2010 (UTC)

I'm not sure the reader would always conclude, from reading that, that the "which is already low" applies only to developed countries. So, I think the above sentence needs to have "in those countries" appended to it. V (talk) 04:54, 18 June 2010 (UTC)

Objectivist, we can make that change if AIY that voted on that version so far doesn't disagree with that.--Nutriveg (talk) 17:17, 18 June 2010 (UTC)

Answer to misplaced commentary

Doc James suggestion had three disagreements: me, Guest9999 and Objectivist, and that phrase as it was has no meaning. Wikipedia is also based in WP:Consensus so counting votes and giving weights to them is also meaningless. I raised my problems with Doc James suggestion and was expecting them to be addressed. SheffieldSteel promised a new suggestion, but he never proceeded with that.--Nutriveg (talk) 20:37, 18 June 2010 (UTC)

Doc James did address your concern - see the edit summary? But you reverted it, on the basis that "you already received votes for that", even though you disparage voting as meaningless. It is totally disingenuous to complain that someone didn't address your objection, when you removed their attempt to do so. How is that conducive to seeking consensus? You need to start being constructive instead of destructive of any attempt to reach a consensus you don't like. Drop the stick. --RexxS (talk) 21:27, 18 June 2010 (UTC)

I didn't said to have just "one" objection, my major objections are those of WP:SYNTH and WP:UNDUE as explained in this whole discussion section. About the meaning issue, those "voters" have voted on a phrase that had no meaning and so couldn't even be evaluated by careful readers. Doc James only realized that after that phrase had already received its five votes so giving a specific meaning at that time, by his own desire, was no longer a viable solution.--Nutriveg (talk) 21:49, 18 June 2010 (UTC)

The objections of SYNTH and UNDUE have already been dismissed as patent nonsense. What is the purpose of discussion? Is it to reach a consensus? If so, how does reverting the change from "The risk of abortion" to "The risk of death from abortion" help us to approach consensus?— Preceding unsigned comment added by RexxS (talk • contribs)

I've argumented about those problems so I'm still expecting the other part to address those problems in the same way, either by recognizing and fixing those problems or explaining why those arguments are not correct, not simpling dismissing those real issues as "patent nonsense". That revert was made to don't misrepresent those votes, as already explained at that time.--Nutriveg (talk) 22:26, 18 June 2010 (UTC)

Why would any volunteer editor carry on addressing your concerns, when you thwart their efforts to do do? SYNTH and UNDUE are clearly nonsensical objections, and simply accusing good faith editors of that doesn't move the discussion forward. We've already agreed that "voting is meaningless" - this isn't a battle of the votes, so how are you going to get closer to consensus by preventing an editor from improving their suggestion? --RexxS (talk) 22:51, 18 June 2010 (UTC)

I've been collaborative explaining that reasoning and expect the same level of discussion instead of simple being qualified as "patent nonsense", "nonsensical objections" and such. I've seem much more assumptions of bad faith against me than an argumentative discussion here.--Nutriveg (talk) 23:04, 18 June 2010 (UTC)

Ok, I'll do my best to demonstrate good faith. As I see your objections, they seem to be that:

1. "has a lower mortality rate" means something different from "is safer" – which I'm already discussing with you;
2. failure to mention that the risk of general maternal death which is low – which I'd agree should be addressed;
3. arriving at "is safer" from "has lower data rates [of mortality]" is WP:SYNTH – which MastCell seems to have refuted above by referring to previous discussions where sources were found.

I'm happy to discuss with you any of the above, as long as we agree that we're looking for common ground on which to improve Doc James' suggestion. Would you like to discuss the points about citing actual numbers for childbirth (MastCell); including the absolute risk for MMR (SheffieldSteel); not mentioning "pregnancy" and omitting lots of numbers (Anythingyouwant); improving the phrase "The risk of abortion" (Objectivist) at the same time? --RexxS (talk) 23:58, 18 June 2010 (UTC)

My major problems are with WP:SYNTH: advancing "lower maternal mortaltity" as "safer", and applying to general abortion something specific about medical abortion. And with WP:UNDUE giving undue representation to a claims supported only by minor sources or, the possible risk of giving more (comparative) representation to an issue than the sources themselves, which mention the issue shortly. There's problem number 2 that is definitely an issue but I think it would better to deal with the WP:SYNTH issue first. After that both versions would look the same so it shouldn't have a need to choose a version to work from.--Nutriveg (talk) 02:02, 19 June 2010 (UTC)

How about "The risk of complications associated with abortion is less than 1 in 100,000 per procedure, in developed countries, making it significantly safer than pregnancy and childbirth." However, didn't someone say that in the most medically advanced countries, the risks are about the same? (On the other hand, I'm not sure I can believe such a claim; the rate-of-occurance of ectopic pregnancies should be about the same everywhere, regardless of the medical development level, and those are always dangerous.) V (talk) 13:43, 19 June 2010 (UTC)

Advancing a position to make a conclusion saying it's safer when the reliable sources don't (consistently) make such conclusion is WP:SYNTH. Giving undue balance to a claim made by few problematic (country specific, primary or unreliable) sources is WP:UNDUE. By the sources presented here so far I don't support the use of the word "safer".--Nutriveg (talk) 13:53, 19 June 2010 (UTC)

Sorry, you are quibbling. Have you never been asked in school to write a description of something, using a source, but in your own words? Phrases such as "less dangerous" or "less risky" are legitimately synonymous with the word "safer"! No "synthesis" there at all! (Synthesis is adding Fact A and Fact B to reach Conclusion C, but to simply describe Fact A in synonymous words is not to do synthesis, at all. V (talk) 06:40, 20 June 2010 (UTC)

It occurs to me to show you an example of Genuine Synthesis: Consider the concept of a Malthusian Catastrophe. This event, generally a 99% drop in a population due to lack of food and/or food-associated resources, is sometimes dismissed as being applicable only to mere animal populations, because humans are too smart for it to ever happen to them. Anyone claiming such a thing is dead wrong, however, because the archeological evidence on Easter Island clearly shows that the Polynesian population there once reached a maximum of about 20,000, and then they cut down the last tree on the island (mostly used as firewood and to make fishing boats), and when the Europeans discovered the place a couple centuries later, the total population was about 200 --a 99% drop from the maximum, entirely consistent with humans suffering a Malthusian Catastrophe. Note that if someone deliberately acts to promote the death of 99% of a population, that person will be called "genocidal". Next, it is observed that Island Earth is having its resources stripped relentlessly, to the extent that there have been plenty of warnings over the past several decades about a likely global Malthusian Catastrophe for humanity. Desertification, and growth of cities, are cutting into the total farmland available. Fish stocks worldwide are in obvious decline. Forested regions much larger than the total area of Easter Island disappear every month. And the world human population continues to grow, partly at the behest of opponents of abortion. Can we therefore conclude that every so-called "pro-lifer" actually has a genocidal agenda, with the goal of encouraging 99% of humanity to die in a global Malthusian Catastrophe, no matter how many abortions they have to oppose, to increase the odds of that happening? Nutriveg, it is very obvious that you don't know the meaning of "synthesis" at all! V (talk) 07:03, 20 June 2010 (UTC)

I don't see your point, we are not in "school" here, we just cite sources. I don't know which "school" you have been but this is a medical claim so we try to use medical standards, where words are used to better represent the state of evidence, and in "med school" advancing such position would represent a fail and shame, like for those vaccine scientits.

Did you wrote all that just to give a synthesis example? Maybe this case doesn't fit your definition of synthesis, since other source (or methodology) was not used to advance that position but editor interpretation. Anyway that's still WP:OR--Nutriveg (talk) 17:13, 20 June 2010 (UTC)

We do indeed cite sources, and we also quote them in limited fashion, per the "Fair use" copyright rules, and the rest of the time, we describe source-information in our own words. The school exercise involves learning to not plagiarize. So, if a source describes percentanges of complications associated with such things as pregnancy and abortion or childbirth, then it is not synthesis at all to sum up the data in a few words, if all the pieces of the data are in a single source. Synthesis in Wikipedia involves piecing a conclusion from multiple sources, got it? Since we do provide the reader with the source material, it is easy for the reader to verify the editors'-own-words description of the data, that was written into a Wikipedia article. V (talk) 18:25, 20 June 2010 (UTC)

If you think that WP:SYNTH doesn't apply, fine, but WP:OR applies anyway:

"Articles may not contain any new analysis or synthesis of published material that serves to advance a position not clearly advanced by the sources"

Advancing that something is safer, from sources that simple present distinct data rates is original research.--Nutriveg (talk) 21:46, 20 June 2010 (UTC)

False. Wikipedia fully allows simple conclusions to be stated when they are obvious in the data. I don't need a source to say that 1+1=2, and I don't need a source to say "If A, then B obviously follows, when B happens to indeed obviously-to-anyone follow A. For example, in the 1800s people working with the material known as "felt" typically used certain mercury compounds in processing that material. There also is considerable data (more recent than the 1800s) indicating that working with mercury compounds can cause various mental illnesses. Finally, a major use of felt in the 1800s was in the manufacture of hats --and in those days people making various goods also tended to themselves work with the raw materials when it wasn't super-difficult. (Some blacksmiths made all their own iron from ore, but most did so only seldom.) It was normal for a hat-maker to also make the felt. Therefore a Wikipedia article that mentions this information, appropriately sourced, can also mention that in the story "Alice in Wonderland" (written in the late 1800s), the person called the "Mad Hatter" was almost certainly given that name exactly because of widespread tales/knowledge (in the 1800s) about hat-makers becoming mentally unstable, even though at the time nobody knew why. SO, if it is obvious to anyone seeing the source data that abortion is safer than childbirth in most developed countries, then any Wikipedia article referencing that data can plainly say it. V (talk) 05:16, 21 June 2010 (UTC)

This is a medical claim, so we follow medical criteria, where there's difference in making an analysis (as described in the section below) and presenting actual data.--Nutriveg (talk) 12:41, 21 June 2010 (UTC)

Really? Then where is that statement in the Wikipedia guidelines, equivalent to the WP:Synth or the WP:OR that you so readily presented in your above failed arguments? V (talk) 13:43, 21 June 2010 (UTC)

The head of WP:OR says Wikipedia editors shouldn't perform analysis, like to say something is safer based on raw data (about two distinct groups). WP:MEDRS presents the guidelines about the use of sources to support medical claims. Welcome to Wikipedia.--Nutriveg (talk) 22:19, 21 June 2010 (UTC)

But when you read the rest of WP:OR, you find these two qualifications:

• "A and B, therefore C" is acceptable only if a reliable source has published the same argument in relation to the topic of the article.

So when Laube compares the maternal mortality rate from abortion with the overall MMR for the US, he opens the gate for any of us to make the same comparison for data from other countries.

• A primary source may only be used to make descriptive statements that can be verified by any educated person without specialist knowledge.

