Talk:Abortion

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New article for definitions?

I just read through the archive and am sure that I am missing something obvious, but has anyone previously proposed creating Definitions of abortion? The note on this article is wonderfully well researched but I doubt that many readers follow the link. I'd be happy to copy its content to the new page but given the sensitivity of the topic I don't want to do so without some form of consensus. Andrew³²⁷ 05:45, 3 January 2013 (UTC)

The dictionary definitions would count only as primary sources for such an article. While I'm not entirely sure about notability requirements for subarticles, I think we would need to find secondary sources that discuss any disagreement among sources to create such an article. NW (Talk) 05:47, 3 January 2013 (UTC)

Thanks for the rapid response. I'll search the literature and see if I can find secondary sources talking about different definitions in a notable manner. If I do, I'll sandbox it and come back here for input. Andrew³²⁷ 05:50, 3 January 2013 (UTC)

Check it out and tell me what you think! I included nine reliable secondary sources that refer to problems that arise from different definitions of abortion. I could find more, but it's starting to get late in my area. I'm open to suggestions. Andrew³²⁷ 07:24, 3 January 2013 (UTC)

I'm not so sure it is worth it to have a separate article. Perhaps a subsection in Abortion#Types would work better instead? NW (Talk) 12:01, 3 January 2013 (UTC)

This amounts to moving the note. I agree it's a bit unwieldy but lots of contentious terms have varying definitions, I'd imagine (euthanasia, rape, ...). Is there precedent among terms like that for this? I'm not so much opposed as unmotivated here. JJL (talk) 06:30, 5 January 2013 (UTC)

It is well done, but given variations, contexts and controversy of the topic / word; it runs a risk of being fork or worse... just a list! Ahhhhh, run! The best path could be something similar to Definition of marriage, thought that could constrain the sub-topic, and I'm fairly sure a sub-section was brought up several times in the past lead debate(s). - RoyBoy 23:00, 9 March 2013 (UTC)

Section and illustration for medically necessary abortions needs to be added

I am appalled to find out that File:Human fetus 10 weeks - therapeutic abortion.jpg was removed from this article as "atypical" for the specific lead image spot it was to go in. Regardless, it is a beautiful image. And the reason why it belongs is that you don't have a section that lays out all the reasons why abortions are held to be medically necessary, for which this would be a perfect example. For example, the photo describes the complete removal of the uterus after cervical cancer was diagnosed. Clearly there are few issues more important to abortion debates, nor which have so much potential to find common ground otherwise warring factions, than what circumstances make the action medically necessary, and "how" medically necessary it really is, and so forth. The topic deserves a book - at least, it deserves a section. But given how much strange discussion I see here, before trying to make one I should first ask - did such a section exist in this article at any point in the past? Wnt (talk) 17:31, 30 April 2013 (UTC)

Anyway, I took a stab at this [1] - though I rushed a bit; I've done better. Wnt (talk) 18:25, 3 May 2013 (UTC)

Part of the reason that image was not used in that article is because of significant ethical concerns about using an image like that without documented medical consent. Accordingly, I am removing it as per multiple past discussions. Additionally, this is a top level article on abortion. While abortion and cancer is certainly a worthwhile article for the encyclopedia to have, I just wonder whether it is a good idea for this particular article to focus so much on it when the subarticle isn't even developed yet. NW (Talk) 18:44, 3 May 2013 (UTC)

I see very little discussion of "ethics" in the last archive [2] when according to the discussion it apparently was removed by means of some person(s) winning an edit war and getting the article protected in the state they wanted. It was rejected in the lead image discussion [3] but I see at least two editors who thought it was good for a non-lead placement and one who thought it was atypical for abortion, but of course, here I want to cover precisely that atypical kind of abortion. Placing it there kind of explains to people how there are occasional oddball images floating around the web of a fetus neatly in its sac after an abortion.

More importantly, I see no relevance of "ethics" here in the first place. In discussions like at Rorschach test, we have, in no uncertain terms, told relevant professional organizations we don't care about their ethics. Which is absolutely the right thing to do. If they want to let us write our own prescriptions and get paid $50,000 or more a year to sit around in a room spouting out vapid ideas about why it's wrong to show people what an embryo in its sac looks like, then we might talk. But for now, we should stick only to valid policy or guideline based arguments, and I don't see any.

I don't think abortion and cancer is quite ready for its own article - at some point it surely ought to be, but right now I can still picture an AfD putting it right back here again. I had in mind to look up some other things like eclampsia at some point, and if I get near having a whole section that systematically covers all the medical reasons why someone would have an abortion, then I can think of a name for it and spin it off and summary-style it here. Wnt (talk) 20:54, 3 May 2013 (UTC)

If you believe that the image was removed because "some person won an edit war", then I think you've badly misread the history of the article. The article has been in a stable state without that image for quite some time now. Of course, consensus can change, and we could decide to use an image in the lead - but for that to happen, we need to have a serious discussion. The Rorschach situation is a poor analogy; here, the ethical concern is displaying an aborted fetus on a high-profile article on a top-ten website with no indication that the mother has consented to, or is even aware, of that usage. That concern plays directly into WP:BLP; we have an obligation to consider the avoidable harm our edits can inflict on real, living people. There were also other rationales voiced for excluding the picture, but that was mine and might serve as one starting point for a discussion. MastCell ^Talk 21:47, 3 May 2013 (UTC)

How does BLP enter into this? I don't think the embryo qualifies, and we aren't making any statements about the mother (I don't think anyone even knows who she is). Wnt (talk) 23:10, 3 May 2013 (UTC)

Somewhere out there, there is a woman who found out she was pregnant, and shortly thereafter found out that she had cancer. She was told that as a result of the required treatment for her cancer, she would not only lose the pregnancy, but also her chances of ever having children in the future. I don't know if you've ever been involved in a situation like that; if not, trust me that the emotional impact is extreme.

