Talk:Abortion/Archive 51

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RfC v2

The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this discussion. A summary of the conclusions reached follows.

An overall consensus here exists for version 2. Some editors here have suggested tweaks to the proposed text here, such as the removal of the word especially, and noting the change in option 2 (where "carrying a pregnancy to term" has been replaced with "carrying a baby to term."), and I would recommend these finer points be discussed in more detail. But overall, for now, a consensus exists for option 2. The finer refinements can continue to be discussed. Steven Crossin ^{Help resolve disputes!} 03:21, 22 September 2019 (UTC)

---

In the above discussion, some are opposed to the current lede sentence on the basis that the precise number is specific to the USA and thus invalid.

There would seem to be three possibilities, not the two listed above.

1. It is safer than carrying a pregnancy to term, which has a 14 times higher risk of death in the United States. (current version)
2. Modern abortion procedures are safer than carrying a baby to term,[1], [2], [3], [4], especially in the US, where maternal mortality rates are among the highest in the developed world.[5]
3. Omit the statement.

Guy (Help!) 08:34, 6 August 2019 (UTC)

Discussion

• I favour 2 (obviously). I note especially [6] and [7]. There is a well documented consensus that legal abortion carried out by properly trained people, especially medical rather than surgical abortion, is remarkably safe, and that all efforts to deny this either through rhetoric or through law are designed to control women, not make them safer. Guy (Help!) 08:34, 6 August 2019 (UTC)
• As an alternative to omission, I'm ok with retaining that sentence in the Abortion#Safety only. Per other users' concerns in this RfC and per MOS:INTRO (which advocates a general summary, saying that "editors should avoid... overly specific descriptions"), the sentence should be removed from the lead. Brandmeister^talk   10:04, 6 August 2019 (UTC)

  OK, so for all your protests about it being overly specific, you're really concerned that people shouldn't know that abortion is safer than childbirth, especially in the US (because we know that most people don't read beyond the lede). Good to know, thanks. Guy (Help!) 13:06, 6 August 2019 (UTC)

  I don't see a net benefit in such generalized statements. If abortion is safer than a normal childbirth, if "making safe abortion legal and accessible reduces maternal death", should a woman have an abortion instead of carrying a healthy pregnancy to term? Simply wow. Brandmeister^talk 14:59, 6 August 2019 (UTC)

  People should also fly everywhere because it's safer than driving. >rolling eyes< Having a baby is not about deciding what's safer, it's about love and the drive to reproduce. Brandmeister, you have become disruptive to this discussion. Binksternet (talk) 16:05, 6 August 2019 (UTC)

  Exactly, it is not about deciding what's safer. So no need to compare it generally with a normal pregnancy and it's not only my opinion in this discussion. Brandmeister^talk 19:47, 6 August 2019 (UTC)

  This is Wikipedia, we deal with reality. In the UK, for example, medical professionals include advice on termination as part of the discussion with pregnant women, explicitly including the fact that abortion is safer. [8]. Guy (Help!) 19:53, 6 August 2019 (UTC)

  2 is problematic. "Modern abortion procedures are safer than carrying a baby to term" is still an unqualified generalization and oversimplification. It depends on a country and on whether abortion is safe or unsafe. For that matter we already state that "When performed legally and safely..." Also, there are conflicting studies on this issue: [9], [10]. Brandmeister^talk 22:37, 6 August 2019 (UTC)

  Your first link shows a study that combines abortion mortality with miscarriage mortality – not relevant. Your second link shows a report that is an outlier, one that is swamped by many other studies showing abortion to be safer than childbirth. The lead section is for stating major trends, not outliers. Binksternet (talk) 03:14, 7 August 2019 (UTC)

  Based on relevant research and RS articles posted in this thread, and in previous sections, I have to agree that saying something like "Modern abortion procedures are safer than carrying a baby to term..." is accurate and a useful sentence (or phrase) for the lead. I appreciate the effort by fellow editors posting relevant studies and RS articles, reflecting research from the nineteen seventies all the way to recent studies in the twenty-teens. That research and this discussion has given me a clear picture of what is accurate. ---Steve Quinn (talk) 17:30, 7 August 2019 (UTC)

• 2 seems perfectly fine, addressing the single study's relevance while noting lesser studies that are still relevant broadly to the world population. --Masem (t) 20:22, 6 August 2019 (UTC)
• 2 seems fine to me, except that the wording of the "especially" clause is ambiguous and could be read as suggesting doubt about the validity of the first part of the sentence outside the US, which is not the way it should be read. Would either of the following changes in wording be agreeable? (a) change "especially in the US" to "by a factor that is especially large in the US..."; or (b) start a new sentence after the four references "Abortion is safer than childbirth by a particularly large margin in the US..." Thanks. NightHeron (talk) 22:49, 6 August 2019 (UTC)
• 3 In addition to the above, the sentence is flawed in another ways. The CDC itself notes: "Errors in reported pregnancy status on death certificates have been described, potentially leading to overestimation of the number of pregnancy-related deaths. Whether the actual risk of a woman dying from pregnancy-related causes has increased in unclear, and in recent years the pregnancy-related mortality ratios have been relatively stable". That's probably why for 2015 we have conflicting figures - 17.2 (CDC) or 14 deaths (CIA Factbook). But even if 17.2 is considered, that's actually is not high for standard 100,000 live births - merely 0.01% meaning 99,99% of all other pregnant women do survive. Even CDC's own website does not consider 17.2 a high number, only talking about an increase. Also, per Maternal mortality in the United States, up to 50% of these deaths are due to preventable causes. This means (and I think many medical professionals would agree) that reducing those preventable causes is the primary solution to maternal deaths, not the abortion. Brandmeister^talk 01:12, 7 August 2019 (UTC)
• 2 works fine, and can be augmented with mortality ratios from a few large countries for comparison. Binksternet (talk) 03:15, 7 August 2019 (UTC)
• 2 looks good, and would be an improvement. Alexbrn (talk) 07:50, 7 August 2019 (UTC)
• 2 would be more factual KFvdL (talk) 13:40, 7 August 2019 (UTC)
• None of these choices, either – Sorry, I'm not trying to be difficult, but we can't go with any of these choices and stay in line with policy. 1 is not good for the reasons given in the previous RfC, above. 3 would be omitting vital information from this article, so that's right out. 2 is absolutely better than 1, but it does not comply with WP:MEDRS and I think is still (unintentionally) inaccurate in a potentially misleading way. First, I don't see how we can use popular press like Popular Science, The Telegraph, and NPR, to back up a medical statement, per WP:MEDPOP. Second, the first PDF link shows up as an "invalid token" error for me, so I'm not sure what that PDF is, and so AFAICS, the only scientific/medical journal source in #2 as drafted is the 2012 US "14x" study (text). #2 as drafted doesn't say exactly what that the study says, which is Legal abortion in the United States remains much safer than childbirth. It's "legal abortion in the United States", not "modern abortion procedures", and it's specifically childbirth, not "carrying a baby to term". What the study does is compare the pregnancy-associated mortality rate among women who delivered live neonates with mortality rate related to induced [legal] abortion (in the US in 1998–2005). (The study also looks at literature on morbidity rates and concludes that the overall morbidity associated with childbirth exceeds that with abortion.) The study itself notes one of its weaknesses is that it doesn't account for other risks involved with pregnancy/carrying a baby to term, either before or after childbirth, nor the risks associated with abortions that can arise after the abortion procedure (long-term risks). Of course, some pregnancies who are carried to term nevertheless result in abortions, and those aren't accounted for, either. The authors say they don't think any of these affect the validity of the study, but it's still just one study–we should include others. I suggest what needs to be done is not an RfC, but a pre-RfC discussion to workshop language and sources. I know there are other academic sources we could use (not popular press), in addition to the 2012 US 14x study, and I'm sure we can come up with accurate consensus language. – Levivich 16:11, 7 August 2019 (UTC)
• 2 seems to solve this issue. It speaks in broader and more generalized terms, while also noting the findings in the USA. It also debunks the myths that say the opposite is true or that say abortion is shown to be an across-the-board, unhealthy alternative. ---Steve Quinn (talk) 18:43, 7 August 2019 (UTC)
• None per Levivich (talk · contribs)Manabimasu (talk) 23:48, 7 August 2019 (UTC)
• 2 It is very important to have this summary of safety in the lead (per WP:Lead: "...summarize the most important points,") Safety is a VERY important point, especially when many are propagating myths about abortion safety. But I agree with editor NightHeron about the "especially" sounding somewhat clumsy and confusing....this can be improved later. ---Avatar317^(talk) 17:19, 8 August 2019 (UTC)
• Vote to prefer the first RfC, however, should that RfC fail, my preference is first for 3, to omit. I would go with 2, but it should read "have a lower risk of death than carrying" instead of "are safer than carrying" because of the issue of conflating multiple risks of safety--such as long-term complications vs. mortality vs. mental heath. Any mention of safety should refer to the type of safety involved. Non-medical professionals should not be expected to know which kind of safety the references are dealing with without explicit clarification.--Epiphyllumlover (talk) 04:28, 9 August 2019 (UTC)

  Some of those sources (and indeed others cited in the article) look in depth at the very questions you raise, and find that there is little to no risk of any of these outcomes that anti-abortionists assert to be common. There is, however, a very strong correlation between those risks and being denied abortion. Guy (Help!) 12:46, 9 August 2019 (UTC)

  Each assertion of safety must be narrowly described and reflect the ref tag at the end of it. Broad strokes of "it is safe" in general expect the reader to know an unreasonable amount of background information. Generalized statements that are difficult to either substantiate or refute reflect the big lie fallacy, which is often used in political rhetoric. If safety is about maternal death, mention maternal death, if mental health, state what type(s) of mental health, if fertility, describe the likelihood of future chronic fertility complications, etc.--Epiphyllumlover (talk) 04:08, 10 August 2019 (UTC)

  The WHO and other sources describe abortion as very safe, and the only sources portraying it as risky are either anti-abortion sites (many of which discuss "risks" that have been analysed and found to be spurious) or are cearly discussing the developing world and other places where abortion is not conducted wihtin a well-regulated medical environment. In other words, it's only dangerous when your medical system isis broken or when it's illegal. And we make that point, with sources, already. Guy (Help!) 10:49, 10 August 2019 (UTC)

  The individual reader cannot be expected to know the medical background of what constitutes "safety". Choosing this vague description is a logical fallacy.--Epiphyllumlover (talk) 04:06, 11 August 2019 (UTC)

  Please re-read my previous response to you. (I added a "reply to" at that location.) The lead should summarize; "safer in ALL respects" is supported by the sources. The relative safety of each complication could be detailed in the safety section. ---Avatar317^(talk) 19:45, 11 August 2019 (UTC)

  Not with respect to fertility--abortion is a risk factor for infertility while birth is not. Correlations with suicide is also stronger with abortion than birth, but this is controversial because maybe woman who choose abortion were already more likely to choose suicide even prior to the abortion. There is no way to know--possibly the suicide risk factors are also abortion risk factors.--Epiphyllumlover (talk) 03:20, 14 August 2019 (UTC)

  Late abortions (which are a very small proportion in countries where abortion is legal) and incompetent abortions (which are not being discussed here) are a risk factor for infertility. Birth by Caesarian section, which in 50 countries constitutes over 27% of births, is a risk factor for infertility. NightHeron (talk) 10:52, 14 August 2019 (UTC)

  This study found no connection between suicide and abortion. [11] Gandydancer (talk) 15:21, 14 August 2019 (UTC)

  Basically, every medical assertion made by Epiphyllumlover is false. (Safely performed) abortion is not associated with subsequent infertility (see RCOG guidelines); unsafe abortion (in settings where abortion is illegal or access is restricted) can lead to infertility, but that's a different issue. Nor does abortion cause mental-health problems or suicide (see the same guideline, along with the findings of every other relevant expert group). Epiphyllumlover, ultimately it is disruptive for you to continue to use this page to propagate misinformation and false medical claims about abortion; please stop. MastCell ^Talk 16:15, 14 August 2019 (UTC)

  For proof of the fertility assertion, see Cleveland Clinic: Asherman's Syndrome. There are eight scholarly references backing this up. I explained how the suicide correlation, though it exists, is controversial due to cause/effect considerations; do not misrepresent me.--Epiphyllumlover (talk) 17:43, 16 August 2019 (UTC)

  The problem is that you have an agenda, but you don't know what you're talking about. The biggest risk factor for Asherman syndrome is pregnancy itself, not abortion. Asherman syndrome can occur after any surgical procedure involving the uterus, and is most commonly associated with D&C performed after live delivery or after a miscarriage. There is no indication that Asherman syndrome is more common after induced abortion than it is after live birth or miscarriage. Separately, many abortions use medication and don't even involve instrumentation of the uterus, and thus pose no risk of Asherman syndrome. That reference doesn't prove your assertion in any way. Expert bodies are quite clear on this: "Published studies strongly suggest that infertility is not a consequence of uncomplicated induced abortion." (RCOG guideline). You're tying yourself into logical knots to avoid recognizing the actual state of human knowledge on this subject, which we have a responsibility to convey accurately to readers. MastCell ^Talk 22:18, 16 August 2019 (UTC)

• 2 is good although I agree with NightHeron about using the word "especially." To quote him, "...except that the wording of the "especially" clause is ambiguous and could be read as suggesting doubt about the validity of the first part of the sentence outside the US, which is not the way it should be read." Gandydancer (talk) 14:13, 10 August 2019 (UTC)
• 2 Looks good. 1 is fine, but 2 is clearer. The bit after it in the current version, about "unsafe abortions", however... It's true, but "unsafe" needs to be more clear. - CorbieV ^☊ ☼ 22:55, 12 August 2019 (UTC)
• 2 is fine, although I guess I worry that it's original synthesis to link the 14x number to the US maternal mortality rate. (Although at least one or two of the cited sources allude to this connection, so it's probably fine). I'd favor simply saying that "Modern abortion procedures are safer than carrying a baby to term." This avoids country-specific estimates, and a general statement like this is appropriate for the lead (with more detail in the body of the article). I would also favor modifying the lead to something like: "Modern abortion procedures, when performed by trained personnel in settings where abortion is legal, are safer than carrying a baby to term." After all, "modern procedures" are not the sole determinant of safety—the legality of abortion and the personnel performing it also impact its safety. But in the interest of compromise, I'm OK with choice #2. MastCell ^Talk 15:57, 14 August 2019 (UTC)

  "Modern abortion procedures, when performed by trained personnel in settings where abortion is legal, are safer than carrying a baby to term childbirth." I think that's a fine way to put it. – Levivich 16:07, 14 August 2019 (UTC)

  After doing a little more reading, I have some concerns about option #2. According to the Royal College of Obstetricians and Gynaecologists, in the U.K. the risk of death from abortion was 0.00032%, whereas the risk of maternal death after live birth was 0.01139% (see "The Care Of Women Requesting Induced Abortion", pp 37–38). So based on those numbers, in the U.K., abortion is actually about 35 times safer than childbirth. That suggests that the relative safety of abortion in the US is not an outlier, and is not driven primarily by the US's relatively high risk of maternal mortality. Therefore, I'd favor simply saying that abortion (with the above caveats about legality/training) is substatially safer than childbirth, but would not include the idea that the US is an outlier, because it doesn't seem to be true. Levivich's suggestion is fine with me. MastCell ^Talk 16:09, 14 August 2019 (UTC)

  Support Levivich's new wording, per MastCell's additional research. We can go into figures for the individual countries further down. Sorry, I hadn't looked at the current version of the lede. I think what we have there is good now. Though adding in the UK figure might be good, as well. - CorbieV ^☊ ☼ 19:56, 14 August 2019 (UTC)

  The high mortality rate in the US stated by some sources is actually dubious. In the CDC graph for 1987-2015 the peak rate per 100,000 births for all those years was 18.0 in around 2014. These Pubmed articles also support a lower recent rate in the US: [12], [13] (16.0 for 2006-2010 and 17.0 in 2011-2013). The 18 per 100,000 births rate means merely 0.01% giving a maternal survival rate of 99.99%. Brandmeister^talk 08:31, 15 August 2019 (UTC)

  And as Brandmeister stated above, there is some dispute over the figures. I would like it to be discussed in the article an efn note.--Epiphyllumlover (talk) 16:14, 17 August 2019 (UTC)

  18 per 100,000 is close to 0.02%, not 0.01%. And it's not "merely". It's the highest maternal mortality rate in the industrialized world, and the US is one of very few countries where the rate has been increasing in recent decades. Nothing to be proud of. NightHeron (talk) 11:02, 15 August 2019 (UTC)

  That's still a purely subjective claim on a global scale, the world is not made just of the industrialized part. Chad or Central African Republic have that rate at around 800 per 100,000 deaths for comparison. Even if the US had the lowest rate of all countries, at 3 per 100,000 births, that will still be within the remarkable 99.99% maternal survival rate (specifically, 99.997%). Brandmeister^talk 13:21, 15 August 2019 (UTC)

• 2 is reasonable. 3 is reasonable only if other details are moved from the lede to the main body of the article, not just the one sentence. Shmuel (Seymour J.) Metz Username:Chatul (talk) 16:28, 15 August 2019 (UTC)
• 2 though certainly factual, could be improved in the light of objections to what some participants represent as partisan presentation, by adding a little more perspective. How about:
  Modern abortion procedures are safer than carrying a baby to term,[14], [15], [16], [17], especially in the US, where maternal mortality rates are among the highest in the developed world.[18] Mortality rates from medically unsupervised abortion however, is far higher still. (Exact wording and citation open to adjustment) JonRichfield (talk) 12:21, 25 August 2019 (UTC)

  As far as I'm aware, the implication that the US is atypical ("especially") is not supported by sources; rather, there seem to be many countries where maternal mortality is much greater than abortion mortality. Similarly, the last sentence (if I'm reading it correctly -- do you mean "far higher" than maternal mortality?) is not consistent with sources. Earlier in this discussion I gave the example of Indonesia, where abortion, even though it's illegal, has a substantially lower mortality rate than childbirth. NightHeron (talk) 14:18, 25 August 2019 (UTC)

• Comment The source currently used for 2 is related only to the US. But even when it comes to the US, the Louisiana Department of Health, for example, after making a risk comparison of abortion vs pregnancy, states there's no absolute safety in abortion vs a healthy pregnancy, as both have their disadvantages (complications) and advantages. The RCOG source itself, cited by MastCell above, says: "Genital tract infection, including pelvic inflammatory disease, occurs in up to 10% of women undergoing induced abortion. Post-abortion infection not only causes immediate morbidity but may also lead to tubal subfertility and an increased risk of ectopic pregnancy". A study from BMC Women's Health arrived to similar conclusion on complications in Sweden. So a generalized statement like "abortion is safer than pregnancy" is unhelpful and shallow. It makes sense only in a limited number of situations. Brandmeister^talk 22:01, 15 August 2019 (UTC)
  • Again, you are trying to diminish the major theme by citing minor and outlier cases, which is a not something we should do in the lead section. Binksternet (talk) 23:38, 15 August 2019 (UTC)

    I do not think the editor is; if you read the above posts, the problem is making a vague generalized assertion of "safety" when reality is more complicated. To avoid cluttering up the lead, just listing mortality instead of "safety" solves your concern. But an assertion of safety is necessarily inclusive of the details, which is why they are being mentioned here.--Epiphyllumlover (talk) 17:46, 16 August 2019 (UTC)

    Brandmeister is reading the RCOG guideline incorrectly. It states that post-infection abortion occurs in up to 10% of women if preventive antibiotics are not given. (That's what they mean when they cite "control groups in trials of prophylactic antibiotics"—the control group is the group which did not receive antibiotics). In modern practice, with antibiotic prophylaxis, infection rates are 0.92% to 1.7% ([19], p.42), which is comparable to or lower than the incidence of post-partum infection. As is the case with many of the efforts here to obscure or suppress expert knowledge on the safety of abortion, Brandmeister has either misunderstood or is misrepresenting the source on this point. MastCell ^Talk 22:27, 16 August 2019 (UTC)

    The effort is not to obscure or suppress the knowledge, but to convey a balanced view on abortion vs pregnancy safety and not to cherry-pick. As noted above, the situation is more complex rather than procedural safety, so it could be hard to summarize in one sentence. To quote the same Dept of Health source: "Women who have had a first full-term pregnancy at an early age have reduced risks of breast, ovarian and endometrial cancer. Furthermore, the risks of these cancers decline with each additional full-term pregnancy. Pregnancies that are terminated afford no protection; thus, a woman who chooses abortion over continuing her pregnancy would lose the protective benefit". Such factors also fall under comparative safety of abortion and pregnancy. Brandmeister^talk 11:22, 17 August 2019 (UTC)

    Vast cohort studies have shown absolutely no detrimental effect form abortion. The only people pushing these "risks" are anti-abortionists. Zoom right out to top level sources like the WHO: safel, legal abortion saves lives and is less risky than childbirth. This is not even remotely surprising. Most abortions are achieved using drugs and exactly as risky as miscarriage, which is to say, not very provided the woman has healthcare and is not cowering in fear of being prosecuted for murder. Guy (Help!) 11:45, 17 August 2019 (UTC)

    This is another reason why blanket generalizations of "safer" are inappropriate---not all classes of pregnancies are the same in terms of safety.--Epiphyllumlover (talk) 16:14, 17 August 2019 (UTC)

    Travelling by train is safer than travelling by car. Train crashes do not invalidate that fact. Guy (Help!) 10:15, 21 August 2019 (UTC)

    Many places are reachable by car and some by train only. Same here, the safety factor is not the only one to consider and single it out. Brandmeister^talk 12:56, 22 August 2019 (UTC)

    But one mode of transportation isn't more likely to leave you with a chronic health condition and the other one more likely to kill you. This is the situation with abortion vs. birth. Birth is more likely to kill you, but abortion more likely to leave you with infertility (such as Asherman's). This fact has never been addressed by people arguing for the blanket designation of safety. Because of this issue of talking-past-each-other, I feel like I am talking to someone coming to my door looking for me to join their group.--Epiphyllumlover (talk) 19:59, 22 August 2019 (UTC)

    On the contrary, this has been addressed earlier in this thread. Your point about infertility is wrong, because of the high rate of C-section internationally. As I said above (you seem not to have read it the first time): Late abortions (which are a very small proportion in countries where abortion is legal) and incompetent abortions (which are not being discussed here) are a risk factor for infertility. Birth by Caesarian section, which in 50 countries constitutes over 27% of births, is a risk factor for infertility. NightHeron (talk) 22:59, 22 August 2019 (UTC)

    You are correct that I had missed that part of the discussion. Thank you for correcting me. As for C-sections, the risk for infertility after C-section is lower (statistically hard to detect at all in this study) than the risk of infertility with D&C (see this article). As the international rate of D&C varies greatly (here is a map), again making a broad brush of "safety" an inappropriate generalization.

Thank you for responding to my point. I assume that in your last sentence you meant to write "C-section" rather than D&C, since that's what the map and article (from CNN) is about. Your other article about the supposedly low risk of infertility from C-section is a good example of why Wikipedia editors, in accordance with WP:MEDRS, are not supposed to jump to conclusions based on a single primary source. The article's introduction refers to earlier studies (two of which are cited) that showed a significant risk of infertility from C-section, but the article claims that this was not the case for the C-sections they studied, all of which took place in Scotland in 1980-1984. Even if this one study is correct about Scottish abortions performed in 1980-1984, does that apply to a later period when vastly more elective (not medically necessary) C-sections are performed? Do you think it applies to the list of 5 countries in the CNN article -- Brazil, Egypt, Turkey, Venezuela, and the Dominican Republic -- in which more than half of births are now by C-section? And what about the other dangers of C-section (mentioned in the CNN article), which explain why experts see the high incidence of C-section as "alarming"?

Concerning D&C, according to the Wikipedia article on the subject, "Because medicinal and non-invasive methods of abortion now exist, and because D&C requires heavy sedation or general anesthesia and has higher risks of complication, the procedure has been declining as a method of abortion.[8] The World Health Organization recommends D&C as a method of surgical abortion only when manual vacuum aspiration is unavailable.[9] Most D&Cs are now carried out for miscarriage management and other indications..." Miscarriage management is for patients attempting to carry a pregnancy to term.

The main point, which several editors have made repeatedly, is that the consensus of secondary sources is that legal abortion is safer than childbirth. We could go on forever debating what different primary sources say, but that's not what we're supposed to be doing here. NightHeron (talk) 03:12, 23 August 2019 (UTC)

• 2 is reasonable for now. If people wish to edit it in future improvements, let them justify their proposals according to the same criteria of accuracy and support at that time. We can't wait forever for perfection, and version 2 isn't going to mislead any readers. JonRichfield (talk) 09:30, 17 August 2019 (UTC)
• 2. It doesn't really need to single out the US but I guess it's useful to clarify that the statement applies to the developed world. ─ ReconditeRodent « talk · contribs » 13:05, 17 August 2019 (UTC)
• Happy with 1 2 is also okay but could use some simplification / summarization. Doc James (talk · contribs · email) 08:52, 20 August 2019 (UTC)

  Doc James, how do you like MastCell's suggestion "Modern abortion procedures, when performed by trained personnel in settings where abortion is legal, are substantially safer than carrying a baby to term." Gandydancer (talk) 12:59, 21 August 2019 (UTC)

  Would shorten 2 to "Modern abortions are safer than carrying a baby to term." Doc James (talk · contribs · email) 01:32, 22 August 2019 (UTC)

• 2 or one of the equivalent variations discussed above is a well-supported summary of Reliable Sources, but drop the US-centric second half and avoid ref-bombing the lead. Maybe keep one ref, but the rest should either be moved to the body of the article or deleted if redundant to refs in the body. Alsee (talk) 10:16, 31 August 2019 (UTC)
• 1 is the best choice of those offered. The problem with 2 is that it is a violation of WP:SYNTH, so it's impossible to implement despite the fine people here who would rather see 2. And 3 is wrong-headed, taking away from the reader a valid, widely reported fact. Binksternet (talk) 15:17, 31 August 2019 (UTC)

  • Had to merge my edit with yours! When you say WP:SYNTH, do you mean the stuff I elaborated on below, about how the 14 times isn't necessarily especially high in the US, or necessarily just due to the high maternal mortality rate? Triacylglyceride (talk) 15:31, 31 August 2019 (UTC)

• 1 -- although it's good to be open about America-centrism, I have a couple of problems with 2. There's a sneaky edit put in there where "carrying a pregnancy to term" has been replaced with "carrying a baby to term." That's non-neutral language and I'd favor "continuing a pregnancy to term." I also think the "especially" is misleading because it implies that the safety ratio might be dramatically smaller in other countries, or is high in the US mainly due to the US's poor maternal mortality rate. The US's poor maternal mortality rate is in part due to the high rate of undertreated comorbid conditions and poverty -- and abortion sees the same issues. From this source I've estimated an abortion mortality rate of just over 1/500K in England Wales, compared to a maternal mortality rate of 8.9/100K (ProPublica) in the UK, so that's 45 times safer or so (unless Scotland and Northern Ireland are throwing us way off). Can we really say that abortion is "especially" safer in the US? Triacylglyceride (talk) 15:28, 31 August 2019 (UTC)

  One should be careful with the C-section statistics in China as C-sections have been used for late-term abortions to enforce population control measures, similar to (or perhaps the same procedure as Hysterotomy abortion).--Epiphyllumlover (talk) 03:54, 16 September 2019 (UTC)

Epiphyllumlover, can you cite any RS that say that late term abortions are being misreported as C-sections (in China or anywhere else) on a significant scale, that is, enough to significantly affect C-section statistics? Thanks. NightHeron (talk) 14:44, 16 September 2019 (UTC)

The abortion in China page says "not all abortions are registered..Family Planning statistics are usually considered state secrets." As China is a large portion of the globe, if you are going to figure out the safety of abortion, this should be a factor. I was unclear in my above statement, I am referring to the "c-section abortion"--which is used as a more-or-less punitive measure on late term women. What I was saying is that any c-section mortality figures from china could be expected to include abortions as well as births. Forced abortions in China have no official statistics because officially it is illegal to force abortions in China. There appears to be overlap between the categories of "forced abortion" and "c-section abortion." This was especially done under the one-child policy, which ended in 2015, but is still within the timeframe of statistics as reported in papers. The best not-dead link I've found for Chinese abortion statistics is here. What we are looking at is an issue of under or non-reporting. I know this is dated because it comes from 2002, but this text it says "In the past 45 years there have been only seven studies on failed abortion suggesting that there has probably been systemic underreporting of its effects on women and their children."--Epiphyllumlover (talk) 00:22, 19 September 2019 (UTC)

Epiphyllumlover, I'm afraid you didn't answer my question, since none of what you write cites a source to support your claim in your previous comment that "One should be careful with the C-section statistics in China" because late term abortions misreported as C-sections occur on a significant scale. As of 2017 the C-section rate in China was estimated at 35% (see[20]), which translates to over 5 million C-sections per year. The World Health Organization (see [21]) has expressed alarm over the number of C-sections in many countries, including China, because of all the health risks. As far as I've seen, the WHO does not mention anything about late abortions disguised as C-sections. From what I can tell from the RS, that seems to be a rare occurrence, statistically speaking. In other words, C-sections are a risk of pregnancy/childbirth, not (to any statistically significant extent) a risk of abortion. You have not given any sourced evidence to the contrary. NightHeron (talk) 01:04, 19 September 2019 (UTC)

As stated before, I used unclear terminology in the post some days back... you are reading too much into this.--Epiphyllumlover (talk) 02:25, 19 September 2019 (UTC)

• 2 works well, 1 is my second choice. 3 is terrible as it removes vital information from most readers. I support 2 in spite of the argument referring to WP:MEDPOP because the greater safety of the modern abortion procedure is so obviously true that it becomes a sky-is-blue statement, not a matter for debate. The medical aspect is not in question; it's the socio-political aspect that drives the issue. Binksternet (talk) 15:02, 16 September 2019 (UTC)
• 2 and then try to work towards a better version, per Levivich. KillerChihuahua 15:40, 16 September 2019 (UTC)
• Comment Prior abortions change the safety of subsequent birth, just as c-sections do: Prior surgical abortion linked to subsequent preterm birth. Comparing the safety of abortion to birth becomes inappropriate if abortion changes the safety of birth.--Epiphyllumlover (talk) 00:35, 19 September 2019 (UTC)

  What? Comparing abortion and live birth is inappropriate if there is a difference? that made exactly no sense. Also, Thomas Jefferson U? Not without other sources, no. KillerChihuahua 00:23, 20 September 2019 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

live birth section with inaccuracies

Hello. I would like to make some edits to the Live Birth section under complications. The changes and references are in my sandbox: http://en.wiki.x.io/wiki/User:NastywomanMD/sandbox Thank you in advance. NastywomanMD (talk) 01:04, 14 July 2019 (UTC)NastywomanMD

Hello again. Given that there is so much inflammatory rhetoric at the moment about live birth, I think it is important to add something addressing the inaccuracies of the rhetoric to this section. My preference would actually be to delete the section, since it disproportionately draws attention to this issue under "Safety" of abortion, when it is quite uncommon. However, since it is already there, I'd like to add some information that provides nuance. This subject has resurfaced due to the proposal of the Born Alive Survivors Protection Act. This article discusses the history around that bill as well as statistics: https://www.factcheck.org/2019/03/the-facts-on-the-born-alive-debate/ Another reference that describes the propaganda: https://www.nytimes.com/2019/02/26/health/abortion-bill-trump.html Thanks! NastywomanMD (talk) 17:17, 30 July 2019 (UTC)NastyWomanMD

Hello! It seems to me that it didn't make Wikipedia better to eliminate these words:

"

Death following live birth caused by abortion is given the ICD-10 underlying cause description code of P96.4; data are identified as either fetus or newborn. Between 1999 and 2013, in the U.S., the CDC recorded 531 such deaths for newborns, approximately 4 per 100,000 abortions.

/"

References

This deletion was made with other adjustments that I don't have a problem with: http://en.wiki.x.io/w/index.php?title=Abortion&diff=906423411&oldid=906181941. I think from the talk page consensus, there should be no resistance to reinstating the deleted words above.170.54.58.11 (talk) 17:20, 3 October 2019 (UTC)

I object to re-adding that content. It is confusingly over technical for the layperson, whom this article is designed for.---Avatar317^(talk) 19:23, 3 October 2019 (UTC)

Let's re-write it, then, as follows:

"

Between 1999 and 2013, the CDC recorded 531 deaths of newborns in the U.S. that were caused by abortion, approximately 4 per 100,000 abortions.

/"

References

170.54.58.11 (talk) 22:25, 3 October 2019 (UTC)

live-birth long-term surviving examples

• I'm coming here from Wikipedia:Categories_for_discussion/Log/2019_May_21#Category:Abortion_survivors. There are three biographies in this category, they are:

  Gianna Jessen
  Melissa Ohden (deleted by expired PROD)
  Oldenburg Baby

I think they deserve some coverage in the section Abortion#Live_birth.

--SmokeyJoe (talk) 01:42, 15 July 2019 (UTC)

It seems to me there's already too much coverage of an extremely rare phenomenon that occurs in only about one out of twenty-five thousand abortions. We don't need more coverage; see WP:UNDUE. NightHeron (talk) 07:09, 15 July 2019 (UTC)

Agree. NastywomanMD (talk) 17:07, 30 July 2019 (UTC)NastyWomanMD

No, the 1 in 25,000 figure is for children who died as a result of abortion, not children who survived abortion. 170.54.58.11 (talk) 18:01, 3 October 2019 (UTC)

The most common definition of "abortion" is the one given in the first sentence of the lead of this article -- termination of a pregnancy before the fetus can survive outside the uterus. The second most common definition (see Definitions of abortion) is termination of a pregnancy before 20 weeks gestation, which essentially means before viability, since before 20 weeks it would be extremely rare for a fetus to be viable, and virtually impossible for a fetus to survive without severe mental and physical abnormalities. There are some unusual cases when a fetus is kept alive for a short time after an abortion, and this is what the CDC statistic of 1 in 25,000 refers to. Discussion of those cases does not belong in the article, per WP:UNDUE. There are also cases when, because of misinformation or medical error, an attempted abortion is performed after viability, which of course means that long-term survival is possible. By definition, that is not an abortion, and so does not belong in the article either. The effort to focus attention on extremely unusual cases is a political framing that does not belong in Wikipedia. NightHeron (talk) 23:42, 3 October 2019 (UTC)

• Understood. Thank you. This confirms that the CfD discussion made the right decision ("delete"). --SmokeyJoe (talk) 00:09, 4 October 2019 (UTC)

Just for clarity for the casual reader today: the CfD in question was for deleting a section entitled "Abortion survivors"; this was not a discussion to delete the statistic that over 500 children have died according to the CDC in recent years because of "termination of pregnancy", i.e. that for every 100,000 abortions four children die. 170.54.58.11 (talk) 15:42, 9 October 2019 (UTC)

Legal section at /Safety/Live_Birth should mention the US BAIPA of 2001 (signed into law 2002)

Hi!

It looks like the section about live birth covers a proposed federal law to protect newborn infants. That's good. But the section regrettably fails to mention something called the US Born-Alive Infants Protection Act of 2001 that became federal law in 2001. This law says:

SEC. 2. DEFINITION OF BORN-ALIVE INFANT.

(a) IN GENERAL- Chapter 1 of title 1, United States Code, is amended by adding at the end the following:

‘Sec. 8. ‘Person’, ‘human being’, ‘child’, and ‘individual’ as including born-alive infant

‘(a) In determining the meaning of any Act of Congress, or of any ruling, regulation, or interpretation of the various administrative bureaus and agencies of the United States, the words ‘person’, ‘human being’, ‘child’, and ‘individual’, shall include every infant member of the species homo sapiens who is born alive at any stage of development.

‘(b) As used in this section, the term ‘born alive’, with respect to a member of the species homo sapiens, means the complete expulsion or extraction from his or her mother of that member, at any stage of development, who after such expulsion or extraction breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section, or induced abortion.

‘(c) Nothing in this section shall be construed to affirm, deny, expand, or contract any legal status or legal right applicable to any member of the species homo sapiens at any point prior to being ‘born alive’ as defined in this section.’.

(b) CLERICAL AMENDMENT- The table of sections at the beginning of chapter 1 of title 1, United States Code, is amended by adding at the end the following new item:

‘8. ‘Person’, ‘human being’, ‘child’, and ‘individual’ as including born-alive infant.’.

https://www.law.cornell.edu/uscode/text/1/8

This is clearly relevant in the abortion article, as pertaining to the current state of the law with regard to live birth, whereas the current paragraph about 2019 legislation doesn't present any background of what the law says today. 170.54.58.11 (talk) 17:14, 9 October 2019 (UTC)

The brief mention of that U.S. law should not be expanded, per WP:UNDUE, especially because termination of pregnancy after viability is not an abortion (see the first sentence of this article). NightHeron (talk) 00:07, 10 October 2019 (UTC)

That whole section is problematic because of far too much emphasis on the situation in one country, one with less than 5% of the world's population. Adding more from that country would make it even worse. HiLo48 (talk) 02:10, 10 October 2019 (UTC)

@HiLo48: In general I'm sympathetic to the view that Wikipedia over-emphasizes U.S.-based data and sources. However, there's good reason to give considerable emphasis to the U.S. in our coverage of abortion-related controversies. The U.S. has long been an international center for this controversy in its most extreme forms (such as demonstrations at clinics and the murder of doctors who perform abortions), and U.S.-based groups (especially Evangelical Christians) have greatly influenced the growth of anti-abortion extremism in other countries, especially in Latin America. Even though, as you say, the U.S. has only 5% of the world's population, it contributes far more than 5% to pollution and climate change, holds 22% of the world's prisoners, and contributes much more than 5% to anti-abortion politics in the world. NightHeron (talk) 20:57, 10 October 2019 (UTC)

I agree: let's get rid of this paragraph:

"In 2019, a US Senate Bill entitled the "Born-Alive Abortion Survivors Protection Act" raised the issue of live birth after abortion.[135][136] The bill would mandate that medical providers resuscitate neonates delivered showing signs of life during an abortion process.[135][136] During the debate around this issue, US Republicans falsely alleged that medical providers "execute" live-born babies. Existing US laws would punish execution as homicide. Furthermore, US abortion experts refute the claim that a "born-alive" fetus is a common event and reject laws that would mandate resuscitation against the wishes of the parents.[136][137]"

170.54.58.11 (talk) 16:27, 10 October 2019 (UTC)

Numbers in sources in safety section

I've looked a little closer at that sentence in the safety section that says that abortion is 14 times safer than childbirth. The citation given backs that up, with 8.8 vs. 0.6 deaths per 100,000 equals 14 times. However, the very next sentence in the article states that the number of deaths from childbirth is 17.2 per 100,000, with the source backing that up too. That would make abortion 24 times safer. Which number is right, or am I missing something?Yhdwww (talk) 17:06, 11 September 2019 (UTC)

The 14 times is specifically in the United States for the time frame 2012. The other data is for 2019. Doc James (talk · contribs · email) 17:04, 22 September 2019 (UTC)

From the CDC, we learn that there is a child mortality of 4 per 100,000 abortions which either must be excluded by naming the other figures "maternal mortality" or added to the safety statistics for abortion. This would increase 0.6 to 4.6 deaths per 100,000 procedures, I think. 170.54.58.11 (talk) 18:04, 3 October 2019 (UTC)

I noticed that the CDC uses the expression "termination of pregnancy" rather than "abortion" for this statistic. I do not believe that this difference warrants the statistic's exclusion from the safety section of the abortion article in Wikipedia, since an attempted abortion with certain mistakes in the process (i.e. wrong gestation age--- not an impossible mistake) is indeed a termination of pregnancy, and that is relevant to the safety of abortion. 170.54.58.11 (talk) 15:45, 9 October 2019 (UTC)

The definition of abortion at the beginning of this article and in standard sources (see Definitions of abortion) all say that a termination of pregnancy after viability and after 20 weeks gestation is not an abortion, so what happens in such cases is not relevant to statistics about abortion. NightHeron (talk) 00:03, 10 October 2019 (UTC)

I'm not convinced by this methodology of identifying a common thread between some sources for definitions under well-established debate, and applying that to Wikipedia so strongly that we change the technical content of the article to match this choice of definition. Have we held a RfC on the definition of abortion? If so, then the first sentence at Late Termination of Pregnancy really needs to be changed, together with that articles's reference #2:

"Belluck, Pam (February 6, 2019). "What Is Late-Term Abortion? Trump Got It Wrong". New York Times. Late-term abortion is a phrase used by abortion opponents to refer to abortions performed after about 21 weeks of pregnancy. It is not the same as the medical definition obstetricians use for 'late-term,' which refers to pregnancies that extend past a woman’s due date, meaning about 41 or 42 weeks."

