Talk:Abortion and mental health

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I would like to get your opinion on this review[edit]

This review has been brought up before, but after searching the archives I could not find a specific rebuttal to it, so I was hoping if I posted a link here, someone would tell me why it is not even mentioned in the article. I am bringing it up because I want to know what the science says, and this review concluded that "...induced abortion increased the risks for...mood disorders substantial enough to provoke attempts of self-harm." I realize that Johns Hopkins is pretty prestigious, but it isn't gospel. Jinkinson (talk) 18:22, 28 July 2013 (UTC)

Only yesterday did I come to this article. So I don't understand why the 2003 study was not mentioned. There must be some reason other than the difficulty that, unlike the 1990 and the 2008 reports that are mentioned, information about it is not sourced to publications with the names Family Planning Perspectives or Contraception: An International Reproductive Health Journal. Esoglou (talk) 19:50, 28 July 2013 (UTC)
I think the paper isn't cited because it's 10 years old, and a huge amount of evidence has subsequently been published which renders its conclusions outdated (see WP:MEDDATE). The 1990 APA panel is mentioned because it's notable in a historical context. Also, the 1990 APA findings were published in a little journal called Science (as PMID 2181664), not in Family Planning Perspectives or Contraception, so your imputation of motive is not only lazy but also ignorant. The 2008 APA findings are clearly notable, as they express the current position of a major expert body on the subject. MastCell Talk 19:57, 28 July 2013 (UTC)
Is it necessary to mention that I set aside ("There must be some reason other than ...") as a reason the choice of citations for the 2008 and 1990 reports (I should indeed have specified which 2008 report) in footnotes 4 and 9? At least you did advance a reason for omitting the 2003 study: it is five years older than the mentioned 2008 papers (which in their turn are five years older than the unmentioned 2013 report). By the way, the article says nothing of the inconclusive judgement of the APA 2008 report on abortions other than a first. Esoglou (talk) 08:01, 29 July 2013 (UTC)
Actually, it does: "The [APA] panel noted a lack of quality data on the effect of multiple abortions. Additionally, the same factors which predispose a woman to multiple unwanted pregnancies may also predipose her to mental health difficulties; therefore, they declined to draw a firm conclusion on multiple abortions." MastCell Talk 18:47, 29 July 2013 (UTC)
What I said was intended in reference to the lead. I should not have written "the article". You are right. I apologize. Esoglou (talk) 06:24, 30 July 2013 (UTC)
No worries. MastCell Talk 21:21, 30 July 2013 (UTC)

recent edits[edit]

I removed the references to Fergusson and Belleini because after rewording them, they seemed a lot more tenuous than the Cochrane and J. Clin Psych references later in the paragraph. There were some WP:PEACOCK words in there too, and I note that the editor who inserted them has also been inserting Belleini et al references into a number of other neonatology (and other) articles. These particular ones did pass MEDRS, but as i noted in my reversion, i think that there is a weight issue here, and the Fergusson and Belleini studies are much less useful; the methodology of the Belleini article actually looked pretty shaky based on the abstract, though i did not read the entire article yet. -- UseTheCommandLine ~/talk ]# ▄ 22:24, 30 August 2013 (UTC)

I can agree that there is a weight issue here, but these 2 reviews are independend and their limits are not greater than those of previous reviews. I do not understand why they cannot be quoted here. Principina. 1 September 2013

I notice that quite a number of your edits so far have been the insertion of references to articles by Bellieni, et al, sometimes with no obvious compelling reason. While that could be a coincidence, my experience is that it's usually someone connected with the authors. If that's the case, you may want to review our policies on conflict of interest as well as our policies on citation spam and self-citation (which are sometimes conflated).
As for the Bellieni paper itself, it comes back to undue weight for me. Perhaps it could be acceptable with less effusive language or in an external links section, but I'm still rather skeptical. Since it was just published, and thereby has fewer opportunities to be cited than even the Cochrane paper, I'm inclined to wait a bit anyway, but open to other arguments. -- UseTheCommandLine ~/talk ]# ▄ 23:55, 1 September 2013 (UTC)
I have the same concerns about self-citation. More broadly, we've tried to move away from detailed descriptions of individual studies to a broader overview of current medical opinion on the subject. A lot of literature has been published on this subject, of greatly varying quality. We've generally tried to wait until specific studies have been appraised by reputable expert bodies (the APS, the Royal College of Psychiatry, Cochrane, etc) before incorporating them, in order to head off long talk-page debates about study methodology. Thus, I'd favor waiting to incorporate this particular article until it's clear how much weight it will be assigned by the relevant expert community. MastCell Talk 23:09, 2 September 2013 (UTC)