So any of us is free to use primary data on MMR to say that "1 is lower than 9" - unless somebody thinks you need specialist knowledge to make that claim. --RexxS (talk) 23:50, 21 June 2010 (UTC)

Not to mention, WP:MEDRS specifically says to "Summarize Scientific Consensus" --which is exactly what you, Nutriveg, are opposing here. V (talk) 04:58, 22 June 2010 (UTC)

RexxS, you're mixing the discussions in another thread. Me and Objectivist are discussing another issue (safer). Laube is a single source, it's primary since it doesn't point its sources, it doesn't say is lower, it just presents those two distinct data rates, so a experienced reader (which has an idea of the data distribution) would be able to infer something about it.

Your interpretation of that phrase from WP:SYNTH is incorrect: ""A and B, therefore C" is acceptable only if a reliable source has published the same argument in relation to the topic of the article. In that phrase the "same argument" other source is using is "A and B, therefore C", it doesn't allow you to mimic scientific work using D (alike A), or E (alike B) to conclude F.

Objectivist, consensus has nothing to do with the "analysis" mentioned in WP:OR and there's no "Scientific Consensus" saying it's safer, reliable sources don't say that at all.--Nutriveg (talk) 14:46, 22 June 2010 (UTC)

There is far more in the way of agreement/consensus that abortion is safer than childbirth in most developed countries, than there is disagreement. Can you present just one RS paper stating that abortion is less safe in those countriese? V (talk) 15:06, 22 June 2010 (UTC)

Burden of the proof is for those supporting a claim. In this case: "consensus (is) that abortion is safer than childbirth". Reliable sources only present different data, they don't advance such position "safer". Please read the section below if you didn't understand that yet.--Nutriveg (talk) 15:26, 22 June 2010 (UTC)

You are quibbling again. If abortion is not safer than birth in most developed countries, then there should be some RS that says so. Since you are the one claiming that the available data does not support Wikipedia editors reaching the conclusion that abortion is safer than birth in those countries, you are the one who must present that data!!!! V (talk) 22:16, 22 June 2010 (UTC)

I'm not saying it's not safer and I definitly don't want to include such information (not safer) in the article, but WP:BURDEN is for those trying to include information (safer). Abortion may be safer but we are limited by the sources. Please take a moment and read Wikipedia policies and guidelines, that way we could have a much more productive discussion.--Nutriveg (talk) 22:40, 22 June 2010 (UTC)

Sorry, your "broken record" mode doesn't cut it, either. The Wikipedia guidelines do in-essence say that editors can state the obvious in any article, period. And in this case the data obviously indicates that abortion is safer than childbirth in many countries. Q.E.D. V (talk) 03:52, 23 June 2010 (UTC)

For some reason that still eludes me, at least one editor finds a semantic distinction between "safer than" and "a lower mortality rate than". Fine. Let's simply state the rates without making any comparison. This has gone on way too long and burned way too many electrons for a petty semantic issue. LeadSongDog come howl! 16:21, 22 June 2010 (UTC)

But... our article said safer for a long time, and had 3 sources [27]. These sources (at least Grimes and Henshaw) specifically used the word "safer". This isn't some junk we are making up, but something found in reliable sources. Multiple editors dug up even more sources after protests from a single user. I have no idea what the heck you guys have been arguing about for the last couple weeks, and I have no idea why you let it go on for so long. We have citations that clearly use the word safer. SO much so that the RCOG uses the word and comparison in their guidelines. This is a non-issue to me, and I have no idea how so much talk page has been wasted on this nonsense. How can it be OR, when it is our sources making the comparison and using the word "safer"??? Jeez Louise! -Andrew c ^[talk] 16:36, 22 June 2010 (UTC)

June 15th, looks like MastCell reached the same conclusion as I, yet that didn't quell debate. I don't see any valid objections, and I think the consensus is clear. I'd urge Nutriveg specifically to drop this issue, and for everyone to move on. -Andrew c ^[talk] 16:38, 22 June 2010 (UTC)

Thank you Andrew, I'd be happy to move on – but not at the expense of letting one editor dictate both the content of the page, and just as importantly, the methods we use to reach consensus where that content is contended. We will just bog down at the next issue while we have an editor dismissing sources, such as an up-to-date medical textbook (Laube, 2009), published by a respected publisher as a "primary source" - it's hard to draw any conclusion other than it's because it makes the very comparison he doesn't want to see in text. We also simply won't make progress while we accept the pushing of contrived versions of Wikipedia polices. Imagine how we will be hamstrung if we can't say something as obvious as "1 is lower than 8" because we can't find a source making that exact comparison, even though the literature is littered with reliable sources making the same argument in relation to the topic of the article. - note the selective emphasis of part of a guideline in the earlier reply to push an idiosyncratic interpretation. It is time to end this nonsense, and I'd be happy to hear how others propose to do that. --RexxS (talk) 17:53, 22 June 2010 (UTC)

If we (meaning LeadSongDog, Andrew c, RexxS, and myself) are agreed about an accurate representation of sources, and Nutriveg is the sole opposition, and we have made strenuous efforts to reach an acceptable consensus but have failed because of what we feel are unreasonable demands and interpretations, then personally I think it's reasonable to move ahead with implementing language that we believe is appropriate.

We've made extensive efforts to accommodate Nutriveg's objections. However, one editor cannot be allowed to indefinitely stall progress with increasingly arbitrary obstructions (see WP:IDIDNTHEARTHAT). If Nutriveg continues to disagree with our collective interpretation of policy in this instance, then it would seem incumbent upon him/her to further pursue dispute resolution, for instance by soliciting additional outside input. That's how I would handle it, anyway. I agree that this has gone on long enough, and that beyond a certain point, humoring unreasonable objections turns into enabling obstructionism. MastCell ^Talk 18:25, 22 June 2010 (UTC)

LeadSongDog, I understand you don't like the "safer" discussion to continue, and would have no problem using the "lower mortality rate" and other editors (MastCell, RexxS) previously agreed with that. But "Objectivist" expressed disagreement and I was addressing his concerns.

Andrew c, since then we have reviewed many sources, and the word safer was rarely used in a worldwide context. If I recall correctly only the owner of an abortion clinic uses that, and without attributing the source. Yourself said that wouldn't join this source discussion, where we searched and discussed those sources. So now it sounds strange for me you came up here ignoring the discussion of the sources presented so far, making it sound like they used such word.

RexxS, in my commentary I dismissed Laube for the purpose you want to use it, together with you interpretation of [[WP:SYNTH]

MastCell, I'm probably the one more interested in accurate representing reliable sources, but that doesn't stop other people from saying the same thing while pushing for WP:OR at the same time, like the ongoing discussion with RexxS where he wants to use MMR as it was that data that based the author's conclusion. We can make progress if people demonstrate that purpose and we continue from the moment we last reached consensus, except for "Objectivist" opinion until later today, which was about using "lower mortality", not "safer". But if others until silent or agreeing users, show up just to ignore the progress we have made so far, and those points we have reached consensus and want to start discuss from the beginning like Andrew source discussion above, or want to use a catharsis moment to exclude another editor, like you're doing, it's unlikely we will reach progress that way. So what we need more is that the current editors collaborate instead of advertising the chaos or ignoring the points we have already reached consensus.--Nutriveg (talk) 22:33, 22 June 2010 (UTC)

MastCell's comment on 22:42, 15 June 2010 (UTC) seems to discredit your claim about the sources not using "safer". Does everyone else here agree with Nutriveg's assessment of the newer sources? (I checked the original sources that were in the article for years, and at least 2 of the 3 use the word "safer", but obviously so much has changed in the last decade, those sources are inaccurate and useless anyway). Also, I didn't know that owning an abortion clinic discredited someone from publishing peer reviewed/scholarly papers. That's like someone arguing that a Christian is automatically disqualified from publishing scholarly information about the historical Jesus (I work on those articles, and some people do try to make that claim!) Reviewing the past 4 days of conversation above, I don't think it's accurate to characterize the discussion as a group of editors working together to reach a consensus compromise. It seems like nonsensical arguing over basic policy points, and multiple editors accusing you of obstructionism, "quibbling", thwarting, etc. If I am mistaken, and everyone was working well with you to reach a compromise, I apologize, and I'll let your progress continue. I fail to see any "progress". I'm just going to back away and agree with MastCell that others are welcome to stop enabling obstructionism any time they wish.-Andrew c ^[talk] 23:17, 22 June 2010 (UTC)

Andrewc, my last discussion with MastCell, that worldwide secondary sources don't consistently use the word "safer" was in 19 June in the section just below Talk:Abortion#Proper use of secondary sources.

I'll take the opportunity to answer your question about that source using the same answer:

"eMedicine doesn't provide the source for that claim, so its unlikely to be classified as secondary, and the eMedicine author owns a clinic that execute abortions since 1973. Such claim is not consistently supported by the other sources that only mention "lower maternal mortality", so it would be at best WP:UNDUE to use those claims."

To summarize, the source has many problems and, beyond that, it would be undue to use that single problematic source to support a claim not supported by secondary sources.

In 19 June 2010, MastCell said: "I would be fine with a statement comparing the mortality rates of abortion and childbirth without using the word "safer". That looks like consensus about something.

So next time you decide to show up, check better what we had discussed after you decided to leave ("I don't have much time to contribute to this") when you were last asked to join the source discussion ("if you're still interested about the outcome of that discussion, I ask you to express your opinion").---Nutriveg (talk) 02:16, 23 June 2010 (UTC)

Let's be clear. I agreed to not use the word "safer" because I want this ridiculous waste of time to end. Not because I think your objections are reasonable (I don't), but because you are clearly so heavily invested that I'm looking for the path of least resistance and least damage to the article. I'm still not sure it was the right call - I'm a little concerned about enabling an endless stream of obstructionism, and this latest round of arguments substantiates that concern.

It doesn't make sense to disqualify a source because it's written by someone who performs abortions. Presumably, the people who are experts on the technique and risks of abortion are those who perform them. If a surgeon had never removed an appendix in his life, would you consider him a serious authority on the risks of appendectomy? MastCell ^Talk 03:57, 23 June 2010 (UTC)

Proper use of secondary sources

Most of the problems related to this maternal mortality from abortion versus from general causes (including childbirth) is how to represent that difference, most of the secondary sources just compare those different mortality rates as such "lower mortality rate" but a significant number of wikipedia editors want to advance that position and use the word "safer" instead, supported only by a few country specific or unreliable sources.