The author of this New York Times article has absolutely no reservations calling something that occurs after 21 weeks gestation "an abortion". It seems that Belluck's criticism of abortion opponents is the expression "late-term", not "abortion". Indeed, New York's recent Reproductive Health Act allows something called "abortion" after 24 weeks gestation and after viability if it is necessary to protect the patient's life or health. It is not OK to remove information about that procedure from this article solely on the basis of a narrow definition for abortion. 170.54.58.11 (talk) 17:02, 10 October 2019 (UTC)

If you want to start an RfC, the place to do it is on the talk page for Definitions of abortion, since you're objecting to virtually the entire content of that article. But that article is based on medical dictionaries, OB/GYN textbooks, statements by the CDC and the WHO, and encyclopedias. Sources that are compliant with WP:MEDRS take precedence over the ways a journalist or politician or advocate might use the term. NightHeron (talk) 20:32, 10 October 2019 (UTC)

The Definitions of abortion article tends toward inclusivity, not exclusivity, in the definition. See, for example, the Oxford English Dictionary (before the "specific to medicine" addendum), Random House's Dictionary dot com, the Merriam-Webster Dictionary, and the Longman Dictionary of Contemporary English. I would also mention that others on the talk page assign this article to a general audience rather than a technical audience (not that it ought to contain inaccurate information, but that it must communicate information accurately as the general reader understands it) and that WP:Jargon would, I think, support the general definition rather than a technical definition--- especially if the technical definition is confusing! 170.54.58.11 (talk) 22:58, 10 October 2019 (UTC)

Yes, the definition should make sense to the general public. The definition of abortion in virtually all the WP:MEDRS-compliant sources is termination of pregnancy before viability. Some specify that before 20 weeks gestation or at less than 500 gm weight a fetus is assumed not to be viable. What that means is completely clear to the average reader. There's nothing "technical" that requires medical training to understand. Some journalists or politicians or others may choose to use a medical word inaccurately (e.g., a teacher exclaiming "these kids are giving me a migraine" when she doesn't really have a migraine in the medical sense), but that doesn't mean that Wikipedia should use a sloppy definition that conflicts with WP:MEDRS. NightHeron (talk) 23:47, 10 October 2019 (UTC)

I will also cite Dorland's Illustrated Medical Dictionary, Merriam-Webster's Medical Dictionary, The American Heritage Science Dictionary, The American Heritage Medical Dictionary, The Dictionary of Modern Medicine, and Churchill's Medical Dictionary. 170.54.58.11 (talk) 23:03, 10 October 2019 (UTC)

I'm glad you agree that the definition should make sense to the general public. But I disagree that the average reader understands the word to apply only to pre-viable situations, as is evident by the wording of the New York law. I am not proposing a general re-forging of this article, but editorial decisions about what to include and what to exclude, made according to the principle of "we would include that but it's technically inapplicable because the sub-category of termination of pregnancy is not called abortion in our reliable sources" are wrong. The death rate of 4 / 100,000 is applicable to abortion, jargon notwithstanding. 170.54.58.11 (talk) 15:53, 11 October 2019 (UTC)

The first sentence of the article states: "Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus before it can survive outside the uterus." This wording is easily understandable and makes sense to the general public. NightHeron (talk) 16:15, 11 October 2019 (UTC)

This wording is understandable, but it is not a true statement because it's not consistent with Definitions of abortion. 170.54.58.11 (talk) 17:05, 11 October 2019 (UTC)

This wording is also inconsistent with Abortion's reference #1 to the Oxford English Dictionary, which limits the "after viability" definition specifically to medicine. And again: not every reader will understand the implication of the first sentence, and not every reader will even read the first sentence! Abolishing information that doesn't fit with the "specific to medicine" definition (as we see at the Oxford English Dictionary) does not make this article understandable to as many readers as it could be. 170.54.58.11 (talk) 18:50, 11 October 2019 (UTC)

It seems to me that this discussion has run its course, unless other editors want to add something. I've already answered all your arguments that merit a response. I don't think "not every reader will even read the first sentence!" counts as a serious argument. NightHeron (talk) 21:34, 11 October 2019 (UTC)

I think that the criticism does merit a response: that the narrow pre-viability definition is contradictory to reference #1's the inclusive definition (from the Oxford English Dictionary), that the narrow definition doesn't follow WP:Jargon, and that the narrow definition doesn't match the obvious plurality of definitions at Definitions of abortion. I am not convinced that the well-known problem of ambiguous terminology has been addressed by our assigning a definition to the word. 170.54.58.11 (talk) 22:07, 11 October 2019 (UTC)

Problematic edit reverted

I reverted Brandmeister's edit because it was not supported by consensus. First, the wording implied that abortion is safer than carrying a pregnancy to term only in countries with high maternal mortality, and this is false. Second, when contrasting abortion with carrying a pregnancy to term the use of the word "baby" is a political spin, since what is aborted is correctly termed a zygote or embryo (early abortion) or fetus (later abortion). That's why "carrying a pregnancy to term" is neutral, whereas "carrying a baby to term" is not. NightHeron (talk) 12:12, 10 October 2019 (UTC)

@NightHeron: The second option had various reservations about the exact wording, including the mention of the US. Would "Modern abortion procedures generally have lower maternal death rate than childbirth" be ok? Brandmeister^talk 13:13, 10 October 2019 (UTC)

@Brandmeister: Actually, Option 2 does include a mention of the U.S., but without the specific figure of 14. The closing decision for the RfC said that the finer points need to be discussed. For example, I would propose the following slight modification of Option 2: "Modern abortion procedures are safer than carrying a pregnancy to term, a difference that is especially pronounced in countries such as the US that have relatively high maternal mortality rates." But I think it's best to wait for a consensus on the finer points before further editing of this passage. NightHeron (talk) 13:55, 10 October 2019 (UTC)

I like the statements in the lead as they are now. My opinion is that adding the phrase: a difference that is especially pronounced in countries such as the US that have relatively high maternal mortality rates. to the LEAD adds complication that would be confusing to the average layperson. ---Avatar317^(talk) 19:51, 10 October 2019 (UTC)

It would also exemplify Wikipedia's systemic bias. HiLo48 (talk) 07:29, 11 October 2019 (UTC)

I also support removing the US. Also, the "safer than childbirth" relates only to the US per cited source. It says that "Legal abortion in the United States remains much safer than childbirth". So making a generalized statement as if it relates to the whole world fails WP:V, this should be fixed. Brandmeister^talk 10:28, 13 October 2019 (UTC)

The "safer than childbirth" statement was already discussed in an earlier thread that you were part of. There's no need to waste everyone's time repeating that discussion now. The section of the article on safety is well sourced with international data, not just US data. The consensus of editors in the earlier thread was against what you wanted, and that won't change if we engage in another discussion of the same issue. NightHeron (talk) 11:49, 13 October 2019 (UTC)

When it comes to comparative safety of abortion vs childbirth, as far as I can see Abortion#Safety mentions only US data. It does not make a generalized statement for the world, as the lead implies. Brandmeister^talk 12:01, 13 October 2019 (UTC)

I added data about other countries to Abortion#Safety. NightHeron (talk) 15:55, 13 October 2019 (UTC)

This is not data, it's analysis! Look:

In the UK, guidelines of the Royal College of Obstetricians and Gynaecologists state that "Women should be advised that abortion is generally safer than continuing a pregnancy to term."[84] Worldwide, on average, abortion is safer than carrying a pregnancy to term. A 2007 study reported that "26% of all pregnancies worldwide are terminated by induced abortion," whereas "deaths from improperly performed [abortion] procedures constitute 13% of maternal mortality globally."[85] It is estimated that in Indonesia in 2000 about 2 million pregnancies ended in abortion, about 4.5 million pregnancies were carried to term, and between 14 and 16 percent of maternal deaths resulted from abortion.[86]

"guidelines state that" is not data, it's analysis. The statement on worldwide abortion "on average" is highly problematic, very highly problematic. Abortion is a very loose category of decisions that does not lend itself to averaging; that's why we should not include the sentence "worldwide, on average, abortion is safer than carrying a pregnancy to term" for the straightforward reason that abortion carries 13% of the worldwide maternal death burden, as we have just stated.

Also, as we know from the Oxford English Dictionary, we are burdened with the expansive definition for "abortion" that includes second-semester abortions which are more risky than first-semester ones. 170.54.58.11 (talk) 20:00, 14 October 2019 (UTC)

The marathon-running article ( https://www.contraceptionjournal.org/article/S0010-7824(14)00574-5/fulltext , current ref #87) uses a figure of 0.7 deaths per 100,000 abortion procedures, but this leaves the 4 deaths per 100,000 abortions completely unaccounted-for. In order to use 0.7 deaths per 100,000 abortions Wikipedia must diligently add the qualification "maternal" on the word "mortality", "safety", and "death" in each and every sentence where the safety rate is referenced. Otherwise, WP:V! 170.54.58.11 (talk) 15:14, 14 October 2019 (UTC)

Whether you want to call it "data" or "analysis", all of the information is well-sourced. You object to talking about worldwide "averages" and aggregate data (such as the 26% and 13% figures), but in that case your quarrel is with the sources, not with the Wikipedia article which cites the sources. Our job is to report on what RS say, and they do give worldwide stats for abortion.

Unless you can get a consensus of other editors that the definition of abortion in the first sentence of this article is wrong -- and hence that the consensus of WP:MEDRS sources in the article "Definitions of abortion" is also wrong, you're not going to accomplish anything by continuing to base your argument on a different definition. NightHeron (talk) 22:56, 14 October 2019 (UTC)

Clinical terms are sometimes weasel terms

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

The article starts with the clinical language:

"Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus before it can survive outside the uterus."

Which seems better than saying

"Abortion is the murder of a baby who is still in the womb."

But the two are similar in their way of injecting political terminology, as it is only in the pro-choice medical jargon that abortion is an "ending" of "a pregnancy" and not the "ending" of a human fetus.

A better course would be to state:

Abortion is the termination of the life of a fetus, which in medical usage may mean by either natural or induced causes, but in common usage refers to the induced termination of human fetuses.

So in this case the "ending a pregnancy" jargon is second rate because it is weasel-worded, using clinical language which is still coming from the practice of abortion and therefore it is political jargon and therefore weasel jargon. And the "murder" version is only weasel-worded in that it comes attached with the pro-life political agenda which considers even early abortions to be "murder." -Zahadan (talk) 01:13, 3 November 2019 (UTC)

As stated repeatedly during earlier debates on this topic, WP:MEDRS must be followed in articles on a medical procedure, such as abortion. The consensus of such sources support the definition given in this article. So the definition should remain as it is. There is nothing "political" about a policy of adhering to WP:MEDRS. NightHeron (talk) 01:23, 3 November 2019 (UTC)

But currently the medical profession is entirely pro-choice, regarding abortion to be a healing practice rather than a homicide; the point of view is entirely that of the mother, and then one who isn't concerned with the life of the fetus. So you say "MEDRS must be followed," can you point me to the relevant Arbcom ruling(s)? -Zahadan (talk) 01:42, 3 November 2019 (UTC)

"currently the medical profession is entirely pro-choice..." Got a source for that claim? HiLo48 (talk) 02:26, 3 November 2019 (UTC)

Here's a front-page editorial in the mainstream / leading medical journal and magazine, The Lancet, calling for worldwide pro-choice policy choices at the UN and vocally opposing a US-led coalition to strike pro-choice policy statements from consensus agreements. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32717-5/fulltext?dgcid=raven_jbs_etoc_email 170.54.58.11 (talk) 18:18, 8 November 2019 (UTC)

Zahadan, your statement "abortion is the termination of the life of a fetus" is factually incorrect. An induced fetal demise can occur without an abortion occurring, and an induction abortion of a 20-week fetus may result in a live birth with demise following, but would still be an abortion. I also notice that your argument regarding weasel words is "the medical community uses these words and I disagree with the medical community, therefore they are weasel words." You are unlikely to find much interest here in changing the language of the article. Triacylglyceride (talk) 02:07, 3 November 2019 (UTC)

Triacylglyceride, you claim my statement is "factually incorrect" because of the existence of unusual boundary conditions of the form one, where the baby dies without induced cause (non-medicals just call those "miscarriages," why not just use the common term?) and two, where the baby lives despite induced cause (perhaps you can supply the Facebook addresses of people who aborted but then wound up with living babies). But you do respect that the term "abortion" has some common meaning, and typically that meaning is where the abortion causes the death of the fetus?

And so then in colloquial, political, and legal talk, the meaning of the word "abortion" is not so much "force remove baby from womb and then get it diapers and pre-school" but rather "force remove the baby from womb and dispose of the remains." So rather than being "factually correct" your argument is a boundary fallacy which quibbles such to say that "abort fetus" and "kill fetus" are entirely different. -Zahadan (talk) 03:29, 3 November 2019 (UTC)

Zahadan, content in Wikipedia needs to be cited to reliable sources. Your personal opinion on what words should be used to describe abortion counts for little (as does mine). We must use the language that quality sources use. This is where WP:MEDRS comes in. Realise too that Wikipedia is a global encyclopaedia, and this is clearly a global article. The language you might be familiar with in your own personal context is not likely to be the same language used the world over. Using the more formal, "clinical" language you object to is in fact our way of avoiding politically loaded language or language specific to just one culture. HiLo48 (talk) 03:48, 3 November 2019 (UTC)

Zahadan, I genuinely don't know how to engage with you (supply the Facebook addresses? Really?), so I'm going to disengage at this point. I'll re-engage if this starts to move towards consensus-building, but I find that unlikely. Triacylglyceride (talk) 07:19, 3 November 2019 (UTC)

Triacylglyceride, what you said was that there were cases where women aborted and then wound up with children, and what I meant was that perhaps you can supply some reference for these cases; how many, etc. I was glad to point out that your argument was a boundary case type fallacy, which all goes toward consensus building. -Zahadan (talk) 21:53, 3 November 2019 (UTC)

Zahadan, you are misquoting Triacylglyceride, who pointed out that "abortion of a 20-week fetus may result in a live birth with demise following" -- not a viable fetus and certainly not women who "wound up with children." NightHeron (talk) 22:31, 3 November 2019 (UTC)

I apologize on that point, but he was clearly trying to state something like abort ≠ kill, equivocating on the meaning of "abort," and its lexical binding to the idea of "kill."

"Aborting" someone out of a car usually won't kill them, but forcing someone to leave a womb almost always will kill them. The manners attributed to the term "abortion" typically involve violences to the fetus, killing it before removing it, or killing it during the removal.

So its not just a forced eviction, its eviction where the former resident always dies by way of injury, or else by way of freezing on the sidewalk. The argument that the fetus is not "killed" because it isn't a person and has no rights or is not a medically defined life form is POV. -Zahadan (talk) 23:42, 3 November 2019 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Refs

Per these edits http://en.wiki.x.io/w/index.php?title=Abortion&diff=927443254&oldid=927336415&diffmode=source and as mentioned on the users talk page proper references are required. Doc James (talk · contribs · email) 15:53, 22 November 2019 (UTC)

User reported here to RR] and advised to self revert. Doc James (talk · contribs · email) 15:59, 22 November 2019 (UTC)

"Fetus deletus" listed at Redirects for discussion

An editor has asked for a discussion to address the redirect Fetus deletus. Please participate in the redirect discussion if you wish to do so. Utopes (talk) 21:50, 24 November 2019 (UTC)

Viability

Here is an issue I did bring to this Talk page's attention years ago. The lead still makes this blanket statement: "Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus before it can survive outside the uterus." This sentence is followed by a note (leading to additional definitions of abortion), but I strongly suggest the sentence be reworded to say: "Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus."

Why? Because it is not true abortion on demand (as in termination of pregnancy for ANY reason) is only performed before viability. Sure, a large number of terminations is performed in the first trimester, but a non-negligible number is indeed performed in the second and third trimesters. In Quebec, abortion on demand (terminations for ANY reason, not just aggravated medical conditions) is available for free during all nine months. Past the fifth month of pregnancy, the govt. will give the woman the money to do it in the United States. Israell (talk) 23:43, 29 October 2019 (UTC)

As stated repeatedly in the long debate on this topic, WP:MEDRS must be followed in articles on a medical procedure, such as abortion. The consensus of such sources support the definition given in this article. So the definition should remain as it is. In contrast to reliable medical sources, the two sources cited above should not be relied upon, because they give out false information. Both sources say that a woman wanting termination of pregnancy after 23 weeks just has to go to the US. The second source says (Google translation from Quebecois): "A woman can have an abortion until the 23 th week in Quebec. Beyond this limit, she will have to go to the United States since no doctor in the province will accept to perform such interventions. The intervention will be reimbursed by the state, but not the displacement." Third trimester termination of pregnancy is illegal in the US (whether or not the woman is Canadian) except under extreme medical conditions, such as danger to the woman's life. NightHeron (talk) 00:36, 30 October 2019 (UTC)

My last sentence is imprecise: late termination of pregnancy is illegal in most US states except in extreme medical conditions, and in a few states it's legal but normally only performed when medically necessary. It is wrong to tell Canadian women that late termination of pregnancy is available on demand in the US. NightHeron (talk) 01:10, 30 October 2019 (UTC)

I see. That's the information, I got from the sources above. I have a question... Does that lead sentence of the article only apply to the United States? My issue w/ it is that it strongly implies abortion in the second and third trimesters is a rare occurance, when it is actually common (in certain parts of the world—especially in the second trimester); lots of cases from China, Russia, etc.

And this: "An estimated 17 to 42 Quebec women go to the United States every year to terminate a third trimester pregnancy." This linked article focus on fetal abnormalities, but it does not state if it applies to the pregnancies of all of those women. Israell (talk) 18:45, 30 October 2019 (UTC)

Wikipedia relies on Reliable Sources, because there is lots of bad/false information on the internet (you might have heard of "fake news"). Your cited source is not considered reliable, (see the table listing in WP:Reliable sources/Perennial sources) so it doesn't matter what it says. And to your China/Russia claims, do you have any WP:RS for those claims? For this article, (abortion) you'd need scholarly studies to meet WP:MEDRS. ---Avatar317^(talk) 21:08, 30 October 2019 (UTC)

The last sentence of the lead explains that termination of pregnancy after viability isn't called an abortion, so that's why it is excluded from the definition. --Yhdwww (talk) 12:39, 31 October 2019 (UTC)

References

The last sentence of the lede doesn't do that. Instead, it acknowledges that such an event is known as "abortion", "late-term abortion". Likewise, the definitions of abortion article reminds us that termination of pregnancy after viability is often called an abortion. 170.54.58.11 (talk) 20:01, 8 November 2019 (UTC)

The last sentence of the lede doesn't have anything to do with termination of pregnancy after viability. I think you mean the last sentence of the first paragraph, which is: "A similar procedure after the fetus has potential to survive outside the womb is known as a 'late termination of pregnancy' or less accurately as a 'late term abortion'." Wikipedia should not use the "less accurate" terminology, which conflicts with the consensus of MEDRS sources. NightHeron (talk) 21:10, 8 November 2019 (UTC)

I think that it's more important for Wikipedia to avoid the possibility of making false statements per WP:V than to stick with "more accurate" terminology per WP:MEDRS. In this case, by attempting to narrow the definition of the word "abortion", Wikipedia is saying "there are no abortions after viability". While technically accurate according to the style guide over at the RCOG / ACOG (not to mention NAF, PPUSA, Guttmacher, etc), this is false to people who don't make that distinction, such as the authors of the OED / MWD, Justice Blackmun's words in the Roe v Wade 1973 decision, commenting on the Texas penal code which remained pretty much the same from 1857 to at least 1961 (where "aborton" was defined as follows: "By 'abortion' is meant that the life of the fetus or embryo shall be destroyed in the woman's womb or that a premature birth thereof be caused.")... it would even be a false statement according to The New York Times' recent opinion piece on the matter, which repeated the expression variously as Late-Term Abortion, "late-term" abortion, our abortion, and late-term abortion. It is not WP:V to say that there are no late-term abortions, or that the statistics for abortion are exclusive of late-term abortion. 170.54.58.11 (talk) 15:32, 11 November 2019 (UTC)

These researchers don't distinguish between "abortion" and "late termination of pregnancy" in Finland: they distinguish between "legal IA" (IA = induced abortion) and "illegal IA". 170.54.58.11 (talk) 16:30, 11 November 2019 (UTC)

And so, somebody reading the Mayo Clinic article on Premature birth should definitely regard late termination of pregnancy as "an abortion", and not say, "Well, the article says that abortion is a risk factor for premature birth, but I got a late termination of pregnancy, not an abortion: my risk is not increased!". 170.54.58.11 (talk) 16:33, 11 November 2019 (UTC)

Actually, arguably they should. Post-viability pregnancy termination is often done using very different approaches than most pre-viability pregnancy terminations; I'd bet dollars to donuts that that Mayo Clinic article is based on evidence regarding early abortion. (I say this without commenting on the quality of that evidence.)

Post-viability terminations are a very small fraction of terminations, and are currently taking an outsized portion of the public discourse. Wikipedia is sticking with some formal medical definitions as the public use of the word shifts; who are we to get ahead of formal definitions? Triacylglyceride (talk) 19:06, 11 November 2019 (UTC)

The first sentence of the lede clearly states the MEDRS-compliant definition of abortion that is used throughout the article. The first paragraph also states that termination of pregnancy after viability is sometimes "less accurately" called "late term abortion." Thus, the reader is being properly informed of (i) how the word is used in the Wikipedia article, and (ii) how it sometimes might be used in other sources. So there is no issue of misleading the reader or giving false information. NightHeron (talk) 19:07, 11 November 2019 (UTC)

The first sentence of the lede makes the claim that abortion is so defined, and by exclusion, not defined more broadly. This claim is unwarranted, and certainly does not make the article understandable to as many readers as possible.170.54.58.11 (talk) 20:54, 11 November 2019 (UTC)

It is a fact -- not a "claim" -- that abortion is so defined. It is so defined by the vast majority of MEDRS sources. It is also a fact that some people choose to use the word "abortion" more broadly, so as to include the relatively very small number of terminations of pregnancy after viability, and this is acknowledged in the first paragraph. You're trying hard to create an issue where none exists. NightHeron (talk)

It is not by any means a fact that a late termination of pregnancy is not an abortion. That is the bone of contention.170.54.58.11 (talk) 21:51, 11 November 2019 (UTC)

It is a fact that post-viability termination of pregnancy is not defined to be an abortion by the vast majority of MEDRS sources. That's what Wikipedia goes by. NightHeron (talk) 22:16, 11 November 2019 (UTC)

How sources define terms is less relevant to Wikipedia than our knowledge of how the word is actually used and our judgment about how to write these encyclopedic articles. We don't say that Einstein wrote nothing about "Relativity" since his works are actually about "Relitivität"--- we translate his words into words that reach the most people. 170.54.58.11 (talk) 23:32, 11 November 2019 (UTC)

. From a reliable source, not LifeSiteNews. Guy (help!) 23:48, 11 November 2019 (UTC)

From the source that became the thesis of Definitions of abortion in its current state, we read: 'Both the lay and professional literature uses obstetrical terms improperly, including "abortion."' and '... some authors refer to "third-trimester" abortion."' The current stance of some editors here has been to adopt the normative / imperative guidance from David A. Grimes, as laid-out in his "Abortion Jabberwocky" article, as a norm for Wikipedia.

But I believe that Wikipedia is neither compelled nor able to follow this norm. That's why I say it is false for Wikipedia to claim that abortion is defined to exclude termination of pregnancy after viability: where is it so defined? Not in medical journals, which employ the term "third-trimester abortion"; not in mainstream reporting, where headlines use the expression "late-term abortion." Not in medical secondary references, where "abortion" counts for any termination of pregnancy, start to finish. Not in law, such as Roe v. Wade, where abortion was not limited to pre-viability abortion. It is not verifiable, this claim that "the way abortion is defined excludes anything after viability." Rather, it is verifiable that "abortion may mean abortion before viability or abortion after viability".

Here's a reliable source that "a late termination of pregnancy is an abortion": "How does CDC define abortion? For the purpose of surveillance, a legal induced abortion is defined as an intervention performed by a licensed clinician (e.g., a physician, nurse-midwife, nurse practitioner, or physician assistant) that is intended to terminate an ongoing pregnancy."

Here's a reference that's definitely not LifeSiteNews: "Although the vast majority of states restrict later abortions—defined variably as abortions occurring once a fetus is viable or beyond a specific point in pregnancy (such as 20 weeks postfertilization or the third trimester)—many of these restrictions have been struck down."

Here's another reference that's not LifeSiteNews: "Q: Does current law allow a woman to get an abortion up until the end of pregnancy? The Supreme Court was clear in Roe v. Wade that women need access to abortion post-viability if their health or life is endangered. States cannot ban abortion at any point in pregnancy when it is necessary to protect the woman’s life or health."

References

170.54.58.11 (talk) 20:18, 12 November 2019 (UTC)

Nice synthesis there. Guy (help!) 21:18, 13 November 2019 (UTC)

You're misrepresenting what other editors are saying when you claim that we're just following Grimes. We've repeatedly pointed to the long list of MEDRS sources in the article on Definitions of abortion that support the definition given in the first sentence. The first paragraph acknowledges that other uses of the word are common. Nothing in the lede is confusing or misleading. And your analogy with Wikipedia using the English term "relativity" rather than the original German word is particularly farfetched. This thread is degenerating into a waste of everyone's time. NightHeron (talk) 02:41, 13 November 2019 (UTC)

Instead of wasting everybody's time, I will suggest that we adopt the recommendation at the top of this discussion topic. 170.54.58.11 (talk) 16:44, 13 November 2019 (UTC)

The current version is correct and supported by reliable sources, so it should stay as it is. --Yhdwww (talk) 18:43, 13 November 2019 (UTC)

In spite of its compliance with normative writing by sources, the current version cannot be verified by reliable sources, because it claims that "late termination of pregnancy is not abortion." 170.54.58.11 (talk) 18:46, 13 November 2019 (UTC)

I'm afraid I don't follow you. The whole point of Wikipedia is to comply with normative sources. We're an encyclopedia, not a blog. Sources define abortion as termination before viability, so that's what we go with. I don't see where the problem is, since there is a Late termination of pregnancy article, too. --Yhdwww (talk) 20:54, 13 November 2019 (UTC)

Thank you for making this clear! Wikipedia is not to comply with normative sources, but to present information that isn't original research, has a neutral point of view, and is verifiable. The narrow definition for "abortion" isn't original research: we obtained that definition from sources. But the sentence we wrote in which we repeat the narrow definition for "abortion" is not verifiable, since it entails a claim that is contradicted by reliable sources. I think that the last sentence of the first paragraph would better reflect verifiable sources if it read as follows:

 Abortions performed A similar procedure after the fetus has potential to survive outside the womb is are known medically as a "late termination of pregnancy" or less accurately as a as opposed to the common expression "late term abortion".  In this article, "abortion" refers to abortion before fetal viability in most cases.

No, that wording is confusing, because Wikipedia would be using the word "abortion" at the beginning of the sentence in a way that's inconsistent with the medical definition that's used in the rest of the article; "the common expression" implies that the definition that Wikipedia is using is not a common one, which is false; and "in most cases" leaves the reader in the dark. The current wording of the lede is clear and unambiguous; there's no need to muddy it up. NightHeron (talk) 00:39, 14 November 2019 (UTC)

References

170.54.58.11 (talk) 21:24, 13 November 2019 (UTC)

@JzG:, my claim, that late termination of pregnancy is an abortion, is explicitly stated by the sources. That's not synthesis. 170.54.58.11 (talk) 23:36, 13 November 2019 (UTC)

Hey! I just found this published on the WHO article, "Unsafe abortion: the preventable pandemic" by David A. Grimes.

 DG, a gynaecologist, has done, taught, and studied abortions for 33 years. He has performed abortions as part of his duties as a medical school faculty member and as a private contractor for freestanding abortion clinics. He has served on the Board of Directors of the National Abortion Rights Action League and Planned Parenthood Federation of America.

 He is a member of the National Abortion Federation, the American College of Obstetricians and Gynecologists, the American Public Health Organization and other groups that support safe, legal abortion. He is a past chair of the Task Force on Postovulatory Fertility Control of the WHO, which conducts abortion research. He is an editor of a textbook on abortion and a chapter contributor to a gynecology text, both of which have provided modest royalties (less than $1000 total). He has testified in defence of physicians in medical liability cases concerning abortion. He has testified before Congressional committees twice regarding abortion. He has received honoraria for speaking about abortion at medical meetings. He currently teaches and performs abortions at the University of North Carolina School of Medicine as part of his faculty duties.

 He receives a fixed salary from the university, which is not dependent upon the number of abortions he does. 

References

170.54.58.11 (talk) 16:05, 14 November 2019 (UTC)

To continue this discussion, I will ask this question, and then repeat my claim: Should the article on Unsafe abortion also use Dr. Grimes' preferred definition? I believe that that article really should not use the narrow definition, since as we see below (at [Gestational Age]) the unsafe-ness of an abortion procedure increases monotonically with gestational age... and thus the public needs clearer information about late abortions, not less-clear information on late abortions. By specifically excluding the safety figures from late abortions from the abortion article, we give readers a false apprehension of safety surrounding late abortion. If this were not the case, then the article on Unsafe abortion would mention either Grimes' definition or something about viability or gestational age; it does not, so we see that this is true! 170.54.58.11 (talk) 19:23, 18 November 2019 (UTC)

What do you consider to be "Grimes definition"? In the jabberwocky article you referenced he used the definition of "termination of pregnancy before viability". In the paper about unsafe abortions, which is a specific medical term, he used the WHO's definition "A procedure for terminating an unintended pregnancy either by individuals without the necessary skills or in an environment that does not conform to minimum medical standards, or both.", which is also used in the article about Unsafe abortion. Considering that, I can't understand what your point is. --Yhdwww (talk) 13:14, 20 November 2019 (UTC)

Oh I'm so sorry, I meant the definition from "Abortion Jabberwocky", not "Unsafe Abortion, the Preventable Pandemic". Should Unsafe abortion use the definition that abortion is the termination of pregnancy before viability, but not after? (I believe that it should not!) 170.54.58.11 (talk) 23:23, 20 November 2019 (UTC)

It shouldn't and in fact it doesn't because, as I stated above, "Unsafe Abortion" is a specific medical term that means something else than "an abortion that is unsafe". Maybe just read these two sources through again, it should answer your questions. Sincerely --Yhdwww (talk) 13:39, 21 November 2019 (UTC)

It does not make Wikipedia better to distinguish "unsafe abortion" from "abortion" according to Dr. Grimes' specific medical terminology. Wikipedia's readers do not only view unsafe abortion and abortion through the medical lens: there is also the social lens, the public health lens, the policy lens, and the lens of people untrained in medicine who are trying to learn more. "Many unsafe abortions aren't abortions at all" is not false in Dr. Grimes' terminology (and not on account of the pregnancy somehow failing to be terminated). Also, "Abortions are safe, but unsafe abortions are not safe" is not a tautology: I can cite statistics and references to make that a completely verifiable claim in Dr. Grimes' terminology. It is impossible to answer "what makes an abortion safe?" in Dr. Grimes' terminology, because many "unsafe abortions" are not "abortions done unsafely." Wikipedia should take pains to answer "what makes an abortion safe?" well and avoid this kind of situation. 170.54.58.11 (talk) 15:39, 21 November 2019 (UTC)

Once again: that is not "Dr. Grimes' terminology", it is the official definition of the World Health Organization, whom I would consider an authority in the matter. If you feel that the Safety section of this article is incomplete, feel free to make improvements supported by reliable sources. However, if you don't have any new suggestions, I don't think it makes sense to continue this discussion here. --Yhdwww (talk) 20:29, 21 November 2019 (UTC)

If you believe that the WHO is an authority on the matter, then we should allow their definition to stand in the unsafe abortion article, as it is today. We should definitely not enforce the "Abortion Jabberwocky" definition over to that article. I agree with you completely on this. Now with regards to Abortion, should we use a definition for abortion that is incompatible with the WHO definition? 170.54.58.11 (talk) 21:22, 21 November 2019 (UTC)

No, we should leave it as it is. Termination before viability. --Yhdwww (talk) 21:37, 21 November 2019 (UTC)

Did you mean, "Yes, we should leave it as it is" (incompatible with the WHO definition)? This choice makes Wikipedia worse. Now's a good time to point out that the second paragraph of Abortion deals with safety and references unsafe abortion; this is not an esoteric conflict, but front and center. 170.54.58.11 (talk) 21:48, 21 November 2019 (UTC)

Actually, the answer to "what makes abortions safe?" in Dr. Grimes' terminology is possible to express, but it completely overlooks the well-known risk associated with terminating pregnancies after viability, as well as our general knowledge that increasing gestational age is a "simple predictor" for risk with these procedures. A reader who asked Wikipedia what makes an abortion risky will thus not learn about this well-documented risk (of which you and I are well-aware) to their clear detriment. 170.54.58.11 (talk) 00:54, 22 November 2019 (UTC)

Alright. I have now researched the matter more intensely and it appears that the WHO doesn't actually have an official definition for abortion, which brings us right back to the start of this discussion. I will refer you to Dr. Stuart Grimes' article, where he also gives further references, which supports the current definition of termination before viability. Unless you provide reliable sources stating the contrary, I will consider this discussion closed. Sincerely --Yhdwww (talk) 18:25, 24 November 2019 (UTC)

You meant David Grimes' article, "Abortion Jabberwocky," right? As for the closing of this discussion, I don't think that there has been any resolution presented to resolve the conflict between the pre-viability defintion and the use of the expression "unsafe abortion". If the WHO doesn't define abortion then maybe we as Wikipedia would be better off following their lead and inserting a sentence like this:

   Abortions performed after the fetus has potential to survive outside the womb are known medically as "late termination of pregnancy" as opposed to the common expression "late term abortion".  In this article, "abortion" refers to abortion before fetal viability in most cases.

References

170.54.58.11 (talk) 15:34, 25 November 2019 (UTC)

The authors at the National Academy of Sciences took this agnostic approach, writing that "Important clinical terms that describe pregnancy and abortion lack consistent definition." ( https://www.nap.edu/read/24950/chapter/3#chapter01_pz33-3 )170.54.58.11 (talk) 23:45, 25 November 2019 (UTC)

This quote

"the Catechism of the Catholic Church teaches that "Human life must be respected and protected absolutely from the moment of conception.", and that "A person who procures a completed abortion incurs excommunication latae sententiae," "by the very commission of the offense," and subject to the conditions provided by Canon Law." http://www.vatican.va/archive/ccc_css/archive/catechism/p3s2c2a5.htm"

We need a better source. This was just published in 1992. Doc James (talk · contribs · email) 20:09, 4 December 2019 (UTC)

Have summarized it further as "Statements made in 1992 in the Catechism of the Catholic Church opposed abortion." Doc James (talk · contribs · email) 20:13, 4 December 2019 (UTC)

@Doc James: In terms of the most important primary sources, there's also Humanae vitae (1968) (see para. 14 [22]), the CDF's "Declaration on Procured Abortion" (1974)[23], and Evangelium vitae (1995)[24]. If you're looking for something recent, here's the 6th edition of the ERD (US-specific, 2018)[25]. Here's a secondary source by Nicanor Austriaco: [26] Cheers, gnu57 17:16, 6 December 2019 (UTC)

Which section should we discuss this in? This one or the one below? What wording do you suggest? Doc James (talk · contribs · email) 20:10, 6 December 2019 (UTC)

Direct quote

User:Edit5001 I had provided the direct quote "Risk to maternal health. This reason was somewhat important overall, having been cited as the main reason by 5-10% in seven countries and by 20-38% in three (Kenya, Bangladesh and India)."

Which better supports "An additional factor is maternal health which was listed as the main reason by about a third of women in 3 of 27 countries and about 7% of women in a further 7 of these 27 countries." Doc James (talk · contribs · email) 20:26, 4 December 2019 (UTC)

User:Doc James Okay, I see the line now. I think if the line will be in the article, it'd be better to give the exact number in those developing countries. In developed countries, maternal health is a very small percentage of the reason women choose to get abortions.

In regards to the other change you undid, the Catechism is an extremely trustworthy source on Catholic Doctrine. It should thus be included to give their complete and factual stance on abortion. Edit5001 (talk) 20:54, 4 December 2019 (UTC)

I think the current paraphrasing is fine. The Catechism is discussed but was moved lower. See section above. Doc James (talk · contribs · email) 20:59, 4 December 2019 (UTC)

Giving the current, exact stance on abortion straight from the Catechism is the most factual and clear way of informing readers about the issue. A single, vague sentence is less optimal than the direct quote I had added. Edit5001 (talk) 21:05, 4 December 2019 (UTC)

They opposed abortion in a 1992 statement. Seems fairly clear. Without when it was published it does not make much sense. Doc James (talk · contribs · email) 21:41, 4 December 2019 (UTC)

@Edit5001: Wikipedia isn't here for you to promote views or decide WHICH statements you think are important for others to see or know. See WP:IS "Independent sources are a necessary foundation for any article. Although Wikipedia is not paper, it is also not a dumping ground for any and all information that readers consider important or useful. For the sake of neutrality, Wikipedia cannot rely upon any editor's opinion about what topics are important. Everything in Wikipedia must be verified in reliable sources, including statements about what subjects are important and why." That is why the source is poor source.