Now, after her pregnancy was terminated, someone took a picture of the fetus and posted it on Flickr (an action which raises all kinds of questions in its own right). We have no idea whether she consented to having that picture taken or published. You're proposing that we use that picture here, on a top-ten website, without any indication that the woman in question has consented to that use. What happens if/when she comes across the picture? Does she have any reasonable expectation of privacy - any expectation that a medical photograph taken under unclear conditions during what is probably the most traumatic experience of her life isn't going to be blithely republished and viewed by thousands of people? I'm going to trust that most people are capable of empathy to the extent that they understand why using this picture creates potential problems. MastCell ^Talk 03:53, 4 May 2013 (UTC)

It's not a picture of her. It's not a picture anyone can use to identify her. I don't think anyone can identify the embryo from the picture - not even her. The only way she could possibly know that was a picture of her embryo is if she already saw the picture, say, to sign a release for publishing it. And even if the picture would potentially cause her distress, some people would still argue that the embryo had its own distress to think about, and would have wanted someone to take a picture of it. But meanwhile, why was the picture taken in the first place? Maybe she wanted someone to get some educational good out of her cancer ordeal - why else was somebody taking snapshots in the operating room? I should note that the Flickr uploader identifies herself as a doctor of obstetrics and gynecology in India; I see no special reason to assume she didn't post that picture within medical ethics at least as people there practice it. Your ethical worries seem positively mythical, absurd, irrelevant. In any case, I think ethics we need on Wikipedia are much more straightforward: to educate. And while there is a policy WP:BLP, that policy is not a policy against including any information that conceivably, somehow, could remind someone who isn't mentioned in an article of a bad time in their lives. Wnt (talk) 04:17, 4 May 2013 (UTC)

It is a great image and is of educational value. I do not think the consent issue is significant personally as the image is none identifiable. As long as the image does not identify a person it can be used without written consent. However I do not feel it is representative of abortion and thus would not consider it appropriate for the lead of this article. Should be within the article on fetal development may be. However there are already a number of similar images there. Should we look for an image for the lead of this article? I would be supportive of further discussion. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:56, 4 May 2013 (UTC)

To be clear, my use (since reverted) was as the sixth figure - see [4]. Personally I'm not that interested in what the lead image is, just the image for the new section - and actually, by now I'm more interested expanding the text of that section, but fortunately I didn't run into opposition with that. Doc, as long as you're watching this article - can you think of a good scientific review, or perhaps some other kind of document developed to inform abortion politics, that would list all of the medical reasons to recommend abortion in one place? Wnt (talk) 14:24, 4 May 2013 (UTC)

That is a difficult question. Of course psychiatry is within medicine. Is mental illness a justification for recommending an abortion? Maybe for some, maybe due to the meds the person may be taking. "medically necessary" is more of a legal term which is poorly defined [5]. This book discusses both the psychological and non psychological reasons. [6] Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:36, 4 May 2013 (UTC)

No surprise here that this image was removed. Reading the article itself, it's easy to determine why the folks controlling this page didn't want anyone to see such an image. I would also suggest that a diagram of a partial birth abortion be included also. Why not video of an abortion via a link with a warning? I doubt such things will ever be allowed to appear, since this is such a biased article that only presents one side of this issue. But it is at least worthwhile to have it on the record here so that others can see what is going on. Maybe I'm wrong, but let's see.. YourHumanRights (talk) 05:48, 30 May 2013 (UTC)

Stages figure

I've just written a Module:Block diagram that can replace figures like the one at right. Hopefully this is more legible, and note the Wikilinks work.

Currently in the article

I've just now gotten the bugs I know of out of it, so I should probably ask what people think before I make the switch ;) Here's the smaller version I have in mind to squeeze into the right-hand column:

 

 

 

Practice of Induced Abortion Methods

MVA

D&E

EVA

Hysterotomy

D&C

Intact D&X

Mifepr.

Induced Miscarr.

0-12 weeks

12-28 weeks

28-40 weeks

 

 

Practice of Induced Abortion Methods

MVA

D&E

EVA

Hysterotomy

D&C

Intact D&X

Mifepr.

Induced Miscarr.

0-12 weeks

12-28 weeks

28-40 weeks

Gestational age may determine which abortion methods are practiced.

I also have a larger version on the talk page at Module talk:Block diagram. Wnt (talk) 18:56, 6 May 2013 (UTC)

This would be neat. Would it be possible to get a border around it? NW (Talk) 19:10, 6 May 2013 (UTC)

I've made a small change in the text input above - is that good enough? Wnt (talk) 19:19, 6 May 2013 (UTC)

On second thought I came up with a way to annotate it like an image. (I should make a template to do this, and was going to at Template:Pseudo image, but the File: syntax is so involved I just haven't worked myself up to drudge through it - probably need a Lua script just to unravel the parameters, and stuff like the vertical align options... well, anyway, I'll see if I get more ambitious. Anyway... the lower right-hand "image" is probably what I'll use. Wnt (talk) 04:02, 7 May 2013 (UTC)

OK, I've tried this out now.[7] Please let me know - and many apologies! - if something looks bad on certain browsers/skins/etc. This relies on a pile of new code - Template:Pseudo image, Module:Pseudo image, and Module:Block diagram - and admittedly, they're all about alpha version level of completeness. Wnt (talk) 21:45, 8 May 2013 (UTC)

Wow, that is pretty awesome! Kaldari (talk) 02:04, 9 May 2013 (UTC)

Abortion and pre-term birth

(Previously named "Having an abortion dramatically increases the risk for preterm birth afterward. This in turn leads to greater incidence of maternal mortality, infant mortality, low birth weight, autism, developmental disabilities, cerebral palsy, etc.", complain at my talk page if you think it was inappropriate for me to rename it.) Triacylglyceride (talk) 18:35, 1 June 2013 (UTC)

This article reads from start to finish like it was written by the director of an abortion facility, and leaves out so much science and so many facts (those that such a person would likely find troubling) that the biggest problem here is knowing where to even start. But let's start with this one, already present on the preterm birth article. People can of course disagree with whether abortion is morally defensible, but deliberately suppressing medical science to do so is absurd under any circumstance. This is especially true given the gravity of this issue, and the results it has already had on many people. Mechanisms include damage done to the cervix as it is forced open, knives pushed through, and the infant's body parts dragged or sucked out. The greater incidence of infections are also suspected here, which also lead to some women who undergo abortions never being able to carry a child to term again in the future.