The reason we prefer to use secondary sources is not because they carry a more reliable nature, from being better peer/editorial reviewed than primary sources, but because they "(summarize) one or more primary or secondary sources, usually to provide an overview of the current understanding of a medical topic". We do not use secondary sources because their original claims carry more truth (which some here often call "facts") but because they better represent the "varying viewpoints". So it doesn't make sense to pick a (country specific or unreliable) secondary source that use the contradictory word "safer" (without even citing the sources it has based to make such claim) when that doesn't better describe what all the secondary sources are commonly saying "lower mortality rate". So the choice of a source to reference a text is not one of who "carries more truth" (or is believed to be more "factual") but which one is more consistent with all the others, in this case, so far, (Lloyd, 2005) is the one which better fits that need.--Nutriveg (talk) 18:18, 18 June 2010 (UTC)

English is a language rich in variety. It is that very fact that allows editors to summarise multiple reliable sources in order to create an article suitable for an encyclopedia. An editor who reads "A has a lower mortality rate than B" and writes "A is safer than B" is not guilty of WP:SYNTH, but is paraphrasing to avoid plagiarism and to make it simpler for a lay person to read. If you think that such a paraphrase is over-simplification, say so, but don't expect editors to accept that "safer" is somehow "contradictory" of what all of the sources say. --RexxS (talk) 19:07, 18 June 2010 (UTC)

It's not a matter of the English language but one of science. Epidemiology is the science that deals with such comparative analysis, when Wikipedia editors do such science by themselves they're doing WP:SYNTH. Unfortunately the editors doing such science don't have no idea about that otherwise they would have long recognized the problem.--Nutriveg (talk) 19:55, 18 June 2010 (UTC)

When you quibble over "is safer" versus "has lower mortality rate", then it is a question of language, not science. You've already acknowledged seeing Yanda use "safer" in an edipemiological analysis – or is that not science because he's talking about medical abortion? If you find yourself the only editor who thinks there's a significant difference between the two phrases, and make unsubstantiated attacks on other editors, it may be time to drop the stick and move on to more productive discussions. --RexxS (talk) 20:15, 18 June 2010 (UTC)

Understanding the problem with Yanda phrase is just one of language:

"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."

She makes clear in the beginning that the phrase is about medical abortion, she makes that even clear by mentioning "the method". Abortion is not a method but a procedure, medical abortion is a method. Applying something said about a specific method to the whole procedure is WP:SYNTH. If my argument about WP:SYNTH wasn't enough for you, in the US at least, maternal mortality from "medical abortion" is lower than "surgical abortion".

I would have dropped my point if the users so far supporting the "lower mortality rate between two distinct groups of people means safer" argument, so far RexxS and MastCell (which clearly said such thing) had some degree of knowledge about Scientific control to know how absurd is the WP:SYNTH conclusion they're proposing.--Nutriveg (talk) 21:06, 18 June 2010 (UTC)

So now it's the difference between "procedure" and "method"?

• procedure: 1. a way of acting or progressing in a course of action, esp an established method - Collins English Dictionary (quoted here)
• procedure: 1. A particular method for performing a task. Synonyms: (method): algorithm, method, process, routine – Wiktionary
• method: 3. The procedures and techniques characteristic of a particular discipline or field of knowledge - Collins English Dictionary (quoted here)

So what you're saying is that it's ok to use the word "safer" for a method, but not for a procedure? --RexxS (talk) 21:47, 18 June 2010 (UTC)

If you can't even interpret that phrase then we really have a problem here. Medical abortion is the subject of the phrase, it's mentioned twice one as "medical abortion" and other as "the method".

If you still fail to understand "method" as "medical abortion" maybe you should go to the text and read the next phrase: "Surgical abortion remains the primary method of abortion, though medical abortion accounts for 40% of all procedures"--Nutriveg (talk) 22:17, 18 June 2010 (UTC)

So what you're saying is that although you accept that we can say "medical abortion is safer", we can't say that "abortion is safer", but we can say "abortion has a lower mortality rate"? Can you see how ridiculous that sounds? --RexxS (talk) 22:40, 18 June 2010 (UTC)

I agree that the source says "medical abortion is safer", but I don't know how that compare to other sources comparing both since we have been so far looking for sources about Abortion not Medical abortion.

I definitely agree we can cite "abortion in developed countries has a lower maternal mortality rate than childbirth" since that has been consistently supported by sources. However I disagree with saying it's "safer" because that's WP:SYNTH since those rates talk about distinct groups of people and such comparison could only be done after statistical adjustment by an external source!--Nutriveg (talk) 22:57, 18 June 2010 (UTC)

Thank you - that is helpful, and I sincerely mean that. Would it be correct to say that you would accept we can say "abortion in developed countries has a lower maternal mortality rate than childbirth", but we can't say "abortion in developed countries is safer than childbirth", because the two statements have different meanings? --RexxS (talk) 23:07, 18 June 2010 (UTC)

They do have different meanings, that is very clear to those with knowledge of the science that should support such statements. We should mention the first phrase because it has been consistently supported by the reliable updated sources presented so far, while the later was supported by only a few country-specific or unreliable ones. And such second phrase doesn't contradict the claims supported by the first one, while the inverse is not necessary true.--Nutriveg (talk) 23:17, 18 June 2010 (UTC)

Thank you again, could you then put your finger on what the difference between the meanings is? --RexxS (talk) 00:12, 19 June 2010 (UTC)

Lower mortality data rate means there's lower mortality between two different groups of people (where those two groups may or not share similar characteristics).

Safer, in the mortality context, would mean something like this: in two statistically identical groups, abortion and childbirth, where a control group (no pregnancy) would also be used, there's lower mortality (per procedure) in the abortion than in the childbirth group and such difference is statistically significant even after elimination of possible confounding factors. Several such epidemiological studies are performed/reviewed and they reach similar conclusions. At that point it would be classified as "probably safer". While/after other scientists would try to identify the mechanism that could justify the difference, relying on scientific knowledge and laboratory studies, when they agree between themselves and with the epidemiological studies, then that would be classified as "safer". That's what I understand by "safer".--Nutriveg (talk) 01:20, 19 June 2010 (UTC)

Well, the authors of UpToDate and eMedicine understand is that abortion is "safer" than childbirth. Generally, their understanding counts for more than yours or mine. Nonetheless: do I understand correctly that you would be OK with a statement comparing the risks of death from abortion and childbirth, as long we do not use the word "safer"? MastCell ^Talk 04:38, 19 June 2010 (UTC)

UpToDate, uses US data, eMedicine doesn't provide the source for that claim, so its unlikely to be classified as secondary, and the eMedicine author owns a clinic that execute abortions since 1973. Such claim is not consistently supported by the other sources that only mention "lower maternal mortality", so it would be at best WP:UNDUE to use those claims.

If you didn't read my suggestions so far I'm ok in citing the data as it is "lower maternal mortality". I don't agree is using the word safer by the explained reasons.--Nutriveg (talk) 12:24, 19 June 2010 (UTC)

I've read and now understand your explanation, and I can see how we have had a problem in communication. As a matter of good faith, I fully accept that you have a very precise definition of "safer", but I hope that you can accept that it is an idiosyncratic use of the word, not shared by many. That's not a criticism, merely an observation that different people can read different meanings into the same word.

Another point: Having discussed this with a real life friend who has lived in the US, I'm informed that the phrase "abortion is safer than childbirth" carries connotations that the phrase "abortion has a lower mortality rate than childbirth" does not, and that the connotations are much more significant to some than a difference in meaning. It seems that the first phrase carries with it an implied endorsement of the pro-choice position. I don't pretend to understand the strength of feeling in the pro-choice/pro-life division, but if that is actually part of your objection, then I'd support you on those grounds alone: there's no need to use phraseology that carries "baggage" when a neutral phrase is available. Disclaimer: Those positions have little or no currency where I live, and I have no desire to promote either on Wikipedia. --RexxS (talk) 14:56, 19 June 2010 (UTC)

If I Google abortion "safer than childbirth", the first 2 pages of hits are virtually all pro-life websites making (largely incorrect) assertions about the dangers of abortion. So I wouldn't say that "safer than childbirth" is a pro-choice talking point. It seems more correct to say that the pro-life lobby considers it very important to make abortion seem dangerous (based on the search engine results).

However, I appreciate RexxS' desire to avoid unnecessary conflict. I would be fine with a statement comparing the mortality rates of abortion and childbirth without using the word "safer". Perhaps such language should be discussed here to avoid edit-warring? MastCell ^Talk 19:08, 19 June 2010 (UTC)

Yes there is not the same controversy surrounding this procedure outside the United States. I am not sure what the objects are to this wording but if it because it carries more significance I am sure we can figure out something that works for everyone.Doc James (talk · contribs · email) 06:47, 20 June 2010 (UTC)

Arbitrary break 2

Well, since that problem looks to have been resolved between the editors so far objecting that earlier suggestion then what would be the problem with:

• "In developed countries the maternal death rate from abortion is below 1 in 100,000 procedures, lower than the rate for childbirth and general pregnancy, which is already low."

--Nutriveg (talk) 17:19, 20 June 2010 (UTC)

It's a reasonable starting point. My quibbles are that it's very vague and innumerate, and does not describe the risk of childbirth in either relative or absolute terms, thus leaving a reasonably sophisticated reader to wonder. I would rather specify either the relative risk of childbirth compared to abortion, or the absolute risk (and leave the reader to compare using their own metrics). This is typically the approach taken by reliable sources.

Also, the writing is a bit awkward (too many comma-separated clauses), and the word "low" is repeated too often. Also, "general pregnancy" should be removed, since it's vague (what is "general" pregnancy?) and the risk in question is associated specifically with childbirth. MastCell ^Talk 18:18, 20 June 2010 (UTC)

May I try? A possible simple and direct reword:

• "In developed countries, fewer than one woman dies per 100,000 abortions; this is lower than the already low rate of maternal deaths in childbirth in these countries."

(This moves the word maternal nearer to childbirth, where I feel it belongs. A 14-year-old aborting in the first 8 weeks is hardly a maternal person.) Hordaland (talk) 18:56, 20 June 2010 (UTC)

What sources would you suggest to cite for these two suggestions? --RexxS (talk) 19:48, 20 June 2010 (UTC)

MastCell, The risk of maternal mortality from childbirth or pregnancy is described as "low", as by the source. I don't think it would be easy to find the number you want since the data is usually collected as maternal mortality as defined by WHO/ICD, which is readily available, instead of that other you're looking for.

This article is about abortion, this sentence is about abortion mortality, there's no need to display childbirth or pregnancy mortality numbers, otherwise that would be WP:Undue. Only few sources cite a number.

The mention of "general pregnancy" is because both childbirth and abortion is pregnancy, so there's a need to differentiate. Sources cite childbirth, pregnancy or both, not just childbirth.

Hordaland, your suggestion looks OK, I just need to check how many sources cite just pregnancy. Maternal was used by WHO definition of maternal mortality, that's about any gestational age. Citing woman may sound abortion is sex-selective to an unaware reader, but since the number is very low and maternal mortality is mentioned afterward I don't think that would be a problem.