Giving the direct statement of the Catechism is not promoting a view, it’s giving their clear stance. The article already mentions the Catholic Church so giving the most direct information is preferable to vague statements. There are plenty of less relevant inclusions about the Church that should be removed, but this should be included. This stance of the Church is absolutely verified by all trustworthy sources; no official source disputes that the Catholic teaching on abortion isn’t what the Catechism states. I’m happy to site other sources but the quotes are relevant, accurate, and the best information to include for this area of the article.Edit5001 (talk) 03:45, 6 December 2019 (UTC)

Very hard to see who's saying what here, but I want to chip in that I agree that the Catechism is not the sum of Catholic views, any more than the press secretary's statements are the sum of the president's views. Triacylglyceride (talk) 01:40, 6 December 2019 (UTC)

There's a lot going on. Could we reference which edit is under discussion? Triacylglyceride (talk) 05:11, 6 December 2019 (UTC)

I'm saying that in the "History and religion" section that the Catholic Church's current teaching on abortion should be made clear. At the moment the section just says "Statements made in 1992 in the Catechism of the Catholic Church opposed abortion.". Part of the issue at hand is these aren't just statements made in 1992, they're the current official stance of the Church. Edit5001 (talk) 06:23, 6 December 2019 (UTC)

So do you want to change it to "The current position of the Catholic Church is one opposed to abortion."? Doc James (talk · contribs · email) 20:09, 6 December 2019 (UTC)

Sorry about my unclear previous comment. In reference to the Catheticism statement, what I was trying to say is that unless this statement is cited, IN ITS ENTIRETY in an INDEPENDENT source, than it is not IMPORTANT enough to be mentioned in Wikipedia, IN ITS ENTIRETY (or even partially). A summary of the Catholic church's position is suitable for inclusion. - I'm ok with: "The current position of the Catholic Church is one opposed to abortion." with one of the references given in the section above.---Avatar317^(talk) 03:27, 7 December 2019 (UTC)

Here's a .edu source from the University of Minnesota which states in regards to Catholic teaching; (http://hrlibrary.umn.edu/instree/congregation.html) -start quote- "Life, once conceived, must be protected with the utmost care; abortion and infanticide are abominable crimes." More recently, the Charter of the Rights of the Family, published by the Holy See, confirmed that "Human life must be absolutely respected and protected from the moment of conception." -end quote-

This was then reaffirmed in the Catechism that was published in 1992 that's basically completely glossed over in this article. If you'd like to not quote from the Catechism as a direct source, I think the above source would be great to quote. Edit5001 (talk) 04:14, 7 December 2019 (UTC)

This isn't an article on the Catholic church's views on abortion, so that quote is undue. You can put that quote here: Catholic Church and abortion. ---Avatar317^(talk) 06:30, 7 December 2019 (UTC)

There's tons of less relevant info about the Catholic Church in this article already than what I'm proposing. What if we replace the sentence ,"Statements made in 1992 in the Catechism of the Catholic Church opposed abortion." with "The Church since the mid-1800s has condemned abortion, restating this position throughout the 1900s, and codifying its full stance in its Catechism published in 1992." Edit5001 (talk) 07:42, 7 December 2019 (UTC)

That section talks about the HISTORY of Christian and Catholic beliefs regarding abortion, which have changed over time. To continue with the history, I propose changing the wording which is currently: "Statements made in 1992 in the Catechism of the Catholic Church opposed abortion." to "Since about [year X - replace with whatever year we can find in a RELIABLE, INDEPENDENT, source, clearly AFTER 1900] the Church has opposed abortion." ---Avatar317^(talk) 23:24, 8 December 2019 (UTC)

@Avatar317: It was in 1931 that the Catholic Church greatly hardened its anti-abortion stance (which had been proclaimed in a weaker form in 1869 after having had a relatively liberal policy before 1869). Concerning 1931, see the Wikipedia article Casti connubii. NightHeron (talk) 23:46, 8 December 2019 (UTC)

Two corrections to what I wrote above: (1) Casti connubii was promulgated on 31 December 1930, not 1931; (2) the Wikipedia article on the encyclical is incomplete. It merely says that the encyclical "reaffirmed" the Church's opposition to abortion. It actually did much more than that. The earlier anti-abortion policy, promulgated in 1869, was vague and could be interpreted to allow abortion in extreme cases, such as to save the life of the woman or in the case of an ectopic pregnancy. But Casti connubii stated unambiguously that abortion was prohibited even to save the life of the woman and even if the fetus was not expected to live. NightHeron (talk) 00:17, 9 December 2019 (UTC)

USA today headline - "hardly any abortions"

@Edit5001: Had Rhododendrites not reverted this addition, I would have, with this edit summary: One reporter's choice of wording for a headline doesn't govern how we state things here. Just because you found one article that phrases things the way you want doesn't mean there aren't many more articles phrasing it differently. Get consensus for this change, I oppose it. ---Avatar317^(talk) 03:42, 12 December 2019 (UTC)

@Avatar317: There has yet to be a valid explanation why something that's 1-2% (this number is not disputed - every current source confirms this percentage) cannot be referred to as, at least, "a small percentage". I don't see any source in the article claiming these are common reasons given for abortion. On top of the USAToday article, even the New York Times has noted in the past that rape and incest are "just" 1-2% of abortions. See: https://www.nytimes.com/1989/10/13/us/rape-and-incest-just-1-of-all-abortions.html. Edit5001 (talk) 04:11, 12 December 2019 (UTC)

There's no discussion of frequency of the rarity or commonality of any of the reasons under "personal" or "societal," which gives a broad overview of possible reasons that I find appropriate to the article. I don't think that going into percentages on those reasons for abortion, which vary widely depending on how people are asked about their reasons, would improve the article. I think that you've found consistent opposition to your including this, and yet you keep making edits as though you've reached a consensus. Should we include what percentage of abortions were related to China's one-child policy? Or lack of access to contraceptive methods? Or intimate partner violence? Triacylglyceride (talk) 06:09, 12 December 2019 (UTC)

There's a chart next to both sections that touches on frequency, so it is there. The chart is lacking however and doesn't break down these rarer reasons and just groups them all into "other". Noone here has suggested that there needs to be a percentage next to every single reason abortions are obtained, but it's worth distinguishing between the main reasons abortions are obtained and the rarer reasons they're obtained. The only objections I've seen to this are, frankly, people who seem to want to hide this very relevant information from readers. Edit5001 (talk) 04:47, 13 December 2019 (UTC)

I don't think there's much value in us continuing to rehash this, especially if you're questioning good faith. I'll rejoin the conversation if you seem closer to obtaining a consensus for the change. Feel free to make an RfC if you feel that's appropriate. Triacylglyceride (talk) 05:23, 13 December 2019 (UTC)2019 (UTC)

(edit conflict) When you note that "even the New York Times has noted in the past that rape and incest are "just" 1-2% of abortions" you apparently do not understand that we are not a news outlet, we are an encyclopedia and our writing differs from that of the Times. I note that you are pretty new to WP and many of those that have responded to your suggestions have been here for many years with hundreds of edits to their credit. Rather than to label them as POV pushers I think you should accept that experienced editors are more capable when it comes to making a judgement in this case. I've been here for a long time and I agree with their position. PS (I'd suggest that we do not need a RfC.) Gandydancer (talk) 05:33, 13 December 2019 (UTC)

@Gandydancer: This article already uses the qualifier "rare" to describe two phenomenon - unsafe abortions used in countries where abortion is legal, and complications in vacuum abortions. The qualifier "very uncommon" is used to describe women giving birth to a live fetus during a post-21 week surgical abortion. We should apply an equal standard to all of these instances of qualifying the rarity of something. Either adding the qualifier where I'm attempting to isn't allowed, and thus all of these other identical qualifiers also shouldn't be allowed, or they all should be allowed. Edit5001 (talk) 06:54, 13 December 2019 (UTC)

A qualifier may well be correct in one instance and not another, as is the case here. Gandydancer (talk) 13:39, 13 December 2019 (UTC)

Okay, why is that? Why is it not a valid qualifier for something that's 1-2% but it is a valid qualifier for the other numerous cases, some of which aren't even specified with a percentage? This is getting to a stage where I will basically certainly be doing a RfC because I think your double standards and lack of cooperation are absurd. Edit5001 (talk) 14:39, 13 December 2019 (UTC)

The answer to your question is obvious. Here's an example: only 1-2% of the students understood the lecture is a reasonable and uncontroversial use of "only", whereas it would be foolish to put "only" before 1-2% of the population will be dying each year from environmentally-related illnesses. At the risk of repeating what Gandydancer already told you, depending on context the use of such words might be appropriate and uncontroversial, might be controversial, or might be foolish. NightHeron (talk) 16:20, 13 December 2019 (UTC)

@NightHeron: The thing is, the example you just used as a qualifier that would be foolish is far more similar to some of the sentences already in the article. Let's take this line from the article as an example - "Complications, which are rare, can include uterine perforation, pelvic infection, and retained products of conception requiring a second procedure to evacuate. If "rare" is tolerated in this sentence, which is actually more similar to your example of a "foolish" inclusion, then "rare" or "a small percentage" should also be justified where I'd like to include it. The other option is we could remove the "rare" qualifier from this sentence and a few others like it, I'd be satisfied with that option too. Edit5001 (talk) 16:37, 13 December 2019 (UTC)

@Edit5001: No, that's not a good example of a misuse or controversial use of rare. As the article on abortion explains, serious complications from legal abortions by medical professionals are more rare than serious complications from childbirth, much lower than 1-2%. Since childbirth with the assistance of skilled professionals is widely considered a very safe procedure with rare complications, it logically follows that in the case of legal abortion, which is even safer, complications can uncontroversially be described as rare. (By "uncontroversially" I am thinking of reliable, WP:MEDRS-compliant sources and am disregarding the false information circulated by US-based anti-abortion zealots.) .NightHeron (talk) 18:34, 13 December 2019 (UTC)

@NightHeron: The quoted sentence does not say "serious complications". It just says '"complications". Some abortion complications are as common as 1 in 10 according to the NHS (https://www.nhs.uk/conditions/abortion/risks/) - that's 10% - and some are as common as 1 in 20 - that's 5%. Complications are thus far more common than the 1-2% number I'm trying to include. There's thus actually less justification to use the word rare in the sentence being quoted as there is to where I'm trying to add it. These double standards are not acceptable for what's supposed to be a neutral article. Edit5001 (talk) 19:23, 13 December 2019 (UTC)

@Edit5001: As I wrote before, whether or not the word "rare" applies depends on context. When talking of serious complications, especially ones that are life-threatening, it would be foolish to say that 1 out of 100 is rare. However, when one is talking about unserious complications, such as an infection requiring antibiotic treatment (or any of the other complications in your NHS source), then 1 out of 100 is rare (a "small risk" in the words of NHS). Here's an example to illustrate the point. The statement "If you leave home at 8, traffic could possibly make you late to work, but only rarely" is a reasonable statement if "rarely" means 1 out of 100 times. However, the statement "Tourists who visit our country are rarely killed by terrorists or drug traffickers" would be a true statement only if "rarely" means much much less than 1 out of 100 times. NightHeron (talk) 22:47, 13 December 2019 (UTC)

@NightHeron: The NHS gives two examples of complications that happen far more frequently than "1 in 100" cases - they give one complication that happens in 1 in 10 cases, and another that happens in 1 in 20 cases. Both of these things are more common percentages by several degrees than the rates abortions are sought for rape or incest reasons. Edit5001 (talk) 01:29, 14 December 2019 (UTC)

@Edit5001: In a medical context to most people, at least in US usage, the word complication means something serious. In talking to patients about an extremely safe procedure such as abortion, doctors do not commonly use the word complication for minor matters such as needing a course of antibiotics. The so-called "complications" in the NHS list are referred to there as minor considerations that do not contradict the statement there that the procedure is very safe, and to include them in this article would be undue emphasis, see WP:UNDUE. NightHeron (talk) 11:52, 14 December 2019 (UTC)

@NightHeron: Citation required for the claim "in US usage, the word complication means something serious". According to medicine.net, a complication is simply "an unanticipated problem that arises following, and is a result of, a procedure, treatment, or illness. A complication is so named because it complicates the situation." https://www.medicinenet.com/script/main/art.asp?articlekey=25405 In the free medical dictionary, complication is defined as "Any adverse medical response to a procedure or therapy; in drug therapy, aka, adverse–side effects". https://medical-dictionary.thefreedictionary.com/complication

@Edit5001: I did not say that the NHS use of the word complication was wrong or in conflict with dictionary definitions. What I said was that at least in the US, the connotation of the word is something serious, and patients would commonly be very worried if a doctor told them that they would be undergoing a medical procedure that has a "1 in 10 chance of complication". (Usage might be different in Great Britain.) Thus, to many it seems very odd to read the NHS state, on the one hand, that abortion is "very safe" and has only "small risk", but, on the other hand, that there's a 1 out of 10 risk of a "complication". Reading more closely, we see that the "complications" that have a high likelihood are very minor matters. Because of the common perception of what the word "complication" means to many people, in Wikipedia it's important to avoid using the word in a way that confuses or scares readers about the safety of abortion. Editors are especially aware of this possibility, because a strategy of people with a strong anti-abortion POV is to deliberately mislead people on this issue. NightHeron (talk) 19:59, 14 December 2019 (UTC)

@NightHeron: The NHS says abortion is "generally very safe", generally is a pretty important qualifier here as it leaves the possibility for these complications that can be as common as 10%. You still need to provide strong citations for the idea that the connotation of "complication" in the US implies a serious problem. You're right that we should be wary of abortion politics, but this applies both ways - we shouldn't be giving inaccurately pro-abortion information either. Edit5001 (talk) 03:41, 15 December 2019 (UTC)

Yes, the article does in fact qualify the statement about safety in the lede: When properly done, abortion is one of the safest procedures in medicine, but unsafe abortion is a major cause of maternal death. NightHeron (talk) 11:13, 15 December 2019 (UTC)

Concerning the connotation of complication, in https://www.merriam-webster.com/dictionary/complication?src=search-dict-hed#examples all three examples of the use of complication in the medical sense involve death or long hospitalization. NightHeron (talk) 11:36, 15 December 2019 (UTC)

Have you ever done it before? To be fair to our to editors that are not familiar with this topic and not be a waste of their time it must be worded properly. I'd suggest that you work with more established editors to set up the RfC properly. But, considering your opinions about the editors that work on this article I very much doubt that you will do that. Gandydancer (talk) 15:59, 13 December 2019 (UTC)

RfC's are used when there is disagreement between MULTIPLE editors and no consensus has been reached. In this case, Edit5001 disagrees with multiple editors, but I haven't seen any other editor supporting Edit5001's positions, so the consensus is already pretty clear.---Avatar317^(talk) 02:15, 17 December 2019 (UTC)

Unfortunately a majority of people here are willing to apply a blatant, obvious double standard to what they deem "rare" and "uncommon" vs what they don't. Edit5001 (talk) 03:05, 17 December 2019 (UTC)

Let's specify a definition for gestational age. Need not be drawn-out.

Hi! I noticed in my reading today that the authors of Risk Factors for Legal Induced Abortion–Related Mortality in the United States make a point to define gestational age, and it goes like this: Gestational age was defined as the number of completed weeks elapsed from the start of the last menstrual period and was categorized as either 1) 8 weeks or less, 9–10 weeks, 11–12 weeks, 13–15 weeks, 16–20 weeks, and 21 or more weeks or 2) first (12 weeks or less) or second trimester (13 weeks or more). This is a really quick paragraph that we should really try to incorporate in little ways here and there in Abortion so that people aren't left wondering what "gestational age" might be among various possible interpretations.

One way would be to add to the little Methods infobox sentence some words from the definition, as I propose below:

 

 

Practice of Induced Abortion Methods

MVA

D&E

EVA

Hyst.

D&C

Intact D&X

Mifepr.

Induced Miscarr.

0–12 wks

12–28 weeks

28–40 wks

Gestational age may determine which abortion methods are practiced. Gestational age is the number of days or weeks since the start of the last menstrual period.

170.54.58.11 (talk) 16:25, 6 December 2019 (UTC)

That infobox proposal seems fine (the bold text was only for clarity here, I assume). The source talks only about completed weeks, not days, but in general I have no objections here. --Yhdwww (talk) 16:40, 6 December 2019 (UTC)

• I don't think that's a good idea to specify here, because gestational age is somewhat complex. Not that it doesn't care mentioning, but it is also re-estimated in later stages of pregnancy by measuring the femur, crown-rump length, head-circumference etc. I would strongly suggest that linking to the article Gestational age is sufficient. Carl Fredrik ^talk 17:08, 6 December 2019 (UTC)

The reason that I brought it up is because the safety statistics used by Bartlett et al 2004, which have been echoed by WHO, D. Grimes, and others are tied to exactly one definition, and therefore anybody who reads the safety statistics should probably have access to this clarification. 170.54.58.11 (talk) 17:53, 6 December 2019 (UTC)

The dates used for the trimesters vary between sources which complicate matters. What wording do you suggest and were? Doc James (talk · contribs · email) 20:08, 6 December 2019 (UTC)

I suppose that the wording belongs together with the proposed addition from this section above, as proposed there. In a quick survey, I couldn't see anywhere else that the gestational age definition became critical to less than a week here or there. 170.54.58.11 (talk) 20:24, 6 December 2019 (UTC)

I agree with CFCF that it seems very cumbersome to include the bolded text. It's unclear to me what edit is being proposed. Triacylglyceride (talk) 00:49, 7 December 2019 (UTC)

Triacylglyceride, the edit being proposed is the same one the IP has been pushing since forever, which is to weaken the fact of abortion being a very safe procedure by talking up the marginal increase in risk with gestational age. Guy (help!) 12:15, 7 December 2019 (UTC)

To clarify what I'm up to here, I think that the infobox doesn't need the bolded change after all, now that I scanned the article again: this degree of detail isn't critical enough for us to specify a house definition for "gestational age". I only feel it is needed at the sentence where I'm proposing to talk about the increase in risk, and I would promulgate the definition without making a point of it, by treating gestational age as a synonym to "time since the beginning of the last menstrual period" there in that paragraph. 170.54.58.11 (talk) 15:45, 9 December 2019 (UTC)

JzG, it is impossible to weaken facts. 170.54.58.11 (talk) 18:58, 10 December 2019 (UTC)

Semi-protected edit request on 10 January 2020

I would like to edit the abortion page 174.255.17.36 (talk) 21:41, 10 January 2020 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. aboideau^talk 22:15, 10 January 2020 (UTC)

Are you the same editor as 170.54.58.11 who posted earlier on this talk page?— Preceding unsigned comment added by Epiphyllumlover (talk • contribs) 01:23, 11 January 2020 (UTC)‎

On the "Personal" section

Rape and incest are combined less than 2% of the reasons given for abortions in most sources this article uses. It's therefor justified to state that they are a "very rare" reason that women get abortions. Edit5001 (talk) 03:50, 6 December 2019 (UTC)

2% is not "very rare" Doc James (talk · contribs · email) 20:06, 6 December 2019 (UTC)

It qualifies as, at the very least, rare. Edit5001 (talk) 22:08, 6 December 2019 (UTC)

14,000 per year in the US doesn't seem "rare" to me. Triacylglyceride (talk) 00:50, 7 December 2019 (UTC)

The fact that it's 2% of the total of reasons makes it a rare reason among the reasons abortion is chosen. However, I'd settle for the wording "a small percentage among the reasons". Edit5001 (talk) 01:58, 7 December 2019 (UTC)

Which other reasons do you want percentages assigned to? Do you think that any other parts of the "motivation" section should be characterized as "rare" or "a small percentage among the reasons?" Triacylglyceride (talk) 17:39, 7 December 2019 (UTC)

This was the one that stood out, if there's any other reasons there that make up less than 5% of the reasons then you could justify adding that wording to them too. Edit5001 (talk) 18:37, 7 December 2019 (UTC)

That's a rather arbitrary number. I think it'd be challenging to do while avoiding a specific national focus. Triacylglyceride (talk) 04:37, 9 December 2019 (UTC)

Either way, it belongs next to the rape and incest reasons. Edit5001 (talk) 05:09, 9 December 2019 (UTC)

No it doesn't. The chart in the section does a good job of comparing reasons across nations. I find your desire to put "rare" next to this, but not next to, say, "compulsory abortion" to be POV. I also object to your reinstating your edit when two people objected to it and one person (you) agreed to it. That's not a consensus. Triacylglyceride (talk) 15:25, 11 December 2019 (UTC)

Make that three objections. The sentence "Additional reasons include" is more than enough to signify the lower percentage. --Yhdwww (talk) 15:33, 11 December 2019 (UTC)

The chart does not specify rape and incest. It simply lists anything not listed as “Other”. Therefor the chart isn’t adequate to get this information across. I also don't see how the phrase "additional reasons" indicates anything in regards to a small percentage; the word additional as defined by the Cambridge dictionary (https://dictionary.cambridge.org/us/dictionary/english/additional) does not imply "small".

By including the words “a small percentage” we bring the article in line with the factual data presented in all sources. There’s nothing “POV” about it. Even further, noone objected to the phrase “a small percentage”, you objected to “rare” and “very rare” phrases, and then failed to respond. If you fail to respond without even attempting to reach consensus with me, it's taken as you either not having an adequate rebuttal or agreeing. In reaching consensus one is supposed to offer a counter proposal that takes the other side's issues into mind. Edit5001 (talk) 19:58, 11 December 2019 (UTC)

Edit5001 stated: In reaching consensus one is supposed to offer a counter proposal that takes the other side's issues into mind. TOTALLY WRONG! It doesn't matter how much you claim the earth is flat, we don't need to slightly flatten it in the Wikipedia article just because we should "take your issue into mind." ---Avatar317^(talk) 01:02, 12 December 2019 (UTC)

If you're going to try to justify keeping facts out of an article you have to provide a pretty strong argument as to why. Further, describing a fact in the article that's reflected in every single solitary source cited on the page is hardly the equivalent of claiming the Earth is flat. The funny thing is, by refusing to include a relevant fact and not providing any real argument as to why, AND not responding to counter-arguments, it'd be you who's engaging in something a lot more similar to calling the Earth flat. Edit5001 (talk) 01:31, 12 December 2019 (UTC)

I understand that you find our disagreements with you not to be "valid," as you write elsewhere. We do not. Triacylglyceride (talk) 06:15, 12 December 2019 (UTC)

I'm still waiting for your response to what I last wrote to you above. Edit5001 (talk) 08:25, 12 December 2019 (UTC)

In many situations the use of words like rare and only is subjective and is an interpretation of the sources that is not in the sources themselves, see WP:EDITORIALIZING. For example, 1% might be interpreted as very small, but if it refers to millions of people in the world it might not be a small number at all. NightHeron (talk) 11:58, 12 December 2019 (UTC)

I feel I've responded adequately when I say that I don't think that individual reasons under "personal" and "societal" merit commentary on frequency. I think that doing so would be immensely challenging to do while maintaining a country-neutral framework. I think that as they're currently presented is the most appropriate. Triacylglyceride (talk) 04:38, 13 December 2019 (UTC)

I know this is a bit old, but instead of arguing about phrases like 'very' and 'rare', just add in the exact number. Surely there have been enough studies done to add in something along the lines of 'This accounts for X% of motivation in the U.S, X% of motivation in the U.K, and so on. TerribleTy2727 (talk) 03:47, 12 January 2020 (UTC)

A positive suggestion, but data is collected differently in different countries, so it would be hard to come up with genuinely comparable figures. HiLo48 (talk) 04:05, 12 January 2020 (UTC)

Safety. Why is gestational age overlooked entirely in the wikipedia article as a primary risk factor?

Hi!

In my limited reading today, I came across these sentences in the article:

 Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen. Second-trimester abortions are generally well-tolerated.

I compared this with what I read at the current ref 6., which refers to a Lancet article regarding unsafe abortion. This article bases the statement "...the risk of complications does increase with increasing duration of pregnancy" on a survey done in 2015 which reported that "Gestational age at the time of the abortion remains the strongest risk factor for abortion-related mortality." This statement was cited to another article from the ACOG, which repeated several times that "[t]he risk factor that continues to be most strongly associated with mortality from legal abortion is gestational age at the time of the abortion." This is repeated in another article as well: "Gestational age at abortion is a simple predictor of risk: later abortions are associated with increased risks for the woman. Late abortions are common; for example, a third of women treated for abortion complications in public hospitals in Kenya were beyond the first trimester."

Our article doesn't mention the risk of gestational age except the statement above with the opaquely-worded expression "well-tolerated", which is taken from a recent article behind a paywall that hasn't made it into the current WHO website or the 2017 Lancet article. This expression implies that there is a higher risk for second trimester abortions, but fails to make that explicit as it would if it were written more clearly.

References

170.54.58.11 (talk) 15:38, 14 November 2019 (UTC)

I checked again... our article cites Lerma & Shaw's "Update on second trimester medical abortion" as a reference for any second-trimester abortion. That's false. Lerma & Shaw's article applies only to medication abortion in the second trimester. 170.54.58.11 (talk) 17:17, 26 November 2019 (UTC)

It literally says "Second trimester surgical abortion is well tolerated", so - no. --Yhdwww (talk) 18:33, 26 November 2019 (UTC)

The article doesn't state that second trimester medical abortions are well-tolerated. Instead, Lerma & Shaw imply the opposite: while the researchers accept that second-trimester surgical abortions are well-tolerated, they couldn't say as much about second-trimester medical abortions. Wikipedia's claim is still left without a citation. 170.54.58.11 (talk) 19:54, 26 November 2019 (UTC)

They state that second-trimester surgical abortion is well-tolerated and that second-trimester medical abortion using mifepristone and misoprostol "reduce[s] burden on patient, provider, and health facility" — Preceding unsigned comment added by Yhdwww (talk • contribs) 20:13, 26 November 2019 (UTC)‎

They make a recommendation about "pragmatic dosing" and show that the results could result in a reduced burden... would it be reduced to the level of "well-tolerated"? Is their guidance going to be well-received, or is "pragmatic dosing" not what every provider will choose to do? Lerma & Shaw 2017 is not a source that second-trimester medical abortion is well-tolerated. 170.54.58.11 (talk) 20:25, 26 November 2019 (UTC)

Second-trimester abortions remain exceedingly safe in the US. I believe (though feel free to double-check) that most of our citations on "abortion is safe" style statements don't exclusively look at first-trimester abortions.

What kind of edit or statement do you have in mind? Triacylglyceride (talk) 15:15, 27 November 2019 (UTC)

Here, I suggest this:

 Types of  complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen. Second-trimester abortions are generally well-tolerated.  Although the overall rate of maternal mortality with safe abortions is extremely low, doctors advise women seeking abortions not to wait, because the risk of complications does increase for each week that passes.

170.54.58.11 (talk) 16:11, 2 December 2019 (UTC)

Those two sentences place UNDUE emphasis on complications. I don't see any problem with a modified, more factual wording (one rather than two sentences) as follows: Although the overall rate of maternal mortality with safe abortions is extremely low (the death rate for women in the US obtaining legally induced abortions during 1988-1997 was 0.7 per 100,000 abortions), doctors advise women seeking abortions not to wait, because the risk of complications does increase for each week that passes.[1]. NightHeron (talk) 01:15, 3 December 2019 (UTC)

References

I'd caution against saying "doctors advise women seeking abortions not to wait." There are circumstances under which pregnant people (because, you know, women aren't the only people who become pregnant) are advised to wait. Like if they're waiting for test results. How about replacing "Second-trimester abortions are generally well-tolerated" with "Although the risks of complication from abortion increase slightly throughout pregnancy, the overall risk of second-trimester abortion remains very low." Triacylglyceride (talk) 01:41, 3 December 2019 (UTC)

I don't see any problem with that sentence either. NightHeron (talk) 02:51, 3 December 2019 (UTC)

I think that we would be keeping more to the sources if we wrote " Although the overall risk of abortion remains very low, risks of complication from abortion increase throughout pregnancy. " 170.54.58.11 (talk) 15:26, 3 December 2019 (UTC)

...that's because it doesn't seem true for us to say "the overall risk of second-trimester abortion remains very low". Starting with Lerma & Shaw 2017, they say that 2nd trimester surgical abortion is generally well-tolerated, but they don't give Wikipedia any background on this statement, (unless that's behind the paywall; others here may feel more willing to pay the $52 on the chance that Lerma & Shaw end up contradicting this) essentially asking Wikipedia to take their word for it. That's a stance that we often do take with secondary sources like guidelines and textbooks, but this is a primary source and it's OK to hold primary sources' claims against their data.

...so the next place to look is "The Preventable Pandemic", which leads us to Linda Bartlett 2004, who tells us that the risks double every 15 days (1.38 ^ (15 / 7) ≈ 2).

References

170.54.58.11 (talk) 20:36, 3 December 2019 (UTC)

That type of statement would be over emphasizing the minor weekly risk increases. To see my point, see the statement on my user page, which I'll copy here: Talithia Williams, a statistician, explains how by knowing the data, we can make much better decisions. She explains how an OB/GYN recommended she be induced because her risk of a miscarriage would DOUBLE when she went past her due date. When she pressed for numbers, her doctor explained that her risk of miscarriage went from 1 in 1000, (0.1%) to 2 in 1000, (0.2%). Meaning that even if she waited, the probability of NOT miscarrying would still be 99.8%. [27].

We should not emphasize the risk increases when the TOTAL risk (even with increases) remains small. That is both confusing and deceptive. ---Avatar317^(talk)01:37, 4 December 2019 (UTC)

(I should have also said:) I'm OK with the sentence as Triacylglyceride suggested and NightHeron agreed to. ---Avatar317^(talk) 01:44, 4 December 2019 (UTC)

I am not suggesting that we repeat wholesale the data in the article, but I wholeheartedly disagree with either of these two approaches: 1) saying nothing about the increase in risk as gestation proceeds and 2) saying that the risk increases slightly. With saying nothing, we are actively withholding our knowledge that the risk increases, preventing our readers (as much as we are able) from making an informed decision. With saying that the risk increases slightly, we are equating two things that our sources tell us are different. I do not support the sentence as Triacylglyceride suggested which NightHeron agreed to because it is not verifiable. Removing the words "slightly" and "second-trimester" makes it verifiable, and it would sound like this:

"Although the risks of complication from abortion increase throughout pregnancy, the overall risk of abortion remains very low."

170.54.58.11 (talk) 16:21, 4 December 2019 (UTC)

According to the study referenced by David Grimes, the WHO, and The Lancet when talking about such things ("Risk Factors for Legal Induced Abortion–Related Mortality in the United States"), the rate of mortality for second-trimester abortion is more than double the rate of mortality for first-trimester abortion. This difference is termed "relative risk (unadjusted) of abortion-related mortality" by the authors. I suppose that they use the expression "unadjusted" because the denominator in their figure for each of these categories is the overall rate of legal induced abortion, not the number of procedures in a given category. 170.54.58.11 (talk) 16:54, 4 December 2019 (UTC)

• It's possible that the issue here might be disagreement over the meaning of the word slightly. If, for example, a risk increased from 1 in 100,000 to 2 in 100,000, I believe that it would be correct to say that it increased "slightly", even though it doubled --- because it only went up by an additional 1 in 100,000. I don't see any problem with keeping the word "slightly" (and also "second-trimester"). NightHeron (talk) 17:23, 4 December 2019 (UTC)

I agree that it is possible, and I wish it were the case. The risk of mortality with second-trimester abortions is twenty times greater than the risk with first-trimester abortion. Bartlett 2004 reports 1.7 deaths / 100,000 abortions between 13-15 weeks, 3.4 / 100,000 between 16-20 weeks, and 8.9 / 100,000 on average for second-trimester abortions "known" to be 21 weeks or greater. This is much closer to the childbearing mortality rate of 17.2 / 100,000 that Wikipedia reports than the earlier abortions. 170.54.58.11 (talk) 17:51, 4 December 2019 (UTC)

CORRECTION OF THE ABOVE: the rate of maternal mortality for second-trimester abortion is more than double the rate of mortality for first-trimester abortion about 20 times greater than with first-trimester abortion on the average; it is anywhere from 32.5 times to 180.8 times greater with abortion at 21 weeks and greater than with abortion at or before 8 weeks. I was wrong in what I supposed about averaging the relative risk over all procedures: the authors already did the more accurate thing and reported risk of procedure per procedure.170.54.58.11 (talk) 17:51, 4 December 2019 (UTC)

I got the number twenty by comparing the deaths per age bracket from Table 2, totaling 49 for the second trimester and 19 for the first trimester, and using a multiplier from elsewhere in the Wikipedia article that only 11% of abortions happen in or after the second trimester, and 87% before that (the other 2% are unknown). ( 49 / 11% ) ÷ ( 19 / 87% ) ≈ 20. 170.54.58.11 (talk) 18:02, 4 December 2019 (UTC)

Sure well "Second-trimester abortions are generally well-tolerated." complications are greater than in the first trimester.

Here is a better ref that says "Abortion-related mortality increases with each week of gestation, with a rate of 0.1 per 100,000 procedures at 8 weeks of gestation or less, and 8.9 per 100,000 procedures at 21 weeks of gestation or greater"[28]

We could summarize this as "The risk of death from abortion increases father a long a women is in pregnancy from 1 in a million before 9 weeks gestation to nearly 1 in 10 thousand after 20 weeks." Doc James (talk · contribs · email) 21:54, 4 December 2019 (UTC)

I would be happy if we wrote this, and I really appreciate the citation. Here's what I propose:

 Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen. Second-trimester abortions are generally well-tolerated.  The risk of death from abortion increases the farther along a women is in pregnancy from 1 in a million before 9 weeks gestation to nearly 1 in 10 thousand after 20 weeks. 

References

170.54.58.11 (talk) 22:14, 4 December 2019 (UTC)

Not throwing my support behind it at this time, but regardless, that should be "after 21 weeks," not "after 20 weeks." The source is "at 21 weeks of gestation or greater," and 20 weeks 2 days is "after 20 weeks" but not "at 21 weeks of gestation or greater." Triacylglyceride (talk) 01:42, 6 December 2019 (UTC)

I'm seeing ambiguities on both sides... maybe it would be smarter to refrain from word-smithing and be laser-focused on the numbers (in this case, the number sentences)... let's write it like this:

 Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen. Second-trimester abortions are generally well-tolerated.  The risk of death from abortion increases the farther along a women is in pregnancy from 1 in a million before 9 weeks gestation to nearly 1 in 10 thousand at 21 weeks or more since the last menstrual period. 

I added that expression "since the last menstrual period" to draw attention to the non-trivial specification made by Bartlett et al 2004 as to how weeks of gestation were defined for their research.

References

170.54.58.11 (talk) 15:54, 6 December 2019 (UTC)

Thank you, 170.54.58.11, your changes will help the article. Compounding this issue is that worldwide, the percentage of later-term abortions appears to be higher in some countries than others. Complicating an analysis of this factor is that such data in China is not released as it is considered a state secret.--Epiphyllumlover (talk) 04:46, 3 January 2020 (UTC)

I would agree with the addition of the boxed statement. Seems evidence-based, non-trivial, and NPOV. I would suggest the poster re-post this in a new section to get fresh feedback.Dig _deeper ^talk 03:12, 27 January 2020 (UTC)

The second sentence in the box is misleading (and hence not NPOV-compliant), since it suggests that 1 in 10,000 is a relatively high risk. Yes, it's relatively high compared to 1 in one million for an early abortion, but maternal mortality in the US in 2018 was about 1 in 5,000, which is twice the risk of a late abortion. NightHeron (talk) 03:39, 27 January 2020 (UTC)

I see what you're saying. Would you feel more comfortable with the following?

 Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen. Second-trimester abortions are generally well-tolerated.  The risk of death from abortion approaches the rate of maternal mortality the farther along a woman is in pregnancy; from 1 in a million before 9 weeks gestation to nearly 1 in 10 thousand at 21 weeks or more (as measured from the last menstrual period). 

Dig _deeper ^talk 19:35, 27 January 2020 (UTC)

@Dig deeper: How about changing The risk of death from abortion approaches the rate of maternal mortality the farther along a woman is in pregnancy to "The risk of death from abortion approaches roughly half the risk of death from childbirth the farther along a woman is in pregnancy"? First, that's an accurate statement, and, second, it replaces the technical term "maternal mortality" by a more easily understood term (just as "death from abortion" is easily understood). NightHeron (talk) 23:49, 27 January 2020 (UTC)

@NightHeron:OK, so for clarity would you support the following addition?

 Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen. Second-trimester abortions are generally well-tolerated.  The risk of death from abortion approaches roughly half the risk of death from childbirth the farther along a woman is in pregnancy; from 1 in a million before 9 weeks gestation to nearly 1 in 10 thousand at 21 weeks or more (as measured from the last menstrual period). 

Dig _deeper ^talk 18:44, 28 January 2020 (UTC)

@Dig deeper: Yes, that wording seems fine to me. NightHeron (talk) 19:19, 28 January 2020 (UTC)

Sounds good, thanks. I will propose this addition in a new section.Dig _deeper ^talk 19:41, 28 January 2020 (UTC)

Change wording regarding second trimester risk as per previous section

Seems we may have come to an agreement (see discussion above in "Safety. Why is gestational age overlooked entirely in the wikipedia article as a primary risk factor?"). Any additional comments or concerns regarding the following change?

Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen. Second-trimester abortions are generally well-tolerated. The risk of death from abortion approaches roughly half the risk of death from childbirth the farther along a woman is in pregnancy; from 1 in a million before 9 weeks gestation to nearly 1 in 10 thousand at 21 weeks or more (as measured from the last menstrual period).

Dig _deeper ^talk 17:28, 30 January 2020 (UTC)

Sounds good to me. Better than the non-clear and not terribly informative text that it will replace. ---Avatar317^(talk) 23:46, 30 January 2020 (UTC)

Also support, per the discussion above. NightHeron (talk) 23:52, 30 January 2020 (UTC)

 Done as per consensus above. Thanks for everyone's input.Dig _deeper ^talk 22:11, 2 February 2020 (UTC)

References

AfD: Church Fathers and abortion

The discussion at Wikipedia:Articles for deletion/Church Fathers and abortion might interest editors here. NightHeron (talk) 02:57, 25 February 2020 (UTC)

Semi-protected edit request on 12 March 2020

These suggested changes are not intended to push an agenda, but to reduce the appearance of bias in the article. Suggestion: At the end of the Introduction section, change "Those who oppose abortion often argue that an embryo or fetus is a human with a right to life, and they may compare abortion to murder." to "Those who oppose abortion often argue that an embryo or fetus is a human with a right to life and that abortion infringes on this right." Frankly7 (talk) 07:55, 12 March 2020 (UTC)

•  Not done. Please obtain consensus on talk before requesting edit-protected changes. Guy (help!) 12:11, 12 March 2020 (UTC)

~O~

Additional edit needed: The definition of abortion should be amended to include the word "elected" or "deliberate" when applied to the statement on termination of pregnancy. It cannot be said that a non-deliberate miscarriage should be called an abortion (nor "non-elective abortion" or any other euphemism) because throughout the whole entire history of abortions (generalizations [sic] included) — both legally and medically — has revolved around the obvious intent to deliberately choose to end a pregnancy. "Miscarriage" has always been the sole terminology accepted for an unintended death of a preborn fetal child. As to the argument further above, it is not inaccurate to state that those who believe abortion is a form of murder to state that they think this. To water down the terminology is an attempt to take away the voice of those whom are being quoted, which pretty much includes most people on the right wing of politics as well as some both on the left and in the middle. To water down the terminology isn't clinical, it is a violation of the truth of what is being reported concerning those on the right.

I'm afraid you're wrong. Where I live the medical definition of abortion includes miscarriages. It doesn't matter where I live. I just want to highlight that global statements like yours are unlikely to be true across all jurisdictions. HiLo48 (talk) 00:38, 7 April 2020 (UTC)

• Spontaneous abortion is a thing. We should really have three articles: a short one on abortion, which describes the concept; one on spontaneous abortion, and the majority of this article should be at termination of pregnancy (currently a redirect), which is the correct term for induced abortion. GTood luck getting consensus for that though. Guy (help!) 16:56, 7 April 2020 (UTC)

...and the rest at late termination of pregnancy.170.54.58.12 (talk) 17:05, 7 April 2020 (UTC)

Yes indeed. That seems quite a decent article. Guy (help!) 20:39, 7 April 2020 (UTC)

Useful ref

• Harris, LH; Grossman, D (12 March 2020). "Complications of Unsafe and Self-Managed Abortion". The New England journal of medicine. 382 (11): 1029–1040. doi:10.1056/NEJMra1908412. PMID 32160664. Doc James (talk · contribs · email) 06:13, 16 March 2020 (UTC)

https://www.nejm.org/doi/full/10.1056/NEJMra1908412

https://www.sciencedirect.com/science/article/abs/pii/S0020729211003250

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1728-4465.2004.00021.x

The Russian Federation study says that a high rate of maternal mortality is due to the prevalence of abortions at 22-27 weeks gestation. If they had used the Wikipedia definition for 'abortion' they would have said that the maternal mortality rate is much lower: a false report of safety. Wikipedia's stance on defining abortion as only procedures done before viability is a sad disservice to the public. 170.54.58.12 (talk) 16:46, 7 April 2020 (UTC)

not ours, that of the literature. Guy (help!) 16:49, 7 April 2020 (UTC)

Wikipedia is under no obligation to follow the glossary of ACOG, RCOG, etc over and against the legal terminology employed in Roe v Wade and other public forums. 170.54.58.12 (talk) 16:51, 7 April 2020 (UTC)

yes we are. See WP:MEDRS. Guy (help!) 17:13, 7 April 2020 (UTC)

Wikipedia is not following the terminology of the literature, it is following some normative guidance about terminology that is written in the literature. Following the normative guidance (exemplified by Abortion Jabberwocky) skews Wikipedia's reporting, resulting in the false report of safety that the researchers in https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1728-4465.2004.00021.x averted. 170.54.118.141 (talk) 17:35, 7 April 2020 (UTC)

I think you're wasting your talents here, go to Conservapedia where you'll be welcome. Guy (help!) 20:33, 7 April 2020 (UTC)

WP:NPOV 170.54.118.141 (talk) 22:31, 7 April 2020 (UTC)

Yes indeed. As opposed to Conservative Point Of View. Guy (help!) 08:17, 8 April 2020 (UTC)

* Back to Doc James' posting... I support working it into the article.--Epiphyllumlover (talk) 00:50, 13 April 2020 (UTC)

https://mumbaimirror.indiatimes.com/mumbai/crime/woman-dies-after-taking-abortion-pills-6-booked/articleshow/75686351.cms 170.54.118.141 (talk) 23:01, 12 May 2020 (UTC)

That source says that a woman in India died from an overdose of pills. That's not relevant to the article, and to include it would be UNDUE. NightHeron (talk) 23:21, 12 May 2020 (UTC)

Does this story in any way seem to counterindicate our 10th sentence that "The drug mifepristone in combination with prostaglandin appears to be as safe and effective as surgery during the first and second trimester of pregnancy.[10][11]" ? 170.54.58.11 (talk) 15:52, 13 May 2020 (UTC)

No, because surgery, if done incompetently by an unqualified person outside the medical system, is extremely dangerous. Overdosing on medication is, too. NightHeron (talk) 17:17, 13 May 2020 (UTC)

No. This is one vague news article about one person using a non-standard medication abortion regimen. It does not speak to the safety of abortion in general. SeeJaneEdit (talk) 17:51, 13 May 2020 (UTC)

Definition of late

@JzG:: What's your reason for restoring the definition of late as post-viability rather than defining it in terms of gestational age? In the thread above I explained my edit as follows: The question of viability early in the third trimester is a complicated one, because it depends on many individual factors, on available medical facilities, and also on whether viability is defined as long-term survival or includes brief survival outside the womb. So viability does not belong in the definition of late abortion. I also pointed out that defining "late" in terms of gestational age is consistent with the definition in Late termination of pregnancy. The latter article treats "late term abortion" as a synonym for "late termination of pregnancy." NightHeron (talk) 23:46, 8 June 2020 (UTC)

And what's he doing changing your edit at all without first discussing it in the above section, Last sentence in first paragraph of lead. Seems like Years of incivility indeed! — Preceding unsigned comment added by 70.181.40.210 (talk) 03:05, 9 June 2020 (UTC)

"When properly done, abortion is one of the safest procedures in medicine,"

Neither one of the two source provided say this.

Needs to be changed as it violates policy. — Preceding unsigned comment added by Siggines (talk • contribs) 14:29, 1 June 2020 (UTC)

Not true. The first source, for example, states: legal abortion in industrialised nations has emerged as one of the safest procedures in contemporary medical practice. NightHeron (talk) 16:54, 1 June 2020 (UTC)

Siggines, yes they do, we already went through this at enormous and tedious length.

Abortions are safer than giving birth, especially in America, where large numbers of poor women lack access to good healthcare, giving red states some of the worst maternal and neonatal mortality rates in the developed world.

Redux: anyone who is pro-life (rather than merely anti-abortion) should be advocating for Medicaid expansion. Guy (help!) 22:15, 1 June 2020 (UTC)

NightHeron Where in the first source does it say that? I have searched for it in there and read all of it, and cannot find that sentence which you put in large letters.

Abortions are in-fact safer than giving birth. This does not equate to Abortion being one of the safest operations, neither does illegal abortions being unsafe equate to this either! And for your information I am not 'pro-life' I'm not even American so that term doesn't mean much to me.

Not only does the operation of Abortion come with risk of major complication, it also has adverse health effects on the woman. https://www.nhs.uk/conditions/abortion/risks/

It is a safe operation relatively speaking, but to say it is 'one of the safest' is groundless and must be removed from Wikipedia under Neutrality as a policy.

The passage I quoted from the first source is in the 5th sentence of the Introduction. As Guy said, this issue has already been discussed at great length, most recently: [29] and [30]. Perhaps you should read some of the earlier discussions. NightHeron (talk) 11:14, 2 June 2020 (UTC)

The source goes on to say, "Worldwide, an estimated 68 000 women die as a result of complications from unsafe induced abortions every year—about eight per hour. This prevalence translates into an estimated case-fatality rate of 367 deaths per 100 000 unsafe abortions, which is hundreds of times higher than that for safe, legal abortion in developed nations.". It is clear that the context is unsafe versus safe. That gives the figure of 367 per 100,000 versus 1 per 100,000. Clearly safe abortion is safer than unsafe abortion. However, no data is adduced in the source that compares safe abortion with any other medical procedure. We have no idea how it compares to lancing a boil (0.001 per 100,000 ? Who knows?). Since the body of the source does not have internal evidence to support the introduction, then its weight as a trustworthy source ought to be reduced. Laurel Lodged (talk) 17:18, 2 June 2020 (UTC)

The authors of the source interpreted 1 per 100,000 as meaning that it's one of the safest procedures in medicine (which does not imply any comparison to lancing a boil). It's not our role to dispute their judgment. If you believe that 1 per 100,000 might not mean that it's one of the safest procedures in medicine, you should find a source that disputes that. Good luck. NightHeron (talk) 22:07, 2 June 2020 (UTC)

Laurel Lodged: Please be aware that all pages relating to abortion are protected by discretionary sanctions and, in particular, are subject to WP:1RR, that is, no more than one revert in a 24-hour period. You made two reverts in less than 7 hours. Please do not edit-war. NightHeron (talk) 22:15, 2 June 2020 (UTC)

• Laurel Lodged, I can't tell whether you're actually reading the cited references before raising these concerns. One of the citations for the "safest procedure" sentence (ref #5 in the current page revision) goes to this article, which explicitly compares induced abortion to plastic surgery, dental procedures, bike riding, marathon running, etc. So I don't understand your contention that "no data is adduced in the source that compares safe abortion with any other medical procedure". The article content is properly sourced and medically accurate. MastCell ^Talk 22:56, 2 June 2020 (UTC)

To say that abortion is one of the safest medical procedures is to ignore the outcome of the procedure for the human fetus. The abortion procedure could be interpreted as nearly always resulting in the death of a human being afterall. To avoid ideological debates, I would suggest an edit to indicate the objective facts ie. abortion is "a medical procedure associated with low maternal death rates."