List of sources
The following discussion has been closed. Please do not modify it.
"Previous abortion is a significant risk factor for Low Birth Weight and Preterm Birth, and the risk increases with the increasing number of previous abortions. Practitioners should consider previous abortion as a risk factor for LBW and PB. " http://jech.bmj.com/content/62/1/16.abstract "Induced and spontaneous abortion are associated with similarly increased ORs for preterm birth in subsequent pregnancies, and they vary inversely with the baseline preterm birth rate, explaining some of the variability among studies" http://www.ncbi.nlm.nih.gov/pubmed/19301572 "Women with a history of induced abortion were at higher risk of very preterm delivery than those with no such history (OR + 1.5, 95% CI 1.1–2.0); the risk was even higher for extremely preterm deliveries (<28 weeks)" http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2004.00478.x/abstract "This study shows that a history of induced abortion increases the risk of very preterm birth, particularly extremely preterm deliveries. It appears that both infectious and mechanical mechanisms may be involved." This study showed that women who gave birth between 28 and 32 weeks of pregnancy were 40% more likely to have had a previous abortion, and mothers who gave birth to extremeley preterm infants from 22 to 27 weeks were 70% more likely to have had an abortion. http://journals.lww.com/obgynsurvey/Abstract/2005/10000/Previous_Induced_Abortions_and_the_Risk_of_Very.3.aspx "A consent form that simply lists such items as "incompetent cervix" or "infection" as potential complications, but does not inform women of the elevated future risk of a preterm delivery, and that the latter constitutes a risk factor for devastating complications such as cerebral palsy, may not satisfy courts" http://www.jpands.org/vol8no2/rooney.pdf "Previous induced abortions significantly increased the risk of preterm delivery after idiopathic preterm labour, preterm premature rupture of membranes and ante-partum haemorrhage, but not preterm delivery after maternal hypertension. The strength of the association increased with decreasing gestational age at birth." http://www.ncbi.nlm.nih.gov/pubmed/14998979 "The latest statistics in the USA (2007) show a preterm (less than 37 weeks) birth rate of 12.6%. Of these, Early Preterm Birth (EPB—under 32 weeks, infants weighing under 1500 grams, or about three pounds.) is at 7.8%, the highest rate in the past 30 years of stats. As noted in the studies above, previous induced abortions’ have an inordinately increased association with “extreme” (<27 wk) and “early”(<32 wk) premature deliveries (compared to 32 – 37 week premature births.) Thus, it follows that abortion will also have an inordinately increased association with cerebral palsy and other disabilities linked to extreme prematurity." http://www.aaplog.org/complications-of-induced-abortion/induced-abortion-and-pre-term-birth/general-comments-on-the-increased-risk/ Of the first-time mothers, 10.3% (n = 31 083) had one, 1.5% had two and 0.3% had three or more Induced Abortions (IAs). Most IAs were surgical (88%) performed before 12 weeks (91%) and carried out for social reasons (97%). After adjustment, perinatal deaths and very preterm birth (<28 gestational week) suggested worse outcomes after IA. Increased odds for very preterm birth were seen in all the subgroups and exhibited a dose–response relationship: 1.19 [95% confidence interval (CI) 0.98–1.44] after one IA, 1.69 (1.14–2.51) after two and 2.78 (1.48–5.24) after three IAs. http://www.ncbi.nlm.nih.gov/pubmed/22933527 Thirty-seven studies of low-moderate risk of bias were included. A history of one Induced Termination of Pregnancy (I-TOP) was associated with increased unadjusted odds of Low Birth Weight (LBR) (Odds Ratio 1.35, 95% Confidence Interval 1.20-1.52) and Preterm Birth (PT) (OR 1.36, 95% CI 1.24-1.50), but not Small for Gestational Age (SGA) (OR 0.87, 95% CI 0.69-1.09). A history of more than one I-TOP was associated with LBW (OR 1.72, 95% CI 1.45-2.04) and PT (OR 1.93, 95% CI 1.28-2.71). Meta-analyses of adjusted risk estimates confirmed these findings. A previous I-TOP is associated with a significantly increased risk of LBW and PT but not SGA. The risk increased as the number of I-TOP increased. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0028978/

The abortion/preterm birth link has been established in so many published studies that - here again - it is difficult to find a beginning and an end. There was a study published in the NEJM that suggested the link was false, but that study was very small, it's own data showed a small increased risk, and the methodology was completely flawed from the start because it did NOT count Danish women who had abortions before the Roe v. Wade decision in 1973. Yes, it failed to consider that an American court precedent had no bearing on women in DENMARK - who had been having legal abortions for years before 1/73! Why this was the one study published in the NEJM medicine says much more about that publication than it does the actual science.

I suggest we start with this. Because it is at least tied with the most important omission in the article for anyone trying to get reliable and unbiased information on this topic. — Preceding unsigned comment added by YourHumanRights (talk • contribs) 05:39, 30 May 2013 (UTC)

Your belief that induced abortion involves "knives pushed through" the cervix leads me to question your understanding of the procedure. And your belief that a pro-life advocacy group (AAPLOG) is more scientifically reliable than the New England Journal of Medicine leads me to question your understanding of this site's sourcing guidelines. But leaving that aside for a moment...

our site guidelines on medical content generally discourage the selective citation of individual journal articles, as you've done above, because it is trivially easy to support all kinds of ideas by cherry-picking the medical literature. Instead, we look at how reputable expert groups have synthesized the evidence. Do you have some such sources you'd like to present? I understand that there's a political effort to publicize this idea, and that such political efforts often coincide with a drive to raise the visibility of an aspect of this topic on Wikipedia, but it's probably best to focus on what reputable expert groups have to say here.

I'll give you an example to start the discussion. Guidelines from the Royal College of Obstetricians and Gynecologists state: "Women should be informed that there are no proven associations between induced abortion and subsequent ectopic pregnancy, placenta praevia or infertility... Women should be informed that induced abortion is associated with a small increase in the risk of subsequent preterm birth, which increases with the number of abortions. However, there is insufficient evidence to imply causality." ([8]) I haven't exhaustively reviewed other expert bodies (e.g. ACOG, the WHO, etc.), but I suspect they've reached similar conclusions given the conflicting literature (only one side of which you've highlighted above). MastCell ^Talk 20:33, 30 May 2013 (UTC)

If you are unaware of what a curette is, it is an abortion instrument that has looped knives on the end of it to cut the infant off of the uterine wall. When necessary, these are also used to dismember him or her to ease removal from his or her mother. Knives are are sharpened metal blades used for cutting through flesh (in this case), and such knives are what is found at the end of curettes. Naturally, they must first be inserted through the cervix - which itself has been forced open in most all abortion procedures. I hope that clears up any confusion regarding the actual mechanics of the procedure.

AAPLOG is a group of over 2,500 OB/GYN's. If you doubt their honesty or the reliability of their work, or their meta analysis of the published literature on this topic, then by all means feel free to point out the errors they have made therein. I did so and pointed out a rather laughable flaw in one study published in the NEJM. I invite you to critique that as well. Suggesting that one group of doctors is dishonest but that others are not is one thing. Being able to demonstrate that is very much another. I have done my part. In addition to other peer reviewed published studies on this topic, I have included three meta-analyses. That is, detailed analysis of multiple studies. Here again, if all these META-analyses are completely wrong regarding the published science here, then perhaps you can share with everyone why that is? I invite you (and anyone else) to do so, as I am sure all those involved in those studies would as well. You understand that a meta-analysis is a far better determining tool in science than a single study, right?

The Royal College of Obstetricians and Gynecologists and ACOG are both groups of doctors who advocate for abortion on demand, and indeed include many of the doctors who routinely perform them in two countries where abortion is commonplace. You can suggest that their conclusions are superior to those of other groups of doctors who have different political opinions, but here again that is merely an accusation made on your part that - so far at least - has no date or methodology behind it. But yet, the RCOG quote you included itself recognizes the link between abortion and preterm birth! The expert groups that you prefer are acknowledging the link, as are the ones you dismiss (without any scientific reasons to dismiss them beyond their political stances).