Rexxs, so far Lloyd,2005 is a secondary source that supports both suggestions.--Nutriveg (talk) 20:00, 20 June 2010 (UTC)

The figure that MastCell suggests to include is easy to find for 2005 from WHO: 9 maternal deaths per 100,000 live births (although Lloyd incorrectly uses "risk" to describe both of these ratios). --RexxS (talk) 20:36, 20 June 2010 (UTC)

Which source says that? From what you say that number is for maternal death, by the WHO definition which I'll paste here since so far some are still failing to understand:

"the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes"

That doesn't include only deaths from childbirth procedure, but to many causes, including abortion. That MMR number doesn't use childbirth procedures or number of pregnancies to calculate the ratio, but the number of live births. While the abortion numbers use the number of procedures to calculate the ratio. See the problem again of comparing different groups? --Nutriveg (talk) 21:20, 20 June 2010 (UTC)

The source is http://www.who.int/whosis/mme_2005.pdf p.16. That's the maternal mortality ratio as defined by the WHO as I understand it. Lloyd says "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" - if the "relatively low risks associated with pregnancy and childbirth" isn't MMR, what is it? Obviously there are two different groups, since one outcome precludes the other. Lloyd makes the comparison, not me. --RexxS (talk) 22:55, 20 June 2010 (UTC)

How about:

• "The risk of dying from abortion in developed countries (less than 1 in 100,000 procedures) is lower than maternal mortality from pregnancy and childbirth (9 per 100,000 live births) in those countries"

to make it clear what is being compared? --RexxS (talk) 23:17, 20 June 2010 (UTC)

(edit conflict)Yeah as expected, that number is not just about childbirth, as by Hordaland suggested text, it includes other causes of maternal death (including abortion), it's not just about different causes but also using a different ratio: not procedure, not pregnancies. Obviously the sources had more data than you, they weren't relying simple in WHO, that was necessary to calculate how many of those registered maternal deaths were caused by abortion so they probably had an idea about other numbers involved, where they had shown no effort to describe those numbers more than necessary or to be "exact", even if you understand the other number, less than 1 as "exact". I repeat, we shouldn't cover this issue more than the sources themselves.--Nutriveg (talk) 23:25, 20 June 2010 (UTC)

RexxS, as explained that's original research, you're using a number not used by the source itself, the second number includes the first, the chosen developed countries are different, the ratio is different, the years are different (7 years at least), description "from pregnancy and childbirth" don't match the definition, you don't know what data was used to compare... Are you still not convinced that we shouldn't do WP:OR no matter how much some editors want that "the source should have said that".--Nutriveg (talk) 23:43, 20 June 2010 (UTC)

I used the number supplied by another reliable source for MMR, what wrong with that? The years are the same (2005). The second number does include the first - that's clear from the definition of MMR, but it's the same comparison that Lloyd makes. The words "from pregnancy and childbirth" are the ones Lloyd used, and you've already pointed out that's what the WHO definition covers. Lloyd did the comparison, not me; I have to accept the conclusions of a reliable source, not try to work out whether they are valid or not. I strongly believe we shouldn't do OR, but that's not what I've done. I've only used the same arguments that the reliable sources do. --RexxS (talk) 00:26, 21 June 2010 (UTC)

You're assuming the WHO data was the raw data used by the researcher who had the same limitation as you (of not having detailed data), which is clearly not the case since they had maternal mortality data from abortion for the same "representative developed countries" which the author call "these countries". Lloyd,2005 is a secondary source, while you're a wikipedia author giving another meaning to primary data. This is WP:OR and it's sad how you don't recognize that.--Nutriveg (talk) 01:31, 21 June 2010 (UTC)

Well, no. Lloyd is talking about MMR, isn't she? What do you think she's talking about? --RexxS (talk) 01:36, 21 June 2010 (UTC)

Would:

• "In developed countries, deaths occur in less than 1 in 100,000 abortions, versus the relatively low maternal mortality ratio of 9 per 100,000 live births."

be clearer? --RexxS (talk) 02:07, 21 June 2010 (UTC)

If you don't care to read the text, Lloyd 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)"

It talks about "pregnancy and childbirth" it doesn't talk about MMR or would make sense to mention it since that also includes deaths from abortion, it's obvious to anyone that first number would always be lower than the second and that phrase wouldn't be meaningful. The source had data you don't have, otherwise it wouldn't be able to distinguish deaths from abortion from other causes of maternal mortality, the source decided it was not important to publish those numbers, maybe because it just got an rough idea of that number. Please accept that and respect WP:DUE and WP:OR.--Nutriveg (talk) 13:21, 21 June 2010 (UTC)

But I'm not the one who has decided that when Lloyd uses the word "risk", she means "maternal death rate" - you are! Look at your suggestion from above:

• "In developed countries the maternal death rate from abortion is below 1 in 100,000 procedures, lower than the rate for childbirth and general pregnancy, which is already low."
• ""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)" added for comparison (my emphasis) --RexxS (talk) 23:38, 21 June 2010 (UTC)

Why do you think you can accuse me of OR, when you're the one who made the interpretation of what the source said? --RexxS (talk) 15:31, 21 June 2010 (UTC)

"Maternal death" is the normalized term for the death of a women while/after pregnant, the definition is linked I just used the technical definition. "Rate" is just a word meaning amount, it can omitted from the phrase if you will.

On the other hand "Maternal Mortality Ratio (MMR)" is a measure defined by the WHO. Its name is derived from "maternal death" but that's a different term which a very specific meaning. You interpreted those two terms as if they had the same meaning, but they don't, the second just derives from the first.--Nutriveg (talk) 22:08, 21 June 2010 (UTC)

Nice try, but that's just bluster. You made the connection between "risk" and a completely imprecise term: "maternal death rate". We all know how "maternal death" is defined (and it is obviously not what Lloyd is referring to), but there's no definition of "maternal death rate". There's no such thing as a "normalised term" in MEDMOS either. I am equally free to make the connection between "risk" and "maternal mortality ratio" - MMR does exist, as it's defined by WHO and has a section in Maternal death on Wikipedia. On the other hand, anyone familiar with the topic will know that "maternal mortality rate" is defined by the WHO to be "Number of maternal deaths in a given period per 100,000 women of reproductive age during the same time-period" - a completely different thing and impossible to be confused with MMR.

Now let's move forward: you make an assumption about what Lloyd means by "risk"; I make another assumption about what Lloyd means by "risk". So either withdraw your accusation about OR (because if I'm guilty, then you are), and we'll thrash out which wording better reflects what Lloyd said; or withdraw your suggestion because it's OR (and I'll do the same), and we can agree that Lloyd is not suitable because "Article statements generally should not rely on unclear or inconsistent passages nor on passing comments. Passages open to multiple interpretations should be precisely cited or avoided." (WP:No original research). Make your mind up. --RexxS (talk) 23:38, 21 June 2010 (UTC)

You're making me sound like I strongly support the use of the word "rate", which I clearly pointed above I don't. I'm not pushing a "term": "maternal death rate". They are just two distinguish terms that were put together by chance "maternal death" and "rate". We can change "rate" back to "risk" if you think that's so different. But you can only make me laugh when you say Lloyd wasn't "obviously" talking about maternal death. I just used the medical standardized term (maternal death) for such event (death of a pregnant woman). What do you want to justify with such absurd arguments? That you're free to make WP:OR by presuming the data used by the authors to conclude the risk is lower. No you're not.

I rephrased mine and Horland suggestions to replace the word "rate" with "risk" so I expect you to abandon those WP:OR intentions and we could move on just following the sources.

• "In developed countries, the risk of a women dying from abortion is fewer than 1 per 100,000 procedures; this is lower than the already low risk of maternal deaths in childbirth in these countries."
• "In developed countries maternal death risk from abortion is below 1 in 100,000 procedures, lower than the risk for childbirth and general pregnancy which is already low."

-Nutriveg (talk) 15:19, 22 June 2010 (UTC)

Nutriveg, I too had a good chuckle when I saw your attempts to do anything to avoid the fact that Lloyd is talking about MMR. Please understand that Wikipedia is not the place to start inventing your own terms: first "maternal death rate", now "maternal death risk". "Maternal death" is an event, a single datum point; while the other three defined terms are statistical measures of its prevalence. Maternal mortality ratio is the number of deaths per 100,000 live births. Maternal mortality rate is the number of deaths per 100,000 women of reproductive age. Lifetime risk of maternal death is the probability of dying from a maternal cause. Those are three different metrics, and they are the ones the rest of the world uses - the "medical standardised terms" in fact. There is absolutely no need to start inventing our own ill-defined terms in an effort to avoid having numbers that can be used. I expect you to acknowledge that your suggestion contains more WP:OR than mine did, and to abandon Lloyd as a source because of its lack of clarity. Then we can indeed move on to summarising the unambiguous sources. --RexxS (talk) 17:19, 22 June 2010 (UTC)

While it might not have been so cited, "maternal mortality rate" is defined here and more generally here on MedTerms, at MedicineNet.com for what it's worth. LeadSongDog come howl! 19:12, 22 June 2010 (UTC)

Thank you, LSD - that definition coincides with the WHO definition of "maternal mortality ratio" (Maternal Mortality in 2005, p.5), where they provide a different definition of "maternal mortality rate". Our article on Maternal death also has a section on Maternal Mortality Ratio (MMR) and provides the same definition. I think that the lesson here is to stick with terms that are unambiguous where possible, and to prefer terms that have a single definition where there is a choice (even it it does mean we have to figure out which one the sources are referring to). --RexxS (talk) 20:09, 22 June 2010 (UTC)

RexxS, the source was not talking about MMR. MMR includes all causes of death (including abortion) while he had detailed numbers (deaths caused by abortion). Don't you see how meaningless would be to say F (which is the sum of the positive numbers A, B, C and D) is higher than A?

LeadSongDog, I think you can get a better source than that website reviewed in 1998. The combination of words ""maternal mortality" + "rate" was just a coincidence I made while rephrasing the sources and carries no other meaning, like RexxS implying it was another term "Maternal Mortality Ratio (MMR)" (which you can surely find better sources for that). And was using that number as the one used by the authors to make the "lower mortality" conclusion.

RexxS "Maternal Mortality Ratio (MMR)" derives from "maternal death" not the opposite.--Nutriveg (talk)

Nutriveg, don't you see that your example is precisely the reason that we should give the absolute numbers, since the reader can then clearly see that B+C+D is much bigger than A ("7 is much more than 1, just as 8 is much more than 1", in this case). It would be deceptive to omit the fact that MMR is often a magnitude of order greater than the equivalent ratio due to abortion. It is utterly bizarre to create an undefined term ""maternal mortality" + "rate" and ascribe it to a source, and then to accuse me of WP:OR!! As for the derivation, I've patiently explained to you that MMR is the number of maternal deaths per 100,000 live births several times; you should be able to see by now that MMR is not the same thing as maternal death, and that Lloyd was was talking about the ratios, not the total number of events, or even "lifetime risk of maternal death" (both of which would be meaningless in that comparison). You're the one who's "rephrasing the sources", so answer the question: When you were rephrasing, what did you think Lloyd mean by "risk"? --RexxS (talk) 00:07, 23 June 2010 (UTC)

We don't do original research here choosing our own numbers and putting them together just because that sounds better. The authors were writing about abortion mortality and used childbirth/pregnancy mortality just to say how low it was. They had no intention of strictly assessing risk of childbirth versus abortion, they just gave a rough idea, that's probably because they didn't cite numbers. It's WP:Undue to over represent that specially by adding WP:OR. There are many things that carry a higher mortality risk than abortion. We don't need to cite them all, we don't need to detail them all, I don't see why you're making childbirth such a special case.

I pointed MMR problems: on one side (of the deaths) it includes deaths from many causes including abortion (so, naturally a higher number), on the other side (of the cases) it counts only live births not all pregnancies (so a lower number). Just to point how problematic WP:OR can be. But you don't need to convince me that's a good comparison, we just cite the sources here and sources saying mortality is lower don't use such number, specially one you choose yourself.