This could be accompanied with references to the numerical figures regarding maternal death rates. Acasualobservation (talk) 19:05, 3 June 2020 (UTC)

It's clear from context that safe means safe to the patient, i.e., the woman. You are expressing the POV of the anti-abortion movement, but the vast majority of law codes globally do not regard an abortion, even a late abortion, as the killing of a human being. In fact, most religious and secular traditions throughout history have not regarded a pregnancy as even being fully established until after quickening or ensoulment, which was thought to occur after anywhere from 40 days to 4 months of gestation. It's only the extreme wing of the modern anti-abortion movement (and the law codes of a few countries, such as El Salvador and Malta) that consider an abortion to be killing a human being. NightHeron (talk) 21:05, 3 June 2020 (UTC)

Acasualobservation, you do know that a substantial proportion of pregnancies abort spontaneously, right? You're accusing God of murder right there. Guy (help!) 21:19, 3 June 2020 (UTC)

I am trying to keep the wiki entry as factually accurate as possible not engage in ideological debate. Just because something is legal doesn't mean it is right. For example, many legal systems in the West considered homosexuality a crime until recently but I presume you also think that the legal system made a mistake in this respect. Saying an abortion is safe for the patient ie. the woman, is an ideological point for the reasons outlined in my previous comment. I did not mention God or religious practices and neither does the wiki entry. Let's focus on the science, the human fetus is a human organism, it is by definition a human being since these terms are synonymous. The pro choice argument in this respect is that the fetus is not a person and this could be true or false depending on how we define personhood. In any case this is not relevant to the edit I suggested to the wiki entry above. Can we try and stay on topic please. Acasualobservation (talk) 21:43, 3 June 2020 (UTC)

That paragraph in the lead is clear and scientifically accurate. As I said, the context is obvious: the term maternal deaths occurs in both of the first two sentences of the paragraph. The zygote or embryo (or fetus if it's a late abortion) is obviously destroyed, since that's what the term abortion means. No reader would be dumb enough to think that a safe abortion is one where the embryo survives and the pregnancy is carried to term. NightHeron (talk) 22:10, 3 June 2020 (UTC)

Acasualobservation, so are we. We do it by reference to scientific publications, you do it by reference to anti-abortion rhetoric. That suggests you're on the wrong website. Conservapedia is third on the left down the hall (but assfly will ban your ass in about ten minutes, as he does most people). Guy (help!) 21:33, 5 June 2020 (UTC)

I do not contend that someone could read the sentence and conclude a safe abortion is one where the fetus survives. My point is that the current wording makes an implied judgement about the value of the human fetus. This is an ideological viewpoint and my suggested edit avoids this pitfall. Acasualobservation (talk) 22:58, 3 June 2020 (UTC)

Not ideological at all. Simply reflecting the universally agreed meaning of the word "abortion". HiLo48 (talk) 23:40, 3 June 2020 (UTC)

Acasualobservation: The current wording does not imply a judgment about the value of the zygote, embryo, or fetus. You're reading something into the wording that's not there. Your alternative wording - associated with low maternal death rates - is imprecise and greatly weakens the statement. Low compared to what? To some readers, low would imply that there still is a very significant maternal mortality, which is false. NightHeron (talk) 23:45, 3 June 2020 (UTC)

I have not made any comments regarding the definition of the word abortion so I am not sure what your point is above with regard to the definition.

The current wording does imply a value judgement on the human fetus. A point is being made that the procedure is safe even though in order to be successful it must necessarily result in the death of the fetus, thus implying the human fetus is of no or little value. It is very clearly a value judgement.

Your point regarding the use of the word low is fair but the same point could also be made about the word safe.Safe compared to what? That is why I suggested referencing the actual figures concerning maternal death rates to remove ambiguity in this respect. Acasualobservation (talk) 05:34, 4 June 2020 (UTC)

The article is titled Abortion, so the definition of that word is somewhat important. HiLo48 (talk) 05:40, 4 June 2020 (UTC)

As I have already stated above, I have not made any comments about the definition of abortion. Acasualobservation (talk) 06:41, 4 June 2020 (UTC)

But the definition is the critical thing here! Let's be blunt. Abortion involves the killing of a foetus. It is therefore pointless to discuss the fact that a foetus is harmed in an abortion. HiLo48 (talk) 06:49, 4 June 2020 (UTC)

I don't deny that abortion involves the killing of the human fetus. My suggested edit does not discuss the fact that a fetus is harmed in an abortion. My point refers to the phrasing of this sentence to avoid implicit ideological bias. Acasualobservation (talk) 15:01, 4 June 2020 (UTC)

Neither your version (a medical procedure associated with low maternal death rates) nor the version currently in the lead (one of the safest procedures in medicine) has anything to say, either explicitly or implicitly, about the value of the zygote, embryo, or fetus that's aborted. The current version has no more "implicit ideological bias" than your version has. Rather, the difference between the two versions is that yours is much weaker and less precise, leaving open the possibility that there might still be some unacceptable health risks to the woman. (Note that mortality is not the only safety issue.) The current version is what's in the sources. Because the anti-abortion movement persists in making false claims of adverse effects on the woman, it's important for Wikipedia to be clear and unambiguous about what the medical sources say. NightHeron (talk) 20:04, 4 June 2020 (UTC)

Your assertion that there is no implicit bias is incorrect in my view. As I have stated above, 'the current wording does imply a value judgement on the human fetus. A point is being made that the procedure is safe even though in order to be successful it must necessarily result in the death of the fetus, thus implying the human fetus is of no or little value. It is very clearly a value judgement.'

My suggested edit only states that there is a low maternal death rate which can be accompanied with citation. If you think an additional edit should be included to specify the risk level in relation to other health outcomes, I would welcome your suggestions.

If the anti abortion movement makes false claims they will be unable to provide evidence to support those claims. Acasualobservation (talk) 21:26, 5 June 2020 (UTC)

When the anti-abortion movement makes false claims, such as invented or exaggerated adverse effects on women's physical or mental health, it's important for people to be able to consult Wikipedia to get information that's supported by MEDRS sources.

The information you suggest adding about other health matters besides mortality is already in the main body in the "Safety" section. It's undue to include those details in the lead. NightHeron (talk) 22:05, 5 June 2020 (UTC)

I am satisfied that your response address the point made in my second paragraph above. However, I am still concerned that stating that abortion is one of the safest medical procedures is unfairly denigrading the value of the fetus. Perhaps it could be reworded to emphasise that 'it is considered to be safe for women undergoing the abortion procedure'. Acasualobservation (talk) 09:27, 6 June 2020 (UTC)

The addition of such a phrase would be awkward and unnecessary, since the reader already understood that "safety" refers to the woman. The issue you mention -- controversy over the value of the zygote, embryo, or fetus -- is in the lead in the 3rd-to-last sentence. NightHeron (talk) 11:35, 6 June 2020 (UTC)

I would disagree. The reference to abortion being one of the safest medical procedures could benefit from qualification. Why would we presume to know how a reader will interpret text when we have the option of being more exact in our wording. Acasualobservation (talk) 21:49, 6 June 2020 (UTC)

What about including a reference to the review article I mentioned in the above discussion? Would you support a brief mention with note as I recently suggested?--Epiphyllumlover (talk) 20:19, 7 June 2020 (UTC)

Do you mean the above discussion of risks to later successful childbirth from an earlier abortion vs an earlier pregnancy? The problem is that the issue is complex, as I argued before, and I can't see how a brief mention of the issue could avoid being over-simplified and misleading. For example, risk to later live births from a previous abortion is insignificant if it's an early abortion but becomes significant as the gestation age increases. So late abortions are risky. But late abortions are normally done only in cases of an abnormal pregnancy (such as ill health of the woman or severe deformity of the fetus), and those are precisely the cases that are most likely to lead to C-section if the pregnancy is continued. A birth by C-section is also risky in terms of subsequent births. A woman who was considering a late abortion because of her own health problems but who wanted to have children later in life should ask her doctor for advice, based on the specifics of her case; she should definitely not rely on Wikipedia for insight on comparing an abortion vs carrying the pregnancy to term.

In the earlier discussion, I suggested that, if we have suitable sources, we might want to write a brief new subsection on the risks of multiple abortions, that is, using abortion as a method of birth control. I think that abortion rights advocates and anti-abortionists can agree that repeated abortion as the main method of birth control is a bad idea. Obviously contraception and sex education are preferable. So it should be possible to write something brief and straightforward that everyone can agree on -- provided, of course, that we have MEDRS sources that describe those risks. NightHeron (talk) 21:15, 7 June 2020 (UTC)

Do you want to be the one writing it? (I have a bad feeling that if I do, it will be deleted.)--Epiphyllumlover (talk) 00:29, 8 June 2020 (UTC)

The question is whether we can find high-quality sources. I haven't had much luck so far. One study is inconclusive because they couldn't control for other factors (in other words, women who have multiple abortions for birth control are very different from women who have 0 or 1 or 2 abortions in their lifetime). I found an article in the Croation Medical Journal reporting on a study that concluded: "The most important obstetric factors for placenta previa development were advanced maternal age especially >34 years, 3 or more previous pregnancies, parity of 2 and more, rising number of previous abortions, and history of previous cesarean section, but not child sex at birth, history of drug abuse and previous placenta previa" (my emphasis). But that's a primary source, and we really need a review or summary article. A 1999 article by the World Health Organization discusses the situation in Vietnam, where many women had multiple abortions because of poor use of contraception and poor sex education at that time, see [31]. That article takes it as a given that multiple abortions are risky, especially in a relatively poor country, and they write that women should be strongly encouraged to use contraceptives instead and should be warned of the risks of multiple abortion. But they are not very specific about what those risks are (obviously, there's a greater chance that there'll be complications from one of many abortions, especially because of conditions in many parts of the country). Please let me know if you know of other sources. I might not be searching in the best way. NightHeron (talk) 01:38, 8 June 2020 (UTC)

Use the sources you have; then put any inherent issues with the methodology into an efn note. If someone has better sources in the future weeks and months they can modify your edit.--Epiphyllumlover (talk) 01:51, 9 June 2020 (UTC)

I don't think it's a good idea to add inadequately sourced content with an efn-note in the hope that other editors will spend a few hours finding better sources rather than (much more likely) spending a few seconds reverting it.

From the time of Margaret Sanger, advocates of legal and easily accessible contraception and sex education have argued that a major benefit will be to reduce the number of women who resort to repeated abortions as a method of birth control. One of the reasons to want to reduce that number is presumably the risk to a woman's health of having repeated abortions. In places where unsafe abortion is common (where it is illegal or where many regions lack providers, as in the US) it's obvious that repeating an unsafe procedure is very unsafe. But what I've been looking for is sources that say that even safe legal abortions, if done repeatedly, carry some risks. I found a Finnish source [32] that reports that repeated abortions prior to first birth "are correlated with an increased risk of some health problems at first birth, even in a country with good health care quality." However, there are two problems with using the Finnish source: (1) it's a primary source reporting on a single study, and so is not MEDRS-compliant; and (2) it cautions that the correlation does not establish causality. In other words, there are so many demographic and life style differences between the population of women with 0, 1, or 2 abortions and those with many abortions that the correlation could have been caused by non-abortion-related differences that the study was unable to control for. So I'm still at a loss for sources. NightHeron (talk) 16:18, 9 June 2020 (UTC)

There are many medical articles on Wikipedia relying on studies for which there is not a perfect degree of control. Surgery studies cannot ordinarily include the same sorts of control treatments as a drug treatment. The best approach to this reality is to do the best you can rather than get hung up on catch-22s. If you would prefer to leave the efn out, I am fine with that; it was a concession to your concerns rather than something I am committed to.--Epiphyllumlover (talk) 18:41, 9 June 2020 (UTC)

The problem is that we editors are not in a position to judge whether a given study has an adequate level of control. That's why we need secondary sources, such as meta-studies that evaluate and summarize work by a number of researchers. WP:MEDRS is clear about this. The Finnish study doesn't even claim to have controlled adequately for non-abortion-related factors. I'm not going to write something up only to have it immediately reverted with edit summary "Removing poorly sourced medical claim, per WP:MEDRS." If you become aware of reliable secondary sources on this question, please let me know. NightHeron (talk) 19:11, 9 June 2020 (UTC)

I provided a meta-study months ago on a related topic and your objections were similar. Do you no longer object to including it?--Epiphyllumlover (talk) 20:05, 9 June 2020 (UTC)

Last sentence in first paragraph of lead

I suggest that this sentence should be modified to read as follows:

A similar procedure to effect the demise of the fetus after it has potential to survive outside the womb is known as "Late termination of pregnancy" or, informally, "late term abortion."

This wording would clarify the fact that "late termination of pregnancy" is intended to end the life of the fetus, rather than merely ending the pregnancy which, after all, is also ended with pre-term birth which may occur at the same stage of gestation. The less significant change would be replacing "less accurately" with "informally." "Late term abortion" frankly, is only considered "less accurate" (by some) because at some time, fairly recently, the medical profession probably decided that it was a more delicate way of denoting the practice. 70.181.40.210 (talk) 18:38, 5 June 2020 (UTC)

No, I'm afraid that wording is inaccurate. Late term abortions, often carried out because continuation of the pregnancy may cause the death of the woman, really are for the purpose of ending the pregnancy and thereby protecting the health of the woman. In some jurisdictions, doctors are required to make extraordinary efforts to keep the fetus alive, even if its prospects for long-term survival are near zero. So the purpose is not to effect the demise of the fetus, although that is what happens in most cases. NightHeron (talk) 20:37, 5 June 2020 (UTC)

I see your point, however, a phrase such as ... and most commonly results in the demise of the fetus could be added to that sentence as it now stands to make it clear that late termination of pregnancy doesn't simply end pregnancy. 70.181.40.210 (talk) 21:26, 5 June 2020 (UTC)

To expand a bit as what I see as the problem, let's place the lead's first sentence, i.e the definition of abortion, just in front of the lead's fifth sentence, i.e. the definition of late termination of pregnancy.

Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus before it can survive outside the uterus. A similar procedure after the fetus has potential to survive outside the womb is known as a late termination of pregnancy or less accurately as a "late term abortion."

It seems to me that this juxtaposition invites the question When a fetus with "potential to survive outside the womb" IS removed from the womb, what normally happens to it. Why not answer the question ? 70.181.40.210 (talk) 02:48, 6 June 2020 (UTC)

There's already a short subsection titled "Live birth" that discusses the extremely rare circumstance when a fetus survives a late-term abortion. Late-term abortions globally are rare, greatly restricted either by the law (in most countries) or by the practice of the medical profession (as in Canada). They are normally done only when there's serious danger to the health of the woman. A tactic of the anti-abortion movement is to pay undue attention to such abortions. The Wikipedia article should not pay undue attention to the question you raise (in other words, it doesn't belong in the lead), but it is answered in the "Live birth" subsection. NightHeron (talk) 11:47, 6 June 2020 (UTC)

The fact that a subsection on "live birth" already exists supports my point since the lead is supposed to briefly preview the body of the article. Simply adding something like and commonly results in the demise of the fetus to the definition of late termination of pregnancy (or late term abortion) would do this quite nicely. 70.181.40.210 (talk) 15:38, 6 June 2020 (UTC)

Thinking more about this, I agree with you that there's a problem with the current wording of the last sentence of the first paragraph, but it's because of the misleading definition of late-term abortion as abortion after the fetus has potential to survive outside the womb. As you point out, that could raise the question in the reader's mind about whether the fetus in such cases typically survives outside the womb. This definition of late-term abortion is not the same as in the article Late termination of pregnancy, which states: Late termination of pregnancy (also referred to as late-term abortion) describes the termination of pregnancy by induced abortion during a late stage of gestation. "Late," in this context, is not precisely defined, and different medical publications use varying gestational age thresholds. So I propose changing the wording of the last sentence of the first paragraph to: A similar procedure during a late stage of gestation is known....

Typically in a long article the lead does not summarize every short subsection. Information about fetus survivability in late abortions should not be given undue importance by putting it in the lead. NightHeron (talk) 16:43, 6 June 2020 (UTC)

It most certainly is due if the lead itself raises the issue in the first place by defining late term abortion (or late termination of pregnancy) as a procedure that takes place after possible fetal viability. That said, you propose an interesting solution by rewording the last sentence of the opening paragraph so that it simply omits mention of viability. Out of sight out of mind. Of course, that might lead the reader to wonder why such a distinction in terminology exists. Why call it something different if is merely the same procedure done later? You also raise a very good point (because I've noticed it too!!) that both within in this article and between this article and the one on Late termination of pregnancy there are glaring inconsistencies in terminology. Curious ones, really, since the articles have largely been controlled by pro-choice medicos. For example, the subsection on Live birth, dealing, with procedures taking place after possible fetal viability, refers to them not as late terminations of pregnancy but as plain abortion. Why bother to make a distinction between the two in the lead and then ignore the distinction in the body? In fact, why bring up the live birth subject at all if this is supposed to be an article on abortion rather than on late termination of pregnancy where the section would be more fitting. In any case, were I you, I would go ahead and change the lead sentence in question to one that doesn't raise the hornet's nest of fetal viability. 70.181.40.210 (talk) 19:36, 6 June 2020 (UTC)

Done.

The distinction between early and late abortions is of central importance to most abortion rights advocates, because there is widespread agreement with strong restrictions on third trimester abortions, as reflected, for example, in the US Supreme Court decision in Roe v Wade. There's nothing strange about drawing a distinction between early and late abortions. The question of viability early in the third trimester is a complicated one, because it depends on many individual factors, on available medical facilities, and also on whether viability is defined as long-term survival or includes brief survival outside the womb. So viability does not belong in the definition of late abortion. By the way, if I remember correctly, the subsection on live births is the result of a compromise between editors (presumably abortion opponents) who thought that it's an important issue meriting major coverage and those who thought that it does not belong in an article on abortion. NightHeron (talk) 21:01, 6 June 2020 (UTC)

Fair enough, and I'll also commend you for removing "less accurately" regarding "late term abortion" since the article later uses this supposedly less accurate term. As to your above statement that Roe v. Wade reflects widespread agreement about restrictions on third trimester abortions, however, I beg to disagree. Roe actually allows the termination of fetuses at any stage in gestation as long as governments allow it. It simply permits governments to also somewhat restrict such terminations during the third trimester if they so choose. 70.181.40.210 (talk) 21:38, 6 June 2020 (UTC)

But they do so choose. In the US legal system regulation of abortion is up to the states and is outside of Federal jurisdiction, except that the Supreme Court can protect the privacy rights of the woman by forbidding certain types of abortion restrictions. In practice, as I said before, globally virtually everywhere late abortions are restricted either by local law codes (e.g., in US states) or by the medical profession. They are generally performed in cases of risk to the woman's life if the pregnancy is carried to term and in cases of severe fetal deformity. NightHeron (talk) 22:25, 6 June 2020 (UTC)

"Late term abortion" is not a thing. It's a political talking point, not a medical procedure. Elective abortions, worldwide, are mostly in the first trimester and anything in the third trimester, pretty much everywhere, is performed only for therapeutic purposes (i.e. because the foetus is unviable or the mother's life in danger). Discussing such cases in the context of a procedure that is almost always entirely different is like citing Nikki Lauda's injuries as evidence that burns are a risk in car crashes. Guy (help!) 21:20, 7 June 2020 (UTC)

JzG That's a rather odd assertion since both this article and the other use late term abortion and late termination of pregnancy interchangeably, though a better case could be made for late termination of pregnancy being the true talking point here, since abortion is both briefer and far more commonly used than termination of pregnancy. Of course most abortions are done in the first trimester. It would be a pretty brutal world if they weren't. However, if you think that elective abortions are almost never done beyond the point of fetal viability, say 24 weeks, except under extreme circumstances, you might scan this summation of George Tiller's career [33]. Seems that he routinely performed elective abortions through 186 days of gestation but generously extended that period if there were fetal abnormalities. 70.181.40.210 (talk) 00:54, 8 June 2020 (UTC)

Late termination of pregnancy is a thing, "late term abortion" is not. Anti-abortionists use "late term abortion" because it allows them to imply that late terminations are done on a whim, when they are not.

George Tiller was an outlier and his outspoken advocacy for abortion on demand at any time is why he was murdered (by, of course, people who self-identify as "pro-life"). In most jurisdictions around the world, termination in the third trimester is on medical need only. Late termination is rare and the exact procedures vary case by case.

The restrictions on late termination are such that again it is going to be safer than carrying to term. In many cases carrying to term simply isn't an option, cf. Savita Halappanavar. Ireland, a Catholic country, now has more liberal abortion laws than than anti-abortion lobby is pressing in the US. Guy (help!) 08:47, 8 June 2020 (UTC)

Perhaps you should take up the terminology issue with NightHeron who recently legitimized late term abortion by giving it pretty much equal billing with LToP in the lead. LTA, seems to be used about 30 times as often as LToP. At least that's what googling them shows. I know that here in America a predominantly pro-choice mainstream news media uses the briefer, easier to say, more to the point LTA a hell of a lot more often than it uses LToP. Perhaps Great Britain is an outlier. Speaking of outliers, while George Tiller may have been one in both his practice and advocacy, it didn't prevent him from being a hero generally to the Pro-choice movement long before he was murdered. Kermit Gosnell, another outlier, is not such a hero, but it is rather curious how long his Little Shop of Horrors was allowed to exist despite numerous complaints. The pro-choice lobby also has a lot of clout in many places. 70.181.40.210 (talk) 14:59, 8 June 2020 (UTC)

I edited the last sentence of the first paragraph, including the removal of "less accurately" before "late term abortion", simply to make it consistent with the article Late termination of pregnancy, to which Late term abortion redirects. The IP-editor's anti-abortion rant is not appropriate here, per WP:NOTFORUM. NightHeron (talk) 16:38, 8 June 2020 (UTC)

What I've said is no more an "anti-abortion rant" than the WP administrator's remarks are a "pro-abortion-rights rant;" but to get back to the topic I introduced above concerning the last sentence of the article's first paragraph, NightHeron's edit was made on the very same basis you've claimed in deleting it, to make its wording consistent with usage in both this article and Late termination of pregnancy which use the terms interchangeably. 70.181.40.210 (talk) 17:16, 8 June 2020 (UTC)

WHOOPS!! My humble apologies Nighr Heron. In my haste I assumed I was addressing JzG. But I still don't think what I said was any more of a rant than what he said. Best Regards. 70.181.40.210 (talk) 17:23, 8 June 2020 (UTC)

No need to apologize.

JzG explained that his dislike of the use of the word "abortion" to include 3rd-trimester termination of pregnancy is connected with the false claim by some anti-abortionists that abortion-rights advocates believe that it's okay to opt for abortion "on a whim" at any stage of pregnancy. My own view is that the abortion-rights movement itself is partly to blame for this because of using the term pro-choice as a label. In some contexts choice is closely associated with freedom, as in choice between candidates in an election, and presumably that's why early abortion-rights advocates liked the term. But in other contexts it has connotations of selfishness or irresponsibility (as when a NY Times article in March accurately predicted that COVID-19 would hit the US particularly hard, because "Americans don't like being told what to do" by public health officials, in other words, Americans like "choice"). In reality, none of the people I know who label themselves "pro-choice" actually believe that a woman should have complete freedom of choice for a late abortion. The US Supreme Court in Roe v Wade made a sharp distinction between trimesters, and the overwhelming majority of "pro-choice" people support that. I personally dislike the term "pro-choice."

Of course, if the fetus survives outside the womb, it is no longer an abortion but a premature birth, per the definition in the first sentence. In that situation "late termination of pregnancy" is the more accurate term. However, many (probably most) late-term abortions occur toward the beginning of the third trimester, when long-term survival of the fetus is far from assured. Also, many late-term abortions involve a fetus with severe deformities, in which case long-term survival is unlikely. NightHeron (talk) 18:41, 8 June 2020 (UTC)

NightHeron, not really, no. Late term is defined pretty much in line with fetal viability. Viability is certainly the cutoff for a lot of laws, albeit sometimes with a buffer of 2 weeks, 4 weeks, or, in red states, all of the weeks. Guy (help!) 20:14, 9 June 2020 (UTC)

In the US, 3rd trimester abortions are allowed only in cases of medical necessity, and my understanding is that the cases when the removed fetus is alive are very few in number. In those cases, the doctors are required to go to extraordinary lengths to keep it alive, but usually it soon dies. In a very few cases it survives, often with severe birth defects. In a tiny number of cases a normal child results. In the last two cases the procedure retroactively should not be defined as an abortion, but that's an extremely small proportion of late term abortions. The wording of Version 3 (potential to survive outside the womb) is weasily enough to perhaps not be totally wrong, depending on what potential is supposed to mean. In early 3rd trimester abortions, I don't think viability can be reliably predicted before the fact. Legally, viability before the fact is defined either according to the doctor's judgment (an educated guess) or according to the gestation age. Even if some law codes define late abortion in terms of viability, I don't think the article should give undue emphasis to questions of viability. Not long ago some anti-abortionists wanted to add material to the "Live birth" section giving the stories of individual "abortion survivors" who grew to adulthood. I think the anti-abortion movement has a list of all their names. There aren't many.

The current wording (Version 1 in the RfC) could be read as implying that there are several thousand "abortion survivors" each year in the US alone (since 1% of the number of abortions yearly in the US is about 10,000). NightHeron (talk) 21:19, 9 June 2020 (UTC)

In 2001 the spokesperson of a major hospital estimated the survivorship figure at 10% to 20%. For more on this, see Jill_Stanek#Christ_Hospital_controversy.--Epiphyllumlover (talk) 19:01, 26 June 2020 (UTC)

The page on Jill Stanek is in many ways not WP:NPOV-compliant, with over-reliance on anti-abortion sources, use of the political-spin term pro-life, and misrepresentation of sources to create a misleading impression. The page mentions the 10% to 20% quote, but fails to give the context. The same article from the Chicago Sun-Times that's the source for that quote also says that the anti-abortion legislator O'Malley "cited accounts from a nurse there of fetuses living as long as eight hours after an abortion." That's not what most people mean by a "survivor." Do we classify a patient as a survivor of an operation if she dies 8 hours later? If "as long as eight hours" means that none of them lived longer, then effectively there were no survivors. NightHeron (talk) 20:09, 26 June 2020 (UTC)

Prior abortions change the safety of subsequent birth

Prior abortions change the safety of subsequent birth, just as c-sections do: Prior surgical abortion linked to subsequent preterm birth. A direct comparison of the safety of abortion to birth becomes inappropriate if abortion changes the safety of birth.

Comparing the safety of abortion to birth is not a simple statistical comparison, because a prior vaginal birth has not been shown to change the safety of a subsequent abortion, while a prior abortion has been shown to change the safety of a subsequent birth.

I propose that the safety comparison data in the article be followed by a brief explanation of this factor.

Lastly, I am not sure how a prior c-section might change the safety of a subsequent abortion. If anyone on here knows of any research on this topic, that could help.--Epiphyllumlover (talk) 04:54, 3 January 2020 (UTC)

The source is of dubious relevance to the birth/abortion comparison of risk to the woman. In the first place, the study concerns risk of a preterm birth rather than risk of serious harm to the woman. Second, the most significant risk (almost 10%) was after "spontaneous abortion" (that is, miscarriage), not after abortion as defined in this article. Third, the comparison made in the source is between having a medical vs surgical abortion. From the source: This is not a study that suggests abortions per se are risky and shouldn't be done. What we are saying is that women should be given a choice between a surgical and a medical procedure, and should also be informed about the potential risk to subsequent pregnancy. The suggestion that medical abortions should be favored over surgical abortions comes from the result that no greater risk at all of subsequent preterm birth was found for medical abortion. NightHeron (talk) 14:49, 3 January 2020 (UTC)

I agree with your sentiment @Epiphyllumlover: - I don't think comparing the safety of abortion directly to live birth is warranted in the first place, but since the article already compares them, the facts you brought up definitely matter. Some abortions affect the safety of live births in the future, while the reverse has not been shown to be true - this should at least be noted on the page. Edit5001 (talk) 01:59, 6 January 2020 (UTC)

If by the reverse has not been shown to be true you mean that it has not been shown that a live birth involves a risk to future live births, I don't think we can say that. This probably depends on the country, because the proportion of live births by C-section varies hugely from one country to another. In some countries it's more than 50%. And C-sections have been shown to increase the risk of future miscarriages. NightHeron (talk) 02:39, 6 January 2020 (UTC)

By reverse I mean it hasn't been shown that previous births affect the safety of future abortions. So we have a situation where some abortions are making births more dangerous, and births aren't making abortions more dangerous - yet the danger is being compared without mentioning that? It's another reason why, in my view, the comparison doesn't even belong in the page. But since it's already here, may as well include that tidbit. Edit5001 (talk) 04:09, 6 January 2020 (UTC)

Thanks for clarifying what you mean. I don't see why anyone would care about a statistic, assuming one could be found, about whether or not an earlier live birth affects the safety of abortion. In the first place, it's doubtful that there is a significant effect in that direction, because the numerous studies that show the safety of abortion have included many women who've had prior live births.

In addition, the reason for including statistics on the safety of abortion does not apply here. Anti-abortion groups consistently try to advance their position by arguing, despite the evidence to the contrary, that carrying a pregnancy to term is safer for the woman than an abortion. That's why it's necessary to have accurate information on that subject in this article. However, have you ever heard of someone making the argument that a woman should avoid carrying a pregnancy to term because it would make it harder to have a safe abortion at a later date? Wouldn't that be a bit bizarre? NightHeron (talk) 12:21, 6 January 2020 (UTC)

NightHeron, the authors do suggest that a medical abortion seemed to give similar stats while a surgical one did not, along with a suggestion that it may be related to a sudden stretching of the cervix rather than as in birth where it takes many hours - so I can't seem to get that out of my mind... On the other hand, this response [34] seems to be offered by people who know how to judge the review a lot better than I do and for now I will let them make up my mind for me. And of course I'm aware that even though the review was large, more than just one review must be considered before any new guidelines are argued. (Which is not to say that I just can not understand why more medical rather than surgical procedures are not being done.) Gandydancer (talk) 13:37, 6 January 2020 (UTC)

Gandydancer: Thank you for your comment. I should clarify my point. The question of risks to future live births coming from certain abortions is not relevant to the article's discussion of the safety of abortion vs carrying a pregnancy to term, in part because if we brought in risk to future live births, we'd also have to bring in the risk to future live births from an earlier live birth. Because of C-sections, which are carried out on an excessive scale in many countries, the latter risk is significant. It would probably be difficult to tease out a comparison between those two risks to future live births, because reliable statistics would be hard to come by, and would differ widely from country to country.

However, I am not opposed to mentioning the risk to future live births from certain types of abortions if this is mentioned in the proper context. A possible appropriate place would be in a new subsection about the issue of multiple abortions used as a method of birth control. As I'm sure you know, abortion rights advocates are also strong advocates of sex education and wide availability of low-cost contraceptives so as to reduce the need for abortion. Otherwise many will use multiple abortions as a means of birth control, and this entails significant risks of pregnancy failure if/when they later want to have children. I haven't seen this issue discussed in the abortion article or elsewhere on Wikipedia. I'm not familiar with the sources that talk about what's bad about using multiple abortions as a means of birth control, so I shouldn't be the one to write such a subsection. But I'd be happy to help edit it if someone else wants to write it. NightHeron (talk) 15:13, 6 January 2020 (UTC)

OK, so good to hear from you and thanks to the editor that brought this review to our attention. I am hoping for more feedback from experienced editors on this review. What do you think? And of course, what about NightHeron's suggestion? Gandydancer (talk) 15:36, 6 January 2020 (UTC)

• I will admit I've lost track of the actual question under discussion here, but one of the advantages of writing about abortion is that there are high-quality expert guidelines about the procedure and its risks. That makes our job as editors relatively easy—we just need to accurately convey expert opinion to our readers. For example, regarding the impact of induced abortion on subsequent preterm birth, the Royal College of Obstetricians and Gynaecologists states: "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." This is basically what the authors of the letter cited by Gandydancer are saying as well. Numerically, women who have an induced abortion have a very small increase in the likelihood of subsequent pre-term birth, but there is no good evidence to suggest that abortion causes the increased risk. The same socioeconomic risk factors which increase the likelihood that a woman will seek an induced abortion also increase the risk of preterm birth, so any observed association may be driven by that alone, and it would incorrect to state or imply that abortion increases the risk of preterm birth. Does that make sense? I'm not sure I'm explaining the source clearly. MastCell ^Talk 17:40, 7 January 2020 (UTC)

NightHeron, "if we brought in risk to future live births, we'd also have to bring in the risk to future live births from an earlier live birth"--I agree with this, but only if a comparison between types of births is being made, like induced labor vs. natural labor or C-section vs. vaginal. However, since the article is very general in its safety-comparison categories, it can be assumed that cumulative risk factors from previous births are already figured in. Most women who give birth have more than one child per lifetime, but most women don't have any abortions. The way that the article is written currently leads readers to falsely assume that the safety comparison is strictly births vs. abortions, while the real-life data that the comparison is based on is not so clear cut. As for the "new guidelines are argued" issue, this is not applicable in this situation because I am only asking to include a small comment along with the existing medical data, not to revise the existing medical data listed. In other words, this isn't a "new/old" medical guidelines issue but rather "another topic/aspect not previously mentioned or considered."--Epiphyllumlover (talk) 20:42, 7 January 2020 (UTC)

Epiphyllumlover: Let me review the situation. The article compares the risk to a woman of an abortion vs carrying a pregnancy to term. The reason why it's important to state what reliable sources say on this matter is that the anti-abortion movement spreads false or misleading information on this in order to scare women out of having an abortion. I understand your main point to be that one should take into account not only direct risk to the woman's health but also risk to later successful live birth. Indeed, many women who have an abortion do so because they are not yet ready for or capable of raising a family, but do want to have children at a later date. So that risk comparison might be worth making. However, I think that making a meaningful comparison of the two risks would be very difficult. The risk to later pregnancies from abortion is generally small, but it can be larger for repeated abortions, late abortions, certain types of abortions, etc. The risk to later pregnancies from an earlier live birth depends on the likelihood that the woman will give birth by C-section (and also on the quality of medical care in her location), and this varies tremendously from country to country and according to the woman's demographics. If you know good sources that sort through all of this, that would be helpful. But we as editors can't sort it out ourselves, per WP:OR. NightHeron (talk) 02:34, 8 January 2020 (UTC)

NightHeron, A brief statement in the qualitative sense (eg. what type of risk is incurred) should suffice and will not violate the OR policy. We do not need to compare the size of the two risks, but instead give a brief mention of the type of risk described by this 2016 review beneath the current quantitative description of risk. Persons interested in this type of risk can do their own homework by opening up the reference and reading up on it themselves or asking their doctors.--Epiphyllumlover (talk) 01:21, 11 January 2020 (UTC)

No, your source does not explicitly interpret its study in the way you're suggesting. It does not compare the risk of later preterm birth after abortion to the risk of subsequent preterm births if the woman carries the pregnancy to term, which your source would have to do in order to be relevant to the abortion/birth comparison. Rather, its only definitive recommendation relates to medical vs surgical abortion. So an editor would need to cherry-pick from the source and impose an interpretation on it, which would be OR. NightHeron (talk) 03:11, 11 January 2020 (UTC)

I did not say to explicitly interpret the review article, but to "give a brief mention of the type of risk described."--Epiphyllumlover (talk) 03:50, 11 January 2020 (UTC)

If you insert a brief general statement that suggests that in comparing abortion to carrying a pregnancy to term there'd be a greater risk of later preterm births with abortion, that's OR because it's not in the source. NightHeron (talk) 12:40, 11 January 2020 (UTC)

I see. I'll edit the article as I see fit and you (along with everyone else in this conversation) can see if it is good enough or not.--Epiphyllumlover (talk) 01:06, 12 January 2020 (UTC)

MastCell, I reviewed the clinical guidelines link you provided. It presents the "correlation does not prove causation" argument. The review article cited by the article I linked to appears to attempt to control for outside factors that could also cause this correlation. The review article attempts to demonstrate causation to the reader as opposed to just correlation. Since the clinical guidelines are from 2011 and the review article is from 2016, I think the people who issued the guidelines need to update them.--Epiphyllumlover (talk) 21:16, 7 January 2020 (UTC)

These are the additions I am proposing to the article:

Surgical methods have been compared to medical methods and found to have a higher risk of causing preterm birth in subsequent pregnancies.

and further down in the article

Surgical abortions are linked to a higher risk of causing a preterm birth than a medical abortion should the woman undergoing the abortion ever carry a subsequent pregnancy to term.:::::Epiphyllumlover (talk) 02:05, 12 January 2020 (UTC)

References

Epiphyllumlover, that's a reasonable source for the reason why medical rather than surgical techniques are preferred. But your statement that prior abortions change risk is false: it is only prior surgical abortions. Surgical techniques are the norm these days only in later term abortions where there tends to be a compelling medical need.

Obviously this does speak to the dangers imposed by efforts to restrict medical abortion, or delay abortion altogether: the research overall is very clear that the earlier it's done, the safer it is. So it would be a great argument in favour of widespread access to Plan B and opening many more Planned Parenthood and other reproductive health clinics. Guy (help!) 09:10, 12 January 2020 (UTC)

JzG, I am hoping you will support my proposed changes to the article (listed above your comment) above because they account for it being only surgical rather than medical techniques. [please replace this with "the more limited edit I just made in the safety section of the article."] Some of the statements I have made in the talk page have been more vague, so I clarified my intended changes to the article especially in response to critique by Nightheron.--Epiphyllumlover (talk) 21:02, 12 January 2020 (UTC)

@Epiphyllumlover: To reply to your comment on my talk page, I HAVE been following this discussion. Upon thinking more about this, I don't believe that your addition belongs in the article at all. To my knowledge, any surgical abortion carries greater risks than a medical one, (but I may be wrong here, depending on gestational age and many other factors, it may get very nuanced) so I don't see a reason to emphasize ONE of the increased risks, and DEFINITELY not in the lead. The current explanations in the Safety section seem quite reasonable.---Avatar317^(talk) 02:57, 12 January 2020 (UTC)

I was wondering about the effect size of this. I came across this study Differences of Maternal Sociodemographic Characteristics With Spontaneous Preterm Birth Among Hospitals In Indonesia: A Comparative Study, where the Student's t test came out to 18.65 for abortion and 19.01 for smoking (nearly the same risk). Granted it is only one study and not a larger one at that, so I wasn't planning on including this smaller study into the article, but I thought it was helpful because it compares a variety of risk factors for preterm birth.--Epiphyllumlover (talk) 03:16, 12 January 2020 (UTC)

Keeping in mind that most likely a large number of editors watch this page, IMO it is not fair to force them to read stuff that you bring up that you do not believe is worthy to include in the article but just because you find it of interest. I have many articles on my watch list that keep me busy enough and I don't like to spend time on your personal interests. I am hoping that others who find this of interest will reply to this on Epiphyllumlover's talk page, not here. Gandydancer (talk) 04:07, 12 January 2020 (UTC)

For context, the last post was a reply to the "Minor risks like this" comment by Avatar317 in the edit summary of the article. I tried to show that it wasn't too minor of a risk. I understand it is not fair to use to assume that you read the edit summary.--Epiphyllumlover (talk) 04:55, 12 January 2020 (UTC)

Epiphyllumlover, not really, no. Not only did you include, in the article, a "see also" to the press release describing it (which is UNDUE as we don't do that for any of the safety claims), but the claim is devoid of necessary context. Guy (help!) 08:23, 13 January 2020 (UTC)

JzGI will remove the "See also" part of the reference and add in more context as well. I will edit the page again and you can see if it is suitable or not.--Epiphyllumlover (talk) 00:14, 14 January 2020 (UTC)

Avatar317, I am open to adding in additional side effect differences if there are adequate sources for it. I didn't start out trying to single out just this topic. I looked online for side effects/complications in general. This was the source I found. I admit I stopped looking for other complications/side effects once I found this review. That said, I have the feeling that if you or I found another complications/side effects difference between surgical and medical abortions it would probably require its own discussion to get it included in the article. As for right now, do you accept adding content only in the safety section? I will edit the article as such and if you disapprove you can revert it and discuss it here.--Epiphyllumlover (talk) 21:02, 12 January 2020 (UTC)

As I said in my previous comment, I DO NOT support adding it to the article anywhere. Surgical (to my knowledge) is generally more risky than medical, and as JzG commented, (which is what my understanding is also) that abortions are done medically if possible, and if not, then surgically, so the later an abortion is done, the more risky, but even with that increased risk, it is less risky than childbirth, and there is no reason to randomly mention this one risk, which emphasizes it over other risks not articulated in the article. That is why it does not belong. It is WP:OR on your part to make the OVERALL risk profile sound different by mentioning this. ---Avatar317^(talk) 21:24, 12 January 2020 (UTC)

Thank for for letting me know. I disagree that it is OR because the review study was the research.--Epiphyllumlover (talk) 00:03, 13 January 2020 (UTC)

Ref says "Prior surgical uterine evacuation for either induced termination of pregnancy or spontaneous abortion is an independent risk factor for preterm birth. These data warrant caution in the use of surgical uterine evacuation and should encourage safer surgical techniques as well as medical methods."[35] Risk increase to 5.7% vs 5.0% for SAB and 5.4% vs 4.4% for ITOP.