NuclearWarfare's revert of my edit[edit]

Mere moments ago, NuclearWarfare reverted my edit in which I removed all mentions of Charles et al.'s review, which at the time seemed like the clearly correct thing to do since previous discussions on this talk page have made it clear that major medical bodies' opinions are what count the most. However it seems the cabal insists on including Charles et al., even though it was done by researchers from Johns Hopkins, which is not a major medical body like the APA or NCCMH. NuclearWarfare's pathetic attempt to justify its inclusion by saying that "Just because seven folks on an APA Committee have a report doesn't automatically mean it's superior to a well done systematic analysis from a team out of a single un[iversity]" isn't fooling any of us, since the last time I checked neither he nor MastCell was the final arbiter of whether an analysis is "well done". (I mention MastCell because he has used his own monumental scientific expertise to dismiss another review on this page less than a year ago.) So if someone would care to explain why we include only the non-major medical body reviews that just so happen to say that abortion doesn't cause mental health problems, and provide a logical reason for our doing so, then I think we can consider this issue resolved. Jinkinson talk to me 01:50, 23 April 2014 (UTC)

Have you done a systematic review before? If you haven't, it's a rather interesting methodological exercise, so please give me the opportunity to explain how it usually works: You take your topic at hand and you find literally every source in multiple databases that could possibly be related. You're up to hundreds or even thousands of studies. You then start whittling. You can't just exclude a source because you think the source's conclusions are iffy or not in line with the rest of the evidence, but you need instead to cite a clear reason for exclusion. What you can do is then take your remaining studies and perform a quality assessment of all of them. You're looking for things like sample size (the more the better!) but also research design: randomization, positive and negative controls, blinding, etc. Only then can you go ahead and summarize/interpret the evidence (Khan, K. S.; Kunz, R; Kleijnen, J; Antes, G (2003). "Five steps to conducting a systematic review". Journal of the Royal Society of Medicine. 96 (3): 118–21. PMC 539417free to read. PMID 12612111. ).

Statements and position papers by large medical bodies are ideally nothing more than well-done systematic reviews. The medicine-related articles' reliable sources page is unequivocal about this (WP:MEDASSESS): "In general, editors should rely upon high-quality evidence, such as systematic reviews, rather than lower-quality evidence, such as case reports, or non-evidence, such as anecdotes or conventional wisdom. The medical guidelines or position statements produced by nationally or internationally recognised expert bodies often contain an assessment of the evidence as part of the report." (emphasis mine). I'm not dismissing the APA's findings. The people on that committee that wrote that report are all far smarter than I am and have put far more work into summarizing the position of their fellow learned mental health professionals. But the exact same is true for Dr. Blum's work, which seems to be widely-cited and accepted in the broader family planning literature (as per a quick Google Scholar search).

I feel like I have rambled on for a while. I hope this explains my position a bit more. NW (Talk) 02:46, 23 April 2014 (UTC)

Not really--your response above is indeed rambling, but contains very little that pertains to the question I actually wanted answered (see a few sentences down for the actual question). I am tempted to add Bellieni's review myself but I don't want to get topic banned or anything, given that this article is subject to discretionary sanctions. Given the ambiguity of the response I received previously here, I will try to rephrase my question less ambiguously: What makes Charles et al. better than Bellieni et al.? I think we should be consistent as far as including literature reviews is concerned; that is, we should include Charles and Bellieni's reviews, or neither of them, and it seems to me that the only arguments about only including one consist of nothing more than special pleading. However, I'm willing to change my mind if someone can answer this question. I might also note that since apparently being highly cited has something to do with your scientific work being good, perhaps Bellieni's GS cites (h-index 17) will sway your views on this. As it is, I think that by cherry picking the reviews that say abortion doesn't cause mental health problems the article does a huge disservice to our readers by creating an impression that differs significantly from reality. Jinkinson talk to me 22:56, 24 April 2014 (UTC)
I disagree with your addition of the Bellieni review. You ask what makes Charles et al. "better" than Bellieni et al. The answer should be obvious: the Charles paper has been accorded far more weight by experts in the field compared to the Bellieni paper. The Charles paper is cited extensively in the reports from various expert bodies, and informed their conclusions on the subject. In contrast, the Bellieni paper has had no discernible impact on expert opinion in the field. (Granted, it's a more recent paper; if it turns out to impact expert opinion down the line, then we can always revise our article accordingly).