I don't see why you're creating so much problem about the use of those two words together, that was merely accidental, carries no specific meaning when put together, except for careless readers looking for information by themselves instead of relying on the provided sources, which mistook "Maternal Mortality Ratio", a WHO defined statistic, with "maternal death rate". Even when the interlink provided, by marking only "maternal death", shows that's simple a medical term next to a word, "rate", used merely to describe "1 per 100000" (a rate). Where that word can be suppressed, inverted "rate of maternal mortality", replaced with "risk" and I won't make a problem about that change, right in the opposite, I immediately suggested a change to address your concerns when you expressed it.

On the other hand you continue to pushing for the use of your WP:OR

Answering your question Loyd used "risk of dying" and "risks" I interpret that second word "risks" was short for the first term "risk of dying", where the plural "risks" was used because it was about two things "pregnancy and childbirth".--Nutriveg (talk) 01:52, 23 June 2010 (UTC)

Moving on towards a baseline version

After all these discussions we have had so far, recently I only saw a couple people disagreeing with the last suggested version and they only wanted to "add more" to that version ("include numbers" or add "safer" instead of "lower mortality risks"), without rejecting that version as inappropriate. Since it's impossible to find a perfect version at first try, we need to move on towards a baseline version we can work from instead of going backwards everytime a new person joins this discussion. That said I'll move on and be bold adding the Hordaland (changed) suggestion to the article.--Nutriveg (talk) 19:10, 24 June 2010 (UTC)

There's no consensus for the version added to the article. Get consensus by proposing changes here before you modify text and remove reliable sources. --RexxS (talk) 20:56, 24 June 2010 (UTC)

Just posting to second this request. We've had enough bold edits and reversions for a while. Let's discuss the problems and find a good compromise. SHEFFIELDSTEEL^TALK 21:05, 24 June 2010 (UTC)

Well, if no one opposed Horland suggestion and other editors only wanted to add more, then there was consensus about a starting point. If you think otherwise please say what's the problem with that version by itself, not how you think it could be better.--Nutriveg (talk) 11:49, 25 June 2010 (UTC)

If you want to start from scratch, why not revert back to the version that was in the article for years: Early-term surgical abortion is a simple procedure which is safer than childbirth when performed before the 21th week.[31][32][33] But really, why even do that? Removing any reference to the comparison because you guys have some minor quibbles is disruptive. It appears there has been some progress, scores of news sources, and more data added. I see no reason to remove that outright simply because one person doesn't like some minor aspect. Discuss whatever changes you feel need to be made here, and keep working on improving it. You don't get to blank the section just because an edit you tried didn't work out. Maybe take it as a minor set back, but keep working on it. -Andrew c ^[talk] 20:12, 25 June 2010 (UTC)

Lead

The lead per WP:LEAD should have 3 or 4 paragraphs. I therefore added one based on 2009 /2010 reviews regarding epidemiology.Doc James (talk · contribs · email) 18:57, 15 June 2010 (UTC)

Organized and moved some content to subpages

I have organized and moved some content to the subpages. Does anyone know how to fix the ICD 10 link in the lead? Doc James (talk · contribs · email) 19:49, 15 June 2010 (UTC)

 Done --RexxS (talk) 21:46, 15 June 2010 (UTC)

Doc James, would you please describe or summarize the material that you have removed from this arrticle? Generally speaking, longstanding material should not be removed from this article without consensus, and there can't be consensus if people don't know what's happening. For example, your edit summaries did not give any clue that you were removing a longstandng image (the edit summary merely said that images were being moved around so the page would look better). This is obviously a very controversial article, so the more transparency the better. Incidentally, I hope you will restore the stuff you have removed, so that you can describe, summarize, and gain consensus. Thanks.Anythingyouwant (talk) 23:50, 15 June 2010 (UTC)

I see the article went from 91,841 to 75,697 in size, while he said to have created at least two paragraphs, I followed his changes a little bit and didn't see any problem until what I saw but then I got lost with so much change. I don't think a full revert is necessary but I'm not a regular editor of this article anyway.--Nutriveg (talk) 00:38, 16 June 2010 (UTC)

It can be easily seen by look at the edits. Mainly I updated a bunch of stuff. And move some stuff to its subpage. Doc James (talk · contribs · email) 02:02, 16 June 2010 (UTC)

Pic removal

This edit removed a picture that had been in this article for quite while. In contrast, the edit summary merely said that pics were being moved. I did not notice any discussion about this here at the talk page either before or after the pic removal. Wazzup?Anythingyouwant (talk) 21:26, 15 June 2010 (UTC)

See previous section, I think. SHEFFIELDSTEEL^TALK 21:46, 15 June 2010 (UTC)

My concern is having a demonic abortion being the top level image in the infobox... -Andrew c ^[talk] 22:59, 15 June 2010 (UTC)

I agree Andrew c. The demonic image should not be at the top. Would one of the admins revert the article back to what it was at the beginning of the day?I'm concerned about massive removal of longstanding material, inadequate edit summaries, and lack of consensus.Anythingyouwant (talk) 23:58, 15 June 2010 (UTC)

Unless someone beats me to it, I'm going to revert the article back to what it was earlier today. Ample reasons have already been explained above, and more reasons are tied to the specific edits.Anythingyouwant (talk) 01:15, 16 June 2010 (UTC)

I think you should try to perform a diff and restore only those sections where change is not clear, tagging such restore as so in the edit summary.--Nutriveg (talk) 01:22, 16 June 2010 (UTC)

I do not know what you mean by "change is not clear." By reverting to the version of earlier today, we would allow editors to propose changes here at the talk page and seek consensus. This is a controversial article, and it will quickly become unstable and chaotic if editors make huge changes without discussion, and without even accurate edit summaries. If you are objecting to the revert I propose, then I will simply do nothing.Anythingyouwant (talk) 01:34, 16 June 2010 (UTC)

The picture is on the subpage as I stated. Having two images that are nearly the same adds little. Doc James (talk · contribs · email) 02:01, 16 June 2010 (UTC)

You may get consensus on that point if you ask for it. I would agree that having an image appear twice in a single article adds little, but that's not the case here at all.Anythingyouwant (talk) 02:18, 16 June 2010 (UTC)

AYW, Ok, as I've already said I've edited only a specific section of this article and don't have a good idea about the other sections content, their edit history and how they integrate so I can not put myself in a position to see those changes the same way as you see them. I only need to alert you the editing environment in this article has not been good in the last few days with a couple of editors trying to resolve content issues by asking administrator "support" against users they see as problematic. So don't hesitate to request article protection if you see things are going out of control.--Nutriveg (talk) 02:09, 16 June 2010 (UTC)

It would be good if you look at the changes that were made. Doc James (talk · contribs · email) 02:11, 16 June 2010 (UTC)

I did look at a bunch of the changes, and others have as well. People don't agree with what you've done with the images, and there are problems with the text as well (e.g. in your first edit you present as undisputed that abortion laws do not affect the number of abortions). Doc James, I know using the talk page can be frustrating, but it's the only way at an article like this. I'm going to restore what was in the article this morning.Anythingyouwant (talk) 02:29, 16 June 2010 (UTC)

(Just saying...) I looked at the article last week, and though the two embryo/fetus images as the first images was a bit much, and was debating removing one myself. I agree with the Doc regarding Having two images that are nearly the same adds little. -Andrew c ^[talk] 02:52, 16 June 2010 (UTC)

I gathered from what Doc James said above that he didn't think it was good to have the same image in both this article and a sub-article. But now that you mention it, maybe he was referring to having both the fetus pic and the embryo pic in the present article.

These two pics have been in the article for quite a while, the embryo pic a bit longer than the fetus pic. The embryo pic is of a spontaneous abortion, whereas the fetus pic is of an induced abortion. If we had to get rid of one of the pics, then I'd agree that the fetus pic is somewhat better for this article. But not only do they illustrate different developmental stages - they also illustrate totally different types of abortion (spontaneous v. Induced).

If we select a top pic that is not one of those two images, then there would no longer be the issue of them being the first two images. So can we talk about the top image? Are you working on another drawing Andrew c? Or maybe we could have the embryo pic be the top pic, and choose some other image to go between it and the fetus pic.Anythingyouwant (talk) 03:19, 16 June 2010 (UTC)

I removed one of the images for two reasons. 1) Both were nearly them same. 2) One of the images was already on the subpage so I removed that one rather than the other one. Doc James (talk · contribs · email) 03:28, 16 June 2010 (UTC)

I was thinking about what sort of image this article was missing, and you know, I don't think we have enough pictures of Hitler in this article. Perhaps the top level picture could be der Führer (I'm entirely kidding, but I just glanced at conservapedia's article on this topic... and wow)-Andrew c ^[talk] 04:21, 16 June 2010 (UTC)

I do not believe it. Concervapedia does not have ONE picture of Hitler but TWO. Thank god the truth has a liberal bias :-) Doc James (talk · contribs · email) 04:33, 16 June 2010 (UTC)

Yeah, they should replace one of the Hitler pictures with a picture of Satan or maybe Richard Dawkins, since they seems quite obsessed with him (like there is a difference between the two).-Andrew c ^[talk] 15:13, 16 June 2010 (UTC)

They however do have an ultrasound image supposedly showing Jesus Christ [28]. Definitely fair and balanced. Doc James (talk · contribs · email) 20:34, 16 June 2010 (UTC)

In all seriousness though, there probably should be a pic. - Schrandit (talk) 06:18, 18 June 2010 (UTC)

Top pic

I've reverted per WP:BRD. By restoring what was in the article earlier today, I hope I didn't inadvertently do too much. Doc James, would you like to start by discussing which pic you think should go at the top and why?Anythingyouwant (talk) 02:43, 16 June 2010 (UTC)

You have removed half a dozen current references. Therefore I have restored them. If you disagree with specific changes discuss them.

I have also fixed the formatting on a number of images.Doc James (talk · contribs · email) 03:24, 16 June 2010 (UTC)

Nope, you're now edit-warring to remove lots of material that has been in this article for months or years, and edit-warring to insert your new POV material. Please see WP:BRD. I'm not going to undertake the kind of persuasion that you have declined to engage in.

I also won't edit-war about this. I have already seen at the fetus article that Wilipedia rules mean little at articles like this. I've had my say, now do as you please. Cheers.Anythingyouwant (talk) 03:37, 16 June 2010 (UTC)

It is unclear if you even read the changes I made. Removing half a dozen references to the peer reviewed literature and a number of updated references with out mentioning why is a little strange. Please be selective in what you do.

You have missed the discuss part as you have not given any reason for the above. You have also not mentioned the improved formatting of the images or the movement of the some the material regarding the abortion debate to the appropriate subpage.

Would you please outline the POV material you say I added?Doc James (talk · contribs · email) 03:41, 16 June 2010 (UTC)

Discuss comes after revert, and I'd be glad to discuss things in any order you like, as long as revert comes first.Anythingyouwant (talk) 03:51, 16 June 2010 (UTC)

You have not discussed you just reverted all changes. This is not how it is done. Most of the changes are completely non controversial and improved the page. Most are completely self explanatory.Doc James (talk · contribs · email) 03:55, 16 June 2010 (UTC)

I've given several examples of why I find your bold edits problematic, and I've offered to discuss them one-by-one with you if we can get past the "R" in "BRD". But since we are never going to get past the "R" I don't feel the need to give you an elaborate "D". Cheers.Anythingyouwant (talk) 04:06, 16 June 2010 (UTC)

Culwell

As discussed above, an editor has overhauled this article, while declining to accept a revert while discussion occurs. I suppose that it will now be necessary for me to obtain consensus to remove material, which is the opposite of how Wikipedia is supposed to work.