C section increases the risk by an OR of 2.2[36] Doc James (talk · contribs · email) 11:38, 13 January 2020 (UTC)

Yes, that is a larger effect size than for abortion, which was ranged from 1.19 to 1.52 in the review. The article Delivery_after_previous_caesarean_section#VBAC_versus_no_previous_Caesarean_section lists out preterm birth in subsequent pregnancy as a risk factor caused by C-sections. This information is not presented with added context as being requested by JzG for this article. On the other hand, I am concerned that if I add in extra context, it will be reverted by others as being undue weight.--Epiphyllumlover (talk) 00:26, 14 January 2020 (UTC)

I reverted the added section because of WP:UNDUE and WP:NPOV. The first sentence misrepresents the source, which deals with only one type of abortion and specifically states that medical abortion does not increase risk of subsequent preterm birth (PTB). The last sentence of the section (Even if the symptoms of the infection are unnoticed, they may still contribute to permanent physical injury) again is misleading and seems written so as to scare women who are considering abortion. The POV in the section deviates from the two sources; the conclusion of source [156] is: Recent changes in abortion practices may be associated with the current decrease in US incidence of PTB. Further study on the effect of surgical versus medical abortion is warranted regarding a possible effect on the incidence of PTB. NightHeron (talk) 04:16, 14 January 2020 (UTC)

And here is the edit summary I had crafted as I was planning to revert that addition: WAY too much text from one reference, which (as Doc Jones pointed out) is about "Surgical evacuation of the uterus" which is also sometimes done after a natural abortion (miscarriage). - WHICH YOU BIASEDLY NEVER MENTIONED. We don't devote an entire paragraph to talk about a "The additional risk is small -- .7 percent" increase in risk. Way WP:UNDUE for a SUMMARY article on Abortion. ---Avatar317^(talk) 04:28, 14 January 2020 (UTC)

Since you are both by now so familiar with this information could you both take a look at this edit? [37] Thx Gandydancer (talk) 04:48, 14 January 2020 (UTC)

Hi (to all three), I preferred a brief mention as well due to fears it would be considered UNDUE (see my comment above to Doc James). However, the earlier brief mention had been reverted due to lack of context and to disproving of putting two citations into one reference. (To Nightheron): "Even if the symptoms of the infection are unnoticed, they may still contribute to permanent physical injury" is a close paraphrase to the statement in the review [38] that "The increased risk of PTB could result from the overt or covert infection following surgically uterine evacuation62 as well as from mechanical trauma to the cervix, leading to increased risk of cervical insufficiency.5," As for the epidemiological study,[39] (reference 156), my statement (which I think is what your are faulting for being POV) "Because of the large number of surgical abortions performed in the US, the procedure has been credited as a driver of rises and falls in the rates of preterm births nationwide" was supposed to reflect "In conclusion, changes in abortion practices may be responsible for the recent decrease in the PTB rate in USA." I think a better paraphrase of that sentence would be "Because of the large number of surgical abortions performed in the US, the procedure may drive rises and falls in the rates of preterm births nationwide". (To Avatar317): My interest in complications of abortion is predated by a strong interest in complications of surgical miscarriage treatments. The "Methods" page on that article could be improved. As for the effect being too small, I disagree especially because the review authors do not seem to think the effect size is too small to warrant attention. As for other references, I would be happy to add in references of some of the more recent studies, but they are not review articles.(To Gandydancer): I'm not sure if you think there is a problem with my edit on that page.

(To all): The short mention that JzG (Guy) thought lacked context:

However, surgical methods have been found to increase the risk of causing preterm birth in subsequent pregnancies.

As for the most recently reverted edit, here it is, with one statement improved following critique by NightHeron:

A small, but significant increased risk of preterm birth has been found when women who have had an abortion get pregnant again. Because of the large number of surgical abortions performed in the US, the procedure may drive rises and falls in the rates of preterm births nationwide. Although the means by which surgical abortion causes preterm birth are not completely clear, it may be due to tearing from forced stretching of the cervix during the surgery. When the abortion involves the scraping of the uterine lining, injuries inside the uterus may be an additional cause. As pregnancy makes women are more vulnerable to infection, injuries to the cervix and uterus could be made worse by infections afterwards. Even if the symptoms of the infection are unnoticed, they may still contribute to permanent physical injury.

--Epiphyllumlover (talk) 05:07, 14 January 2020 (UTC)

References

Epiphyllumlover, nope. The problem here is that it doesn't include any consideration of the underlying reasons for termination. Surgical termination tends to be used in later term, and later term termination is overwhelmingly performed due to pressing health concerns. The study does not address the question of matched cohorts - women who had terminations due to life-threatening pre-eclampsia, for example, would need to be compared with women who successfully carried to term with life-threatening pre-eclampsia. In isolation it appears to serve an anti-abortion agenda, rather than informing the reader. Guy (help!) 09:51, 14 January 2020 (UTC)

Instead of the longer version, would you support a brief mention similar to the mention of subsequent pre-term birth as a side effect in Delivery_after_previous_caesarean_section#VBAC_versus_no_previous_Caesarean_section?--Epiphyllumlover (talk) 01:31, 15 January 2020 (UTC)

Both seem likely to be undue. Guy (help!) 15:44, 23 January 2020 (UTC)

The quantity of studies on this topic particular topic suggests that it is not undue. One advantage to discussing this issue would be to reduce the The_lady_doth_protest_too_much,_methinks#Later_usage effect that has been harming this article. Already the suggestion by Dig Deeper is a step away from this pitfall, but there is more to go. If the editors active on this page can resist the push to censor this issue out of concern that pro-lifers are inch/mile types, they might be able to raise the interest of some med (or even high school or pre-med) student somewhere, who might one day as part of his or her career figure out a way to reduce or even eliminate the risk of pre-term birth.--Epiphyllumlover (talk) 22:13, 4 February 2020 (UTC)

We were not advocating censorship, and your accusation that we were is a violation of WP:AGF. You are mischaracterizing the arguments made against inserting a simplistic statement about risk of future preterm birth. To recap some of the reasons we gave: (1) The risk is much greater for late abortions, which are almost always carried out for health reasons (such as increasingly high blood pressure, diabetes complications, extreme abnormalities of the fetus, etc.). So a relatively minor risk that might be important to consider in the context of an early abortion (except that the risk of future preterm birth is very small for an early abortion) would not be relevant for typical late-term abortions. (2) Correlation between abortion and subsequent preterm births does not mean causality. It is likely that women who have late abortions (i) have more health issues connected to pregnancy than women who have early abortions or no abortions, and (ii) come from more economically disadvantaged backgrounds with worse prenatal care than women who have early abortions or no abortions, so their greater likelihood of later preterm births might have nothing to do with their abortion. (3) The article compares risks from abortion with risks from live birth, and so the risk of future preterm births from abortion should be compared to the risk from a typical childbirth, which is quite high if the birth is by C-section. So a woman wanting a child a little later in life might be better able to have a successful childbirth then if she has an early abortion now rather than carrying the pregnancy to term with a likely C-section. NightHeron (talk) 01:15, 5 February 2020 (UTC)

It is generally recognized in medicine that perfectly controlled experiments are not possible or not ethical concerning a large number of medical procedures. This is one of them. The lack of the most ideally controlled experiments conceivable should not prevent us from reporting what the research indicates so far. Since the authors of the review reported evidence for causation and described several possible routes that could cause it, that should be enough to describe this complication as causation in the article. Questions and concerns about the finer details of research are where readers can read the study for themselves. As a side note, my last reply should be considered a collective plea to keep good faith rather than an assumption that anyone is currently engaging in bad faith.--Epiphyllumlover (talk) 00:14, 22 February 2020 (UTC)

You're ignoring the arguments I made. I did not say that "the lack of the most ideally controlled experiments" was why we could not conclude causality. I gave concrete reasons to doubt causality. Namely, the women who had trouble having a subsequent successful childbirth were in general the ones who had late abortions. Late surgical abortions are far more intrusive procedures than early abortions, and they are also much more restricted. In general, physicians do not perform late abortions "on demand," but only for serious reasons, such as health difficulties of the woman (diabetes, very high blood pressure, ectopic pregnancy, etc.). Those same health difficulties are also likely to present obstacles to subsequent successful childbirth. Also, women in that situation are often poor, often have poor prenatal care, and in general are not typical of women who have abortions. Many women with health difficulties who do opt to continue the pregnancy anyway then need to deliver by C-section, and C-section increases the chance of miscarriage or other complications in subsequent pregnancies, especially when the C-section is not performed in the best hospitals in the wealthy countries. It would be misleading to summarize the situation in the way you propose.

A simplistic summary of the article would also clash with the way the authors summarize their own work, and so would violate WP:OR. Note that those authors are much more cautious than you are in stating conclusions: "This is not a study that suggests abortions per se are risky and shouldn't be done. What we are saying is that women should be given a choice between a surgical and a medical procedure, and should also be informed about the potential risk to subsequent pregnancy," Dr. Berghella says. But he added that due to the limitations of some of the studies included in this meta-analysis, "it is difficult to definitively recommend that surgical abortion should be avoided and that medical methods should be preferentially offered." NightHeron (talk) 00:54, 22 February 2020 (UTC)

Given that the authors thought women "should also be informed about the potential risk to subsequent pregnancy," it seems to me that the brief mention option would work just fine. It appears you are objecting to the longer explanation. If you would like to put additional clarification into an efn type note following the brief mention I would be okay with that.--Epiphyllumlover (talk) 04:01, 18 March 2020 (UTC)

Epiphyllumlover — I think you're quite gravely misinterpreting the discussion above — and I'm no longer convinced you are acting in good faith. Carl Fredrik ^talk 10:15, 18 March 2020 (UTC)

One of the study authors is the advisor for a a pro-choice student group. Does knowing this change anyone's mind about the study, I mean in the direction of regarding it as legitimate science and not biased)?--Epiphyllumlover (talk) 00:46, 13 April 2020 (UTC)

But aren't the majority of the medical profession pro-choice? The chance is quite small that a multiply-authored medical article has no author who believes in women's reproductive rights. NightHeron (talk) 03:07, 13 April 2020 (UTC)

Have the events of the last few months changed anyone's mind about the need for this article to reflect science as opposed to the politics?--Epiphyllumlover (talk) 20:59, 16 May 2020 (UTC)

I think the best approach at this point is to include a brief mention along with a lettered note briefly discussing the inherent limitations of the research. This way the article will reflect the concerns reflected above while still preventing undue weight.--Epiphyllumlover (talk) 20:16, 7 June 2020 (UTC)

After waiting for a while, it appears there are no objections to implementing the suggestion I made immediately above this comment. I will go ahead and edit the article per Wikipedia:Silence and consensus.--Epiphyllumlover (talk) 18:56, 26 June 2020 (UTC)

@Epiphyllumlover: I think it would be best if you first propose what you'd like to insert. I don't think that WP:Silence and consensus applies, since your 7 June suggestion is essentially a repetition of your 18 March suggestion (the brief mention option would work just fine), to which Carl Fredrik strongly objected. I don't think it's a good idea to put an over-simplified version in the text and then explain some limitations in a note, because readers who don't bother to read the note (i.e., most readers) will be misled by what's in the text. NightHeron (talk) 19:33, 26 June 2020 (UTC)

On the contrary, he didn't say anything specific about the proposal I had just made but appeared to be reacting to either an earlier comment (but not sure which one) or just the whole discussion. You can tell me what you would like to go into the efn note. One possibility: Following "Complications after second-trimester abortion are similar to.." sentence, another sentence could be inserted starting "A small but significant increased risk of preterm birth..." and if you would like to propose possible endings after the ... fill me in now. Then an efn note could give additional caveats (although as of right now you may not want that).--Epiphyllumlover (talk) 02:44, 27 June 2020 (UTC)

Actually, several editors have objected to undue emphasis on this. Maybe you could put all of what you want to add in an efn note, and propose text here for that note. I can't speak for other editors, but I'd find an efn note less likely to violate WP:UNDUE than additions to the text. NightHeron (talk) 10:17, 27 June 2020 (UTC)

After rereading the above discussion from January through March, I have real doubts that even a note saying what you want to add would work. A short note, while not violating WP:UNDUE (in my opinion), would (1) not provide adequate context (as explained in great detail in the earlier discussion) and (2) be inappropriate insofar as a reader could take it as a medical warning. The passage you quoted before to argue for inclusion (Given that the authors thought women "should also be informed about the potential risk to subsequent pregnancy") does not really justify inclusion in Wikipedia, because the doctor quoted in the article was presumably directing his remarks to other doctors, who are the ones to help women decide these difficult issues. That is, a doctor who knows the woman's specific situation can decide whether or not to warn her about possible slightly higher risks of future failed pregnancies that are associated with an abortion, especially a late abortion (although, as remarked in the earlier discussion, the association is not known to be causal). The woman should hear this, if at all, from her doctor -- not from a footnote in Wikipedia. NightHeron (talk) 16:10, 27 June 2020 (UTC)

I just put in an efn note that includes the concerns about controlled studies. As I understand it, medical articles are not supposed to be directed just to patients; I think students might be interested in this. It seems likely that best practices for abortion will change in coming years and that someone, somewhere will figure out how to solve it. In particular, the fact that African American women have a higher rate of surgical abortion and a higher risk of giving birth to a preterm child makes this the sort of thing that young people interested in correcting systemic racism might try to solve. Obviously there are other explanations for why African Americans are more likely to be born pre-term, but since it seems there are multiple causes it makes sense that people should be able to consider each particular cause and how to reduce or eliminate it. Fixing the medical best practices on surgical abortion could in the long term help reduce racial inequality in school performance and also economically.--Epiphyllumlover (talk) 16:39, 27 June 2020 (UTC)

@Epiphyllumlover: Your efn should not be in the lead, which is supposed to contain summary information and not minor details. In addition, as discussed above, it's clear from context that the comparison with carrying a pregnancy to term relates to maternal mortality, so the last sentence serves no useful purpose. In the third place, the use of "cause" is misleading. Correlation does not imply any causal relation whatsoever. That part of the note could be reworded as follows: It currently appears that having had a prior surgical abortion correlates with a small but significant increase in the risk of preterm birth in future pregnancies. The studies supporting this did not control for factors not related to abortion, and hence the causes of this correlation have not been determined, although multiple possibilities have been suggested.[ref] If a note with this wording or a similar wording is inserted in an appropriate section (not the lead), that would not be misleading or inappropriate in my opinion, although other editors might disagree. NightHeron (talk) 17:10, 27 June 2020 (UTC)

In the paper the authors concluded it was causation and not merely correlation. It seems that a skeptical approach to this study affirms it is correlation but rejects the causation part. It is not incorrect to note that the study describes a correlation because causation is inclusive of correlation. At worst it could be characterized as a half true or lie-to-children approach to just not mention the causation part. At best your solution is a way to compromise without overloading the reader with medical detail. If someone complains, he or she should come up with an improved alternative text first.--Epiphyllumlover (talk) 00:32, 28 June 2020 (UTC)

RfC about sentence in lead concerning late termination of pregnancy

There are two issues concerning a sentence in the lead of the Abortion article: whether late termination of pregnancy should be defined in terms of fetus viability or in terms of gestational age, and whether late term abortion is neutral terminology. NightHeron (talk) 17:06, 9 June 2020 (UTC)

Which of the following versions (or other alternative) is best?

Version 1 (current) A similar procedure after the fetus has become viable is known as a "late termination of pregnancy" - this is rare, accounting for fewer than 1% of abortions in the United States, and is usually for medical reasons.

Version 2 (recent) A similar procedure during a late stage of gestation is known as a "late termination of pregnancy" or "late term abortion".

Version 3 (also recent) ] A similar procedure after the fetus has potential to survive outside the womb is known as a "late termination of pregnancy" or less accurately as a "late term abortion".

NightHeron (talk) 17:06, 9 June 2020 (UTC)

Discussion

• I prefer version 2 because the question of viability early in the third trimester is complicated, depending on many individual factors, on available medical facilities, and also on whether viability is defined as long-term survival or includes brief survival outside the womb. When the woman has health problems or the fetus has severe deformities (which are the common situations for late abortions), viability is especially doubtful. So viability does not belong in the definition of late abortion. In addition, to the best of my knowledge late term abortion (not to be confused with the political-spin term partial-birth abortion) is a commonly accepted term. Version 2 is consistent with the article Late termination of pregnancy, and the other versions are not. NightHeron (talk) 17:06, 9 June 2020 (UTC)
• Version 1 makes the point that late termination is very rare and almost always for compelling medical reasons - that seems to me to be an important fact given that early terminations are generally elective and face a low bar in most developed countries. There is a distinction to be drawn, and that is the distinction. It's not a hill I'm going to die on, though. Guy (help!) 17:14, 9 June 2020 (UTC)

JzG: What would you think about Version 2 with the "this is rare..." clause from Version 1 added at the end? To answer the objection of 70.181... to giving just US stats, do you know the UK stats? Is it also less than 1%? NightHeron (talk) 19:27, 9 June 2020 (UTC)

Actually, I just looked at the article Late termination of pregnancy, and the incidence is less than 1% at least in the UK, Norway, Sweden, and New Zealand. NightHeron (talk) 19:27, 9 June 2020 (UTC)

I am open to correction, but I seem to recall that in the countries you list, and most others in the developed world (the US being an exception) late term abortions are illegal except in cases of extreme medical necessity. -Ad Orientem (talk) 20:07, 9 June 2020 (UTC)

That is the norm, as I understand it. Late termination (i.e. post-viability - 22 weeks in Sweden, 24 in the UK IIRC, etc.) is performed only in extremis and is heavily restricted. And anti-abortionists typically use lurid descriptions of late terminations as propaganda, characterising abortion rights activists as wanting to decide whether the baby lives or dies after it's born (maybe they are thinking of Biblical times, when this was common). There are significant differences between pre-viability and post-viability terminations, and it's important to make that distinction. Guy (help!) 08:46, 10 June 2020 (UTC)

In the US, restrictions on late term abortions are left up to the states, but the states ban them except in case of medical necessity. I believe that most countries where normal abortions are legal either have similar restrictions on late abortions or else (as in Canada) leave it up to the medical profession, which will not perform late abortions except for pressing medical reasons. The words "is usually for medical reasons" in the "this is rare..." clause could probably be replaced by your term "extreme medical necessity," but to be certain, perhaps we should keep the present wording.NightHeron (talk) 20:21, 9 June 2020 (UTC)

NightHeron, from the Grimes article: "Abortion is defined as removal of a fetus or embryo fromthe uterus prior to the stage of viability". Late termination is, by definition, after viability, so does not fit the definition of abortion. In abortion, the fetus is not considered a separate life. After viability, it is. Use of the phrase "late term abortion" is designed to obscure that and we should not be so lazy. Guy (help!) 09:14, 10 June 2020 (UTC)

JzG, If almost 1% of "abortions" in the US are actually late terminations of pregnancy in the sense you define it, that means that almost 10,000 procedures per year either destroy viable fetuses or result in birth of children. I don't think that's true. From what I understand, most such fetuses could not survive or could survive only for a short time. In an abnormal pregnancy (such as extreme health problems for the woman or fetus), very early-stage viability might be only a theoretical possibility and not a likely one. NightHeron (talk) 11:48, 10 June 2020 (UTC)

NightHeron, 1% of terminations are post-viability (not my figures, that comes from Grimes and other sources), but legally these must be for medical reasons - the fetus is considered to be an independent life, so you have to demonstrate either that the fetus is nonviable or likely to be severely disabled (anencephaly, for example) or that the life of the mother is in danger (pre-eclampsia is a leading cause). The ethical, medical and practical considerations are profoundly different.

In a non-trivial proportion of these cases, the problem would either have been missed in screening - a false negative - or the decision was delayed to see if early results were wrong, see e.g. [40] (there are a handful of similar papers from other countries I think).

The phrase "destroy viable fetuses" is begging the question: is a fetus with a severe developmental abnormality actually viable? Is a fetus viable if the mother will die before it can be safely delivered? But stick to sources. Grimes gives an excellent overview. Trimesters are arbitrary and of no medical or developmental relevance, the crucial question is viability, and the survival rates have not changed hugely over time. The survival rates of extreme preterm births have increased marginally but mean survival rates at 22 weeks gestational age are essentially zero. Most fetuses born at this age die. Over 80% of the minority who make it out of the womb alive, die anyway, and a third of those who survive suffer severe impairment.[41] By 27 weeks over 80% survive, mostly unimpaired. And this is recognised in both law and medical practice. Guy (help!) 12:33, 10 June 2020 (UTC)

NightHeron, are you basically saying that you want to include the words "late term abortion" in there whatever? I'm not implacably opposed, but it's a term mainly used by anti-abortionists. Guy (help!) 20:08, 9 June 2020 (UTC)

JzG: "Late term abortion" seems like the most common term in the media and among most people. The term the anti-abortionists prefer is "partial-birth abortion". NightHeron (talk) 21:35, 9 June 2020 (UTC)

NightHeron, in the same way that "pro-life" and "pro-choice" are most common, and "climate change skeptic", and all the other carefully selected Orwellian terms used to brand extreme viewpoints as cuddly and fluffy. Guy (help!) 08:30, 10 June 2020 (UTC)

JzG, how is late term abortion more "cuddly and fluffy" than late termination of pregnancy? If late term abortion is a political-spin term, then I agree with you. But I haven't seen that. It's used by people on both sides. The political-spin term I'm aware of is partial-birth abortion. Also, late termination of pregnancy is somewhat inaccurate, because it can be read as including both early 3rd trimester abortions (when there's theoretical viability but not true viability) and cases when premature birth is induced (after certain viability) because of risks to the mother, with no intent to abort. I'm not questioning our use of that term, but just pointing out that some of the accepted terminology is not 100% accurate. NightHeron (talk) 12:08, 10 June 2020 (UTC)

NightHeron, I fear the obvious inversion may have obscured the point. It's all to do with framing. If you frame late termination as a choice issue, you engage one set of feels, If you frame it as abortion, you engage another, lumping it in with abortion, a procedure which is largely performed on request in the civilised world

So the comparison is inverted: "late term abortion" seeks to lump all abortion together as performed on a whim and terminating viable babies, a bait-and-switch tactic.

In current law (and this is sufficiently widespread that it's hard to foresee any other framework) post-viability termination is heavily proscribed. It's neither choice nor homicide. Guy (help!) 12:42, 10 June 2020 (UTC)

JzG I think that you are reversing usage reality. "Abortion" was not recently hijacked to extend to procedures taking place after fetal viability when it had previously been used to denote only pre-viability procedures. Historically it was used to denote BOTH. Rather it is "late termination of pregnancy" which has recently become the preferred medical term for the procedures taking place after fetal viability. Do you have any source that shows otherwise? Tigerbaum (talk) 14:46, 10 June 2020 (UTC)

Tigerbaum, do I have a source that refutes your speculation? Not offhand. But we have a source (Grimes) that documents the correct usage. Guy (help!) 15:46, 10 June 2020 (UTC)

More like a Blue Sky observation. Her's an Oxford Medical Dictionary definition. Nothing about before viability. Of course, it is rather ancient at ten years old:[42]. — Preceding unsigned comment added by Tigerbaum (talk • contribs) 16:33, 10 June 2020 (UTC)

Looking back at our own article Late termination of pregnancy the switch-over from late term abortion is fairly recent--I think sometime in 2017. Gandydancer (talk) 15:56, 10 June 2020 (UTC)

Version 2 is preferable for a number of reasons. Since this is an article on abortion generally not abortion in the United States throwing in U.S. statistics on its frequency/infrequency as version 1 does is inadvisable. Version 3 gratuitously says that the late term abortion is a less accurate term than late termination of pregnancy; but it is not less accurate, it is only less formal within the medical profession these days. It is used far, far more often than late termination of pregnancy, and not just by anti-abortion partisans but by the news media and the general public. Moreover, both this article and the one on Late termination of pregnancy in various places refer to these "terminations" as abortions. So Wikipedia itself basically uses the terms interchangeably. 70.181.40.210 (talk) 18:18, 9 June 2020 (UTC)

• version 1 also applies to most of the developed world. Guy (help!) 20:09, 9 June 2020 (UTC)

• Question What are the references for each of these proposed statements and what do they say exactly? -Ad Orientem (talk) 20:03, 9 June 2020 (UTC)

The reference at the end of the sentence (in all 3 versions) is, which deals with definitions and terminological challenges. There are several references for the low incidence of late abortions in the article Late termination of pregnancy. NightHeron (talk) 21:28, 9 June 2020 (UTC)

• How's this? A similar but comparatively rare procedure later in the gestation period is known as a "late termination of pregnancy" or, informally, as a "late term abortion." 70.181.40.210 (talk) 21:55, 9 June 2020 (UTC)

  s/informally/incorrectly/. Guy (help!) 12:42, 10 June 2020 (UTC)

• version 1 per Guy rationale--Ozzie10aaaa (talk) 13:10, 10 June 2020 (UTC)

• The commonly understood meaning of abortion is induced termination of pregnancy, not including induced premature live birth. In contrast, the first sentence of the lead, following Grimes, defines it as pre-viability termination of pregnancy. But even the current wording (Version 1) says that late termination of pregnancy is rare, accounting for fewer than 1% of abortions in the United States (emphasis added). The article Fetal viability discusses the many different notions of viability, states that the US Supreme Court's decision in Roe v Wade permits states to freely regulate and even ban abortion after the 28th week, and describes state laws restricting post-viability abortions. In these cases, just as in popular discourse, the term abortion is used for post-viability termination of pregnancy. The article Late termination of pregnancy treats the term as synonymous with late term abortion and defines late in terms of gestational age, not viability. JzG, do you think that all these uses of abortion are wrong and should be changed so as to avoid the word abortion?

A problem with all three versions is that they state that late termination is a similar procedure, whereas in fact the procedure used depends heavily on the gestational stage. Third trimester termination is not a similar procedure to first trimester abortion.

Perhaps the sentence on late termination of pregnancy should be removed entirely from the lead. The topic gets no substantial coverage in the main body. Perhaps the place for a careful discussion of medical, ethical, legal, and definitional aspects is in the article Late termination of pregnancy. By the same token, perhaps the subsection Abortion#Live birth should also be moved to Late termination of pregnancy.

I notified WP:WikiProject Medicine about this RfC, and I hope we get input from medical people. NightHeron (talk) 20:23, 10 June 2020 (UTC)

• Comment - I don't have the knowledge in this area to vote for either "late-term abortion" or "late termination of pregnancy", but I do like including the statistic that this procedure is ~ 1%, and I would suggest that we should clarify the vague: "for medical reasons" with something like: "because of risk to the woman's life and in cases of severe fetal deformity, where long-term survival is unlikely" ---Avatar317^(talk) 23:57, 12 June 2020 (UTC)

• A proposal to avoid the issues in all 3 versions.

It's really helpful to read Definitions of abortion, which is linked from note1 at the end of the first sentence of the lead, and also to read Late termination of pregnancy, which covers definitional complexities and other issues in more detail than we can in the Abortion article without giving late abortions undue emphasis. In particular, the article Late termination of pregnancy deals with viability issues, which should probably be avoided in the Abortion article. In order not to put undue emphasis here on late termination of pregnancy, I've moved the "Live births" section from Abortion to Late termination of pregnancy.

I propose making the following changes in the lead so as to avoid having to explain the different definitions of viability or discuss post-viability abortion, which is not covered in the main body. The new wording of the sentence on late termination of pregnancy just links to the page with that title and mentions its rarity and the medical context for it (using Avatar317's suggestion):

(1) Change the first sentence to Abortion is the ending of a pregnancy by removal or expulsion of a zygote, embryo, or fetus.[note1]

(2) Change the last sentence of the first paragraph to Late termination of pregnancy, also called late term abortion, is rare, accounting for fewer than 1% of abortions in the United States, and is usually done because of severe fetal deformity, where long-term survival is unlikely, or because of risk to the woman's life.[5] NightHeron (talk) 18:47, 13 June 2020 (UTC)

At first glance, the only problem that I see with these proposed definitions is that they do not mention the (perhaps too) obvious common goal of all abortions, including late terminations of pregnancy/late term abortion, which is the demise of the incipient human organism. Tigerbaum (talk) 17:10, 14 June 2020 (UTC)

No, the common goal of all abortions is the wellbeing of the woman, and often it's to save the life of the woman. In an ectopic pregnancy, for example, there is virtually no possibility of survival of the fetus with or without abortion, but there is a good chance to save the life of the woman through abortion. NightHeron (talk) 22:05, 14 June 2020 (UTC)

Sorry, but the goal of All Medical Procedures is supposed to be the well being of the patient, so you're simply handing us a tautology above. Physically, the goal of a properly done abortion is to remove the human embryo/fetus from a woman so that it does not survive but so that the woman survives in good health. All abortions, however, whether ham-handed or skillfully done, or whether done early on or late, have the common goal of getting rid of the embryo/fetus. If a fetus somehow survives the procedure then the abortion provider has botched his assignment. 70.181.40.210 (talk) 03:59, 15 June 2020 (UTC)

The SPA's comment claimed that abortion is an exception to this tautology, which it's not. The definition of abortion in the proposed first sentence of the lead says that it involves the removal or expulsion of the zygote, embryo, or fetus, so I don't see that we have any disagreement there. NightHeron (talk) 11:06, 15 June 2020 (UTC)

In the famous Brazilian case of a 9-year-old rape victim carrying twin fetuses, doctors judged that the girl's life was in danger if the pregnancy continued, and performed a legal abortion. Archbishop Sobrinho had tried to prevent the abortion, and after the abortion he invoked excommunication of the girl's mother and medical team. If I had an anti-Catholic POV, I'd say that Sobrinho's goal was the demise of the girl. Of course, that wasn't his motive. His motive was to enforce Catholic doctrine as he saw it; the demise of the girl would be an unfortunate biproduct from his point of view. By the same token, only an extreme anti-abortion POV would claim that the goal of all abortions is the demise of the zygote, embryo, or fetus. The goal is the "tautological" one, the wellbeing of the woman. NightHeron (talk) 14:22, 15 June 2020 (UTC)

NO. I did not say that abortion was an exception to the tautology that abortion, like any other medical procedure, is supposed to benefit the patient; in fact I said exactly the opposite. Regarding the definition of abortion, however, spouting tautologies doesn't do us any good. Readers can already assume it is being done for the well being of the patient. Our definition should be a brief, broad and "fits all" description of the procedure. Its immediate purpose is to remove and bring about the demise the embryo/fetus without harming the patient. 70.181.40.210 (talk) 17:26, 15 June 2020 (UTC)

I'm sorry if it wasn't clear. My comment about the common goal of all abortions being the wellbeing of the woman was in direct response to the comment by the SPA Tigerbaum (not by you), who claimed that the common goal of all abortions is the demise of a zygote, embryo, or fetus, which, if this were true, would mean that abortion is an exception to the tautology. Of course, the view of the more extreme anti-abortionists is that the patient is not just the woman, but also the zygote, embryo, or fetus, so they do believe that abortion is an exception to the tautology. I'm not saying that that's your view. NightHeron (talk) 17:51, 15 June 2020 (UTC)

• Version 1 – the main page for this, late termination of pregnancy, makes it clear that that is the preferred medical term and that there are issues with using the term "term" in the proposed way. WP:COMMONNAME and WP:JARGON apply, and readers without medical knowledge may not know the technical difference between "termination" and "abortion," but the words are similar enough for laypeople to get the general idea. I also like the inclusion of the 1% statistic; I think it does a good job of appropriately weighting content in light of controversy. People who oppose abortion often bring up "late term abortions" and would want them mentioned in the lede since they are performed. I think this option maintains a WP:NPOV by communicating that while they do happen, late terminations are hardly representative of the procedures that fall under the unqualified term of "abortion." — Tartan357  ^(Talk) 05:17, 24 June 2020 (UTC)
• Version 1 per Tartan357 and Guy Idealigic (talk) 17:57, 25 June 2020 (UTC)
• Expanded Version 1 I guess? Agree with others that inclusion of the statistic is essential in any version. Personally I'm happy to ignore the problems of "after the fetus has become viable" at least for now if we better explain the circumstances in which such a procedure is usually carried out (like NH's version). It also clarifies roughly how many abortions take place in the context of a viable fetus which the V2 phrasing on its own does not, at least for introductory readers. Just because it's a medical context I'd probably hedge by saying "or less accurately as a "late term abortion"" or some such but whatevs. Might be good to separate out the issues in a separate rfc tbh. ─ ReconditeRodent « talk · contribs » 13:53, 1 July 2020 (UTC)

References

• Version 1 gets my vote! Dutchy45 (talk) 20:57, 4 July 2020 (UTC)

Citation

Citation number 5 is incorrect. It links to a paper on the use of abortion terminology. It should link to a paper discussing the reasons for late term abortion. Acasualobservation (talk) 19:04, 5 July 2020 (UTC)

Thanks. I put in an appropriate reference at the end of the first paragraph. NightHeron (talk) 19:57, 5 July 2020 (UTC)

The sentence highlights the risk of severe fetal abnormality or risk to a woman's life as the reasons for late term abortion. However, this is not supported by the research which suggests the main reasons for late term abortion are similar to the main reasons for abortion in general - educational, financial or partner relationship concerns, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457018/#__ffn_sectitle Acasualobservation (talk) 13:47, 13 July 2020 (UTC)

That article is an opinion piece by someone with a strong anti-abortion POV (see, for example, Studnicki's article [43]). Unsurprisingly, he cherry-picks and distorts sources. His main source [44] discusses the fact that in the US many women, especially young and low-income women, experience long delays: "Later abortion recipients experienced logistical delays (e.g., difficulty finding a provider and raising funds for the procedure and travel costs), which compounded other delays in receiving care." Its conclusion is: "Bans on abortion after 20 weeks will disproportionately affect young women and women with limited financial resources." A recent book on the subject of obstacles to US women who seek abortion points out that the TRAP laws that exist in many US states cause long delays in obtaining abortion, "an increase in women traveling out of state for an abortion as well as a substantial increase in the number of women who had second-trimester abortions." (Note: Second trimester includes weeks 20-26; third trimester abortions are very rare; according to the same book [page 64], "Going even further into pregnancy, there are only five clinics in the US as of this writing that openly offer abortion in the third trimester, with many of their patients presenting with fetal anomalies, threats to their own health, or other serious problems.") NightHeron (talk) 16:21, 13 July 2020 (UTC)

The main source also states reasons for late term abortion - 'Most women seeking later abortion fit at least one of five profiles: They were raising children alone, were depressed or using illicit substances, were in conflict with a male partner or experiencing domestic violence, had trouble deciding and then had access problems, or were young and nulliparous'. Points about delays in accessing abortion or the availability of late term abortion providers or even the personal opinions or views of authors is irrelevant to my point regarding the reasons stated for late term abortion. Acasualobservation (talk) 16:45, 13 July 2020 (UTC)

I also suggest changing the reference to 'fewer than one percent of abortions in the US' to reflect CDC data which states - The majority of abortions in 2016....(1.2%) were performed at ≥21 weeks’ gestation, see https://www.cdc.gov/reproductivehealth/data_stats/abortion.htm Acasualobservation (talk) 18:15, 13 July 2020 (UTC)

That the author is an anti-abortion activist is relevant to the question of reliability of the article he wrote. The main source he cites found large numbers of women who were forced to delay abortion because of the difficult access to abortion and deliberately burdensome legal restrictions (i.e., TRAP laws) in many US states. This caused many of them, especially those who had already delayed abortion for personal reasons (such as late discovery of pregnancy), to delay abortion into late 2nd trimester, but in most cases not into the 3rd trimester. It's unclear how many of those women would even count in the most common definitions of late abortion, which is usually taken to mean either 3rd trimester (variantly defined as after 24 weeks or after 26 weeks) or post-viability. In any case the data from women who live in the parts of the US where abortion is inaccessible or severely restricted do not tell us anything about women living in other parts of the US or in other countries. NightHeron (talk) 19:06, 13 July 2020 (UTC)

There are many people with different views to me on many subjects but I would not suggest that their views would preclude them from doing useful research. In any case, either the position is supported by the data or it isn't. The paper he has cited provides a list of reasons late term abortion is sought. It is also broadly in line with other similar studies examining the reasons for abortion, for example: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729671/

I agree with your concern regarding 'late term' abortion as like you said it is not well defined. I suggest switching to weeks of gestation to make the article clearer.

As stated above, delays or difficulties in accessing services or the availability of providers is not relevant to the point. Acasualobservation (talk) 20:05, 13 July 2020 (UTC)

The main source cited is, as I said, concerned with abortions primarily in the TRAP-law states of the US. Those places are outliers internationally. As far as I know, nowhere else in the world is abortion legal but with huge obstacles (legal restrictions and intimidation of providers and patients) put in the way of access.

We agree that the meaning of late varies widely (between 20 and 28 weeks). It would be WP:UNDUE for the lead of the abortion article to try to resolve this ambiguity. Let me suggest a simple compromise: replacing "usually" with "often" in the last sentence of the first paragraph.

I believe that if late is taken to mean after 28 weeks, or even after 26 weeks, "usually" would be the accurate term. But probably not (in parts of the US) if late is taken to mean after 20 or 21 weeks. NightHeron (talk) 00:06, 14 July 2020 (UTC)

The current wording makes reference to the United States. I don't think it would be appropriate to speculate on the causative relationship between the factors influencing the statistics.

It is not clear to me under what basis we would make the claim of 'often' or 'usually' when discussing the reasons for late term abortions. These terms are not very exact and as discussed the defition of late term is unclear.

I would also still have concerns about asserting 'fewer than one percent of late term abortions' in a context where we have not specified a definition for late term abortion. The use of weeks of gestation would remove ambiguity here and would allow for more useful citation to be provided.

I would note that the Washington Post article currently cited refers to the CDC data concerning abortions at or beyond 21 weeks gestation and it uses a definition of 'late term' abortions as "generally understood to take place during or after the 21st to 24th week of gestation"

The articles goes on to quote Diana Greene Foster a professor at UCSF’s Bixby Center for Global Reproductive Health as saying “[t]here aren’t good data on how often later abortions are for medical reasons.”

In addition, the article notes “Based on limited research and discussions with researchers in the field, Dr. Foster believes that abortions for fetal anomaly ‘make up a small minority of later abortion’ and that those for life endangerment are even harder to characterise.”

The current wording is not supported by the data.

Propose to use weeks of gestation rather than the looser 'late term' abortion.

Propose to cite CDC data on the number of abortions at 21+ weeks gestation.

Propose to remove reference to the reasons for late term abortion currently stated and replace with reference to the 5 profiles identified for those seeking abortion at 20+ weeks gestation, see link https://onlinelibrary.wiley.com/doi/full/10.1363/4521013 Acasualobservation (talk) 13:31, 14 July 2020 (UTC)

What I think we agree on is that it's a complicated issue because of lack of agreement about definitions, conflicting sources, and regional variation. Note that there is no significant discussion of late term abortion in the main body of the article. That seems to suggest that the best way to resolve this is simply to delete the sentence you're objecting to (the last sentence of the first paragraph) and not try to rewrite it. That would be consistent with WP:MOSLEAD. NightHeron (talk) 16:08, 14 July 2020 (UTC)

Not what source says

I reverted the statement that medical abortion is usually done by a physician because the source only says commonly administered in the presence of clinicians, which is not the same thing. Also, the source does not investigate frequency of administering medical abortion by a physician; rather, it's concerned with the safety of self-administered medical abortions, and concludes that they're generally safe. NightHeron (talk) 12:35, 16 July 2020 (UTC)

Dear @NightHeron: thank you for noting this and for reverting my edit. I agree with you with. It is my error in paraphrasing (usually versus commonly). I appreciated you noting this.

How do you feel about the second paragraph that I proposed, highlighting the research gaps? There was not enough evidence to determine safety in this systematic review, however, moderate-quality evidence showed that self-administered was as effective as physician administered medical abortion. I did note that this 2020 Cochrane Review cites another 2011 systematic review by the WHO that has evidence of safety. I have not worked on this article before. I can see that there are numerous active contributors here that would know much better than me which information should be shared and would have additional awareness based on previous talk-page debates. If the community feels that evidence from this Cochrane Review should be included, here is my suggestion:

"Self-administered abortion", where the women is provided with the medications and instructions to take home, has been shown to be effective. Further research is required to determine if self-administered medical abortion is as safe as provider-administered medical abortion, where a health care professional is present to help manage the medical abortion. Safely permitting women to self-administer abortion medication has the potential to improve access to abortion. Other research gaps include how to best support a women who wants to take the medication home for a self-administered abortion.

I appreciate you noticing my initial mistake. Thank you again for helping to keep this article evidence-based!

JenOttawa (talk) 12:52, 19 July 2020 (UTC)

@JenOttawa: Thanks for your comment. Since there's one source for the entire paragraph, the conclusions should be attributed to the source, rather than simply stated in wikivoice. You might even use a direct quotation (such as a blockquote with ellipsis perhaps) so that it's clear exactly what they're saying. Also, this is an area where nuance is important, for example, how telemedicine fits in. In the US, this is a big issue, with some states requiring the physical presence of physicians and others not (see [45]). According to a recent book, "The safety of medication abortion via telemedicine has been well established." Of course, telemedicine is especially important during the pandemic. NightHeron (talk) 15:36, 19 July 2020 (UTC)

Thank you for the quick feedback. It is my understanding that for medical information paraphrasing is preferred to direct quoting, I am not familiar with block quoting or ellipsis but I would be happy to learn more. I could add in the following, is this what you mean by attributing to the source versus wikivoice?