Again, I invite you or anyone to demonstrate why and how it is that both AAPLOG, RCOG, and the AAPS are all groups of doctors who have this issue totally wrong. Unless someone can do so, then this very important health risk needs to be included in this article. Calhoun, Shadigian, and Rooney have concluded from their meta-analyses of published medical studies on this topic that abortion can be attributed to an increase of 31.5% in the rate of early preterm births (less than 32 weeks gestation). Statistically speaking, it is thus probable that hundreds of thousands of children – at the very least – are now needlessly living with various mild to severe birth defects due directly to their mother’s previous abortion(s). Meanwhile, the total preterm birth rate for women in America prior to 1970 was approximately 6%; preliminary data for 2010 indicates a preterm birth rate of 11.99%.

I don't think that - especially given the gravity of these issues - that all the meta-analyses and doctors groups can or should be able to be kept quiet because some you or anyone has decided to dismiss them. Either you can demonstrate why and how they are all wrong, or it is you that is wrong. I think you are wrong, and the doctors groups and published science is correct. I invite you to show me and everyone else that I am incorrect. In the meantime, the abortion/preterm birth link has already been accepted on the page regarding preterm birth. And it should be included and accepted here on this page as soon as possible also. YourHumanRights (talk) 18:01, 31 May 2013 (UTC)

I know what a curette is. It's quite different from a knife. For example, curettes are used to remove impacted earwax, but the procedure is not generally described as "shoving a knife into your ear canal". Furthermore, the vast majority of induced abortions in the Western world are not performed via curettage; they are either medically induced or performed via vacuum aspiration. Were you aware of that? Actually, don't answer that, it's irrelevant.

Your posts are composed of 90% politically-charged rhetoric and 10% substance, which is a suboptimal ratio. Insofar as the substance of your post, you are free to make the case that ACOG, RCOG, or the WHO are unreliable sources of medical information. You are free to make the case that the New England Journal of Medicine is a biased and unreliable source of medical information. I don't think you'll get much traction, but it's your time. MastCell ^Talk 18:52, 31 May 2013 (UTC)

Sharpened metal edges used to cut flesh are knives, regardless of their configuration. Any further debate on such a topic is a nonsensical waste of time. It would be like debating if a knife handle was part of a knife, or of a scalpel was a knife or not. I can provide a link to videos of these knives in abortion action if anyone really wants me to, but I doubt anyone will find this particular tangent about knives interesting.

My posts have dealt very deliberately with the published science regarding this topic, and in particular with the meta-analyses thereof. Much as you would like to dismiss all of it and insult me personally for trying to make this being biased and incomplete article factually correct, I will remind you that even the RCOG guide you provided yourself said the following:

"Women should be informed that induced abortion is associated with a small increase in the risk of subsequent preterm birth, which increases with the number of abortions."

MastCell, you seem to be very keen here that people NOT be informed of any such thing in this article. So, it is YOU that is disagreeing with RCOG regarding this issue - not me. Furthermore, I challenged you to discredit the three meta-analyses that have been published - none of which have been challenged and unpublished. You clearly want no part of that. I have backed my claims up here with lots of published science. You have backed up your wish to keep this issue off of this page with a PDF from a doctor's group who themselves say that "Women should be informed.." So, you really haven't come up with ANYTHING to counter my claims here.

Because you think that you can simply declare that one group of doctors is unreliable and other groups are, that doesn't make any of your claims true. Again, if you can explain how and why all the meta-analyses on this topic are all completely wrong - please do so. If you cannot, then don't expect everyone else to simply take your word for it. That's not how science works. Science works by challenging the published and per reviewed literature, and clearly you cannot. I didn't say that RCOG was wrong, although they may indeed be bending as much as they can to keep the numbers and the risk as low as they can given their political position on the topic. On the contrary, I am trying to get what RCOG and other groups of doctors have had to say on this topic into this article. the bottom line is that the article gets much better if we include what the published science has to say..

YourHumanRights (talk) 22:51, 31 May 2013 (UTC)

This thread is fringe nonsense written by someone unfamiliar (and seemingly uninterested) with how Wikipedia works (look at the length of the title!) and pushing a blatant, unacceptable POV. It should be at least hatted, or probably better, deleted right now. HiLo48 (talk) 22:56, 31 May 2013 (UTC)

I see one review article in the list and summary of it recommends caution. "This review concluded that the risk of a child having a low birth weight or preterm birth increased for women with a history of pregnancy termination compared with those without such a history. This conclusion should be treated with caution due to the presence of clinical heterogeneity, confounders, and publication bias between the studies." We typically just go with just high quality secondary sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:03, 31 May 2013 (UTC)

Reading this one article would give anyone a firm idea of how wikipedia works with regard to controversial topics. That is, one side will get to use the article as an advertisement, and the article itself will be "protected" from edits by those up the wiki food chain. We can attempt to twist words this way or that way, but I certainly am not doubting this medical science when one commenter after another fails to offer up anything whatsoever to refute it. Scientific debates usually involve quoting competing published studies, but nobody seems to be able to even come up with a meta-analysis that would attempt to make the other three vanish somehow. It seems those opposing including the published science here cannot find a single meta-analysis to henpick themselves..

I'll separate the three meta-analyses below. Please, anybody, post a meta-anaysis that refutes these conclusions if indeed you can find one. Please also have a look at the numbers regarding the increased risks inside these analyses of the published literature. Do they look "small" to you? If they do, I guess the next question would be what the definition of "small" is.. In my opinion, a risk that doubles is not a small increased risk.

"Induced and spontaneous abortion are associated with similarly increased ORs for preterm birth in subsequent pregnancies, and they vary inversely with the baseline preterm birth rate, explaining some of the variability among studies"

http://www.ncbi.nlm.nih.gov/pubmed/19301572

Thirty-seven studies of low-moderate risk of bias were included. A history of one Induced Termination of Pregnancy (I-TOP) was associated with increased unadjusted odds of Low Birth Weight (LBR) (Odds Ratio 1.35, 95% Confidence Interval 1.20-1.52) and Preterm Birth (PT) (OR 1.36, 95% CI 1.24-1.50), but not Small for Gestational Age (SGA) (OR 0.87, 95% CI 0.69-1.09). A history of more than one I-TOP was associated with LBW (OR 1.72, 95% CI 1.45-2.04) and PT (OR 1.93, 95% CI 1.28-2.71). Meta-analyses of adjusted risk estimates confirmed these findings.

A previous I-TOP is associated with a significantly increased risk of LBW and PT but not SGA. The risk increased as the number of I-TOP increased.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0028978/

A literature review retrieved 49 studies that demonstrated at least 95 percent confidence in an increased risk of preterm birth (PB), or surrogates such as low birth weight or second-trimester spontaneous abortion, in association with previous induced abortions. A list of these studies, which probably does not comprise all such studies, is appended to this article. If these 49 statistically significant associations were the result of chance alone, as may happen in 5 of 100 tests, IA should be associated with a reduction in PBs, with P<.05, in an equivalent number of tests. Not one such instance has been found in the literature.”