It is our job to clearly convey the state of knowledge and expert opinion in a field. In this case, reputable expert bodies are unanimous in finding that abortion does not cause mental-health problems. It is misleading to present the Bellieni review in a he-said-she-said manner, as a "rebuttal" to the Charles review. Doing so creates false equivalence and a false impression as to the degree of expert support for these viewpoints. It is completely legitimate—and, in fact, required by fundamental site policy—to weight the Charles paper more substantially than the Bellieni paper, because experts in the field have weighted them thusly. It is "cherry-picking" (to use your term) to artificially prop up studies which have failed to gain traction among experts in the field.

Since you raise the question of Bellieni's credentials, it's perhaps notable that he is an anti-abortion advocate and a prominent member of the Pontifical Academy for Life, an anti-abortion lobbying arm of the Catholic Church. These associations do not discredit his published research, but neither are they totally irrelevant. MastCell Talk 21:11, 28 April 2014 (UTC)



references #5 and 6 are dated per Wikipedia:Identifying_reliable_sources_(medicine) ....these newer reviews could replace them [1] and [2] ....IMO--Ozzie10aaaa (talk) 08:37, 22 September 2015 (UTC)

Mental health and abortion law[edit]

@SocraticOath: your new addition seems a bit like original research, can you find some secondary sources which talk about the significance of mental health in these laws? –Roscelese (talkcontribs) 18:45, 1 October 2015 (UTC)

@Roscelese:, please see the refs that I added today to justify this paragraph's inclusion.SocraticOath (talk) 21:21, 2 October 2015 (UTC)
The Guttmacher source seems relevant, but the Newsweek not so much, and neither address the British law. Can you find better sources? –Roscelese (talkcontribs) 21:58, 2 October 2015 (UTC)
@Roscelese:, I included references to a 2014 book by a reliable-sounding publisher regarding the American portion of this discussion. The British portion has been very easy to demonstrate with sources... please see today's additions.SocraticOath (talk) 13:19, 5 October 2015 (UTC)
What I'm trying to convey isn't that I don't believe that's really in the law, but that the article would benefit from sources commenting on why the inclusion of mental health is significant. –Roscelese (talkcontribs) 13:31, 5 October 2015 (UTC)
Don't you mean, the article would benefit from sources commenting on why the inclusion of law is significant for this article?--SocraticOath (talk) 15:35, 5 October 2015 (UTC)
I think I figured out what was confusing before... the mental health reason to allow abortions is only really important in the US regarding late terminations of pregnancy; it's not really much of an issue legally surrounding abortions performed before viability. In the UK, I think it's more of an issue because of their stricter rules surrounding abortion. -SocraticOath (talk) 15:55, 5 October 2015 (UTC)
"Don't you mean, the article would benefit from sources commenting on why the inclusion of law is significant for this article?" - Or that, but I meant what I said. Why do law-related sources believe the inclusion of mental health in the law is significant? –Roscelese (talkcontribs) 17:56, 5 October 2015 (UTC)
I think that one thing people want to know when they read about abortion is, "Where and under what conditions can folks legally get an abortion?" So if this article includes a paragraph related to this question, then so much the better. There is an abortion law article, but it is more written to survey the world's policies than to focus on specific issues.
As for how this is significant in law, seeing as the law is written to protect a woman's health, I suppose it would be common for a person to ask for a clarification: "Is that for physical health only or does that also include mental health?" Now this article provides some insight there too.--SocraticOath (talk) 18:44, 5 October 2015 (UTC)
Why not try to find sources that do this analysis instead of attempting to do it yourself? –Roscelese (talkcontribs) 19:34, 5 October 2015 (UTC)

────────────────────────────────────────────────────────────────────────────────────────────────────@Roscelese:, would you kindly help me to understand your question a little better? Which of the statements of the paragraph on mental health and abortion law seem like original research to you? -SocraticOath (talk) 21:11, 5 October 2015 (UTC)

I modified the wording of the first paragraph to more closely follow what's said in the Guttmacher article in the second paragraph under the heading, "...but not in Abortion Context". -SocraticOath (talk) 22:47, 5 October 2015 (UTC)
SocraticOath's edits appear to be sensible to me, but I also suggest some additional citations, at least for the UK context. This gives some useful background. This research paper on reasons for abortions may also be of some relevance. Bondegezou (talk) 22:52, 5 October 2015 (UTC)