A 2020 Cochrane Systematic Review concluded that "self-administered abortion", where the women is provided with the medications and instructions to take home, is effective. The systematic review also concluded that further research is required to determine if self-administered medical abortion is as safe as provider-administered medical abortion, where a health care professional is present to help manage the medical abortion. Safely permitting women to self-administer abortion medication has the potential to improve access to abortion. Other research gaps that were identified include how to best support a women who wants to take the medication home for a self-administered abortion.

Do you want to add your telemedicine point to it with the text book as the source? The 2011 WHO systematic review may be a little old as per WP:MEDDATE. I can also let leave this up for a few more days in case other community members have some ideas on how to best share this information.

Thank you again! JenOttawa (talk) 16:49, 19 July 2020 (UTC)

Sure, it's fine to paraphrase, but please be sure it's exactly what the source is saying. The studies were not of medical abortion entirely administered at home, but rather of self-administering the second stage, and effective means a successful abortion (This review shows that self-administering the second stage of early medical abortion procedures is as effective as provider-administered procedures for the outcome of abortion success.) Feel free to put a paragraph in the article, and then I could edit it slightly and add a bit about telemedicine. Then we'll see if other editors have any objections or want changes. NightHeron (talk) 19:31, 19 July 2020 (UTC)

"how to best support a women who wants" A woman who wants or women who want. Choose either singular or plural. Dimadick (talk) 16:44, 20 July 2020 (UTC)

I am very sorry, I waited a week and did not return. I have re-worded the paragraph to highlight the second stage of a medical abortion and that it results in a successful abortion.

A 2020 Cochrane Systematic Review concluded that providing women with medications to take home to complete the second stage of the procedure for an early medical abortion (known as a "self-administered abortion") results in an effective abortion. Further research is required to determine if self-administered medical abortion is as safe as provider-administered medical abortion, where a health care professional is present to help manage the medical abortion. Safely permitting women to self-administer abortion medication has the potential to improve access to abortion. Other research gaps that were identified include how to best support women who choose to take the medication home for a self-administered abortion.

Thanks and I am sorry once again about dropping off on this.

JenOttawa (talk) 10:48, 17 August 2020 (UTC)

References

Request to clarify "self-administered"

@JenOttawa: Since you work extensively with Conchrane studies, perhaps you could clarify something I'm confused about, namely an apparent inconsistency with the article Medical abortion. Your edit defines self-administered as providing women with medications to take home to complete the second stage, which seems to suggest that the woman initially has a medical appointment for the first stage. In Medical abortion#Self-administered medical abortion (which cites the same 2020 Cochran study) self-administered means that women take the abortion drug without direct medical supervision, suggesting that there is no medical appointment at all. If the definition used in the Medical abortion article is the standard one, then probably the reference to the 2020 Cochran study in both articles should state that it dealt with abortion where only the second stage is self-administered, which is not the same as an entirely self-administered abortion.

The Medical abortion article also discusses telemedicine (which is not discussed in the general Abortion article). This raises a related question: Is it considered self-administered if drugs are sent by mail and administered without a clinician present, but after a video consultation with a physician? I think that both articles need some editing in order to be clear on the different types of medical abortion, depending on how much of it is done without clinical supervision. Thank you. NightHeron (talk) 14:18, 17 August 2020 (UTC)

Thanks so much for all your help here. Just popping in to say that I will return to this. I have also contacted the Network Fellow from Cochrane to get some assistance. I will remove the "self administered" from the article for now.JenOttawa (talk) 11:03, 18 August 2020 (UTC)

Abortion and HIV

I would really appreciate others' views on this. I wanted to cite a Cochrane review on medical v surgical abortion for women with HIV and firstly, I'm not sure which section of the article would be best for the new citation and secondly, if my wording will be acceptable: "For women living with HIV it appears that medical and surgical abortions may be equally safe and effective as for women without HIV, but the evidence from clinical trials and observational studies remains largely uncertain about the possible risks of abortion for women with HIV." I think this is a fair reflection of the conclusions of the review and I think the issue of abortion in women with HIV is worth a mention on this page. What do others think? Many thanks in advance. Fi Stewart (talk) 07:54, 18 August 2020 (UTC)

The problem with including that is that any discussion of safety and effectiveness must adhere to WP:MEDRS, in particular WP:MEDASSESS. When the authors themselves say that they didn't have enough data to reach definitive conclusions ("Due to the paucity of studies, we were unable to determine if outcome differences exist between women living with HIV and women without HIV who undergo medical or surgical abortion."), this means that their work is only preliminary and does not meet WP:MEDRS standards for inclusion. (The article states that there was only one study that met their criteria for inclusion in their review, namely, a study of 68 women with HIV in Ukraine.) NightHeron (talk) 10:34, 18 August 2020 (UTC)

Thanks for posting here @Fi Stewart: I also find the wording "equally safe and effective...but uncertain about possible risks" makes it very unclear if it is safe to have an abortion. Could just the second part be shared, something like "the risks associated with abortion for women with HIV are not known"? JenOttawa (talk) 10:51, 18 August 2020 (UTC)

Could this WHO source be used that says

:::"despite limited research there is no clear reason to doubt that both medical and surgical abortions are safe and effective for women living with HIV, and either option can be considered for this population"

This would have to be paraphrased if used. JenOttawa (talk) 11:05, 18 August 2020 (UTC)

I'm just wondering what statements of the form "despite limited research there is no clear reason to doubt..." tell us. The wording could even be read as suggesting that there is reason to doubt but that it is not a clear reason because of limited research. Usually it's WP:UNDUE to cite sources that mainly say that more research is needed. NightHeron (talk) 16:12, 18 August 2020 (UTC)

I agree with WP:UNDUE guideline, however, sometimes I find it is helpful to at least point out important gaps in knowledge so that people don't make an assumption (either way) because something is or is not mentioned. To be honest, I find this a really tricky area to edit in to begin with, as I do not have a background and have not read all the recent literature on abortion to put it into context. Thanks again. JenOttawa (talk) 16:24, 18 August 2020 (UTC)

I also find this a tricky area, especially in relation to HIV. I've read about abortion, but next to nothing about HIV/AIDS. One question is whether special considerations apply to women living with HIV. A study published in 2010 that's cited in HIV/AIDS#Antiviral therapy reported that certain HIV medications may cause birth defects; this (in addition to fear of HIV transmission to the fetus) could affect a decision to have an abortion. More generally, although for the general population there is extensive evidence that abortion is safer than bringing a pregnancy to term, I don't know if there are any sources that compare the effects of giving birth vs abortion on the health of women living with HIV (for example, effects on antiretroviral treatment). NightHeron (talk) 17:13, 18 August 2020 (UTC)

References

I support including the concerns related by User:Fi Stewart. In order to do this without violating UP:UNDUE, all one would need to do is to qualify the existing assertion of safety to clarify that it applies to the general population of healthy women, but there is ongoing research about the safety of abortion in women with particular chronic conditions. Another possibility would be to comb through the list here and write a subsection detailing the contraindications to abortion and areas of uncertainty. If one were to include multiple contraindications in the same section it would not violate UP:UNDUE.--Epiphyllumlover (talk) 19:37, 26 September 2020 (UTC)

Your source does not list contraindications to abortion, but rather contraindications to medical abortion. For example, one of the contraindications is ectopic pregnancy. If a woman with an ectopic pregnancy does not get an abortion, then the most likely outcome is the death of the woman and the fetus. So that's obviously not a contraindication to abortion; rather, she needs a surgical abortion, not a medical abortion.

This illustrates the difficulty with stating that abortion carries risks for women with certain health conditions. First of all, that sounds as if such women should be advised to continue their pregnancy. Depending on the details of her condition, it might be that continuation of the pregnancy is more dangerous than aborting it. According Wikipedia policy, we're required to adhere to WP:MEDRS, and this is especially important if we make statements about weighing the risks for women with HIV or ectopic pregnancy or other serious health conditions. NightHeron (talk) 21:50, 26 September 2020 (UTC)

In this case it should be considered that this is a real life problem facing women with HIV. See our article HIV and pregnancy and note that abortion is not even mentioned. Considering the fact that HIV medications do bring a certain amount of risk to the outcome of a pregnancy, I feel that this topic is so important that to state what we've got is better than saying nothing. I'm grateful to Fi Stewart for bringing this up. I had suggested that it be listed as a possible topic for students but apparently this would not be appropriate for students if it is difficult for even experienced editors.Gandydancer (talk) 23:23, 26 September 2020 (UTC)

Article subject

Is the primary purpose of this article to discuss the abortion procedure of the human fetus or human embryo? The beginning synopsis does not make it clear. Rapprochement (talk) 23:52, 26 September 2020 (UTC)

The first sentence makes it clear that it's both. EvergreenFir (talk) 00:34, 27 September 2020 (UTC)

Abortion rates worldwide

The section on incidence could use a little update, IMHO. In particular, regional differences could presented in a clear and easily comparable way. To this end, I have prepared a draft based on data from a recent Lancet article, as well as the existing reference from the Guttmacher institute. If any experienced editor would like to use the material in the main article, please feel free:

Abortion rates worldwide 2015-2019

Variability in the availability and reliability of data poses challenges for measuring and monitoring trends in unintended pregnancy and induced abortion, which are related phenomena. A study by Bearak et al, published in The Lancet in 2020, estimated regional rates of these phenomena, using statistical modeling based on determinants of fertility. The point estimates are given in the table below. These estimates are subject to a a degree of statistical uncertainty. The uncertainty intervals are not listed here. The groupings are defined by the UN sustainable development goals (SDG). All values are annual averages for 2015–2019. Rates of abortion and unintended pregnancy represent the number of those events per 1,000 women aged 15–49.

Unintended pregnancy Abortion
World 64 39
Sub-Saharan Africa 91 33
Western Asia and Northern Africa 86 53
Central and Southern Asia 64 46
Eastern and Southeast Asia 58 43
Latin America and the Caribbean 69 32
Europe and Northern America 35 17
Australia and New Zealand 38 15
Oceania (excl. Australia & New Zealand) 78 34

All information in this section is extracted from:

Bearak, J., Popinchalk, A., Ganatra, B., Moller, A. B., Tunçalp, Ö., Beavin, C., ... & Alkema, L. (2020). Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. The Lancet Global Health, 8(9), e1152-e1161.

Unintended Pregnancy and Abortion Worldwide (Fact sheet, July 2020, based on results from Bearak et al), https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide

KaldeFakta68 (talk) 22:05, 27 October 2020 (UTC)

Moved URL

In the Abortion introduction, after defining abortion, There is a statement "An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion" and occurs in approximately 30% to 50% of pregnancies".

This statement has hyperlinked references, However, for the latter half of it the link URL source has moved and when relocated on the same site at "https://www.nichd.nih.gov/health/topics/pregnancyloss/conditioninfo" was found to state "occurring in about 10% of confirmed pregnancies".

~Arabia Kawlls — Preceding unsigned comment added by Arabia Kawlls (talk • contribs) 19:21, 25 November 2020 (UTC)

It seems that "30% to 50%" should be changed to "30% to 40%". Otherwise, there is no contradiction here. Two sources are given. The first source states that Thirty to forty percent of all conceptions result in miscarriage, and also that Ten to fifteen percent of clinically recognized pregnancies (what the second source calls confirmed pregnancies) result in miscarriage. NightHeron (talk) 00:29, 26 November 2020 (UTC)

I'm no medical expert, so pardon my stupidity. But is miscarriage even related to abortion? Miscarriages are occurred without intention, whilst abortion (at least to my knowledge) is premeditated. If this is right, I suggest just having a template "Not to be confused with Miscarriage, the natural death of an embryo of fetus." GeraldWL 14:27, 8 January 2021 (UTC)

The medical literature refers to a "miscarriage" as "Spontaneous Abortion". (Often abbreviated as SA). There are plenty of medical references in this article if you'd like to see that for yourself. ---Avatar317^(talk) 02:04, 9 January 2021 (UTC)

Arbitration motion regarding Abortion

The Arbitration Committee has resolved by motion that:

The one-revert restriction on all articles related to abortion, authorized by the community here and modified by the Arbitration Committee in the Abortion arbitration case, is formally taken over by the committee and vacated. Discretionary sanctions remain authorized for all pages related to abortion, broadly construed.

For the Arbitration Committee, Kevin (aka L235 · t · c) 16:59, 22 September 2020 (UTC)

Discuss this at: Wikipedia talk:Arbitration Committee/Noticeboard § Arbitration motion regarding Abortion

I appreciate the notice suggesting discussion in WT space, but I think it is important to clarify here for those of us not versed in legal terminology - please could someone explain the impact of this decision? I have followed the links and have read a description of what 'vacated' means in a legal sense, but notice that this talk page still has the 1RR notice at the top. Thanks |→ Spaully ^~talk~  14:16, 7 October 2020 (UTC)

The impact is to reduce the rate of additional enforcement actions. I came across this study: The left-wing bias of Wikipedia by Shuichi Tezuka and Linda A. Ashtear. About half way through it discusses the abortion related enforcement stats from November 2011 until the end of August 2020, in particular in that for all seven instances a decision was made against a pro-lifer.--Epiphyllumlover (talk) 19:12, 1 November 2020 (UTC)

Calling this piece a "study" is like calling a political editorial a "fact sheet". jps (talk) 13:40, 3 November 2020 (UTC)

ජපස, nevertheless, we can all agree that Wikipedia needs to neutralize itself and not lean towards the left. We must not lean towards anything and act like fact-checkers. I've seen some articles acting as such, and it's miserable. GeraldWL 14:30, 8 January 2021 (UTC)

As they say, "Reality has a known left-wing bias." jps (talk) 16:53, 8 January 2021 (UTC)

Who is "they"? Stephen Colbert says that. — Preceding unsigned comment added by 2001:56B:DCB3:9500:D0AE:AED8:996D:9A62 (talk) 04:25, 15 January 2021 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 25 January 2021 and 12 May 2021. Further details are available on the course page. Student editor(s): Olivialauryn.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 16:47, 17 January 2022 (UTC)

Undue Weight in the article subject

The second two paragraphs of the article subject clearly take the point of view that abortion should be legal. I am not questioning the validity of the sources cited. However, a significant number of people worldwide believe that abortion should not be legal; therefore, the facts presented in the second two paragraphs of the article subject give that section undue weight. These two paragraphs would fit better in the Unsafe Abortion subsection. Mariachiband49 (talk) 18:00, 18 October 2020 (UTC)

Abortion is first and foremost a medical procedure, and hence the medical facts concerning abortion, and especially safety issues, are of paramount importance and so belong where they are in the lead. NightHeron (talk) 18:09, 18 October 2020 (UTC)

This article should discuss abortion as a medical procedure; however, use of the word "legal" in the second paragraph shows that abortion is also inevitably a political issue (it is also a moral issue). The second paragraph of the lead informs readers about safety concerns, but it also implicitly constructs an argument that abortions should be legal. For example, the statement, "Making safe abortion legal and accessible reduces maternal deaths," strongly implies that abortion should be legal, and does not belong in the lead unless it is immediately balanced by a counter-claim showing a caveat of abortion. This statement would fit better in a section such as Safety or Abortion debate, where readers expect a more extensive discussion with due weight. In the current climate, it is especially important that the lead takes a neutral point of view.

To properly address the safety of abortions while taking a neutral point of view, I propose that the second paragraph be changed to the following two paragraphs:

When properly done, abortion is one of the safest procedures in medicine. It is safer than childbirth, which has a 14 times higher risk of death in the United States. Modern methods use medication or surgery for abortions. The drug mifepristone in combination with prostaglandin appears to be as safe and effective as surgery during the first and second trimester of pregnancy. The most common surgical technique involves dilating the cervix and using a suction device. Birth control, such as the pill or intrauterine devices, can be used immediately following abortion.

Unsafe abortion is a major cause of maternal death, especially in the developing world. Unsafe abortions (those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities) cause 47,000 deaths and 5 million hospital admissions each year.

And I propose that the WHO's recommendation be appended to the fourth paragraph, where due weight is given:

Historically, abortions have been attempted using herbal medicines, sharp tools, forceful massage, or through other traditional methods. Abortion laws and cultural or religious views of abortions are different around the world. In some areas abortion is legal only in specific cases such as rape, problems with the fetus, poverty, risk to a woman's health, or incest. There is debate over the moral, ethical, and legal issues of abortion. Those who oppose abortion often argue that an embryo or fetus is a human with a right to life, and they may compare abortion to murder. Those who support the legality of abortion often hold that it is part of a woman's right to make decisions about her own body. Others favor legal and accessible abortion as a public health measure. The World Health Organization recommends safe and legal abortions be available to all women.

This removes implications that abortion should be legal from the discussion of safety, while addressing this argument in a later paragraph where due weight is given. Mariachiband49 (talk) 21:43, 18 October 2020 (UTC)

Mariachiband49, that's the view of pretty much every reputable medical organisation in the world, so it's not a surprise to see it reflected as the consensus of reliable sources. Guy (help! - typo?) 21:47, 18 October 2020 (UTC)

The reality is that legality of abortion is inseparable from safety. The World Health Organization is concerned with public health, not with moralistic or political debates. The WHO recommendation that abortion be legal and accessible is based on the extensive evidence that in parts of the world where all women have access to legal abortion it's one of the safest procedures in medicine. In places where abortion is illegal or greatly restricted, there tends to be a high rate of maternal mortality caused by unsafe abortion. So in a discussion of safety the question of legality should not be swept under the rug. NightHeron (talk) 23:36, 18 October 2020 (UTC)

I support Mariachiband49's proposal. It would help remedy a safety-related "The lady doth protest too much, methinks" problem that I mentioned earlier.--Epiphyllumlover (talk) 19:08, 1 November 2020 (UTC)

The lead as currently written accurately reflects the fact that a major global issue in women's health is the prevalence of unsafe abortions in places where abortion is illegal. There is consensus among public health sources that legality of abortion is better than illegality from the standpoint of women's health. That is a medical judgment, not a political or moral opinion. It can be easily ignored by anti-abortion advocates, who believe that carrying pregnancy to term is an absolute imperative irrespective of the consequences for the health of the pregnant woman.

There is also a consensus of WP:MEDRS sources that abortion, when legal and accessible, is one of the safest procedures in medicine. When you write "The lady doth protest too much", I suppose that the "lady" in this case is the consensus of reliable sources. NightHeron (talk) 22:00, 1 November 2020 (UTC)

I've reviewed the article myself and it seems neutral enough. Any article that describes an abortion will seem as if it's in favor of legalized abortion. But I do think that more information against abortions should be provided, such as non-abortive family planning, like prophylactics, reduces abortion rates, and thus removes the necessity for an abortion procedure. Another issue is that the article does not once say that a terminated pregnancy results in the death of the embryo, fetus, infant, etc, although that addition is simply my opinion at this moment. I don't know if it was decided against adding that information in an earlier consensus. JazzClam (talk) 15:48, 23 February 2021 (UTC)

References

Decreasing clear bias in the first paragraph

'Abortion is one of the safest procedures in medicine' 'Making safe abortion legal and accessible reduces maternal deaths' 'It is safer than childbirth, which has a 14 times higher risk of death in the United States.' I feel all these statements in the first paragraph paint abortion in a good light and should be rewritten or cut from the first paragraph, and if placed in the article, should be placed under something such as 'arguments in support' — Preceding unsigned comment added by Isben88 (talk • contribs) 12:49, 18 February 2021 (UTC)

The issue is not whether abortion is "good" or "bad", but rather what the medical consequences are of legality/accessibility vs illegality. The information in the lead is factual concerning this. It's important to have this factual information prominent in the article in order to counter medical misinformation that gets spread by the more extreme elements of the anti-abortion movements. NightHeron (talk) 13:27, 18 February 2021 (UTC)

Though the information is well sited and factual, when compared to other similar topics, the intro appears to be overly long. The second paragraph could be placed under safety, which after reading the safety section it appears that there is all the same information. The third and fourth paragraph could probably be combined to be a primer into the rest of the article. Reason being that both paragraphs are cover similar topics relating to the main. I would reference to other topics on Wikipedia that discuss medical procedures such as amputations, heart surgery, blood transfusion, tracheotomy, ect, ect for basis on making these changes TauGuys (talk) 21:11, 18 February 2021 (UTC)

The lead is not too long. According to WP:MOSLEAD, the lead should be no more than four paragraphs. But a lead section of four paragraphs is reasonable for a long article, which this is. This article has length 170KB. The first article you mention, Amputation, is less than 1/4 as long, and it has a lead that's almost 2/3 as long as this article's. NightHeron (talk) 22:07, 18 February 2021 (UTC)

I agree that the lead is not too long, and per WP:MOSLEAD : "The lead is the first thing most people will read upon arriving at an article, and may be the only portion of the article that they read." ...especially in a larger article like this one, so covering all the major topics in the lead is important. ---Avatar317^(talk) 22:31, 18 February 2021 (UTC)

The introduction has many good, well cited points, that atleast for an intro appear to be almost too specific if that makes sense. Mostly looking at paragraph two. Here is my Proposal on a per paragraph basis to tighen up the intro.

1. Keep as is.

2. Incorporate with later paragraph

3. Combine 3 & 4 Historically, abortions have been attempted using herbal medicines, sharp tools, (removing forceful massage, which, based on its linked article is not a technique) or through other traditional methods.[23] Around 56 million abortions are performed each year in the world,[17] with about 45% done unsafely.[18] Abortion rates changed little between 2003 and 2008,[19] before which they decreased for at least two decades as access to family planning and birth control increased.[20] As of 2018, 37% of the world's women had access to legal abortions without limits as to reason.[21][22] Abortion laws and cultural or religious views of abortions are different around the world. In some areas abortion is legal only in specific cases such as rape, problems with the fetus, poverty, risk to a woman's health, or incest.[24] There is debate over the moral, ethical, and legal issues of abortion.[25][26]

4. When properly done, abortion is one of the safest procedures in medicine,[5]:1 [6]:1 but unsafe abortion is a major cause of maternal death, especially in the developing world.[7] Making safe abortion legal and accessible reduces maternal deaths.[8][9] It is safer than childbirth, which has a 14 times higher risk of death in the United States.[10] Modern methods use medication or surgery for abortions.[11] (removing specific methods which are mentioned later in the page) When performed legally and safely on a woman who desires it, induced abortions do not increase the risk of long-term mental or physical problems.[14] In contrast, unsafe abortions (those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities) cause 47,000 deaths and 5 million hospital admissions each year.[14][15] The World Health Organization recommends safe and legal abortions be available to all women.[16]

TauGuys (talk) 14:54, 19 February 2021 (UTC)

I see no reason to make those changes. Paragraph 2 does not need to be deemphasized, and it is not "almost too specific". NightHeron (talk) 16:29, 19 February 2021 (UTC)

With the proposed write up, it is mentioned that there are both medication or surgical options. Which are expanded upon further later in the article. Maybe I fail to realize the importance of listing in the intro specific medications and medical procedures, that are talked about in greater detail later. TauGuys (talk) 17:16, 19 February 2021 (UTC)

It is hard for me to understand why you object to this: "The drug mifepristone in combination with prostaglandin appears to be as safe and effective as surgery during the first and second trimester of pregnancy." I would think that we need to be very specific and it seems very lead-worthy to me. Exactly what is your objection? Gandydancer (talk) 17:47, 19 February 2021 (UTC)

The objection I have, is that it seems that the intro is giving drug recommendations, without greater discussion same goes for the surgical options as well. TauGuys (talk) 14:17, 23 February 2021 (UTC)

Giving accurate information and giving a "recommendation" are not the same thing. Similarly, the second paragraph of the article COVID-19 vaccine assures the reader that "several COVID-19 vaccines demonstrate efficacy as high as 95%." In both cases such information in the lead is necessary to counteract the misinformation spread by fringe groups -- anti-vaxxers in one case and anti-abortion extremists in the other. NightHeron (talk) 15:06, 23 February 2021 (UTC)

I think it's disingenuous to say that all opposed to abortion are zealots, most people opposed to abortion believe that since 56 million abortions are undertaken worldwide, that's 56 million deaths. JazzClam (talk) 15:52, 23 February 2021 (UTC)

If most people opposed to abortion believe...56 million abortions occur worldwide, they are making thinks up, because the figures aren't available. In my country abortions aren't counted separately from other procedures. HiLo48 (talk) 04:58, 24 February 2021 (UTC)

Even if that was the case, what would that have to do with information on the specific methods? --Yhdwww (talk) 17:46, 23 February 2021 (UTC)

@JazzClam: I didn't say that, so please read WP:NPA and don't accuse me of being "disingenuous". I said that "anti-abortion extremists" spread misinformation. There's nothing "disingenuous" about saying that. NightHeron (talk) 18:27, 23 February 2021 (UTC)

@NightHeron: using the Covid-19 lead as an example, it is mentioned that there are vaccines, but there is not mention of a specific vaccine or procedure within the lead. Similarly, to how I believe the lead should be change here. TauGuys (talk) 13:23, 24 February 2021 (UTC)

It is a mistake to expect similar information at the COVID article. The pandemic search for a "cure", so as to speak, is still just getting started and there are many new approaches with speculated outcomes. On the other hand, the "cure" for an unwanted pregnancy is well studied and documented...and certainly lead worthy. Gandydancer (talk) 14:30, 24 February 2021 (UTC)

When I first read the intro, it felt like I was reading a persuasive essay about why abortion should be legal rather than an article about abortion in general. Dullbananas (talk) 03:46, 25 February 2021 (UTC)

The lead is factual, based on reliable WP:MEDRS sources. Some of the more extreme anti-abortion groups circulate false information, for example, claiming that abortions are dangerous. Giving factual information is not the same thing as writing "a persuasive essay" trying to convince abortion opponents that they're wrong. Many of the (less extreme) abortion opponents acknowledge the facts about the medical consequences of illegality, but this does not change their opinion that abortion should be illegal. The article does not take sides on "should be". NightHeron (talk) 11:11, 25 February 2021 (UTC)

I agree that it reads like a "persuasive essay". But who's it trying to convince? Surely not those who believe it one of the safest procedures in medicine? Do they need further convincing? Laurel Lodged (talk) 12:57, 25 February 2021 (UTC)

Wikipedia is not out to "persuade" people of anything except in the limited sense of wanting readers to know the facts and not be swayed by misinformation or fringe nonsense. That's why information on the safety of abortion is in the lead here, and why information about the efficacy of COVID-19 vaccines is in the lead of that article. NightHeron (talk) 13:37, 25 February 2021 (UTC)

Yes, the result of making abortions illegal is not no abortions, but illegal, or dangerous abortions. It makes a lot of sense to address that in the lead. HiLo48 (talk) 18:59, 25 February 2021 (UTC)

Also, we follow POLICY on how to write articles, and that means we rely on what Reliable Sources WP:RS (in this case WP:MEDRS) sources say. We don't care if some editor "feels like" it sounds like a persuasive essay, those OPINIONS are irrelevant here. ---Avatar317^(talk) 21:16, 25 February 2021 (UTC)

Ok I now love Wikipedia even more Dullbananas (talk) 02:04, 27 February 2021 (UTC)

Lead image

I think an image of tools used for abortion should be used as the lead image. Dullbananas (talk) 18:58, 2 March 2021 (UTC)

That's WP:UNDUE for the lead. Medical abortions don't use "tools". The section on surgical abortion already has an image showing a tool. NightHeron (talk) 19:13, 2 March 2021 (UTC) Also note FAQ #5 at the top of this talk page. NightHeron (talk) 22:26, 2 March 2021 (UTC)

I removed the rather large picture of an abortion pill because it is not helpful and appropriate for the article. This article is not about an abortion pill. Gandydancer (talk) 16:35, 8 March 2021 (UTC)

Following the request from @Dullbananas: I had inserted a rather normal sized picture of an abortion pill because it is helpful and appropriate for the article. @NightHeron: objected that tools were UNDUE. I took this to mean that non tools (i.e. the most commonly used method) would be DUE. Laurel Lodged (talk) 18:37, 8 March 2021 (UTC)

I also pointed out FAQ #5 at the top of this talk page, which states that in an earlier discussion "the proposal that garnered a majority of support is to explicitly have no image in the lead." NightHeron (talk) 19:34, 8 March 2021 (UTC)

Edit notice

I think an edit notice should be added for this page saying to read the FAQ before editing. Dullbananas (talk) 22:28, 8 March 2021 (UTC)

Abortion

@NightHeron: Just saw your edit. I don't find the mention of Shennong to be authentic at all; the cited source[46] is not an expert in history per WP:HISTRS. Shennong is a mythological figure, with no existence in literature before common era. There is also some consensus that Shennong was the same mythical person as Yan Emperor. Mentioning him on a serious subject like Abortion fails WP:EXCEPTIONAL. Georgethedragonslayer (talk) 15:12, 5 July 2021 (UTC)

@Georgethedragonslayer: Thanks. I see that the source says "attributed" to Shennong, so the wording in the article definitely needs to be weakened. But the source does give a reference to a book by a historian, namely N. E. Himes' "Medical History of Contraception", which (on p. 109-110) supports the statement (also saying "attributed" to Shennong). The Wikipedia article Shennong#Historicity says that there is no written record because there was no written system on a durable medium before the 13th century BC. So the attribution of knowledge of abortifacients to Shennong is part of the belief that, despite the absence of extant written records from that time, a large body of medical knowledge, especially herbal knowledge, goes back to Shennong's time. Do you know where we could find a source that says what the consensus of historians and archaeologists is on whether this belief is credible? NightHeron (talk) 17:23, 5 July 2021 (UTC)

I changed the wording and put in a citation to Himes. NightHeron (talk) 22:46, 5 July 2021 (UTC)

I am in hurry right now thus I can't add more for now. But we should at least remove the traditional dating (2700 BCE) from the article given it varies from tradition to tradition. Mention of Shennong with proper attribution is not that bad. Georgethedragonslayer (talk) 03:38, 6 July 2021 (UTC)

Sure. What should we replace 2700 BCE with? NightHeron (talk) 10:11, 6 July 2021 (UTC)

Nothing. "Ancient India since its Vedic age" has no mention of a date either. Georgethedragonslayer (talk) 12:33, 6 July 2021 (UTC)

Done. NightHeron (talk) 12:59, 6 July 2021 (UTC)

Effect of legalizing abortion

Does making safe abortion legal cause the number of abortions to increase? If not, this should be mentioned in the second paragraph. Dullbananas (talk) 22:23, 8 March 2021 (UTC)

A source for a related (but somewhat different statement) -- that overall the abortion rates are the same or higher in countries that greatly restrict abortion than in those that don't -- is: [47]. This source reports that "abortion rates are similar in countries where abortion is restricted and those where the procedure is broadly legal (i.e., where it is available on request or on socioeconomic grounds). In analyses that exclude China and India, whose large populations skew the data, the abortion rate is actually higher in countries that restrict abortion access than in those that do not." NightHeron (talk) 12:40, 9 March 2021 (UTC)

Is there a better analysis of this point? The cited paper provides no real explanation for why India or China should be excluded from the analysis. It also makes no attempt to consider other factors that could influence the abortion rate like cultural or religious backgrounds, governance structures, education systems etc. Essentially I am no further to understanding if abortion rates are influenced by the legality of abortion or not. Perhaps there are studies of individual countries just prior to and post legalisation of abortion or vice versa. Acasualobservation (talk) 21:00, 1 June 2021 (UTC)

I think that they exclude India and China because they have both legality and high abortion rates. Because countries are weighted in proportion to population (and those two countries together have about a third of the world's population), including them would give the impression that legality means more abortions, which is not true in most countries. At least that's my interpretation of what the source says. Your point about other factors is well taken. The main difficulty with comparative statistics, either between different countries or within a country before and after legalization, is that it's very hard to accurately estimate the number of abortions when abortion is illegal or greatly restricted. Often mortality statistics from illegal abortion are known more or less accurately, and researchers then make assumptions such as "let's suppose that 1 in 50 abortions ends in maternal mortality", in other words, they have to make a guess. NightHeron (talk) 01:33, 2 June 2021 (UTC)

Data on anything illegal is hard to get accurately. I read that the total quantities of illegal drugs being consumed in a country is generally estimated by assuming that authorities seize ~10% of all shipments...but that's quite an assumption, and researchers were shocked at how low that resulting estimate was compared to the quantity of cocaine metabolites they found when looking at concentrations in the sewers in Italy...meaning illegal drug usage was MUCH higher in quantity than was being estimated. ---Avatar317^(talk) 04:50, 3 June 2021 (UTC)

China will not release the stats per national security reasons. The fact-sheet above is not helpful because complete data is unavailable.--Epiphyllumlover (talk) 02:55, 8 August 2021 (UTC)

UNDUE and promotional sources

@Avatar317: the Guttmacher Institute is heavily cited here. So is the National Abortion Federation, Childbirth By Choice Trust, From Abortion to Reproductive Freedom: Transforming a Movement, Sexual and Reproductive Health Matters, Management of unintended and abnormal pregnancy: comprehensive abortion care, and so forth. By your standards, would these be WP:PROMOTIONAL in presenting only one side of the issue? By your standards, would these be WP:UNDUE to include in articles under this topic? Elizium23 (talk) 15:12, 18 June 2021 (UTC)

Since I originally disputed the reliability of the Catholic Church sources for the claim that "freedom of speech" was a central motivating belief for the anti-abortion protests in Ottawa, I'd like to remind you that I did not say that such sources couldn't be used in other contexts or that publications of organizations or news outlets that have a general anti-abortion POV can't be used. The Guttmacher Institute is used largely for statistical information and other factual matters. A source that supports abortion rights should not be used to support a statement that identifies belief in "freedom of speech" as the central motivating belief for American protests in support of abortion rights, even if one of the things that the protesters were opposing was the laws in certain states that direct physicians that they must make certain statements (including false or exaggerated ones) to women desiring abortions. The point I made was that terms like "freedom of speech", "pro-life", and "pro-choice" are used by both sides for political spin. Editors reached a consensus to avoid political spin 3 years ago, when we changed the titles and word choices in abortion-related articles so that "pro-life" and "pro-choice" would not be used in wikivoice. NightHeron (talk) 15:43, 18 June 2021 (UTC)

NightHeron, the US Supreme Court claims that the right to abortion is the "right to privacy". Is this political spin? Elizium23 (talk) 15:50, 18 June 2021 (UTC)

That term would be political spin if it were used in the way "freedom of speech" is used in this discussion. If properly attributed to the US Supreme Court as it was constituted in 1973, of course that has plenty of RS sources not affiliated with abortion rights organizations. Similarly, if a court in Canada or the US ruled that some of the pro-abortion rights laws in Canada or some of the anti-abortion laws in the US are incompatible with "freedom of speech", then there'd be plenty of RS to cite that say that that was the court's rationale for its decision. But if a pro-abortion-rights source were to state that "right to privacy" is what motivated abortion-rights protesters, that wouldn't belong in a Wikipedia article. So yes, your analogy is a good one. NightHeron (talk) 16:01, 18 June 2021 (UTC)

There is a significant difference between FACTS and OPINIONS. Guttmacher and some of those others you mentioned are sourced for FACTS, not OPINIONS, and their reliability is because they are academic sources or they are highly cited by Reliable Sources: See WP:USEBYOTHERS. One sided sources include plenty of OPINIONS from their side, and none from the other. I haven't seen any cases of Guttmacher being sourced for opinion statements by abortion-rights individuals; I don't think they even publish that type of content. ---Avatar317^(talk) 22:15, 18 June 2021 (UTC)

Avatar317, you reject self-published facts from organizations such as membership numbers and other statistics as WP:PROMOTIONAL. Guttmacher is a clearinghouse for self-reported Planned Parenthood statistics. How is this different? Elizium23 (talk) 00:11, 19 June 2021 (UTC)

Please do not WP:SHOUT. It's not done here. Elizium23 (talk) 00:13, 19 June 2021 (UTC)

I am willing to support shifts away from the sources faulted by Elizium23 for WP:UNDUE. Ideally they could be replaced by third-party medical or independent academic sources. This sounds like a lot of work, going through each one and finding an appropriate replacement source.--Epiphyllumlover (talk) 02:48, 8 August 2021 (UTC)

For further discussion please see the RfC below. NightHeron (talk) 11:52, 8 August 2021 (UTC)

Problematic lead sentence

The lead sentence currently reads, "Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus." This definition seems to suggest that caesarean sections or induction of labor resulting in a live birth are abortions. I think there is a key component missing from the definition, namely that abortions prevent a live birth from happening. Shouldn't we include that fact in the lead? 24.228.128.119 (talk) 03:02, 5 May 2021 (UTC)

Since no one uses the term "ending of a pregnancy" when they mean a live birth, the present wording is clear. NightHeron (talk) 09:58, 5 May 2021 (UTC)

Actually every live birth is the ending of a pregnancy. What about an alternative: "Abortion is a pregnancy that results in the death of an embryo or fetus by removal or expulsion from the womb." Laurel Lodged (talk) 11:22, 5 May 2021 (UTC)

Makes no sense. The pregnancy that's ended is not the abortion. The present wording is fine, as explained above. NightHeron (talk) 11:48, 5 May 2021 (UTC)

Laurel Lodged, nope. Termination of a pregnancy would be more accurate I guess. Guy (help! - typo?) 16:11, 5 May 2021 (UTC)

I like the definition in Merrion-Webster Medical dictionary: "[T]he termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus".24.228.128.119 (talk) 13:51, 5 May 2021 (UTC)

The word "death" is emotive and medically inaccurate since the fetus is generally not capable of independent life. Guy (help! - typo?) 16:12, 5 May 2021 (UTC)

I don’t think that is correct. Skin cells are not “capable of independent life”. Yet, if you peel off skin cells from your body, we would certainly describe the cells as dead.24.228.128.119 (talk) 17:02, 5 May 2021 (UTC)

Also, if something needs to be capable of independent life in order to be described as dead, then the lead sentence of miscarriage is inaccurate, which says, “Miscarriage, also known in medical terms as a spontaneous abortion and pregnancy loss, is the natural death of an embryo or fetus before it is able to survive independently.” 24.228.128.119 (talk) 17:09, 5 May 2021 (UTC)

There is a whole page dedicated to this: Definitions of abortion. I think the key point is that WP aims for consensus drawing from reliable sources, "death" only features in 2 out of 33 listed different definitions on that page. If there is space for improvement it would be to add that it generally occurs before the fetus is "viable" or "able to sustain life", though adding this risks making it less succinct. |→ Spaully ^~talk~  16:41, 5 May 2021 (UTC)

Change "ending" to "termination". That conforms with language used by RS and does not have the same possible confusion re: Caesareans. EvergreenFir (talk) 17:51, 5 May 2021 (UTC)

I agree with changing to "termination of pregnancy", but otherwise keeping the lead sentence as is. NightHeron (talk) 19:42, 5 May 2021 (UTC)

I agree with EvergreenFir and NightHeron, and Spaully's sourcing point. ---Avatar317^(talk) 21:02, 5 May 2021 (UTC)

While it may be clear to those familiar with the subject, a person with no knowledge of pregnancy jargon could still interpret “termination” to refer to procedures which deliver a live baby, like a C-section, labor induction, or premature delivery, which are clearly not abortions. 24.228.128.119 (talk) 21:58, 5 May 2021 (UTC)

Unlikely. Termination is the formal medical term for abortion, and implies a deliberate ending of the pregnancy. At worst, it is less ambiguous than any of the alternatives provided above. Guy (help! - typo?) 23:25, 5 May 2021 (UTC)

It's not just " to those familiar with the subject". There was a very famous movie named The Terminator, so there is little doubt that the average person would think that a LIVE birth would be named a "termination".---Avatar317^(talk) 23:41, 5 May 2021 (UTC)

I know 3 people who used to think that birth is abortion. I think the lead sentence should include "without birth" or "without preserving the embryo/fetus". Dullbananas (talk) 22:47, 6 May 2021 (UTC)

"To terminate" in English is a synonym of "to end", and its usage to mean "to kill" in the movie mentioned is irrelevant since it is derived from a euphemistic usage of the verb in an entirely different context. Therefore, an entirely reasonable reading of the opening sentence by somebody who is not already aware of what abortion is (who presumably are the only people who need to read the sentence) would include live births (since the pregnancy no longer continues, it has terminated). If the term is being used in a way that is medical jargon, then it should be hyperlinked since it is not the most common usage of the term (though I don't know where the hyperlink should lead, since "termination" is just a synonym for "abortion" in the medical context). The argument used in the FAQ that the death of the foetus should not be mentioned because "everyone already knows this" is illogical as there is no policy against stating facts that are too well-known (in fact, this would be an argument for not even needing a citation for the claim as per WP:BLUE). This also contradicts the claim that stating it is a POV bias towards anti-abortionists since if everyone agrees on the fact that an abortion kills the foetus then it is impossible for the statement to be an example of ideological bias. I agree that it should not be worded in an unnecessarily emotive way, but failing to mention the fact altogether on the grounds that it might be emotive is a clear violation of WP:CENSOR. Therefore, I would suggest something like "Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus, resulting in its death". TWM03 (talk) 19:15, 16 July 2021 (UTC)

• The first two paragraphs of this article are ambiguous, which makes phrasing the lead sentence difficult. The first paragraph makes this article about "abortion" in general (spontaneous or induced). The second paragraph then describes "abortion" as a medical procedure. It needs to be clarified if the article is speaking primarily about spontaneous or induced abortion. The second paragraph is further unclear because it was not well established that the fetus survives or not. The sentence "Abortion is one of the safest procedures in the world", without a clear definition of what an induced "abortion" does, could easily be interpreted to be induced labor, where the developed child is successfully delivered. Wikipedia is not censored, and is intended for a general audience. Relying on dictionaries aimed a medical professionals that speak of abortion generally, when this article is mostly about "induced abortion" dances around the fact that induced abortion ends the embryo/fetal life. I am not convinced by the argument that "death" is emotive; we can easily speak of organ death despite a kidney having no ability to survive independently. At a minimum, an older phrasing "removal or expulsion ... before the point of viability" should be restored, but even this is jargon laden. I would prefer something more akin to the Merriam-Webster definition noted above, a mainstream general reference source that unambiguously defines abortion as resulting in the death of the fetus. –Zfish118^⋉talk 23:26, 17 July 2021 (UTC)
• There's nothing "ambiguous" about the first two paragraphs. The first paragraph explains how the term abortion is used, and its concluding sentence states: The unmodified word abortion generally refers to an induced abortion. The second paragraph uses the unmodified word abortion in the sense of induced abortion. It's obvious that the article is not about delivery at childbirth. Editors with an anti-abortion agenda have repeatedly lobbied for inclusion of some reference to "fetal death" (even though the vast majority of abortions occur before the embryo reaches the fetal stage). That's not needed for clarity. The present wording is accurate and neutral. NightHeron (talk) 00:15, 18 July 2021 (UTC)

• While it is obvious from the context of the rest of the article that it is not about childbirth, the argument is that the definition given in the opening sentence can reasonably be interpreted to include childbirth and is therefore unclear. Since the most obvious distinguishing factor between the two is the death of the embryo or fetus, that is why I think it should be mentioned (thank you for the correction on appropriate terminology for the majority of abortions). This is not part of an anti-abortion agenda. Adding "before viability" is also inaccurate, as while the vast majority of abortions occur before viability, an abortion that occurs after that point is not excluded from being an abortion by definition. TWM03 (talk) 01:00, 18 July 2021 (UTC)

• It's hard to believe that any reader could possibly think that abortion means childbirth. They'd have to think that miscarriage (spontaneous abortion) also means childbirth. Even a reader who reads only the lead will see the sentence Those who oppose abortion often argue that an embryo or fetus is a person with a right to life, and they may compare abortion to murder. This hypothetical reader at that point would have to wonder to themselves "Why are they comparing childbirth to murder? And why are some people opposed to childbirth anyway?" NightHeron (talk)

• I believe you may have misunderstood my point. The vast majority of readers will understand the difference between abortion and childbirth. But they will understand this despite, not because of, the article as it is. And, even considering this hypothetical reader, where in the article will they find the answers to those two questions they will ask themselves? Confusion is a possible outcome, even if entirely the wrong conclusion is not, and ambiguity can easily be removed by adding this statement. TWM03 (talk) 09:03, 18 July 2021 (UTC)

• My point is that there is no ambiguity. Even when something is clear and unambiguous, there's always the possibility that a hypothetical reader will misread what's clearly written, as is the case with many articles. But there's no consensus of editors that the definition of abortion needs to be expanded. NightHeron (talk) 10:23, 18 July 2021 (UTC)

• @NightHeron: It should be noted that the miscarriage article has a definition that does not have this ambiguity: Miscarriage, also known in medical terms as a spontaneous abortion and pregnancy loss, is the natural loss of an embryo or fetus before it is able to survive independently. I would favor a consistent definition between the two articles and would like to see at least "before it is able to survive independently" added back to the first sentence here. Text to this effect has long been in the definition, and I mostly protest its removal at some indeterminate point. –Zfish118^⋉talk 00:14, 9 August 2021 (UTC)

• @Zfish118: But don't you think the words before it is able to survive independently in the definition in miscarriage are a bit redundant? If the embryo or fetus could survive independently (which an embryo can never do), then there was no "loss" of an embryo or fetus. The word "loss" already says that it wasn't able to survive independently. I'd favor trimming the unnecessary words from that definition. NightHeron (talk) 00:38, 9 August 2021 (UTC)

"Loss" is only appropriate because it used in certain medical instances. It would otherwise border very closely on being euphemistic, similar to "passed away", which is explicitly mentioned as inappropriate WP:Weasel word. "Loss of pregnancy" is medical jargon, that is not necessarily obvious especially to non-native speakers. For instance, could you find a "lost" pregnancy. Wikipedia is intend for all audiences, including non-technical and non-native English speakers. Clear unambiguous definitions improve the project. Definitions need not be minimalistic. –Zfish118^⋉talk 01:11, 9 August 2021 (UTC)

You're confusing two things. The term "pregnancy loss" is given as an alternative term to "miscarriage", but the definition does not say "loss of pregnancy" but rather loss of an embryo or fetus. I believe these words are perfectly clear to non-native English speakers; at least in the non-English languages that I know the literal translation means exactly what the phrase means in English. Adding redundant words does not make a definition clearer.