The lead of this article now cites an article by Culwell et al. The four lead authors are from the International Planned Parenthood Federation, which is a pro-choice organization. Are people opposed to letting readers know this in our footnotes? If so, then I may bring this up at WP:RS; while information about authors' affiliations should not necessarily be required in the footnotes, it should be allowed.

Additionally, citing an article like this which costs $31.00 via the internet seems unnecessary, unless no free source is available on the internet. So, I intend to bring up at WP:V whether verifiability would be enhanced by requiring editors who cite material like this to first determine whether a free reliable source is available on the internet (and if so to cite that instead, or additionally).Anythingyouwant (talk) 01:57, 24 June 2010 (UTC)

In reverse order, I'll see your WP:V and raise you a WP:PAYWALL! As for Culwell: is the content itself disputed? if so, we shouldn't include it in the first place. Do you have a better source? If you don't like the source, but don't dispute the content, you are more then welcome to find another source, but if the content is fine, then locating redundant sourcing seems almost trivial/moot. I mean, I'd encourage you to find another source, but if you aren't disputing the content in the first place, I don't think it is worth fussing over here on a talk page. If other editors want to help find sources that say the same thing that are either free and/or not affiliated with controversial(?) organizations, then that's great, but I don't think that would be a good use of my person time. Sorry ;) Finally, do you have evidence their affiliation or political views affected their research? Did they declare a conflict of interest? (I'll help you out since I have full access to the text, under the header "Conflict of interest" it says The authors declare no conflict of interest.) Is there reliable sources responding to this article in regards to affiliation and/or conflict of interest? If not, then there is no reason for me to support including a footnote saying they are pro-choice (if that is the case). It seems like well poisoning, and very suspicious. It's like a disclaimer, and I have no idea what the disclaimer would be implying (that their research should be questioned because they are in league with Satan??) If reliable sources don't make the connection somehow, it is inappropriate for us to do it. I'd welcome 3rd opinions from any of the various message board you mentioned above!-Andrew c ^[talk] 02:26, 24 June 2010 (UTC)

Andrew c, first of all, I am disappointed but not surprised that you don't seem to care whether this Wikipedia article has been overhauled without consensus, and that these edits were edit-warred back into the article. This is against WP:BRD, but entirely consistent with practice at this particular article. By the way, your own comments about Hitler and Conservapedia ought to be removed from this talk page per WP:Not a forum (or at least Godwin's law).

Anyway, regarding Culwell, I never said that a $31.00 reliable source shouldn't be used here. I just said that maybe an editor who wants to use it should check whether there's an alternative reliable source that's free on the internet. WP:V says: "The principle of verifiability implies nothing about ease of access to sources: some online sources may require payment, while some print sources may be available only in university libraries." Maybe this statement ought to be modified as suggested above.

Further regarding Culwell, I know that some of what's cited in this article to Culwell is disputed. For example, there's a huge controversy about whether the number of abortions in the USA shot upward when Roe v. Wade was decided. That in itself may not necessarily mean that Culwell should be omitted, but certainly the present wording in our article is slanted.

And further still regarding the Culwell article, the authors declared no conflict of interest, but also declared their employment at Planned Parenthood. If this were an article by a bunch of NRLC employees I would feel exactly the same way: their affiliation may not be required in our footnotes, but it ought to be allowed for the benefit of Wikipedia readers. So I think it's an excellent issue to bring up at WP:RS.Anythingyouwant (talk) 02:59, 24 June 2010 (UTC)

Your objection to the authors' affiliation with Planned Parenthood is fairly easily addressed. The fact that making abortion illegal does not decrease abortion rate is virtually unanimous among scholarly sources, and is not unique to PP. If you'd prefer, we could cite the World Health Organization (e.g. PMID 20085681: "Legal restrictions on safe abortion do not reduce the incidence of abortion. A woman's likelihood to have an abortion is about the same whether she lives in a region where abortion is available on request or where it is highly restricted.") MastCell ^Talk 04:31, 24 June 2010 (UTC)

I am reluctant to research this issue, or argue about it, because the article is developing ass-backwards, so to speak. An editor edit-wars huge changes to the article, disregarding consensus, BRD, and the rest, and this shifts the burden to anyone who disagrees with the huge changes.

Whether you meant to or not, MastCell, you've just cited an article which is available on the internet for free.[29] Hurray! So, it would be a much better source than the $31.00 source by Planned Parenthood that is now cited in the lead.

On the other hand, the point at issue is highly disputed. The source that you cite does not say that its conclusions are "virtually unanimous among scholarly sources" as you assert. In fact, it's hard to see where the source you cite even gets its conclusions from. The issue here is what happens in a single country when abortion is made illegal, and I don't see what can be learned from comparing different countries while they do not change their laws; different countries that have very similar laws may have very different abortion rates due to cultural and other factors.

I'm not going to spend much time researching this, because the cart is before the horse. But glancing briefly at online sources, I find....

“With the introduction of legal abortion on demand through the 1974 abortion act, the abortion rate [in Singapore] rose sharply...." Population policies and programmes in Singapore, page 58 (2005).

“[M]any women were having abortions before abortion was legalized, but...the numbers increased, perhaps by about a third [in New York].” Decoding abortion rhetoric: communicating social change, page 203 (1994).

"The legalization of abortion in the United States is well known to have led to changes in reproductive behavior. Birthrates declined by about 5-8% as a consequence of abortion legalization." Did Abortion Legalization Reduce the Number Of Unwanted Children? Evidence from Adoptions (2002).

The pro-life camp chimes in here.

Legalization of abortion makes it safer and cheaper, so it would be almost nonsensical if it did not increase the abortion rate. Some scholars say that legalization of abortion in the US resulted in a tenfold increase in the number of abortions. See Syska, Hilgers & O'Hare, An Objective Model for Estimating Criminal Abortions and Its Implications for Public Policy, in New Perspectives on Human Abortion 178 (Hilgers, Horan & Mall eds. 1981).

I could find lots more sources, and better ones too, but I'm very disenchanted with the way this editorial process is going. Spinning wheels is a drag. But not as much of a drag as the lead of this article, which is biased.Anythingyouwant (talk) 07:34, 24 June 2010 (UTC)

I'm happy to have a source-based discussion. Secondary sources that are recent and global in scope seem to conclude that abortion rate is not affected by the legality of the procedure:

• WHO 2007: "Legal restrictions on abortion do not affect its incidence."
• PMID 17933648 (Lancet 2007): "The findings presented here indicate that unrestrictive abortion laws do not predict a high incidence of abortion, and by the same token, highly restrictive abortion laws are not associated with low abortion incidence. Indeed, both the highest and lowest abortion rates were seen in regions where abortion is almost uniformly legal under a wide range of circumstances." Secondary source coverage of this study from the New York Times: Legal or Not, Abortion Rates Compare.
• Guttmacher 2009: "Legal restrictions on abortion do not affect its incidence." (I suppose one could try to disqualify Guttmacher as a "pro-choice" source, although they keep the best statistics on abortion in the US).

One should probably be cautious in asserting a single country's experience as a rebuttal to these unequivocal global conclusions. It cannot be said with any certainty that abortions "rose" after Roe v. Wade, since a large number of illegal abortions pre-Roe were obviously unreported due to the fear of legal consequences. Clearly, the rate of reported abortions, and those amenable to surveillance, rose - but that's not the same thing. It's unclear how the baseline incidence of abortion pre-Roe was determined, when reporting involvement in an illegal abortion could lead to criminal prosecution.

Most of the arguments supporting the WHO position are based on comparisons between abortion rates in "legalized" vs. "restrictive" countries (they are no different). Additionally, there has been a well-described liberalization of abortion laws globally over the past several decades (PMID 18957353), which has coincided with global decreases in abortion rate - a finding suggesting that legal status is not a major determinant of abortion rate. MastCell ^Talk 23:31, 24 June 2010 (UTC)

As evidenced by the comments above, there are reliable sources taking a variety of positions on this. It's not our job to decide what the truth is, and proclaim it in the lead. Like I said, my inclination is just to throw up my hands and let you do whatever you want with this article. Are admins required to be evenhanded, or is it acceptable to be passive in the face of edit-warring for a particularly sympathetic POV?Anythingyouwant (talk) 23:47, 24 June 2010 (UTC)

It's our job to provide up-to-date syntheses of relevant information from reputable expert sources, which is sort of where I was going with the citations I listed. Your question seems designed as a rhetorical attack rather than an honest inquiry, but since you ask... I'm in an editorial role at this article. It would be inappropriate for me to take an admin role, since I'm involved in ongoing content disputes. As an editor, I'm trying to model what I think is correct behavior in such disputes - that is, I'm not participating in any edit wars that develop; I'm limiting myself to 1RR at most; I'm trying to address reasonable concerns on the talk page, while drawing a distinction between productive discussion and enabling unreasonable obstruction; and I'm striving to ignore obvious provocation. MastCell ^Talk 00:27, 25 June 2010 (UTC)

My question is sincere, and the question stands. You and other admins get involved now and then In administrative proceedings regarding this article, so I'm just wondering if there is any kind of "code of conduct" or "honor code" or the like for admins. Even assuming that all the admins who watch this article have been amply justified in the actions they've taken, I'm curious about the actions not taken, and whether there is any obligation not to overlook violations. This was not meant as a vague hypothetical question. This article was massively overhauled recently, via edit-warring, and against policy, and I've mentioned some of what I consider pro-choice-slanted edits within that overhaul.

Anyway, regarding this particular material in the lede, it is: "The frequency of abortion is, however, similar whether or not access is restricted." Basically, this is equivalent to saying: "Whoever wants to restrict abortion is either deluded or merely wants to kill women.". I suggest the material be removed until there is consensus for how it should be dealt with later in the article. I've already removed it once, so I'm not going to do so again. This stuff in the lede does not reflect any of the sources I mentioned; as far as I can tell, this stuff is not based on studying a single country's before-and-after-legalization statistics, and that ought to be mentioned in this article if we want to neutrally address this issue.Anythingyouwant (talk) 03:15, 25 June 2010 (UTC)

Editors can read all they like about administration elsewhere. This is not the talkpage for discussing it. The appropriate response to your disagreement with a statement is to verify the sources cited. If there are none, the appropriate response is to request citation, usually by the use of {{cn}}. It is not to create absurd paraphrasures. Editors can have principled disagreements without maligning each others' positions. One can acknowledge that the opposite side in the debate has good intentions but different priorities. Both sides in this debate want less abortions done, but while one side believes that they can and should approach that goal by restricting legal access, the other believes they can and should do so by education on and promotion of better contraception. Neither "merely wants to kill women" and the allegation of such is simply irresponsible and should be retracted. LeadSongDog come howl! 16:43, 25 June 2010 (UTC)

I never said that either side wants to kill women, so I have nothing to retract. Which side do you think I accused of that? If you want to edit the lede to say that one side believes the number of abortions can be reduced by restricting access, please do. The lead currently says such a thing is impossible.Anythingyouwant (talk) 16:55, 25 June 2010 (UTC)

No, you didn't say either side wants to kill women, you equated the existing statement in the lede to a position which clearly differs from its intent. In any case if you did not wish your words to have that interpretation, I urge you to revise them to something that will be less likely to be mistaken as such. I believe the lede correctly reflects the published research that indicates the bans have been ineffective. That does not mean those laws haven't reduced access to legal abortion, but rather that by making access illegal for some they have in the process making it more dangerous, difficult or expensive for others. My use of the word "legal" was intentional and it carried meaning that you disregarded. LeadSongDog come howl! 18:30, 25 June 2010 (UTC)

I have no idea what the intentions were behind the recent edit-warred changes to the lede. The effect of those changes is that this article now declares that people who wish to reduce abortions by legally restricting access are attempting the impossible, though they would succeed in making abortion less safe and more dangerous to womens' lives. That's an accurate characterization of what the edit-warred lead now says, in my honest opinion, and this disregards a substantial body of reliable sources, while reducing the NPOV of this article's lede.