"A consent form that simply lists such items as "incompetent cervix" or "infection" as potential complications, but does not inform women of the elevated future risk of a preterm delivery, and that the latter constitutes a risk factor for devastating complications such as cerebral palsy, may not satisfy courts"

http://www.jpands.org/vol8no2/rooney.pdf

YourHumanRights (talk) 23:55, 31 May 2013 (UTC)

YourHumanRights - please stop wasting your time and ours. The changes you're asking for are not going to get into the article. This is a reality. You may see this as some sort of evil conspiracy, and you are entitled to that view (I think you're wrong, of course), but whatever the reason, you're wasting your time. HiLo48 (talk) 00:06, 1 June 2013 (UTC)

Are the cited studies looking at curettage? The available methods differ greatly, and if curettage is folded into the statistics then such numbers are not relevant to aspiration or other methods. Binksternet (talk) 00:07, 1 June 2013 (UTC)

And, once again, the opponents of the published science regarding this topic can offer no science of their - just personal insults and a very open and proud declaration that anyone actually presenting the facts here is wasting their time. Why would presenting scientific facts be a waste of anyone's time if this supposedly is a site dedicated to doing exactly that?

Binksternet, some of the studies do indeed separate the methods of abortion, but others do not. Indeed, we are speaking of surgical abortions here rather than chemical abortions that poison, kill, then expel the infant (and have occasionally also killed mothers such as Holly Patterson).

The latest published study on this topic comes from McGill College in Canada just a few months ago. They found the same results as just about everyone before them has in their study of 17,916 women's reproductive histories.

"Women who reported one prior induced abortion were more likely to have premature births by 32, 28, and 26 weeks; adjusted odds ratios were 1.45 (95% CI 1.11 to 1.90), 1.71 (95% CI 1.21 to 2.42), and 2.17 (95% CI 1.41 to 3.35), respectively. This association was stronger for women with two or more previous induced abortions."

http://jogc.com/abstracts/201302_Obstetrics_5.pdf

I have now provided TEN sources. Zero have been presented to refute these ten, and indeed none of them have been challenged and unpublished. Oh, and this will not be a waste of time - one way or the other.. I am well aware that the likelihood is that those who wish to keep women in the dark about this due to their affinity for abortion on demand will ultimately make this entire thread vanish. I hope that they realize what a cruel thing that would be to do and not do that, but I am keeping a careful record of every word posted here. In the event that those near the top of the wikipedia pyramid of editors want to use their delete buttons, there will be a detailed record of how this went down that I will be happy to share in the blogosphere.

YourHumanRights (talk) 01:06, 1 June 2013 (UTC)

Yawn. HiLo48 (talk) 07:40, 1 June 2013 (UTC)

Of the ten sources provided,

• Five are WP:PRIMARY (1, 3, 6, 8, and 10).
• One is a duplicate (4 duplicates 3)
• Two are not WP:RS (5 and 7)
• One includes spontaneous abortion (i.e., miscarriage) (2 - "Induced and spontaneous abortion are associated with similarly increased ORs for preterm birth in subsequent pregnancies, and they vary inversely with the baseline preterm birth rate, explaining some of the variability among studies.").
• One includes a word of caution (9 - "This review concluded that the risk of a child having a low birth weight or preterm birth increased for women with a history of pregnancy termination compared with those without such a history. This conclusion should be treated with caution due to the presence of clinical heterogeneity, confounders, and publication bias between the studies.").

None show a causal link between induced abortion and preterm birth. As noted by the author of source 8,

"To put these risks into perspective, for every 1,000 women, three who have had no abortion will have a baby born under 28 weeks," said Dr Klemetti. "This rises to four women among those who have had one abortion, six women who have had two abortions, and 11 women who have had three or more."

She added that there might still be social factors that they had not allowed for, related to some women's way of life, life habits, and sexual and reproductive health. She said also that the study could show a link, but not prove that abortion was the cause. — source

Also...Holly Patterson was killed by a rare bacterial infection (C. sordellii) that is not specific to or caused by medical abortion (see this). Making such false, misleading, inflammatory, and unsourced statements is not helpful. — ArtifexMayhem (talk) 09:32, 1 June 2013 (UTC)

I wonder if they took into account confounders like smoking? Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:09, 1 June 2013 (UTC)

So now we have 5 people who have responded to the medical science on this topic, and zero have offered up published studies to refute it. All we have is people making excuses, trying to dismiss meta-analyses, and pretending that forcing open a cervix and inserting steel knives through a vagina and into a uterus to cut and tear at flesh shouldn't have any negative affects afterward regarding whether that cervix can stay closed in a future pregnancy. The infection mechanism is also a VERY common sense mechanism here, but given the politics surrounding this topic, some not all) are squeamish about noticing the elephant sitting on the coffee table. Claiming that Holly Patterson's demise had nothing to do with the very powerful poison she took just a few days previous is a great example of the blinders people are willing to put on here. I respect your right to disagree with me here, but that is really absurd. Holly is not the only woman to have died from RU-486, but alas chemical abortions are not what we are talking about in this thread. But we really don't know how many there have been due to the wanton unreliability of the abortion industry.

http://articles.chicagotribune.com/2011-06-16/news/ct-met-abortion-reporting-20110615_1_abortion-providers-fewer-abortions-national-abortion-federation

But that is for another thread and another edit of this article - not this one. Alas, there is no evidence linking early chemical abortions to preterm birth later on. I included that fact in my edits on the preterm birth page. I am not the one here trying to include some information and repressing other information.

The National Academy of Science is just the latest group to have finally given up the ghost on these facts, folks, although they too do what they can to diminish it's visibility. Have a look at what is listed third here as a cause of preterm birth:

http://www.nap.edu/openbook.php?record_id=11622&page=625

But wikipedia editors atop the pyramid here know better, right? Reminder: Every peer reviewed, published study that has not been successfully challenged matters. There are indeed some that attempt to explain away their own numbers, but I invite anyone to find and link to a study that does not show higher preterm birth numbers for women who have had abortions in the past. Yes, that includes miscarriages, because of course that is a traumatic event for a human body also. This process is very similar to the one that transpired when the tobacco industry was first accused of hiding evidence that its products caused cancer. Then as now, sooner or later the science and the numbers will prevail. Does wikipedia really want to make a stand here, on this topic? If you have any doubts, here's some more facts from AAPLOG - an organization of over 2,000 OB/GYN's..

"The latest statistics in the USA (2007) show a preterm (less than 37 weeks) birth rate of 12.6%. Of these, Early Preterm Birth (EPB—under 32 weeks, infants weighing under 1500 grams, or about three pounds.) is at 7.8%, the highest rate in the past 30 years of stats. As noted in the studies above, previous induced abortions’ have an inordinately increased association with “extreme” (<27 wk) and “early”(<32 wk) premature deliveries (compared to 32 – 37 week premature births.) Thus, it follows that abortion will also have an inordinately increased association with cerebral palsy and other disabilities linked to extreme prematurity.