It is interesting that you lead with me being confused and attempt to carefully explain the definition, as my whole point is that the definitions are legalistic and confusing. Here I paraphrased; I could just have easily said "find a lost fetus"; which as I noted euphemistic phrases such as "loss" or "passed away" to describe death are specifically discouraged in WP:Weasel word for this reason. The only reason cited in this whole discussion that it should not be clearly stated that the products of conception don't survive an abortion/miscarriage is that anti-abortion extremists have advocated for such language. A lead sentence should summarize a topic in a way that the average reader would expect. I simply do not believe that the average reader expects a strictly medical definition, and shouldn't have to read the whole lead to confirm it is the correct article for the topic. The hold lead is awkward, with a disclaimer that that it is hard to define such a controversial topic, without noting that it the induced death of the embryo or fetus is the primary reason for that controversy. Withholding and merely implying true and verifiable information, that the embryo does not survive removal or expulsion seems to be done here for purely ideological reasons to avoid feeding an antiabortion narrative. –Zfish118^⋉talk 16:43, 11 August 2021 (UTC)

NightHeron (talk) 01:25, 9 August 2021 (UTC) I agree with NightHeron that the article is fine as it is. Wikipedia is an encyclopedia, NOT a dictionary. ---Avatar317^(talk) 01:12, 20 July 2021 (UTC)

Another term used is "separation"--a birth, abortion, or miscarriage is a "separation event". Such terms could be defined in the article.--Epiphyllumlover (talk) 02:52, 8 August 2021 (UTC)

That term doesn't appear to be in widespread use in reliable sources; as best I can tell, its use seems confined to a small handful of anti-abortion advocates. That said, if there's evidence that the term is in widespread use by high-quality sources then we should of course include and define it. MastCell ^Talk 16:51, 11 August 2021 (UTC)

References

RfC on the Guttmacher Institute as a source

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

Is the Guttmacher Institute a reliable source for the purposes for which it is used in the Abortion article? NightHeron (talk) 11:32, 8 August 2021 (UTC)

Here are some sentences in the article that reference the Guttmacher Institute:

The unsafe abortion rate in developing countries is partly attributable to lack of access to modern contraceptives; according to the Guttmacher Institute, providing access to contraceptives would result in about 14.5 million fewer unsafe abortions and 38,000 fewer deaths from unsafe abortion annually worldwide.

The rate of legal, induced abortion varies extensively worldwide. According to the report of employees of Guttmacher Institute it ranged from 7 per 1000 women per year (Germany and Switzerland) to 30 per 1000 women per year (Estonia) in countries with complete statistics in 2008.

The Guttmacher Institute estimated that "most abortions in the United States are obtained by minority women" because minority women "have much higher rates of unintended pregnancy".

The Guttmacher Institute estimated there were 2,200 intact dilation and extraction procedures in the US during 2000; this accounts for <0.2% of the total number of abortions performed that year.

A 2014 Guttmacher survey of US abortion patients found that many reported a religious affiliation—24% were Catholic while 30% were Protestant.

NightHeron (talk) 18:45, 8 August 2021 (UTC)

Discussion

• Yes for the reasons given in the above thread titled "UNDUE and promotional sources". Namely, the Guttmacher Institute is used in the article for statistics and facts, not subjective judgments, and it's widely cited by other RS. NightHeron (talk) 11:32, 8 August 2021 (UTC)
• Only as an opinion not statement of fact The institute is for all intensive purposes the research arm of Planned Parenthood, the largest abortion provider in the United States and lobby for abortion legalization in the Country and around the world, thus issues of bias/ conflict of interest seem clear. It can be used for showing its views on matters, but for statements of facts, I am inclined to oppose. 3Kingdoms (talk) 18:14, 8 August 2021 (UTC)

  Only as an opinion not statement of fact Per 3Kingdoms. This is a involved organization and obviously is not a reliable source for impartial claims. — Preceding unsigned comment added by 155.246.151.38 (talk • contribs) 23:20, 8 August 2021 (UTC)

  @3Kingdoms, can you suggest a better source for any of the statements of fact currently cited to this source? WhatamIdoing (talk) 20:36, 8 August 2021 (UTC)

  Off the top of head I can not. However, I would think that HHS here in US and other health departments around the world keep data on abortion. Also Pew and other polling outlets could have information needed. 3Kingdoms (talk) 00:28, 9 August 2021 (UTC)

  The CDC (which is part of HHS) does keep abortion statistics, but they're widely recognized to be inferior to and less complete than those maintained by Guttmacher. In fact, the CDC itself regularly relies on Guttmacher's research and statistics, which reinforces the obvious reliability of Guttmacher according to Wikipedia's policies and guidelines. We actually have a somewhat-decent article on Abortion statistics in the United States, if you're interested in learning more. MastCell ^Talk 16:04, 10 August 2021 (UTC)

• Yes. The Guttmacher Institute is recognized as an authoritative source for medical content related to abortion, and is frequently cited as such by other reliable sources. It would be frankly sort of ridiculous to bar it from being used as a source of fact in a serious, reputable reference work about abortion, although here we are, I guess. MastCell ^Talk 21:38, 8 August 2021 (UTC)
• Yes as other sources rely on their content, and also because all of the indicated uses are indirectly attributed, not strictly describing factual statements in wiki-voice. Any fact-based wiki-voice statements sourced to them should probably be undisputed.--Shibbolethink ^{(♔ ♕)} 23:55, 8 August 2021 (UTC)
• Yes - Reputable as evidenced by WP:USEBYOTHERS, and also that others frequently point out that Guttmacher's statistics are more EXTENSIVE (cover more areas not required to be reported to states or federal government). ---Avatar317^(talk) 00:46, 9 August 2021 (UTC)

• Yes. Reputable source of the kind Wikipedia likes to use. Not seeing what the problem was supposed to be. Alexbrn (talk) 04:19, 9 August 2021 (UTC)
• Comment GI data is complicated by their use of voluntary response surveys of abortion providers. This would, at the minimum, impact the race figure, the "2,200 intact dilation and extraction procedures" figure, and the "religious affiliation" figure. (They also rely on government statistics.) The "religious affiliation" figure cannot be substantiated by another source, but the previous two have better sources out there (somewhere). Looking at the very incomplete table on this personal website (not suitable as a source) it is clear that the "2,200" figure is too low. Race stats are reported by the CDC, but some states are missing: TABLE 13. Reported abortions, by known weeks of gestation, age group, and race/ethnicity — selected reporting areas, United States, 2018.--Epiphyllumlover (talk) 05:42, 9 August 2021 (UTC)
  • Comment "it is clear that the "2,200" figure is too low." The figure is an estimate from the year 2000. I would suspect there have been changes over the last two decades. Dimadick (talk) 13:48, 9 August 2021 (UTC)

    @Epiphyllumlover, if you look the first table in the personal website you linked to, the "2,200" figure is exactly the number it gives under the heading "various estimates, total procedures, United States" for the year 2000. In the text after the table, this website says "Reasonable estimates of the annual number of PBAs in the U.S. range from 2,200 to 5,000, with somewhat higher numbers possible". Since this (admittedly unreliable) website gives 2,200 as a reasonable annual estimate, I can't agree that the "2,200" figure is clearly too low. WhatamIdoing (talk) 02:33, 11 August 2021 (UTC)

• Yes As they are a reputable source and experts on the matter. However a few sentences sourced to them seem to reflect the situation two decades ago, and we may need more recent information. Dimadick (talk) 13:46, 9 August 2021 (UTC)
• Yes It is a reliable source but having a recent updated information will be better. Sea Ane (talk) 20:03, 9 August 2021 (UTC)
• Yes Guttmacher is a reliable source widely consulted for summary statistics, policy tracking, and synthesis/interpretation of research. Exactly the kind of source that comes in handy when editing on "contentious" topics. SeeJaneEdit (talk) 21:51, 9 August 2021 (UTC)
• I think it is reasonable to query whether an organisation that represents one side of a very polarised debate is offering facts and statistics that are accurate and fair. We shouldn't assume that some institution or think tank that claims to have expertise in a subject is a reasonable source of facts. Many just exists to pollute the debate with made up or cherry picked facts that they hope will become news headlines. Organisations that exist to push an agenda will have a strong desire to publish figures supporting that agenda, and suppress figures that are unhelpful to its cause. Several users have said this institution does have a reputation for fact checking and accuracy, which is what matters for facts, vs their opinion on moral or ethical matters. The statistics presented here seem relatively objective. I'd be more wary of using a one-sided organisation for statistics derived from polls about people's feelings or attitudes. For those, it is too easy to accidentally or deliberately design questionnaires that tend towards some result, or to simply bin the results of studies that don't produce the answers one wants. -- Colin°^Talk 09:28, 11 August 2021 (UTC)
• Yes. It's a widely respected research organisation, described by FactCheck.org as producing the "most highly respected" and "most accurate figures available" on sexual health. As well as being a reliable source, all the specific uses here are attributed inline, which means the point is moot anyway. If anything, some of the statements (2 and 3 in particular) would read better without inline attribution. ─ ReconditeRodent « talk · contribs » 18:56, 12 August 2021 (UTC)
• Yes, Guttmacher is a reliable source as others rely on their content due to their expertise. BristolTreeHouse (talk) 06:37, 13 August 2021 (UTC)
• If it will be mentioned that Guttmacher Institute is a pro-choice research organisation, I think we could use it as a source. --Martin Tauchman (talk) 12:08, 13 August 2021 (UTC)
  • If there is no real dispute about the reliability of the data they provide (and there isn't; see above), then it's not necessary, and arguably inappropriate, to flag the data as coming from a "pro-choice" source. There is no evidence that their political viewpoint affects the accuracy or reliability of the data and statistics that they provide. By describing them as "pro-choice" in-text, we're implicitly casting doubt on the reliability of their data even though they are clearly considered a highly reliable and reputable source. (In contrast, if we present the Guttmacher Institute's views on abortion legislation or political aspects of the topic, then we should definitely note their advocacy for access to safe/legal abortion). MastCell ^Talk 15:11, 13 August 2021 (UTC)
    • Voluntary-response surveys from individual abortion providers are inherently less reliable than the Medicaid stats in the paper I am still hoping to use as a reference. The main point in GI's favor of GI is that the CDC is incomplete too, since they omit certain states like California and may have other issues too. There really isn't the same sort of higher-quality data regime in the US as there is for some European countries; it seems that this is because there is no national health care with a single-payer system in the US. When I was searching for studies I noticed a disproportionate of the public health statistics sort using data from single European countries. Even American researchers were using European data.--Epiphyllumlover (talk) 18:50, 13 August 2021 (UTC)

      I believe Medicaid covers about 15% of working-age US adults, which means that their stats are about 85% incomplete, too. In two-thirds of the states, Medicaid doesn't pay for most abortions, so Medicaid numbers would significantly undercount abortions performed. There are also significant population effects there, since Medicaid disproportionately covers very poor and disabled people. The Medicaid numbers are probably worth including, but they're not necessarily better. WhatamIdoing (talk) 01:08, 19 August 2021 (UTC)

      The study only looked at the 1/3 of states where Medicaid does pay for all abortions. The numbers are useful for some public health purposes, but not as a record of the total number of abortions.--Epiphyllumlover (talk) 21:24, 21 August 2021 (UTC)

Religious stats

I'm a bit wary of the "religious affiliation" statistic. It seems too vague to be useful. That could range perhaps from someone who is a member of a church they attend every week (in non-covid times) to someone who was last in a church on their wedding 15 years ago. Was the source more precise? The statistic on its own doesn't really answer the real question perhaps of whether the religious beliefs of those who have had an abortion in the US is much different to the population as a whole. The rest of the paragraph mentions some of that, though I think it needs to be more careful about identifying which are US statistics and which are global (or some other grouping). For example, the attitudes of the US protestant church on many things is not aligned much with those from other countries. -- Colin°^Talk 09:28, 11 August 2021 (UTC)

With religion statistics, the number of self-reported members is always higher than the official number, for denominations which keep such records. This isn't a problem in-and-of itself, but when comparing between denominations the problem is that some denominations have a much greater spread of unofficial members. The strongest effect that I know of is with Mormons, about 4 times as many people claim to be LDS as are actually recognized by the LDS organization. And especially in smaller communities, there are many people who will claim membership (not officially recognized) not only to a denomination, but also a particular congregation in the community. Another denomination may have a much smaller spread, maybe 2x or 1.5x. So a comparison of Catholics vs. Protestants partly reflects this discrepancy. How strong it is in this case I am not sure.

Geographically there are some differences in religion, and also in abortion rates. Mississippi has smaller communities, is more Protestant, and has a low abortion rate, while large urban areas in the east and midwest tend to be more Catholic than Protestant, and have higher abortion rates. At some level the religion-abortion stats also reflect the geographical influences.--Epiphyllumlover (talk) 15:33, 11 August 2021 (UTC)

State level stats are even more detailed than is necessary here, in an articled that is rather US-centric already. I think the sentence starting "A 2014 Guttmacher survey " could be dropped as the reader isn't really given enough information to interpret this. Affiliation is nebulous and there's no comparison to an equivalent stat for the general population of women. The subsequent sentences are sourced to a very old study (and the wording is too close to being a copy-paste) but actually the 2014 study can supply similar information comparing patients with population. Scroll down to the "Religious Affiliation" section and you'll have more recent data comparing Catholic, Mainline Protestant and Evangelical Protestant patient vs population. However, it is worth also scrolling to the second "Religious Affiliation" section in the appendices, which notes assumptions made about the classifications. -- Colin°^Talk 17:21, 11 August 2021 (UTC)

Related to the last presidential election, I read that many white people in the US identify as "Christian" as a cultural thing, rather than a religious thing. The article was primarily pointing out that the self-identified Christians who said they went to church regularly were less likely to be Trump supporters than self-identified Christians who didn't. I would be surprised if a survey about abortion tried to get into details about whether the person "really" had a religious affiliation. I'm not even sure what questions you would want the pollster to ask. WhatamIdoing (talk) 01:38, 19 August 2021 (UTC)

References

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Update of Mental Health Section Using Reliable Sources

I'm restoring an edit I made of the section on mental health that was inappropriately reverted. My edit relies on reliable secondary sources, specifically peer reviewed literature reviews, that are much newer than the old sources cited. For example, the APA review was in 2008, and predated the studies reviewed by Reardon in 2018 and the 2013 metanalysis by Fergusson. Moreover, the 2018 review also provides a good summary of more recent studies, like the cited Sullins study from 2016 which used a nationally representative sample of women. Moreover, the previous version of this section misrepresented the APA's report, which I've corrected. --Saranoon (talk) 21:15, 3 October 2021 (UTC)

Your sources don't support what you claim they do. You wrote Abortion is statistically associated with higher rates of mental illness but your first reference states in the conclusion "some women do have significant mental health issues that are caused, triggered, aggravated, or complicated by their abortion experience" which does not in any way support a claim of "statistically higher rates of mental illness." Your third reference explicitly says "There is suggestive evidence that abortion may be associated with small to moderate increases in risks of some mental health problems" which is pretty far from "statistically higher rates of mental illness." Notfrompedro (talk) 22:08, 3 October 2021 (UTC)

Your sources are woefully inadequate for overturning consensus. In the 2018 paper Reardon's abstract gives 4 conclusions related to abortion, none of which claim any statistical evidence for likely mental health problems resulting from abortion, and 6 additional conclusions about difficulties in research on the subject. NightHeron (talk) 22:21, 3 October 2021 (UTC)

You both need to look at the whole sources, not just the abstracts. Also, Notformpedro, you have a fundamental misunderstanding of what "statistically associated" means. Look, for example, at [Figure 1 in Reardon 2018, and you will see that all the studies with "statistically significant" results are those wherein the line showing the lower and upper confidence interval is to the left of the vertical line. This is explained in the text of the article near Figure 1. Even though there are some findings that overlap the vertical line (and therefore, are not statistically significant), they do not contradict the statistically significant results unless there is no overlap between the confidence intervals of two different studies. When you understand how these "statistical associations" are properly compared, it is clear that trend in the findings from these many studies, especially those with a short line (meaning they have larger sample sizes and less variance due to sample errors), generally show that abortion is "statistically associated" with higher rates of various mental illnesses. But here's the next important part: statistical association is not proof of causation. That is why my statement makes clear that there is no longer any dispute over the "statistical association" between abortion and mental illness, but there is dispute over when, if ever, is abortion the sole cause of mental illness. It is important to inform readers of these distinctions.

NightHeron, my sources are reliable sources published in peer reviewed medical journals that are more recent (WP:MEDDATE) than the outdated sources and per the standards described in WP:MEDRS should be reflected in the article. As described above, if you read these sources, and also the APA review, you will see that the "statistical association" between abortion and mental health problems is not disputed. Only the explanation for this statistical link is disputed. This if fully explained in the cited sources, if you read them in their entirety. But if you'd rather begin the revision with material from the abstracts, even that would still be an improvement over the outdated material in previous versions of this article. --Saranoon (talk) 15:56, 4 October 2021 (UTC)

In your first paragraph above you're interpreting Reardon's article in a different way from how the author himself summarizes his conclusions in the abstract. That's OR. In your second paragraph you write that "my statement makes clear that there is no longer any dispute over the "statistical association" between abortion and mental illness, but there is dispute over when, if ever, is abortion the sole cause of mental illness." So you're conceding that the sources do not say that there's statistical evidence that mental illness associated with abortion is ever caused solely by the experience of abortion (rather than by confounding variables, such as underlying psychological conditions that may be more common among women experiencing an unwanted pregnancy). In that case the term "statistical association" is misleading, or at least can easily be misunderstood by the nontechnical reader, to whom it may sound like an implication of a causal relationship. Since no causal relationship is known, it's undue to add an edit that hints at (but does not directly assert) a causal relationship.

Another issue is that the relevant mental health comparison would not be between women who desire to carry their pregnancy to term and those who desire an abortion. Rather, it's between women with an unwanted pregnancy who get an abortion versus women with an unwanted pregnancy who go through with the pregnancy, childbirth, and all the consequences. The women with an unwanted pregnancy are more likely than other women to have been victims of rape, incest, or partner abuse. An additional effect that's hard to measure is that in certain places, especially in the U.S., the anti-abortion movement makes a deliberate effort to cause the abortion experience to be as upsetting as possible -- for example, organizing intimidating protests outside of clinics, passing laws at the state level that require physicians to give misleading and erroneous information designed to worry and unsettle women who desire an abortion, and so on. NightHeron (talk) 17:30, 4 October 2021 (UTC)

So, would you prefer that I should instead state, as according to Reardon's abstract: "Abortion is consistently associated with elevated rates of mental illness compared to women without a history of abortion; (b) the abortion experience directly contributes to mental health problems for at least some women; (c) there are risk factors, such as pre-existing mental illness, that identify women at greatest risk of mental health problems after an abortion; and (d) it is impossible to conduct research in this field in a manner that can definitively identify the extent to which any mental illnesses following abortion can be reliably attributed to abortion in and of itself." I'm fine with that.

Secondly, we are supposed to base our article on reliable sources, like Reardon's paper. So your personal judgment about what the relevant comparison group should be is immaterial. As discussed at length in the section ["There is no perfect control group; yet all comparison groups provide insights"] the importance of many different comparison groups is discussed. We can add all of these to the article if you like. But we should definitely not violate WP:DUE and exclude the material from this and other reviews I've cited just because of your personal viewpoint. --Saranoon (talk) 22:09, 4 October 2021 (UTC)

You guys are talking about this David Reardon, right? Is it really so certain that his paper is reliable? - MrOllie (talk) 22:15, 4 October 2021 (UTC)

His review paper is reliable, by definition, since it is published in a respected peer reviewed medical journal. The reliability and credibility of his work (much less the other works by other researchers I have cited) is vouched for by the editors and peer reviewers who determined that his review and analysis was consistent with the studies he cited in the paper.--Saranoon (talk) 22:22, 4 October 2021 (UTC)

It's in an open access journal that isn't indexed by MEDLINE, and the authors qualifications are minimal at best, so I'm not sure it meets WP:MEDRS requirements. - MrOllie (talk) 22:27, 4 October 2021 (UTC)

You're wrong. The article is indexed by Medline/PubMed as you will see here:https://pubmed.ncbi.nlm.nih.gov/30397472/ https://pubmed.ncbi.nlm.nih.gov/30397472/]--Saranoon (talk) 16:28, 9 October 2021 (UTC)

PubMed and Medline are two different things. Medline has quality checks, and pubmed includes extra stuff that hasn't passed those checks. MrOllie (talk) 16:32, 9 October 2021 (UTC)

MrOllie, please cite some source supporting your view that PubMed indexed journal articles are not reliable sources unless they are also indexed in Medline. Also, according to this National Library of Medicine link NLM Catalog search of Sage Open Medicine it would appear to be indexed by the National Library of Medicine. Therefore, please cite where in WP:VERIFY policy it is established that that peer reviewed articles indexed in PubMed are not to be treated as reliable sources, or even that preference should be given to articles indexed in Medline. Finally, please provide links demonstrating that all the other sources cited in the current section on mental health are indexed in Medline, not just Pubmed. It is important that the standards for recognition of reliable sources should apply to all articles cited as sources.––Saranoon (talk) 17:21, 19 October 2021 (UTC)

Feel free to check the status of the journals yourself, instructions are in WP:MEDRS, which is also where the preference for medline indexing is stated. Even if some other source doesn't pass muster, though, that doesn't mean we should add more questionable sources. MrOllie (talk) 17:29, 19 October 2021 (UTC)

I see nothing in WP:MEDRS which suggests that journals indexed in PubMed are not reliable. Nor have you supplied any information to support the view that Sage Open Medicine is a unreliable or predatory journal. Sage Journals is a well known and respected publisher of scientific journals. Simply because you assert that a source is "questionable" does not, and should not, override WP policy which requires only that the source be verifiable, and in the case of medical studies, peer reviewed. All three sources I have cited meet those criteria.--Saranoon (talk) 21:57, 19 October 2021 (UTC)

You need to read WP:MEDRS more carefully. "Other indications that a journal article may not be reliable are its publication in a journal **that is not indexed in the bibliographic database MEDLINE**" ---Avatar317^(talk) 05:04, 20 October 2021 (UTC)

Of the 4 statements you're quoting from the abstract, (a) doesn't mean anything relevant, since "associated with" could be entirely because of confounding variables; (b) is anecdotal ("some women" --- yes, obviously the ones who have to pass through a gauntlet of jeering anti-abortion extremists at the clinic might suffer mentally from the experience); (c) just alludes to confounding variables; and (d) just says we don't know. So all of this is undue. NightHeron (talk) 00:56, 5 October 2021 (UTC)

The 4 statements can and should be interpreted in the context of the entire review article. Your personal opinions are irrelevant. The sources I site are reliable secondary sources, and more current than the previously cited sources. See WP:MEDRS. It is appropriate and necessary to update the article to reflect the information contained in the articles I have cited WP:DUE. It is inappropriate to completely revert the edits I have made WP:OWNBEHAVIOR. The proper way to proceed is to include both my edits and other appropriate material.--Saranoon (talk) 16:28, 9 October 2021 (UTC)

You're wrong about how Wikipedia works. Controversial edits that are challenged do not get added until a consensus is reached on the talk-page. What I noted about the author's 4 statements in the abstract are not personal opinions. It's a fact, not an opinion, that the author in his own summary of his work does not claim a causal connection between statistics on abortion and mental health problems. It's also a fact, not an opinion, that the term "associated which" is often misunderstood by the public to imply a causal connection. NightHeron (talk) 17:27, 9 October 2021 (UTC)

On this one point "There is suggestive evidence that abortion may be associated with small to moderate increases in risks of some mental health problems."[48] Even with two uncertainty modifiers in one sentence, I am happy that with the statistics quoted in the abstract "Abortion is statistically associated with higher rates of mental illness" is a fair summary of this one paper. It may not however be a fair summary of the subject as a whole. Dushan Jugum (talk) 23:03, 10 October 2021 (UTC)

The trouble with the sentence "Abortion is statistically associated with higher rates of mental illness" is that its context and meaning are not clear. Does it mean that those women who decide to get an abortion are slightly more likely to have a mental illness than those who do not get an abortion? Does it mean that for a small number of women the experience of an abortion adversely affects their mental health? Does it mean that mental illness is slightly more likely to occur if the woman has an abortion than if she carries the unwanted pregnancy to term? Does it mean that abortion results in more women with symptoms of depression than does normal childbirth (i.e., Postpartum depression)? The term "associated with" is too vague to be informative. NightHeron (talk) 23:33, 10 October 2021 (UTC)

Sometimes the science is vague, we should still report it. However (watch as I subtly change my mind) by putting a correlation on this page we are assuming/implying a causation. And without more information the reader is almost forced to pick their subconsciousness favorite of the options you gave. I am still in favor of the current/original wording of the section, without these new refs. Dushan Jugum (talk) 23:53, 10 October 2021 (UTC)

There is no justification for excluding these new references. They are peer reviewed, reliable sources that are newer than the sources currently cited. They are also required by WP:DUE. The concern that readers may misunderstand what "statistically significant" means can and should be addressed by adding material to explain it rather than hiding the fact that these effects are statistically significantly related to abortion. I believe this is adequately explained in the following text. Please propose how it can be improved.

Abortion is statistically associated with higher rates of mental illness,[1][2] both in general and relative to women who carry unplanned pregnancies to term.[3] While there is also agreement that negative emotions are common after an abortion, and that abortion can contribute to pre-existing mental health issues, the primary dispute is over when, if ever, abortion is the sole cause of subsequent mental health issues.[1] For example, the 2008 report by the American Psychological Association Task Force on Mental Health and Abortion concluded that while while some women "experience clinically significant disorders, including depression and anxiety"[4] the most likely explanation for the higher rates of mental illness observed among women who abort are pre-existing risk factors, including prior mental health problems. Subsequent research, however, has revealed that the higher rates of mental health issues seen among women who have abortions cannot be fully explained by prior mental health issues, and that there is also a dose effect, with each abortion contributing to increased risk.[1][2][3]

As noted, there is no policy justification for blocking the addition of new reliable sources, especially when they are newer than previously cited sources. Rather than make ideologically driven edits, editors should work together to edit the new material in a way that most properly explains the material, including the caveats, such as the distinction between an event, such as abortion, contributing to mental illness versus being the sole cause of mental illness.--Saranoon (talk) 16:58, 11 October 2021 (UTC)

Just because you disagree with the policy based justifications to prefer the current version does not mean they do not exist. - MrOllie (talk) 17:52, 11 October 2021 (UTC)

Improper removal of tag

See WP:MAINTENANCEDISAGREEMENT which makes clear it is improper to remove a tag if "The issue has not yet been resolved;" or "There is ongoing activity or discussion related to the template issue;"

Clearly there is an ongoing discussion. Moreover, it is clear that those opposed to adding material based on the more updated reliable secondary I have cited are violating WP:DUE. It is especially inappropriate to remove a tag calling attention to the dispute within minutes of it being posted. The whole point of tags is to invite wider participation by editors. --Saranoon (talk) 17:33, 11 October 2021 (UTC)

You might benefit from a read of WP:1AM. - MrOllie (talk) 17:40, 11 October 2021 (UTC)

Straw poll on tag

It seems only one editor is in favor of including the proposed content. That said, this page has many more watchers than participants in this conversation. While discussion continues on whether to include the new material, should we Keep the disputed section tag or Remove it? Firefangledfeathers (talk) 17:12, 11 October 2021 (UTC)

• Remove (as the proposer) as editors have good-faith, policy-based concerns about the reliability of the sourcing and the presentation of the material. WP:ONUS is on Saranoon to build consensus for inclusion. Firefangledfeathers (talk) 17:12, 11 October 2021 (UTC)
• Keep I have sought to add three peer reviewed, highly reliable sources: https://journals.sagepub.com/doi/10.1177/2050312118807624, and https://journals.sagepub.com/doi/10.1177/2050312116665997, and https://journals.sagepub.com/doi/10.1177/2050312116665997 which have not been given WP:DUE representation in this section. The editors opposing these changes have not raised any policy arguments to justify the exclusion of these sources. If one looks at WP:MEDRS there is also a clear preference for updating articles to reflect more recent review articles, which applies in this case. The purpose of tags, such as this one, is to invite editors to review the talk page and participate in the discussion and editing. This premature effort to delete the tag runs counter to the whole goal of increasing the involvement of editors and appears to be driven by an inappropriate ownership behavior WP:OWNBEHAVIOR. My edits serve the goal of improving and updating the article to reflect a large body of more recent research.--Saranoon (talk) 17:41, 11 October 2021 (UTC)
• Remove. The template says: Relevant discussion may be found on Talk:Abortion. Please help to ensure that disputed statements are reliably sourced. This is misleading, because the talk-page discussion has been about WP:RS and WP:DUE as applied to the sources for Saranoon's disputed edit, not the sources for the stable version of the section on mental health. When one editor wants to make changes in a section and their edits are disputed, that does not justify placing a tag that questions the sourcing of the stable version of the section. NightHeron (talk) 17:46, 11 October 2021 (UTC)
• Remove. Maintenance tags aren't a way for one editor to register their disagreement. - MrOllie (talk) 17:50, 11 October 2021 (UTC)
• Remove. And lets talk about how "Current evidence finds no relationship between most induced abortions and mental health problems"(Wikipedia) conflicts with "Abortion may be statistically associated with higher rates of mental illness"(published paper). Dushan Jugum (talk) 19:22, 11 October 2021 (UTC)
• Remove. - Which I have just done. I agree with MrOllie. Tags aren't what you get to put somewhere where you have lost the Talk page discussion. ---Avatar317^(talk) 22:27, 11 October 2021 (UTC)
• Comment This controversy is related to a previous one. I hope editors can come to a decision about how to define "risk", see the end of the discussion at Talk:Abortion#Repeated_abortions_and_pre-term_birth. The way the article is currently written entails multiple understandings of risk vs. correlation; the sense used is different in different parts of the article. It includes both the medical definition of risk, which can include mere statistically significant association without assurance of causation, and the ordinary, popular audience definition of risk in which direct causation is always implied. I could go either way, but I want the article to be consistent with using either one sense of risk or the other throughout the article.--Epiphyllumlover (talk) 00:40, 26 October 2021 (UTC)

Reverted edits based on primary source

Per WP:MEDPRI, I reverted edits based on a single primary study. The study in question is actually a good example of why WP:MEDRS says not to use a primary study as the only source for medical content. The source is used in the edit to say that low-income women in the US, who are more likely than high-income women to have multiple abortions, are also more susceptible to maternal mortality. But correlation is not causation. Low-income women in the US generally receive worse medical care and have worse outcomes than high-income women. If the same women carried multiple pregnancies to term, they would also undoubtedly be more susceptible to maternal mortality than high-income women. The Charlotte Lozier Institute that funded the study is an anti-abortion think tank founded in 2011 [...] dedicated to electing candidates and pursuing policies that will reduce and ultimately end abortion.[49] NightHeron (talk) 11:14, 8 August 2021 (UTC)

I think this paragraph should be included following the paragraph starting with "In the US from 2000 to 2009, abortion had...":

Low-income women in the United States whose first pregnancy ended in abortion are considerably more likely to undergo subsequent abortions and also to experience an increased number pregnancies over their lifetimes. In contrast, women whose first pregnancy ended in birth or miscarriage tend to have subsequent live births and a lower total number of lifetime pregnancies. The additional number of pregnancies in women undergoing repeated abortions results in an increased overall risk of maternal mortality compared to other women.< ref >{ { cite journal|last1=Studnicki|first1=James|last2=Fisher|first2=John W.|last3=Reardon|first3=David C. |last4=Craver |first4=Christopher |last5=Reardon|first5=Tessa |last6=Harrison |first6=Donna J. |title=Pregnancy Outcome Patterns of Medicaid-Eligible Women, 1999-2014: A National Prospective Longitudinal Study |journal=Health Services Research and Managerial Epidemiology |date=2020|volume=7|issue=1|pages=1–10|pmid=32844103|doi=10.1177/2333392820941348 } }< /ref >

Possibly information from this study could also be included: Estimating the Period Prevalence of Mothers Who Have Abortions: A Population Based Study of Inclusive Pregnancy Outcomes

This does not violate WP:MEDRS, because it does not contradict the existing sources. None of the existing sources discuss the effect of a first-pregnancy abortion on choices made during subsequent pregnancies. This study does not question the finding that individual abortions have a statistically lower maternal mortality. Possibly some clarification to this effect could be made to the disputed paragraph.

The study compared low-income women to each other; the women having repeated abortions were not necessarily any different in their income levels than those giving birth.

The results of the study are biologically plausible because pregnancies ending in abortion are usually shorter than full term. So it makes sense that a group of women having abortions will have more total pregnancies over their lifetimes. In contrast, getting pregnant and not having an abortion typically prevents subsequent pregnancy for 9 months (unless it ends in miscarriage or an early stillbirth). The overall spacing between pregnancies could be longer if birth is followed by lactational amenorrhea or contraception intended to space out births. Abortion might be followed by contraception, but not lactational amenorrhea.

As for the quality of the source, it can't be any more partisan than Guttmacher Institute. The data came from Medicaid and the journal is a peer-reviewed source.--Epiphyllumlover (talk) 18:11, 8 August 2021 (UTC)

I think you're misunderstanding the reason for reverting the edit. The reason why it violated WP:MEDRS was not because it contradicted other sources, but because it's a primary study (not a secondary source) being used as the only source for medical content. The second study you want to use is also a primary source funded by the same anti-abortion think-tank and written by mostly the same authors as the first primary study. NightHeron (talk) 22:28, 8 August 2021 (UTC)

Pregnancy has a carve out to the general rule you discuss. The table at Wikipedia:Biomedical_information#The_best_type_of_source says "As these are often overlooked areas, check every type of source." For Causes, Mechanism, and Diagnosis I agree the journal article is insufficient. (The journal article contained some psychological speculation about possible causes for why some women undergo subsequent abortions. In accord with the table, I did not summarize that in the paragraph.)

Pregnancy outcome statistics falls under "Pregnancy" in the table and the journal qualifies for the article as a kind of "every type of source". Also cross reference Wikipedia:Identifying_reliable_sources_(medicine)#Biomedical_journals; such journals are not forbidden and the guideline states, "Any text that relies on primary sources should usually have minimal weight, only describe conclusions made by the source, and describe these findings so clearly that any editor can check the sourcing without the need for specialist knowledge. Primary sources should never be cited in support of a conclusion that is not clearly made by the authors". Also consider that the journal article itself is not the "basis" for the content; rather Medicaid is the basis.--Epiphyllumlover (talk) 01:27, 9 August 2021 (UTC)

First, check every type of source does not mean you should use every type of source or that you should ignore MEDPRI. Using those questionable primary sources to support a statement about medical risks from abortion would be incompatible with "minimal weight". The dramatically worded conclusion increased risk of maternal mortality is given without context. Compared to what? Compared to women who don't have unwanted pregnancies? Compared to women who use contraception? Compared to women who are better educated and have more stability in their lives? Compared to women who have better overall access to medical care, including prenatal care? NightHeron (talk) 01:43, 9 August 2021 (UTC)

I am comfortable with rewording the paragraph. The increased risk of maternal mortality is for women who have more pregnancies over their lifetime; when compared to those who have less pregnancies. The study relies on the existing understanding that lifetime maternal mortality corresponds to the number of pregnancies. (More pregnancies means higher mortality.) This is already a known (and self-evident) fact no matter which income level researchers are concerned with. If you need a reliable source for it anyway, this table will do. The article also cites another article which states that abortions are associated with negative health outcomes: Pregnancy associated death in record linkage studies relative to delivery, termination of pregnancy, and natural losses: A systematic review with a narrative synthesis and meta-analysis. This cited article (which I am not proposing to cite or rely on for the Wikipedia Abortion article) states

Of 989 studies, 11 studies from three countries reported mortality rates associated with termination of pregnancy, miscarriage or failed pregnancy. Within a year of their pregnancy outcomes, women experiencing a pregnancy loss are over twice as likely to die compared to women giving birth. The heightened risk is apparent within 180 days and remains elevated for many years. There is a dose effect, with exposure to each pregnancy loss associated with increasing risk of death.

Besides this, it is also established that mothers have lower mortality than childless women; see Childlessness, parental mortality and psychiatric illness: a natural experiment based on in vitro fertility treatment and adoption.

So one question is why? This National Prospective Longitudinal Study answers the question in terms of the total number of pregnancies experienced. The statistics in the article demonstrate that (US, low-income) women who have subsequent abortions have, as a group, a higher number of pregnancies when compared to (US, low-income) women who undergo childbirth, stillbirth, or miscarriage. There is discussion of this in the article, along with the implication for overall lifetime maternal mortality. Since being low-income is already a risk factor, it makes sense for a study with implications for maternal mortality to focus on low-income women. If it focused on high-income women, the findings would be less significant because high-income women are less likely to die from pregnancy-related complications. The article discusses this:

There are limitations related to the use of Medicaid claims data. Medicaid-eligible beneficiaries are by definition financially disadvantaged and are not representative of all women experiencing abortion. Conversely, a data set composed entirely of low-income women may also be considered an advantage since results are unlikely to be explained by differences in income or other factors strongly associated with income.