As for what Wikipedia policies may or may not say about whether edit-warrng should be treated consistently regardless of POV, I was asking where at Wikipedia this ought to be addressed, so that I can go there. But never mind, I'll figure it out.

Also, if I overlooked any word you used, then I apologize.

I am going to step back from this article and talk page for awhile, due to the atmosphere here. I may remove it from my watchlist. So, please feel free to contact me at my talk page if you have further concerns. Thanks, and I hope you'll consider my comments in this section in the NPOV spirit n which they were offered. Cheers.Anythingyouwant (talk) 18:49, 25 June 2010 (UTC)

In reply to the as evidenced by the comments above, there are reliable sources taking a variety of positions on this, I just want to reiterate a comment made by MastCell: One should probably be cautious in asserting a single country's experience as a rebuttal to these unequivocal global conclusions. And perhaps we should repeat the Lancet conclusion: Indeed, both the highest and lowest abortion rates were seen in regions where abortion is almost uniformly legal under a wide range of circumstances. Finding 2 possible exceptions to the rule does not mean the rule is no longer valid. I mean, those global overview studies could be wrong, but I don't find the (basically) anecdotal evidence sufficient to discount those sources. I think we'd need to find a source on par with those others, yet with different conclusions. That said, we could consider rephrasing the sentence to make it clear that there are exceptions? -Andrew c ^[talk] 01:19, 25 June 2010 (UTC)

It's not clear to me that there are exceptions. The belief that the US abortion rate "rose" after Roe v. Wade seems founded on iffy statistical approaches and a misunderstanding of American abortion surveillance. See (for example) Wetstein 1996; using an autoregressive model, he concluded:

...when controlling for the increasing trend [in abortion] already at work, and the apparent leveling off at average around 1978, the Roe variable did not have a positive effect on the national abortion ratio... These findings from national data contradict popular claims about the impact of Roe v. Wade. Conventional wisdom tells us that Roe was the catalyst for a substantial increase in abortions in the United States. Yet time series analysis demonstrates that Roe did not significantly alter the trend in abortion utilization in this country, at least when examining the aggregate data.

The use of abortion data reported to the Centers for Disease Control may be inappropriate for measuring the true levels of abortion nationally. In the years prior to Roe, only states that had legalized abortion were providing data to the federal government. Thus, the data represent only reported legal abortions prior to 1973. The vast majority of unreported, illegal abortions are not included in the time series.
Therefore, the increase in abortions and abortion rates in the wake of Roe may represent better reporting of the real abortion rate. This might also explain the plateau of abortions and abortion rates around 1980. In essence, more systematic reporting of abortion by the states may have revealed the true abortion rate in the US only around the 1979-1980 period.

Sorry for the lengthy quote, but I think a direct quantitative approach is a useful counterpoint to the vaguer and more oblique assertions in the sources cited by Anythingyouwant above. MastCell ^Talk 06:13, 25 June 2010 (UTC)

I suspect that multiple factors come into play when examining the effect of legalisation. From what I find in the literature, it seems certain that availability of reliable contraception is the biggest single factor affecting the abortion rate globally. I see that a BBC news article (not a scholarly source, but normally reliable in reporting) says that the number of reported abortions in the UK rose sharply in the years immediately following legalisation (1967-1971) and has risen steadily since then - even taking into account the population increase. In a country where both contraception and abortion are generally freely available now, I would suspect that there may be an effect due to a increasingly relaxed attitude to abortion over 40 years, because the consequences of inadequate contraception have become less severe. This is pure hypothesis on my part, of course, so I would suggest looking for any studies that have examined such an effect before daring to add anything to the article. In summary, like MastCell, I believe the general conclusions of the WHO, but would caution that other confounding factors may need to be taken into account in any particular country. --RexxS (talk) 12:10, 25 June 2010 (UTC)

Picture in the lead

We should have a picture in the lead. The one I placed there is as good as any that we have. If someone prefers another I am sure I would have not great qualms. Doc James (talk · contribs · email) 03:45, 16 June 2010 (UTC)

As noted above, at least two editors have objected to placement of that picture at that location, but you edit-warred it back after it was moved. I don't know why you started a new section here, when there's already a section above titled "Top pic".Anythingyouwant (talk) 03:02, 24 June 2010 (UTC)

Placenta previa

We seem to be stuck on linking abortion to placenta previa. The article should make clear that any link (which is controversial to begin with) is specific to abortion performed by sharp curettage. Abortion via vacuum aspiration is not linked to any increased risk of previa. This is an important distinction. An increasingly large majority of abortions are performed by vacuum aspiration, so the article should not imply that this procedure carries a non-existent risk. I've amended it with an (up-to-date) secondary source. MastCell ^Talk 05:38, 16 June 2010 (UTC)

Since that was about a specific procedure I moved to Dilation and curettage.--Nutriveg (talk) 12:21, 16 June 2010 (UTC)

And I've reverted that "move" since what was deleted didn't match what was added, since the removed text talked about two procedures, not one, and since a section covering risks of specific procedures seems to be a good place to document... risks of specific procedures. SHEFFIELDSTEEL^TALK 14:07, 16 June 2010 (UTC)

I see no point of mentioning "no risk" when phrase the just above says such "Abortion does not impair subsequent pregnancies, nor does it increase the risk of future premature births, infertility, ectopic pregnancy, or miscarriage". This risk is about a very specific procedure so it should be moved to the article of that procedure. As I previously did hearing MastCell concerns: "We seem to be stuck on linking abortion to placenta previa."--Nutriveg (talk) 14:15, 16 June 2010 (UTC)

Do you see any point in avoiding edit wars and seeking consensus? SHEFFIELDSTEEL^TALK 14:34, 16 June 2010 (UTC)

The sentence "Abortion does not impair subsequent pregnancies, nor does it increase the risk of future premature births, infertility, ectopic pregnancy, or miscarriage" is junk. (1, 2, 3, 4, 5) While the risk to subsequent pregnancies is relatively low, abortion decidedly does impair them. - Schrandit (talk) 06:18, 18 June 2010 (UTC)

First, I don't know how many will find your comment, hidden as it is.

Then, your sources are convincing:

1. 2003, admits in intro that previous studies have been inconclusive, then reports on study with 600 subjects
2. MayoClinic, rare but serious risk
3. Denmark, 1999, huge study checking only for pre-term, post-term, after abortion(s)
4. 2003, review showing strong and plausible association and a dose-response relationship indicating causality
5. 1980 in JAMA, concludes "that multiple induced abortions do increase the risk of subsequent pregnancy losses"

This should be more than sufficient to warrant your editing the sentence you refer to as junk. Go for it. - Hordaland (talk) 11:34, 18 June 2010 (UTC)

That's three primary studies between 1980 and 2003 (Levin, Zhou, Dhaliwal), a 2003 review (Rooney) and a 2009 expert opinion (Harms). The current sentence is hardly junk because that's what the 2004 Grimes overview says. If we went by the strict rules of MEDRS, then the later secondary source (Grimes) is preferred over any of the four primaries and the earlier secondary. However, I'm not prepared to push that argument. It would be worth searching for a more recent secondary to settle the apparent conflict between the two secondaries – Harms is obviously basing his opinion on something. I'd strongly suggest opening a new section (where this would be more visible) and linking back to here in an effort to seek consensus before making an edit which may be challenged on the grounds I outlined above. --RexxS (talk) 13:16, 18 June 2010 (UTC) removing support from Rooney, having read the refs in Association of American Physicians and Surgeons - doesn't alter my overall opinion. --RexxS (talk) 20:53, 18 June 2010 (UTC)

A more recent systematic review and meta-analysis from 2009 is PMID 19301572. LeadSongDog come howl! 13:38, 18 June 2010 (UTC)

Thanks, LSD, that's a compelling analysis (even though I can only see the abstract). It looks to me like it settles the issue of the effect of abortion on subsequent pre-term birth, although I will take someone with better medical knowledge than I (that's most of you) to write a good summary. Does anyone know of any recent secondaries addressing the issues of other late sequelae? --RexxS (talk) 13:50, 18 June 2010 (UTC)

Sorry, wrong paper, that one speaks to pre-term birth. PMID 20362515 from 2010 makes it clear that present evidence is inconclusive on the association of various outcomes with distinct methods. LeadSongDog come howl! 13:57, 18 June 2010 (UTC)

The Journal of American Physicians and Surgeons (ref. 4) is not a suitable source for any assertion of medical fact. Despite its generic title, it is the publication of a fringe right-wing political group. It has a very poor track record of correctness and zero scientific currency. It certainly fails WP:MEDRS and should not be cited here. The other sources look reasonable, and we should probably discuss how to best summarize all available sources in the article. MastCell ^Talk 16:39, 18 June 2010 (UTC)

Vacuum aspiration and D&C are currently two different articles. If the citation is about vacuum aspiration, why was it moved to the D&C article? -Andrew c ^[talk] 15:01, 16 June 2010 (UTC)

It was removed from this article but not added to that one. That's one of the reasons I reverted - I didn't want to see sourced material deleted. SHEFFIELDSTEEL^TALK 15:03, 16 June 2010 (UTC)

I removed it from the D&C article because it seemed off topic. I didn't add it to the vacuum aspiration article, but if anyone things that is the proper course of action, I'd encourage them to make that edit (I have no intentions of making the edit myself, and if that makes me a bad editor :P ) -Andrew c ^[talk] 15:07, 16 June 2010 (UTC)

The cited source clearly discusses both sharp curettage and vacuum aspiration in the context of abortion, and contrasts the reported associations of both with placenta previa. A move to D&C would be inappropriate, because the source specifically addresses abortion, rather than D&C in general. This is the correct location for information on the health risks of abortion, and that is exactly what the source, a 2009 medical text, addresses.