The total prematurity rate for women in America before 1970, before abortion became legal and common, was approximately 6%. It is of interest to note that in Ireland, where induced abortion is illegal, the prematurity rate in 2003 was 5.48%, less than half the U.S. rate of 12.3%. Is there a message here??

Further very interesting statistics come from the Polish experience. Between 1989 and 1993, Poland’s induced abortion rate decreased 98% due to a new restrictive abortion law. The Demographic Yearbook of Poland reports that, between 1995 and 1997 the rate of extremely preterm births (<28 weeks gestation) dropped by 21%. Is there a message here??"

The stubborn refusal of ACOG to accept the abortion/preterm link - from a doctor's group that includes the abortionists themselves - is perhaps the best example currently of politics trumping science..

YourHumanRights (talk) 16:40, 1 June 2013 (UTC)

Four things: 1. Everybody, please be aware that a similar discussion is taking place on talk:preterm birth under both talk:preterm birth#bacterial vaginosis and abortion and talk:preterm birth#Abortion - preterm birth link. RoyBoy and YourHumanRights are posting similar lists of sources, and the preterm birth article contains claims of relation. 2. Because I wanted to refer to this section from elsewhere, I renamed it. The new name has the benefit of not being obnoxiously long and of being neutral. YHR, feel free to complain about this on my talk page. 3. If this entire section is meant to be closed for discussion, the declaration of that should be moved out of the list of sources and to somewhere more visible -- it's currently unclear if it applies to the section, or just to the list of sources. 4. Given that it's unclear, I just want to throw in my hat that YourHumanRights isn't even trying to approach this neutrally. YHR, if you were, you would not keep saying that "knives" are "pushed through" the cervix. It's like if I used trauma shears to take off someone's underwear and you said a knife was pushed into their genitals. It is not the case that anything with a sharp edge on it is considered a knife; when you use the word "knife," people will think of a handle attached to a free blade. A curette is very different from a knife. You could not put a knife into a cervix without damaging it. One can put a curette into a cervix without damaging it. If you were interested in having an actual discussion, you would not use misleading language to color the debate. Triacylglyceride (talk) 18:35, 1 June 2013 (UTC)

Well, YHR has done at least one useful thing here. He's made it obvious that the curette and dilation and curettage articles badly need improvement. LeadSongDog come howl! 04:12, 2 June 2013 (UTC)

Recent textbook chapter, RCOG guideline, N.C. Senate bill

Sections of the following 4-year-old medical reference textbook chapter discuss several of the studies published prior to 2009 mentioned by YourHumanRights:

• Hogue, Carol J Rowland.; Boardman, Lori A.; Stotland, Nada (May 11, 2009). "Chapter 16. Answering questions about long-term outcomes", pp. 252–263, in Paul, Maureen; Lichtenberg, Steve; Borgatta, Lynn; Grimes, David A.; Stubblefield, Phillip G.; Creinin, Mitchell D. (eds.) Management of unintended and abnormal pregnancy: comprehensive abortion care. Oxford: Wiley-Blackwell. ISBN 978-1-4051-7696-5. DOI: 10.1002/9781444313031.ch16.
  • Abortion and future reproductive health
    • Does having one abortion imperil the woman's future reproductive health?
      • Preterm delivery
  • If one abortion does not harm reproductive health, are multiple abortions also safe?

A section of the following 18-month-old RCOG clinical guideline discusses several of the studies published prior to 2011 mentioned by YourHumanRights:

• Royal College of Obstetricians and Gynaecologists (November 2011). The care of women requesting induced abortion, 3rd revised edition. Evidence-based Clinical Guideline Number 7. London: RCOG Press, pp. 44–45:

  Chapter 5 Adverse effects, complications and sequelae of abortion: what women need to know
  5.5 Future reproductive outcome
  Preterm birth
  RECOMMENDATION 5.12 Women should be informed that induced abortion is associated with a small increase in the risk of subsequent preterm birth, which increases with the number of abortions. However, there is insufficient evidence to imply causality. (Grade B recommendation).

  Evidence supporting recommendation 5.12.
  A systematic review and meta-analysis by Shah et al. in 2009¹⁹⁹ reported that a history of abortion is associated with a small increase in the risk of preterm birth, giving an adjusted odds ratio of 1.27 (95% CI 1.12–1.44) increasing to 1.62 (95% CI 1.27 to 2.07) with more than one abortion. A recent large Australian population study of 42,269 births²⁰⁰ comparing term with preterm deliveries supports these findings. Among women with no history of miscarriage or induced abortion, 7.1% had a preterm birth compared with 8.9% of women who had one or more induced abortion (OR 1.25, 95% CI 1.13–1.40). Among women with a history of one or more miscarriages, 8.4% had a preterm birth, which also represents a borderline increased risk (OR 1.11, 95% CI 1.00–1.23).
  However, these findings should be interpreted with caution since few of the reviewed studies controlled for important confounders associated with preterm birth (such as socioeconomic status), and the associations have not yet been shown to have a causal relationship.
  In addition, the Shah review was confined to surgical methods of abortion. Where medical (mifepristone and prostaglandin) and surgical methods have been compared, there has been no significant difference reported in the risk of preterm birth.^201–203
  Furthermore, evidence increasingly points to an association between miscarriage and preterm birth. While previous reviews have been conflicting,^189,204,205 a recent systematic review²⁰⁶ suggests that the odds of preterm birth are similarly increased for both miscarriage and induced abortion. It has been postulated that the increased risk may be related to instrumentation of the cervix and uterus at the time of surgical evacuation.
  Further research is needed to understand this and other risk factors for preterm birth as well as abortion methods and gestation.
  
  189. Thorp JM Jr, Hartmann KE, Shadigian E. (Jan 2003). Long-term physical and psychological health consequences of induced abortion: review of the evidence. Obst Gynecol Surv 58 (1): 67–79. PMID 12544786.
  199. Shah PS, Zao J; Knowledge Synthesis Group of Determinants of preterm/LBW births (Oct 2009). Induced termination of pregnancy and low birthweight and preterm birth: a systematic review and metaanalyses. BJOG 116 (11): 1425–1442. PMID 19769749.
  200. Freak-Poli R, Chan A, Tucker G, Street J. (Jan 2009). Previous abortion and risk of pre-term birth: a population study. J Matern Fetal Neonatal Med 22 (1) :1–7. PMID 19085629.
  201. Chen A, Yuan W, Meirik O, Wang X, Wu SZ, Zhou L, et al. (Jul 15, 2004). Mifepristone-induced early abortion and outcome of subsequent wanted pregnancy. Am J Epidemiol 160 (2): 110–117. PMID 15234931.
  202. Virk J, Zhang J, Olsen J. (Aug 16, 2007). Medical abortion and the risk of subsequent adverse pregnancy outcomes. N Engl J Med 357 (7): 648–653. PMID 17699814.
  203. Gan C, Zou Y, Wu S, Li Y, Liu Q. (Jun 2008). The influence of medical abortion compared with surgical abortion on subsequent pregnancy outcome. Int J Gynaecol Obstet 101 (3): 231–238. PMID 18321519.
  204. Henriet L, Kaminski M. (Oct 2001). Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal survey. BJOG 108 (10): 1036–1042. PMID 11702834.
  205. El-Bastawissi AY, Sorensen TK, Akafomo CK, Frederick IO, Xiao R, Williams MA. (Mar 2003). History of fetal loss and other adverse pregnancy outcomes in relation to subsequent risk of preterm delivery. Matern Child Health J 7 (1): 53–58. PMID 12710800.
  206. Swingle HM, Colaizy TT, Zimmerman MB, Morriss FH Jr. (Feb 2009). Abortion and the risk of subsequent preterm birth: a systematic review with meta-analyses. J Reprod Med 54 (2): 95–108. PMID 19301572.

A better example of "politics trumping science" may be North Carolina Senate Bill 132: "An act to include instruction in the school health education program on the preventable causes of preterm birth, including induced abortion as a cause of preterm birth in subsequent pregnancies."
which passed the North Carolina Senate on May 13, 2013 by a vote of 48–10 (Republicans 42–0; Democrats 6–10),
and was referred to the North Carolina House Committee on Health and Human Services on May 15, 2013
(Republicans have a 77–43 majority in the North Carolina House, so it looks like the curriculum in North Carolina from the 7th grade up will be revised beginning in the 2013–2014 school year).

• Leslie, Laura (May 8, 2013). "Senate to debate abortion 'risk' bill". Raleigh, N.C.: WRAL.com.

  But UNC School of Medicine Clinical Professor of Obstetrics and Gynecology Dr. David Grimes called the bill "unnecessary and uninformed."
  "Senate Bill 132 would establish a state-sponsored ideology," he said. "The statement is scientifically false."
  Grimes formerly directed abortion surveillance efforts at the U.S. Centers for Disease Control and Prevention.
  "The World Health Organization, the CDC, the American College of Obstetricians and Gynecologists, the American Academy of Pediatricians and the American Public Health Association all have uniformly concluded that abortion does not cause prematurity, " he told the committee. "How did they all get it wrong?"

• Bowden, Carol (May 16, 2013). "Senate bill controversy". Goldsboro, N.C. Goldsboro Daily News.

Bobigny (talk) 21:50, 1 June 2013 (UTC)

The tangential discussion about whether a sharpened blade used to cut and tear flesh and remove limbs is a knife or not is perhaps not a waste of time at all. Perhaps it is indicative of the philosophical backflips that must be done in order to defend the violence of dismemberment in uetro. All manner of nonsense is game here, and that includes pretending that the procedure itself is *not* a violent and bloody one that always results in at least one dead body to dispose of. The comments of former abortion doctors on this topic are easily found online, and I need not repeat them here any more than I need to explain what a cranioclst is used for. But the image/diagram in this article is woefully inaccurate, and the deletion of an actual image of an infant at 8 to ten weeks gestation is further proof of how far the folks controlling this page are willing to go to keep people in the dark about things.

Back to the issue at hand, what we have here is a repeat of what the tobacco industries were up to back in the 1960's and 1970's. The doctor's groups who include OB/GYN's actually doing the abortions themselves have very keen interest in covering up the science here - for both legal and financial reasons. This includes the AMA, who went as far recently as to defend a woman in Alabama who had used many powerful illegal drugs while pregnant - arguing that nobody existed in utero - so there is no victim of what she did (Ankrom v. State of Alabama). ACOG used to publicly state that the abortion/preterm link did not exist also. That would come in handy if any of their abortionists got sued by a woman for being denied informed consent before having an abortion. The denial has since vanished from the ACOG literature, but not been replaced with a reversal to their earlier errors. Interesting, huh?

On the other side we have groups of doctors - AAPLOG, AAPS, etc. - who refuse to perform abortions and instead adhere to the Declaration of Geneva as reaffirmed following the Nazi Doctors Trial, The Nuremberg Code, and the UN Declaration of the Rights of the Child addendum to the Universal Declaration of Human Rights. These groups are slandered regularly on wikipedia. Just have a look at the AAPS page!

With reference to Senate Bill 132 in North Carolina, the same denials of the science regarding this matter have come into play by the folks doing the abortions themselves. (There is also a draft bill on this bouncing around the desks of the Virginia General Assembly, but it has not been introduced yet) The University of North Carolina-Chapel Hill has recently started abortions in house, and will do them in the first AND second trimester..

http://www.med.unc.edu/obgyn/Patient_Care/specialty-services/Womens_Options_Center

Abortionists at colleges are just as aware as their colleagues in small private abortion facilities how explosive this issue could be for them legally and financially. At this point, all they can do is fall back on a few doctors groups that include the abortionists themselves claiming that the link doesn't exist in spite of all the evidence. But, just as we can see here, they can't come up with much of anything to thwart the meta-analyses and large studies such as the ones I have linked to here. If indeed these or any sources and published studies are from such corrupt organizations and that produced such flawed studies, then why can't anyone refute them or point out their errors? I know lots of people have probably been trying, but ZERO of them have been challenged to date.

This is a slam dunk, folks. It's just the folks with great interest in keeping it quiet, many who have very keen legal and financial interests in doing so, who are engaging in such childish philosophical backflips about study authors and causality who are trying so hard to deny women informed consent here. Not surprisingly, wikipedia's upper echelon of editors is doing everything they can to assist them. They should either post and present the alternative view in well done meta-analyses, or they should give up the ghost here and update this article to present the scientific facts. Looks to me so far that they have no intention of doing either, but instead fall back upon a childish "because we can" philosophy.

YourHumanRights (talk) 16:54, 3 June 2013 (UTC)

At this point it is quite evident that you have little or no interest in crafting a serious, neutral treatment of this subject, and instead are intent on using this talkpage as a platform for your personal views on the subject, in violation of this site's guidelines. Your posts are a mix of false assertions (for example, the UN does not take an anti-abortion stance) and politically charged rhetoric which, I think it is fair to say, is aimed at provoking a strong emotional reaction from other editors rather than improving our article. I'm not willing to interact with you further, barring a major change in your approach, per WP:SHUN. MastCell ^Talk 17:10, 3 June 2013 (UTC)

When advocates for a political position are confronted with scientific fact that makes that position less tenable, and they have great difficulty refuting, they can tend to want to change the subject. In this thread, this has taken the form of an entirely tangential discussion of what is and is not a knife - and now we have the accusation that I have made up something regarding foundational human rights accords. MastCell, you will be more familiar than most regarding these foundation human rights documents, as you intervened to delete them from the AAPS Page a few years back - even though the leaders of that organization were AOK to have them included on their page..