I am OK with not mentioning previa at all, but if we do mention it, then we need to discuss it in a clear, informative, and representative manner. The earlier text (which stood for awhile, partly because of edit-warring and partly because it had presumably escaped notice) incorrectly claimed that abortion in general increased the risk of previa. In fact, more recent sources are clear that vacuum aspiration (the most common technique) does not increase that risk. This is an example of how game-playing, ownership, and edit-warring are getting in the way of our ostensible goal of providing accurate, clear, and representative medical information. MastCell ^Talk 20:08, 16 June 2010 (UTC)

Agreeing: the specific abortion info about D&C belongs here. (Whether it also belongs in the D&C article is another question.) - Hordaland (talk) 20:25, 16 June 2010 (UTC)

I've restored the more up-to-date version of this text (citing the grimes review), since we seem to have consensus. I trust that, if there are any other concerns with this, they will be raised here. SHEFFIELDSTEEL^TALK 13:26, 18 June 2010 (UTC)

I could find nothing in grimes-overview associating "placenta previa" and "sharp curettage" as in your edit. Please provide a direct quote for that under WP:V.

Further this discussion is unlikely to have reached consensus yet, as you imply in your justification for making that revert, LeadSongDong just provided an updated review supporting a different conclusion: "Some data suggest that (induced abortion) may be linked with an increased risk of (...) placenta previa. (but) large prospective cohort studies (...) are needed to provide definitive answers". From your history of have already been involved in that edit war, where you already reverted to that version twice, please undo your revert.--Nutriveg (talk) 14:57, 18 June 2010 (UTC)

The ref at the end of the following sentence (Paul p.232) says:

• "... repeated sharp curettage procedures ..., but not multiple vacuum aspirations ..., were associated with risk of subsequent placenta previa."

so I think we can take it that Paul supports the distinction between the two procedures. Grimes 2004 says:

• "The question of placenta previa is unsettled; some reports have found an increased risk for this abnormal placental attachment in later pregnancies, whereas others have not."

which supports the text of the second part of the first sentence. Are you asking for the Paul cite to be repeated at the end of each of the two consecutive sentences? I see nothing in Lowit 2010 that disagrees with the text SS has given. --RexxS (talk) 15:43, 18 June 2010 (UTC)

Grimes review, the source SheffieldSteel used to justify that revert, doesn't support the text it's referencing: "Abortion via sharp curettage may increase the risk of placenta previa" so that reference should be removed or the text should be rewritten to reflect the source it's based upon. But since we are still discussing that issue and haven't decided on a better source/text, she should undo that second revert while this matter is discussed.

Lowit 2010 doesn't concluded that data is "conflicting" but that more data is needed.--Nutriveg (talk) 17:09, 18 June 2010 (UTC)

Presumably, "more data are needed" because existing data are inconclusive or insufficient. That's a straightforward logical inference. We could move the Grimes ref one sentence further along, so it's next to the Paul ref. In combination, the two sources clearly support the text SheffieldSteel inserted, so it doesn't seem necessary to quibble excessively over their ordering. MastCell ^Talk 18:49, 18 June 2010 (UTC)

(edit conflict) Sheffield Steel added TWO related sentences and supplied TWO refs. Anyone reading those two refs can see that Paul (p.232) clearly supports BOTH the first part of the first sentence and the second sentence, while Grimes supports the qualification placed at the second half of the first sentence. We are not required to cite every sentence as long as it can be verified. The verification is provided at the end of the very next sentence. Is that clear enough now? --RexxS (talk) 18:54, 18 June 2010 (UTC)

Mastcell, we don't "presume" anything, we just cite the sources conclusion, that 2010 review presents the current state of evidence as supportive not as conflicting. The point of it not being conclusive is a problem of lack of (better) data not of conflicting data. We don't combine sources to reach another conclusion and we don't use sources to support text that can't be verified by such source (Grimes).

Sheffield Steel added nothing he just reverted an edit (again) without having consensus about that change. She should discuss changes before doing reverts of problematic text, specially using as excuse a source (Grimes) that can't even be used to verify the information.--Nutriveg (talk) 20:10, 18 June 2010 (UTC)

When an editor reverts, especially when they revise the text and citations from the earlier version (as in this case), they take responsibility for the contribution. You've now been told by two editors that Paul and Grimes together support the text. We do summarise multiple sources all the time, we don't just use spurious objections to exclude all the sources except the one that we like. --RexxS (talk) 20:32, 18 June 2010 (UTC)

I don't see how Grimes could be "the source" supporting that phrase if he didn't even mention the association "Abortion via sharp curettage may increase the risk of placenta previa", but it looks that WP:SYNTH is exempted to be respected in this particular article.--Nutriveg (talk) 21:33, 18 June 2010 (UTC)

You don't see that Paul:

• "... repeated sharp curettage procedures ..., but not multiple vacuum aspirations ..., were associated with risk of subsequent placenta previa."

supports "Abortion via sharp curettage may increase the risk of placenta previa"? I'll ask again: Are you asking for the Paul cite to be repeated for the two consecutive sentences? --RexxS (talk) 21:52, 18 June 2010 (UTC)

Did you see me questioning Grimes or Paul here? If Paul is the source that support the text, the text should be properly referenced, I would turn those two phrases into a single sentence and properly reference to Paul, not Grimes. But first we need to decide if Lowit 2010 is a better source.--Nutriveg (talk) 22:06, 18 June 2010 (UTC)

I see you continually complaining that Grimes doesn't mention "Abortion via sharp curettage may increase the risk of placenta previa", even though it's clear that Paul does. Here's what WP:Cite#Inline citations says:

• "If the material is particularly contentious, the citation may be added within a sentence, but adding it to the end of the sentence or paragraph is usually sufficient"

Paul has been placed at the end of the paragraph which it supports, as may be done according to our practice. In what way exactly is this anything other than properly referenced? --RexxS (talk) 22:29, 18 June 2010 (UTC)

My problem with Grimes is citing him out of context of his actual phrase, if you didn't realize that yet, but I won't continue this discussion until we decide which is the better source for the Abortion article, (Lowit,2010) or (Paul,2009)?--Nutriveg (talk) 22:35, 18 June 2010 (UTC)

You still refuse to understand that issues sometimes need 2 or 3 sources to properly reflect the range of views expressed. I'm not going down the route of you picking a single source again and excluding other views, so I'll comply with your decision not to continue this discussion. --RexxS (talk) 22:56, 18 June 2010 (UTC)

Pro-choice?

I noticed that the introduction mentions and links to the "Pro-Choice" thing. The name "Pro-Choice" is a deliberate misrepresentation and fallacy that encourages people to mistakenly believe that abortion is a women's rights issue when really it's totally unrelated. Referring to the opposite of "Pro-life" as "Pro-Choice" is akin to saying that Common Era is purely a political correctness measure; the name political correctness immediately conveys other suggestions and prejudices to the reader. I would say that all references to "Pro-Choice" ought to be removed from the article, in accordance with WP:NPOV, except where a specific mention is made that it's almost exclusively the "Pro-Choice" people themselves who call it that, just like the names Republic of China etc. (Huey45 (talk) 04:24, 26 June 2010 (UTC))

Yes, it should go, along with Pro Life. Both are sneaky, politically driven, marketing names chosen with the deliberate intent to make the opposite view sound bad when derived from the chosen names, eg. Anti Life, Anti Choice, or Pro Death. Just naming them is pushing a POV. HiLo48 (talk) 04:33, 26 June 2010 (UTC)

I strongly disagree. While these are politically driven terms they are commonly used among the public and media.Boromir123 (talk) 07:51, 26 June 2010 (UTC)

This was discussed recently in the archives Talk:Abortion/Archive_54#Terminology. -Andrew c ^[talk] 12:05, 26 June 2010 (UTC)

I read that archive just then and it appears that the discussion faded away without really being resolved. What if we still called them "pro-life" and "pro-choice" but explained early in the article that those names are almost exclusively used by each respective group to describe themselves? The article as it is now is encouraging the use of the political names. It's different to "Palestinian Liberation Army" and the like because the names "pro-choice" and "pro-life" represent sides of a debate rather than an actual organisation. It's akin to labelling the sides of a debate about Fat camp as "the fat pigs" and "the healthy people". (Huey45 (talk) 12:51, 26 June 2010 (UTC))

We're not labelling anyone. This is an encyclopaedia, remember? As a tertiary source, we report what primary and secondary sources write on the subject. And pro-choice/pro-life are the terms used. SHEFFIELDSTEEL^TALK 13:49, 26 June 2010 (UTC)

Almost right. We reflect what the best available current sources write. While those terms are still used by polarized sources, especially advocates of one or the other position, many of the best sources use plain English instead of Newspeak. Wikipedia should select and cite the best quality sources, then reflect their usage, not impose its own. LeadSongDog come howl! 14:16, 26 June 2010 (UTC)

There are like 2, maybe 3 instances where those terms are used in this article, and I think its in clear contexts describing sides of the debate. It isn't a major component of this article by any means, but perhaps it is controversial because it is in the lead (but really, would a lead of an article on abortion not mention the debate??) Otherwise, I find the amount of content this is taking up in the article rather minor indeed. As for but explained early in the article that those names are almost exclusively used by each respective group to describe themselves, this may be acceptable, assuming this is backed up by reliable sourcing. We should be mindful of sourcing vs. personal preference/knowledge. -Andrew c ^[talk] 14:32, 26 June 2010 (UTC)

I don't think this is the correct venue for this discussion. Pro-life and pro-choice are different articles. If "pro-life" and "pro-choice" are not the correct names for them, perhaps one of more discussions ought to be initiated at Wikipedia:Requested moves. If and when a consensus has been established that those are in fact the wrong terms, it will be a trivial matter to update the terminology used in this article. Note that I'm extending the discussion to include both topics here, since to only change one name could give the impression of non-neutrality. SHEFFIELDSTEEL^TALK 14:54, 26 June 2010 (UTC)

Measuring the "abortion rate"

The article says that "abortion rates" are the same in countries where it is legal and illegal. But there are two ways of measuring the abortion rate: the number of women per 1000 per year who have abortions, versus the abortion to live birth ratio. If you're pro-choice, you'd see the "abortion rate" as being the rate at which women are affected by abortion, but if you're pro-life you'd see the abortion rate as the rate at which embryos and fetuses are affected by abortion. Why does this article A) measure the incidence of abortion in pro-choice terms, and B) not even say that this is how the incidence of abortion is being measured? —Preceding unsigned comment added by Austin Nedved (talk • contribs) 02:44, 27 June 2010 (UTC)

Gee. you've used a fine tooth comb on the article to identify that difference. I've read it many times, and again just then, to see what you were talking about, and I can't see it. It probably is there, but you will have to point it out for me. One of my concerns about counts is that methods of counting are bound to vary between countries, and this is a global article. In my country, Australia, numbers of elective abortions are not at all clear because they are included in numbers which contain several other medical procedures. That makes it certain that global figures cannot contain Australia's figures, or if they do, they are wrong. Global figures for abortion is a difficult area. HiLo48 (talk) 03:00, 27 June 2010 (UTC)

When I spoke of the "method of measuring the incidence of abortion," I wasn't talking about data collection, I was talking about how that data is presented. What does this article mean by "abortion rate" - "X number of 1,000 women per year" or "abortion to live birth ratio"? The former is how it would be measured by pro-choicers, and the latter is how it would be measured by pro-lifers. Since the article linked to is from a pro-choice organization, I'm betting on the former. But that's how the pro-abortion side would measure the incidence of abortion, so this part of the article is biased.