“I will maintain the utmost respect for human life, from the time of its conception; even under threat, I will not use my medical knowledge contrary to the laws of humanity; I will practice my profession with conscience and dignity”

Hippocratic Oath Declaration of Geneva Following the Nazi Doctors Trial at Nuremberg

“WHEREAS the child, by reason of his or her physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth”

United Nations Declaration of The Rights of the Child Universal Declaration of Human Rights

“The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision”

The Nuremberg Code

You can accuse me of whatever you want, MastCell. The record is clear that you have taken a great interest in this topic yourself, and have strong feelings about it. We disagree, clearly. The difference here is that you are threatening to censor someone who disagrees with you. I have no need to try and censor you. You have offered up absolutely nothing here to refute the findings of any of the large scientific studies and meta-analyses I have linked here. I could post more.. Perhaps you could be less personal and more scientific in your future responses?

Now then, BACK TO THE ACTUAL TOPIC:

It seems that the University of North Carolina is experiencing an interesting battle between two of its doctors at present. Bobigny quoted one doctor at UNC above regarding Senate Bill 132. As an OB/GYM, he is perhaps the man actually performing the abortions at UNC. If so, the worry about the legal and financial ramifications of this issue certainly would come into play here - even if he is just defending his colleagues who are performing the abortions inside a publicly funded facility. As I said above, the tact he employed was again is to simply fall back on the larger organizations who have denied the link in the past. What he fails to mention is that ACOG has most recently removed the denial, but has not replaced it with a confirmation of the link. The RCOG and the National Academy of Sciences, both rather large organizations, have finally accepted that there is a link!

Here is the *other* opinion of a doctor at UNC that was absent from Bobigny's post above:

BEGIN

"UNC School of Medicine Associate Professor of Pediatrics Dr.Marty McCaffrey is a member of the state's Child Fatality Task Force. He spoke in support of the bill, calling the evidence that abortions increase risk of later preterm births "immutable."

Citing studies and meta-studies of data, McCaffrey said evidence shows abortion as a risk factor for preterm birth "dwarfs" smoking as a risk factor.

"It’s been estimated abortion may be responsible for 31 percent of preterm births in North Carolina," he told the committee. "It’s time to educate our young citizens about preterm birth.""

END

Note the crucial reference to "Citing studies and meta-studies of data,.."

Now then, can anyone *here* do that and demonstrate why and how myself, AAPLOG, the RCOG, and the NAS are all wrong about this??

YourHumanRights (talk) 17:54, 3 June 2013 (UTC)

Link to the article quoted..

http://www.wral.com/senate-to-debate-abortion-risk-bill/12425226/

YourHumanRights (talk) 18:04, 3 June 2013 (UTC)

Sources

Most of the sources proffered by YourHumanRights were analyzed by User:ArtifexMayhem here. In the interest of moving this discussion in a more productive direction, a brief and non-comprehensive roundup of some reputable secondary sources regarding abortion and subsequent preterm birth would include the following:

• The American Congress of Obstetricians and Gynecologists (ACOG) does not list induced abortion as a risk factor ([9]).
• The Royal College of Obstetricians and Gynaecologists (RCOG) states that abortion is associated with a small increase in the risk of subsequent preterm birth, which increases with the number of abortions. However, RCOG emphasizes that there is insufficient evidence to imply that induced abortions cause prematurity. That is, the association may reflect common risk factors which predispose to both abortion and prematurity. ([10])
• The Centers for Disease Control does not list abortion as a risk factor for subsequent preterm birth ([11]).
• The Mayo Clinic lists "multiple miscarriages or abortions" as a risk factor for preterm birth ([12])
• Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice (6th edition, 2009, which I believe to be the current edition) states: "The magnitude of the risk of preterm birth related to elective abortion is small but appears to be real."

This list isn't intended to be comprehensive, but rather a starting point for an informed discussion. Additional sources would be most welcome. MastCell ^Talk 19:02, 3 June 2013 (UTC)

As consistent as the numbers are in study after study, the Moreau study suggests that they are actually smaller than the reality due to under-reporting of previous induced abortions.

"As commonly reported in fertility surveys based on women's reports, it is likely that induced abortion was under-reported. The extent of under-reporting varies between 40% and 65% in the literature.23 However, in this study, data on previous induced abortion were taken from hospital records that were filled in prior to enrolment, which reduces the risk of differential recall according to gestational age. In a specific study addressing this question in relation to cancer, Tang et al.24 found no differential reporting of induced abortion between cancer cases and controls. In addition, under-reporting varies according to women's social and demographic background and is more common among older women and women living alone, with a low educational level.25–27 Thus, we would expect more under-reporting among cases than among controls, and consequently, an under-estimation of the association."

Their discussion also includes the mechanisms, which of course blend in with the causality issue - which seems to me to be very much a matter of common sense given the process of forcing open a cervix and the violence taking place inside of the uterus. This study's authors also into detail regarding other maternal details (smoking, poverty, etc.) and says that the link consistently remained even when all of those other factors were subtracted out. This would be a second reason why all these numbers in all these studies are probably themselves smaller than reality. But even with them, the RCOG claim that the risk is small doesn't appear in any of the meta-analyses. Nor does it appear in the large Moreau study.

http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2004.00478.x/full

ACOG's silence on the issue these days (in contrast to what some in North Carolina have suggesting in a continuing denial of the link) as well as RCOG's current stance that it does indeed exist but is "small" seems to me to be the result of both legal and financial worries on the members of both these organizations who are themselves doing the abortions themselves. They would obviously have a very keen interest in not giving lawyers across the world a golden opportunity to sue them for the denial of informed consent *and* for the costs associated with raising a child with severe developmental disabilities.

AAPLOG has no such concerns, and is itself *a part* of ACOG. AAPLOG doctors are members of ACOG.. If ACOG could indeed refute what AAPLOG has been saying regarding this topic, I would think they would have done so by now over the past several years - but they haven't. Anyone else here is invited to do the same, and do their job for them. Indeed, I'll repeat my request for anyone to show us a single published study that does *not* show women who've had abortions later having more preterm deliveries in their DATA. I have reviewed dozens of studies on this topic, and have never found one that showed such numbers in its actual numbers/results.

Falling back on the curious statements of a few doctors groups who themselves have been dragging their feet on this topic for years (the same ones who publicly support abortion on demand and have members that perform them) is not the same thing as demonstrating via published studies that the link is fictitious. All these days and all these paragraphs later, and nobody has been able to come up with even ONE as of yet.. If that situation continues, there is no reason not to update this article.

YourHumanRights (talk) 21:00, 3 June 2013 (UTC)