The reverted paragraph could be clarified; would you like to rewrite the paragraph?

I am not disregarding MEDPRI; I am applying it in the way it was intended to by the writers of the various WP pages (as best as I can tell). The carve out is there for a reason, that pregnancy is "often overlooked". The concern with "minimal weight" does not apply in this case because there are no contradicting secondary or tertiary sources to weigh it against. If there were, the "minimal weight" designation would be a demerit for this particular source. Additionally, the article not so large that items of minimal importance must be axed for size purposes.--Epiphyllumlover (talk) 03:45, 9 August 2021 (UTC)

My objection to your paragraph from the beginning has been to the quality of the source. As I said at the beginning of this thread, it's a good example of why WP:MEDPRI cautions against using only primary sources for medical content. The source contains no data on maternal mortality. It does not report maternal mortality rates of the women at all, let alone compare two groups. The "conclusion" section where they mention maternal mortality and the paragraph of the text where they explain their reasoning are speculative.

The issue of maternal mortality is complicated, due to many confounding factors. You correctly pointed out that all the women they studied are low-income (because they're Medicaid recipients). However, the material circumstances (e.g. stable job or not), social and personal status (e.g., stable marriage vs a series of abusive boyfriends), sex education level (e.g., use of contraceptives), access to medical care (including prenatal care), and many other factors vary hugely within that group. And of course "low income" ranges from lower-middle class to homeless & indigent.

Implicit in your proposed paragraph is the claim that a woman is ill-advised to abort her initial pregnancy, because it is likely to lead to many later abortions and a higher risk of maternal mortality. But there's no reason to think that a woman who aborts her initial pregnancy is facing the same circumstances as the average woman who carries her first pregnancy to term (or has a miscarriage). Her alternative to abortion is likely to involve significant hardships (financial, psychological, and possibly medical) that she has to weigh against the negative consequences of abortion (such as the difficulty of access in many parts of the US, the possibility of harassment by anti-abortion demostrators at the clinic, and, in the case of a late abortion, greater likelihood of miscarriage in future pregnancies). She also faces a higher (though still small) probability of maternal mortality if she brings the pregnancy to term, especially if she does not get adequate prenatal care, than if she gets an abortion (especially if it's an early abortion).

The speculation about maternal mortality in your primary source over-simplifies a complicated situation, and it's misleading. The authors had a clear interest in including it, because their funding source was obviously eager to see a strong statement about health dangers to women who abort.

I don't see how, based on the sources you've proposed, you or I can rewrite the paragraph to bring it up to Wikipedia standards. We'd have to be careful to adhere to WP:NOR and WP:MEDRS, without over-simplifying the issue. NightHeron (talk) 11:08, 9 August 2021 (UTC)

"In contrast, women whose first pregnancy ended in birth or miscarriage tend to have subsequent live births and a lower total number of lifetime pregnancies." Interesting premise, but do we have medical or sociological data concerning the number of lifetime pregnancies in the life of the average woman? Did the study use a sample of the population? Dimadick (talk) 13:33, 9 August 2021 (UTC)

The researchers used Medicaid statistics for 17 states for a 15-year period. 7,388,842 pregnancies for 4,966,549 women were included in the study; which limited itself to five pregnancies per woman. Pregnancies 6 and up were not included in the study. They separated the women by the outcome of the first known pregnancy; 421,011 women started with an abortion, 3,807,694 with a live birth, 449,182 with a miscarriage or stillbirth, and with 288,662 listed as undetermined.

The reason the researchers could only use data from 17 states is because only these seventeen used their funds to pay for (or mostly pay for) abortions. Due to the Hyde Amendment, most abortions are not funded by the federal government, so the statistics are incomplete for the other 33 states. They did a literature search for existing demographic study or similar type studies but "found no published research".--Epiphyllumlover (talk) 15:36, 9 August 2021 (UTC)

NightHeron, the confounding variables you describe are the same ones which confound the "14 times higher risk of death in the United States" statement already in the article. If you can include that statement; you can also include results from this study.--Epiphyllumlover (talk) 15:42, 9 August 2021 (UTC)

The 14-times-safer statistic is based on a direct comparison of mortality rates from live births vs abortion for US women from all demographic groups. If there is any substantial difference in the confounding variables between the average woman having a live birth and the average woman having an abortion, it would be that an abortion is often motivated by financial worries, job insecurities, or an unstable personal situation, and this would suggest that the average abortion is associated with a woman who is more disadvantaged than the average woman having a live birth. This would imply that the 14-times-safer statistic somewhat understates the true situation, and if you controlled for socioeconomic status it would be more than 14.

In contrast, what you want to include is not based on a direct comparison. The authors make an indirect inference. Moreover, the confounding variables undermine their conclusion. If we take the confounding variables into account, the sources give no reason to think that the average woman with an unwanted first pregnancy will encounter greater risk of maternal mortality then or later in life if she aborts than if she carries to term. NightHeron (talk) 20:55, 9 August 2021 (UTC)

Your list has the same confounding variables which affect the National Prospective Longitudinal Study. To be consistent, include both statistical analyses, or neither. As for inferences; the frequency of pregnancies and the correlation of the first pregnancy outcome are not indirect inferences. They could be reported in the article without a discussion of the impact on mortality.--Epiphyllumlover (talk) 22:57, 9 August 2021 (UTC)

I thought the issue we were discussing was reliability of the statement about maternal mortality. There's also an indirect inference being made that having one's first pregnancy end in abortion causes more frequent future unwanted pregnancies than carrying one's first pregnancy to term. That is not obvious. It could be that the main causal variable is use of contraceptives. That is, a woman whose first pregnancy is planned rather than unwanted is much more likely to be using contraceptives. The same woman will have few unwanted pregnancies in the future. It could be that some women rely on abortion to end unwanted pregnancies, while others prevent them by using contraceptives. I'm not familiar with the sources, but I imagine there would be sources that say that the use of repeated abortions in lieu of contraceptives is a bad idea and often has adverse health consequences for the woman (such as inability to carry a pregnancy to term later in life when she wants a child). NightHeron (talk) 23:48, 9 August 2021 (UTC)

I am okay omitting the statement about statement about maternal mortality if you prefer. Looked for studies on repeated abortions; found this on mice and this article has a good section on "Predictors of repeated abortion". This study links repeated abortions with uterine cancer. In this study, the likelihood of getting a repeated abortion is associated with the type of birth control used, and in this study it is linked to SES and demographic factors. This public health document states "Repeated abortions can cause damage to your cervix and increase the risk of early labours. (pre-term labours)".

Another aspect is that any single abortion, especially if incomplete, poses the risk of infection, which in turn can lead to pelvic inflammatory disease and endometriosis. There is academic literature linking single abortions to both pelvic inflammatory disease and endometriosis, but I didn't find any for repeat procedures.--Epiphyllumlover (talk) 16:24, 10 August 2021 (UTC)

The article cites RS confirming that a legal abortion carried out by a qualified person is extremely safe. The "incomplete" abortions you're talking about are essentially botched illegal abortions.

If you have sources that discuss the negative consequences when failure to use contraceptives or the use of low-quality contraceptives leads to repeated abortions, or when repeated abortions are used in lieu of contraception, please suggest a new sentence or paragraph about that. I don't know the sources, but I'm pretty sure that medical consensus would view the use of contraceptives as far preferable to repeated abortions. Organizations that are concerned with access to contraceptives, such as the Gates Foundation, have also argued that an advantage of improved access to contraception is a reduction in the number of women who resort to repeated abortions. NightHeron (talk) 17:39, 10 August 2021 (UTC)

I will work on rewording the paragraph, and also go through the links I put in the above comment to see if they can contribute. I found this: The rate of incomplete abortions depends on the type of method used: "The reported rate of such complications is less than 1 percent after a D&E; whereas, following a labor induction procedure, the rate may be as high as 36 percent."

On top of that, not all uteruses are the same shape. Some may be harder to operate on, especially if the procedure is not ultrasound-guided. So even if the risk is less than 1%, it appears more likely that a woman with one incomplete abortion will also have subsequent incomplete abortions.--Epiphyllumlover (talk) 19:37, 10 August 2021 (UTC)

Can I ask how you ended up with the Louisiana Department of Health, and with the Studnick article, as your preferred sources? Neither one comes to mind if I were to start out looking for the best possible sources on the topic. Not to put too fine a point on it, but my concern is that you have specific points you want the article to make, and are casting around for sources that might support your agenda. In general, it's best to start by looking for the highest-quality sources and then follow where they lead, especially on politically controversial topics like this one. MastCell ^Talk 19:52, 10 August 2021 (UTC)

The recent plethora of links were ones I had just come across on searches for the health effects of repeated abortions when writing the response, and not vetted much or at all. I don't expect they will all make it into a revised paragraph. I should note that "labor induction procedure" means a medical rather than surgical abortion. The risk of an incomplete abortion when taking misoprostol is 36%; if follow-up appointments are kept by the patient, the 36% will get surgical attention ASAP. If not, then an infection, endometritis, and/or Asherman syndrome become likely complications.

One difficulty is missed follow-up appointments; such patients are more likely to end up in a bad state and are taken to the ER: Abortion-related emergency department visits in the United States: An analysis of a national emergency department sample--Epiphyllumlover (talk) 23:48, 11 August 2021 (UTC)

What?

• First of all, "labor induction procedure" does not does not mean a medical abortion. It refers to an abortion performed in the 2nd or 3rd trimester via labor induction.
• Secondly, medical abortion typically involves a combination of mifepristone and misoprostol, with a completion rate of >95% ([50]); it's misleading to quote a failure rate for single-agent misoprostol when that it not how medication abortions are typically performed.
• Finally, the article you quote about ED visits makes clear that the vast majority (~80%) of ED visits are for minor issues (not because women are in "a bad state"), and nowhere does it invoke missed follow-up visits (in fact, the article suggests that anti-abortion efforts to close down clinics and limit access may lead to these ED visits).

I don't expect you to know everything, of course, but that's a lot of glaring errors for a single post. Given that abortion is a topic where medical misinformation abounds, I'm asking you not to continue contributing to its spread. MastCell ^Talk 01:36, 12 August 2021 (UTC)

Thank you for explaining; yes I was confusing the use of medication in the second trimester with the use in the first trimester. This is a good source explaining it. I was confused because even though it is not called "labor induction", misoprostol alone even in the first trimester is able to cause labor. Not everyone will experience labor in the first trimester though.--Epiphyllumlover (talk) 02:55, 12 August 2021 (UTC)

Repeated abortions and pre-term birth

I found this meta-analysis article which links repeated abortions to preterm birth: "The risk increased as the number of I-TOP increased." I-top is induced termination of pregnancy. Is this brief mention, cited to the study, a suitable addition to the existing paragraph on abortion and pre-term birth?

The risk of subsequent pre-term birth increases for each prior abortion.[###]

--Epiphyllumlover (talk) 03:43, 12 August 2021 (UTC)

It has been nine days since I suggested adding "The risk of subsequent pre-term birth increases for each prior abortion.[###]" to the article. Seeing no response one way or the other so far, I am willing go ahead on the basis of Wikipedia:Silence and consensus and add it to the article. I will reword it as "The risk of subsequent pre-term birth increases for each additional prior abortion.[###]"--Epiphyllumlover (talk) 21:28, 21 August 2021 (UTC)

There already is a brief discussion of the issue of risk of preterm birth after a prior abortion, and the sources for that discussion (sources 106 and 107) are more recent than the metastudy you're proposing to use (2016 and 2017 as opposed to 2009). I think that your proposed added sentence, based on a 12-year-old source, would give undue attention to a safety issue that's much less clearcut and much less significant that some other ones. NightHeron (talk) 22:32, 21 August 2021 (UTC)

I am of the opinion that the proposed source for the comment, although older, is a higher quality source than the metastudy currently cited for the discussion of preterm birth and prior abortion. Could the comment be added as an efn note?--Epiphyllumlover (talk) 23:29, 21 August 2021 (UTC)

It appears that the 2009 metastudy established a small but significant correlation between multiple prior abortions and preterm live birth, but without controlling for factors that likely go along with multiple abortions (such as lower socio-economic class); hence, no conclusion can be drawn about causality (although the authors speculate about possible causal mechanisms). So any efn would have to be stated carefully, e.g., "small but significant correlation" without stating or suggesting causality. NightHeron (talk) 23:50, 21 August 2021 (UTC)

Medical scholarship discussing this study would not require the additional caveat. On the other hand, doctors already know that in this sort of think "risk" implies "correlation". WP is written for a general audience. Here is a proposed revised version: "Their appears to be a greater correlation of subsequent pre-term birth for each additional prior abortion.[###]" This will satisfy my request. But then you'd need to be consistent: The same is true for maternal mortality; we only have a relatively low degree of evidence that a full term pregnancy actually causes higher maternal mortality than abortion. There are some variables that can't be controlled for; this is the nature of a great deal of medical research. So the phrase in the article "higher risk of death in the United States" could be rephrased to "greater correlation with maternal death in the United States".--Epiphyllumlover (talk) 01:31, 22 August 2021 (UTC)

The two types of statistics have very different contexts. There's an obvious confounding factor in the case of women with multiple abortions, who are likely not to be using contraception, are likely to have instability/insecurity in their lives, are likely to be of lower socio-economic class, are likely to be less well-educated, and are likely to get less consistent prenatal care when they do have a live birth. In contrast, can you think of any confounding factor that would explain (or partially explain) the greater maternal mortality for pregnancies carried to term than for abortion? How would the average woman giving live birth be disadvantaged (in health) compared to the average woman having an abortion? In statistical studies, you don't have to control for everything, only for differences that could skew the results.

I agree with you that we need to think of the average reader. She is likely to interpret a statement about greater risk as something she should weigh (against the medical or psychological risks of having an unwanted child) in deciding whether to have an abortion. That's why abortion opponents in some US states have (successfully) lobbied for laws requiring doctors to give exaggerated and false warnings before authorizing an abortion. Wikipedia should not play that role, per WP:NPOV. Any statement about abortion risk, especially if what's really meant is a small unexplained correlation, must be made carefully. NightHeron (talk) 08:53, 22 August 2021 (UTC)

Some confounding factors for the 14x risk stat:

1. Data is collected differently. Birth data is more complete; the quality of the abortion statistics is lower because it is generated from voluntary response surveys submitted to abortion providers. I have looked for and cannot find a 14x risk described for a European county with a single-payer system which includes both births and abortions. Such data is of higher quality. Additionally, the GI data is not broken down by state, while maternal mortality data is available for each state: There is a 14x difference in maternal mortality between Louisiana and California. (California's low rate has been has been attributed to the CCMQCC program, which among other things worked to improve treatments given for preeclampsia and hemorrhage.) So it follows that childbirth is 14x safer in California... to extend this to the absurd, a Louisiana woman who is advised that abortion is 14x safer might also be advised to move to California to become 14x safer. On the not-so-absurd side, it seems highly unlikely that abortion is 14x safer in both California and Louisiana at the same time.

2. The "Healthy Pregnant Woman effect", when it shows up in European figures, appears to be cumulative per each birth; mothers weighing birth vs. abortion who already have children will likely have less risk due to this. Why this effect? One factor could be due to the fact that in the last generation, a greater proportion of firstborn babies are conceived out of wedlock compared to subsequent births. Subsequent births are more likely to due to married mothers. Because marital rates and the median total lifetime children born to each woman differ considerably throughout the US, the "Healthy Pregnant Woman effect" is unlikely to be consistent throughout the US.

3. In particular, rural areas see a considerably higher percentage of women with 2 births and 3 or more births, while urban areas see a higher percentage of childless women. Figures for mothers with one child are similar for both areas. Another factor is that the fertility gap between rural and urban has increased in the last generation (the 14x ratio came from 1998-2005 data). Meanwhile, the ratio of pregnancies ending in abortion is higher in urban areas than rural areas. I don't know about rural vs. urban abortion mortality, but US maternal mortality is higher for rural areas than for urban areas. There are also considerable maternal mortality differences between states; some states have figures comparable to third world countries; others are comparable to first world countries. There is not necessarily a predictable pattern; West Virginia and Alabama are not terribly wealthy, yet have low maternal mortality rates, meanwhile New Jersey is one of the wealthier states yet has a higher maternal mortality rate.

4. Another factor is that women who have abortions are less likely to have a subsequent birth, while women who have births are less likely to have a subsequent abortion. This is part of why, in the US, the median maternal age for births is higher than that of abortions. Additionally, some of the maternal mortality attributed to births is due to the increased risk that is actually from prior abortions which made the subsequent births less safe. Preterm birth and placenta previa are both associated with higher maternal mortality.

5. Somewhere around 1 percent of births are home births; in the US there are no home abortions. It is unknown what difference home birth vs. hospital birth makes for maternal mortality. The 14x comparison included home births, but not home surgical abortions, which are not legal in the US.

6. There are other factors besides what I just explained, and maternal mortality factors may be considerably different in other countries. In China, the demographics are different than the US. From my limited reading on it, Chinese women having abortions are more likely than US women to be older and already mothers. So if the 14x risk figure is only a correlation with weak evidence in the US and a variety of confounding factors, in China it is unlikely to be a helpful comparison figure. I'm not sure if the risk ratio is higher or lower in China. Also, US maternal mortality, although similar to Canada's figures, is more than double for most other wealthy countries. So the 14x figure is also likely to be an unhelpful comparison figure for a number of other English speaking countries. Why are the US figures so different? Factors could include a proportionally smaller maternal care workforce in the US, larger travel distances to health care providers, and a lack of paid maternity leave with less postnatal healthcare. I suppose a majority of the readership is US, so this somewhat makes up for the outlier aspect of the US mortality data. It does not make for it all the way.

So how much of the 14x risk difference comes from factors #1-5? It is not possible to know, and if the article article includes a caveat about the risk of subsequent pre-term birth for each additional prior abortion, then it should word the 14x risk factor in an equivalent manner.--Epiphyllumlover (talk) 17:07, 22 August 2021 (UTC)

Have you read the article to which the 14x figure is sourced? Here's what it says about the likely direction of any inaccuracy:

These results may underestimate the relative safety of choosing abortion over continuing a pregnancy for two reasons. First, our comparison was limited to live births; we omitted other pregnancy outcomes: spontaneous abortion, stillbirths, ectopic pregnancies, and gestational trophoblastic disease. The number of pregnancies ending in these outcomes was not available. Stillbirths and ectopic pregnancies are associated with higher risks of death than is live birth. We likely therefore underestimated the mortality associated with opting for pregnancy continuation.

Second, patients undergoing abortion appear to be at higher underlying risk than women who opt for delivery. Women who had abortions were more likely to be African American or unmarried, demographic characteristics strongly associated with increased mortality. In addition, because comorbidities are sometimes the motivation for abortion, the underlying medical risk of patients undergoing abortion may be higher than that of other pregnant women. Women in good health may be more likely to choose to continue their pregnancies than those who are ill (selection bias termed the "healthy mother" effect). Thus, mortality among patients undergoing abortion may overestimate the mortality risk of the procedure itself.

The authors also comment that, over time, abortions are becoming safer, largely because of the increasing use of early medical abortion (which can often be done at home, contradicting your point #5). Meanwhile, in the US pregnancy carried to term is becoming more risky because of increased obesity and increased delivery by Caesarian section. Since the 14x figure was based on data from 1998-2005, the current figure is probably greater.

Concerning your specific points:

1. The authors got their figure for deaths from abortion from the CDC, and used Guttmacher surveys only for an estimate of the total number of abortions. If, as you say, the latter data were incomplete, that would mean that the true number of abortions is higher, and so the true value of deaths per 100,000 abortions is lower.

3. Your discussion of rural vs urban abortions fails to account for contraception. A decision by an urban woman not to have children or to limit family size likely means that she'll use contraception rather than repeated abortion. In general, compared to rural women in the US, urban women have better sex education, more access to contraceptives, and more possibility to purchase them anonymously.

Some of your points are not directly related to the issue at hand. The 14x figure is an aggregate figure (not state-by-state), and is only for the US. That's clearly stated in the article. If the 14x figure needs any caveat at all (I don't think it does), it is that the true figure is probably greater than 14x. NightHeron (talk) 23:04, 22 August 2021 (UTC)

I did not read the whole thing; but expecting me to is moving the goalposts; you had asked "In contrast, can you think of any confounding factor that would explain (or partially explain) the greater maternal mortality for pregnancies carried to term than for abortion?" so that is what I looked into.

Urban women are more likely to use both abortion and contraception; both patterns make sense because urban women have more access to health care in general. Meanwhile a disproportionate number of births are occurring to women in rural areas, which are not as well served by health care in general. Pretty much any medical event is safer when you are closer to a hospital--the percentage of road fatalities goes up the further away you get from a level IV trauma center. This is a confounding factor because it would be best to compare compare rural abortions to rural births, and urban abortions to urban births. Comparing national figures gives you births that are more rural and abortions that are more urban.

It has been suggested in the medical literature by authors who are not a fan of abortion rights that the CDC abortion risk data was incomplete and tended to under-report. I also came across a reputable medical review that is overall supportive of abortion rights, yet characterized the evidence for modern surgical abortion's safety as "low". The problems with CDC maternal mortality figures are similar to the problem with CDC abortion deaths figures, and are described in some detail here. So it is not just me finding faults.

The spread in maternal mortality between CA and LA is 14x; it doesn't make sense to expect abortion to follow this same trend and be a consistent 14x difference from state to state. A hypothetical analogy: Say that I cited a national average that SUVs are 14x safer than sedans, but ignored that the sedans driven in different states are on average wildly different years, makes and models. A low-income state like South Dakota has a lot of old beaters, while the (hypothetical) sedans in high-income New York are newer and mostly outfitted with the latest semi-autonomous safety devices. Say the spread for fatalities between the state with the worst sedans and the the state with the safest sedans is 14x. Wouldn't it be misleading in an article to say that SUVs are 14x safer than sedans, when the intra-state spread between sedan safety itself is 14x? If an SUV dealer in New York put up ads that sedans were 14x more dangerous, wouldn't a sedan dealer object to that?

I should add that the study dealing with the 14x risk was put out before CA figures improved so much.

If the 14x figure doesn't need a caveat, then "The risk of subsequent pre-term birth increases for each additional prior abortion.[###]" does not require a caveat either.--Epiphyllumlover (talk) 04:00, 23 August 2021 (UTC)

You're just not making any logical argument for the claim that the 14x figure is too high. I looked at your link to the Vox article that starts out "We finally have a more accurate estimate" of the US maternal mortality rate. The new figure is 17.4 per 100,000. Our source for the 14x figure used 8.8 maternal deaths per 100,000 known live births (see their Table 1). The new figure is higher both because the data-gathering has improved and because the incidence of maternal mortality has been going up. If our source for the 14x figure had been able to use the recent "more accurate estimate" for maternal mortality, the danger from live birth divided by the danger from abortion would have been twice as great, that is, about 28x. NightHeron (talk) 10:24, 23 August 2021 (UTC)

I'm making claims concerning the need for a caveat. We don't yet know why US maternal mortality has risen nationally; it is possible that mortality due to abortions has also risen, but we don't know that. Either the 14x claim needs a caveat, or the "The risk of subsequent pre-term birth increases for each additional prior abortion.[###]" does not. Otherwise the article will be inconsistent in how it interprets medical data.--Epiphyllumlover (talk) 11:56, 23 August 2021 (UTC)

Our source for the 14x figure further says that "the relative safety of abortion has increased substantially since the first decade after nationwide legalization, when child birth related mortality was approximately seven times the mortality related to abortion." So the figure doubled from 7x to 14x from the mid-1970s to 2005, and your source from Vox suggests that it may have doubled again from 14x to 28x between 2005 and now. I'd have no objection to a caveat stating that the true figure for relative abortion safety is probably higher than 14x, although I'm not proposing such a caveat, since I don't think it's necessary. NightHeron (talk) 12:24, 23 August 2021 (UTC)

I still have this article on my watchlist but usually don't edit it now because, since I started editing it, I've become an expert in the area and it gets frustrating to engage in these conversations where one person's ignorance and another's expertise are on the equal footing of the Internet. However, I want to call out some very enthusiastic logical jumps on the part of User:Epiphyllumlover, both here and in the placenta previa section. Thank you User:NightHeron for putting in the work on rebutting them. I agree with NightHeron's view that it would be reasonable but unnecessary to include a caveat that the 14x is likely an underestimate. EpiphyllumLover, there isn't meaningful debate in the ob/gyn community over whether abortion or continued gestation is safer, and your list of confounding factors doesn't hold water. On the other hand, it's obviously clear that risk factors for a person choosing to have an abortion go hand-in-hand with risk factors for preterm birth, like low socioeconomic status.

I've attempted to engage with your car analogy but have ultimately found it too flawed to engage with. Suffice to say, pregnancies aren't cars.

I'm unlikely to be an active participant in this conversation, for the reasons I've endeavored to be polite about, above. I'll let you know if your arguments move me and I change my mind, and I'll step in if you're claiming consensus. Triacylglyceride (talk) 16:29, 23 August 2021 (UTC)

I agree that confounding factors can work in both directions, but I'd expect it to be a state-by-state phenomenon rather than a national 28x trend line sort of thing. That is, it seems plausible that abortion may be less than 14x safer in California, and more in Louisiana.

The question is whether one add in the word "corresponds" and omit the word "risk" in "The risk of subsequent pre-term birth increases for each additional prior abortion.[###]" . I am looking for opinions whether the article should treat the meta-analysis article in question with similar caveat/lack of caveat as The comparative safety of legal induced abortion and childbirth in the United States. I am of the opinion that as long as the results of the second link are stated as "risk" instead of "corresponds", one should use similar language when describing the results of the the meta-analysis article.--Epiphyllumlover (talk) 19:32, 23 August 2021 (UTC)

You keep raising the point that the 14x statistic is an aggregate figure for the whole US, whereas "it seems plausible that abortion may be less than 14x safer in California, and more in Louisiana." No one has responded to that particular point for a good reason: it's totally irrelevant. Since the 14x figure is almost certainly an under-estimate and the true value could easily be as high as 28x, for the sake of argument let's suppose that in Louisiana it's the higher figure, and in California it's only half of the lower figure: 28x as opposed to 7x. So what? The misinformation circulated by anti-abortion groups who try to convince women that the decision to abort rather than carry to term entails extra risks is a blatant falsehood in California as well as Louisiana and other states. No one is misled by seeing the well-sourced aggregate statistic for the US. NightHeron (talk) 21:07, 23 August 2021 (UTC)

The spread between the states, just from the size of the spread, reinforces the concerns some have in the accuracy of the underlying stats and the degree of confidence that should be placed in them.

Will you accept "The risk of subsequent pre-term birth increases for each additional prior abortion.[###]" as is?--Epiphyllumlover (talk) 15:55, 24 August 2021 (UTC)

In response to your first paragraph, what you say applies to virtually all aggregate statistics. Are you saying that Wikipedia should not carry statistics for whole nations? The same argument would also imply that we shouldn't carry statistics for whole US states either. Statistics (regarding abortion or almost anything else) are likely to vary widely between different counties of California. And between different cities in a county.

In response to your second paragraph, the problem with your proposed sentence is that its tone wrongly suggests that multiple abortions are causally responsible for likely preterm births. The truth of the matter is that there is a small but statistically significant correlation between multiple abortions and preterm births, but all or part of the explanation could be certain correlates with multiple abortions, such as low socio-economic status, less access to prenatal care, or underlying health problems. So any statement about risk has to be phrased much more tentatively, with an appropriate caveat. NightHeron (talk) 20:11, 24 August 2021 (UTC)

Some aggregate statistics have a higher spread than others. That the spread is high & there are already known issues with the data (for explanation, see the Vox article I linked to earlier; the study that found the 14x risk erroneously claimed the CDC stats to be a strength rather than a weakness) leads to questions about how much of the spread could be from extraneous factors. The study finding a 14x risk correctly acknowledged likely underreporting of deaths both due to birth and abortion. Some of the 14x spread between individual states could plausibly be related to better or worse reporting systems.

If it is okay to use the word "risk" instead of "correlation" for the 14x claim, than it is okay to do it here. The 14x claim also appears to attribute causality--yet there may be both some direct causality (which I do not doubt, given that infection & blood loss can directly kill), and some of it may be due to confounding factors like the ones I listed earlier. When "The Comparative Safety of Legal Induced Abortion and Childbirth in the United States" says "risk of death" it means it in the scholarly, medical sense of the word "risk"; a sense that is not exclusive to direct causation. An example of this sort of medical speak can be found in this study about men with ED. It says that the "risk of dying was 1.4 times higher" even though everyone knows that ED itself cannot cause death.

The issue with the readers' understanding vs. the professional use of "risk" with both articles is really the same issue; it should be decided consistently throughout the entire article.--Epiphyllumlover (talk) 23:12, 24 August 2021 (UTC)

We seem to be repeating ourselves and going around in circles. Let's suspend this debate, and wait to see if other editors want to comment. At this time there's certainly no consensus to add your proposed text. See, for example, the above expert comments by Triacylglyceride. NightHeron (talk) 00:13, 25 August 2021 (UTC)

I disagree with suspending the conversation, and instead request a reply to "The issue with the readers' understanding vs. the professional use of "risk" with both articles is really the same issue; it should be decided consistently throughout the entire article". First, can you agree with the need to use and consider the terms "risk" and "correlation" consistently throughout the article? Then, if so, how does this apply to the proposed addition? (I understand you may not accept the proposed addition for other reasons; but we can work through the issues more gradually than before, and perhaps avoid circular conversations).--Epiphyllumlover (talk) 22:14, 25 August 2021 (UTC)

I agree with NightHeron and Triacylglyceride that the 2009 meta-analysis does not warrant changing the article text. Not only is the meta-analysis itself older than the current citations on preterm birth, none of the the studies that it analyzes are less than 20 years old. Many are from the 1960s and 70s. As the meta-analysis authors themselves point out, and as anyone with any expertise in this area could tell you (if you would let them), these old studies do not reflect innovations that have improved the safety of abortion care. I do not support your proposed new sentence. SeeJaneEdit (talk) 23:16, 25 August 2021 (UTC)

SeeJaneEdit, can you weigh in on the general principal of the issue with the readers' understanding vs. the professional use of "risk"?

I came across a letter in a medical journal from someone in the UK about how to to reduce the likelihood of cervical damage during surgery, which is one of the proposed ways that abortion causes subsequent pre-term birth. Very tentatively from what I've seen, it seems that his is an isolated effort, and most have not adopted his procedures.

Even if abortion is safer now than when the studies were conducted, wouldn't the pattern of more abortions = more risk of preterm birth still hold up, just at a weaker level?--Epiphyllumlover (talk) 20:45, 26 August 2021 (UTC)

Epiphyllumlover, your two questions seem largely dependent on the medical journal letter that you mention. I do not feel that I can begin to weigh in without seeing it. SeeJaneEdit (talk) 15:41, 30 August 2021 (UTC)

It was over a year ago when I saw it; I looked again and did not find it. It was a specific protocol for cervical priming. But I came across Cervical dilation before first-trimester surgical abortion, which generally takes a stance against cervical priming. For the cause & effect relationship, see Cervical length for prediction of preterm birth in women with multiple prior induced abortions. The medical scholarship supports cervical preparation for second-trimester abortion ([51], [52]) but there are conflicting opinions about first trimester abortion. Some of the procedures involved in cervical preparation appear to increase the overall time needed to perform an abortion, perhaps considerably. In place of that missing source, Cervical priming with misoprostol before manual vacuum aspiration versus electric vacuum aspiration for first-trimester surgical abortion is another example of an experimental protocol for first trimester cervical preparation.--Epiphyllumlover (talk) 13:59, 5 September 2021 (UTC)

SeeJaneEdit, is that enough background for you to answer the two questions?--Epiphyllumlover (talk) 20:53, 18 October 2021 (UTC)

This discussion is related to the " "Safe" is subjective " discussion below.--Epiphyllumlover (talk) 15:26, 11 December 2021 (UTC)

Risk of placenta previa

This review article links a prior abortion to an increased risk of placenta previa. This seems significant enough to include in the article; although it is not about repeated abortions.--Epiphyllumlover (talk) 00:14, 12 August 2021 (UTC)

Your edit (reverted by another editor) was misleading, because it failed to distinguish between an early abortion (hardly likely to lead to placenta previa) and a late abortion. Note that the surrounding discussion of safety does make it clear that it's not talking about early medical abortion. From the introduction to your 2nd source: Placenta praevia is associated with previous uterine scar, smoking, maternal age over 35 years, grandmultiparity, recurrent miscarriages, low socioeconomic status, infertility treatment, previous curettage, previous myomectomy, previous uterine surgery, submucous myoma, Asherman's syndrome, a short caesarean- or curettage-to-conception interval.

Please reach a consensus on the talk-page before adding tendentious material to the article. NightHeron (talk) 01:06, 12 August 2021 (UTC)

I mentioned it on the comment above. No one responded, I listed it in a brief manner similar to the longstanding description of the association on the Placenta praevia article. It had been there probably for years; it is certainly not "tendentious". If you want to improve it, go ahead and revise it somehow. The edit was:

A prior abortion increases the risk of placenta praevia in subsequent pregnancies.< ref >{ { cite journal|last1=Karami |first1=Manoochehr | last2=Jenabi|first2=Ensiyeh|title=Placenta previa after prior abortion: a meta-analysis |date=28 July 2017|journal=Biomedical Research and Therapy|volume=4|issue=7|page=1441–1450|url=http://www.bmrat.org/index.php/BMRAT/article/view/197%7Cdoi=10.15419/bmrat.v4i07.197%7Cpmid=9396896%7Cdoi-access=free } }< /ref >< ref name=Pal2013 >{ { cite journal|last1=Palacios-Jaraquemada|first1=JM|title=Caesarean section in cases of placenta praevia and accreta.|journal=Best Practice & Research. Clinical Obstetrics & Gynaecology|date=April 2013|volume=27|issue=2|pages=221–32|doi=10.1016/j.bpobgyn.2012.10.003|pmid=23127895 } }< /ref >

--Epiphyllumlover (talk) 02:36, 12 August 2021 (UTC)

In the meta-analysis article it does not distinguish between early or late term. It states "increased risk of placenta previa after prior spontaneous abortions (2.0; 95% CI: 1.7, 2.3)" which is a slightly stronger correlation than with induced abortions. 80% percent of spontaneous abortions are first trimester. From this it appears that early abortions can lead to placenta previa too.--Epiphyllumlover (talk) 02:45, 12 August 2021 (UTC)

Early abortions (usually medical abortions, not surgical ones) are very different from late abortions and from spontaneous abortions. Even for spontaneous abortions, what you say doesn't follow. There is no statistical reason why the risk couldn't come from the 20% late ones.

One indication of the weakness of your sources is that they don't distinguish between different types of induced abortion or between different gestational stages.

There are good reasons why WP:MEDRS insists on high standards for sources for medical content. Otherwise, readers could be given misleading information that they could even take as medical advice (e.g., to avoid certain things, such as a vaccine or an early abortion, because of risks that in reality are miniscule). NightHeron (talk) 10:16, 12 August 2021 (UTC)

Induced abortion: a risk factor for placenta previa specifically looked at early term, but it is from 1981. That may or may not be relevant here. Maybe in 1981, sharp curettage was more prevalent than now. So the correlation showed up back in 1981 but it could be different now if methods have changed?

The increased risk of placenta previa may be from the scarring or damage due to infection. Since both of these can happen from an early trimester abortion, it makes sense that a first trimester abortion could still increase the risk of placenta previa.--Epiphyllumlover (talk) 19:49, 12 August 2021 (UTC)

I don't think that the average reader of this article would benefit from reading what User:Epiphyllumlover conjectures a first trimester abortion "could" increase the risk of. "Maybe in 1981, sharp curettage was more prevalent than now" -- after many deleted sentences here the best I can do is "why don't you go look that up and come back when you know?" I express gratitude for User:NightHeron's pushing back on these proposed edits with a more polite tone than I can manage, and second MastCell's earlier expression of surprise at the poor understanding of the subject Epiphyllumlover displayed.

I encourage Epiphyllumlover (and everybody!) not to misuse terms like "early term" (37w-38w6d) or "late term" (41w-41w6d) or use non-terms like "early trimester" (there are only three! Why not say first?), and instead use terms that unambiguously show how many weeks gestation you mean. Triacylglyceride (talk) 16:29, 23 August 2021 (UTC)

Transcluded from Talk:Placenta praevia:

I think this article should be used as a reference in this article: < ref >{ { cite journal|last1=Karami |first1=Manoochehr | last2=Jenabi|first2=Ensiyeh|title=Placenta previa after prior abortion: a meta-analysis |date=28 July 2017|journal=Biomedical Research and Therapy|volume=4|issue=7|page=1441–1450|url=http://www.bmrat.org/index.php/BMRAT/article/view/197 } }< /ref > --Epiphyllumlover (talk) 21:04, 13 August 2021 (UTC)

This source was discussed at Talk:Abortion, where editors objected on several grounds: first, that The Vietnamese Journal of Biomedicine is a rarely cited minor journal with an unknown reputation; second, that the article fails to distinguish between different types of abortion and different gestational stages (that is, between early medical abortion and late surgical abortion); fourth, that it over-simplifies a complex issue; and, fifth, that correlation does not mean causation. NightHeron (talk) 22:16, 13 August 2021 (UTC)

It is a meta-analysis; it is not uncommon for a meta-analyses to omit the sort of details you list. As a rule they are more general in scope than the articles they use data from. However, the individual studies on the topic do address these issues. Just because it doesn't include the specific details you mention does not mean it "fails" as a legitimate review article for the purposes of the medical content policy.

I looked through other articles of the Vietnamese Journal of Biomedicine; it is a credible journal of the sort usually used as a reliable source on Wikipedia and is not a crackpot publication.

On the other talk page, you have not yet responded to the specific study I cited which discussed the association between placenta previa and early surgical abortion alone.

Probable mechanisms for this effect are discussed in the existing academic literature. It is not an overly complex topic, although it is not firmly nailed down yet.--Epiphyllumlover (talk) 00:52, 14 August 2021 (UTC)

I don't think a debate here between the two of us, largely running over the same ground, would be productive. This discussion should continue at Talk:Abortion, where it is likely to get input from more editors than here. Note that before our edits during the last 2 days there had been a total of 14 edits to this talk-page since 2008, an average of 1 edit per year. NightHeron (talk) 01:11, 14 August 2021 (UTC)

Instead I think each article warrants its own discussion, & if you don't want to have two conversations I don't mind if you use a transclusion template to combine them.--Epiphyllumlover (talk) 04:02, 14 August 2021 (UTC)

Greenbot added the reflist-talk template, but I don't think it did anything.--Epiphyllumlover (talk) 01:18, 15 September 2021 (UTC)

I looked up more about sharp curettage, and it appears that its frequency is about the same then as now.--Epiphyllumlover (talk) 21:00, 18 October 2021 (UTC)

References

This discussion is related to the " "Safe" is subjective " discussion below.--Epiphyllumlover (talk) 15:27, 11 December 2021 (UTC)

Top hatnote

I believe the top hatnote ({{Other uses|Abortion (disambiguation)}}) should be changed to either:

{{Other uses}}, because it already gives the disambiguation page in the first place, or,

{{Other uses|Abort (disambiguation)}}, because the page it leads to is Abort (disambiguation) --The Tips of Apmh 15:54, 16 December 2021 (UTC)

"Safe" is subjective

How exactly can an abortion be referred to as "safe" in Wikipedia's voice? This seems to violate WP:NPOV. DeaconShotFire (talk) 22:16, 2 October 2021 (UTC)

"Safe" is not subjective if one says what one means by it, e.g., safer than childbirth. The term is what's used in reliable sources, and Wikipedia follows those sources. Opinions have to be attributed, but facts can be in wikivoice if properly sourced. NightHeron (talk) 22:45, 2 October 2021 (UTC)

"safe abortion" seems to be used to mean professional or legal abortion, which is not a perfect match, but if neutral reliable sources use this term in this way I am happy. I had a brief look at the Vaccination page, I am happy we are consistent enough. Given that nothing is ever 100% safe, I think, the word 'safe' always means safer to some extent. Dushan Jugum (talk) 23:25, 2 October 2021 (UTC)

The article needs an article-wide standard about what exactly is meant by terms like "risk" and "safety". This could even be discussed in the article as an aside in an existing section. Then when/if the terms are used in the article, they could be used consistently throughout.--Epiphyllumlover (talk) 15:30, 11 December 2021 (UTC)

I am not sure safe is the correct term, it seems that it is fatal for %50 percent of the individuals involved? The lead seems to put undue weight on how safe the procedure is WP:RSUW half of the paragraphs talk about how safe it is. The lead should stick to facts related to the description of the process and summarize the article MOS:LEAD. There is a section dedicated to the "safety" of the procedure so I think mentioning it is appropriate, but when half of the paragraphs talk about it and it is only 1 of 8 sections it leads me to believe that bias and an agenda is in play.Tepkunset (talk) 16:27, 6 January 2022 (UTC)

@Tepkunset: are you able to make changes to the article directly? If so, go ahead in lines with your comment and what DeaconShotFire wrote. In my past history editing this article and talk page, making an edit to the article itself has seemed to be the best way to start out proposing something new or different. It might get reverted; if so your version will be reflected in the edit history. I can paste it here and we can talk it out. If you are not able to edit the article directly, Wikipedia:Edit requests explains the procedure for making a formal, specific request on the talk page.--Epiphyllumlover (talk) 21:01, 6 January 2022 (UTC)

The coverage of safety is not undue, because, as in any medical procedure, a central concern is safety of the procedure for the patient, in this case the pregnant woman. Despite the evidence from MEDRS sources that abortion is extremely safe when legal and carried out by qualified health care providers, this assertion is disputed by many in the anti-abortion movement. That's another reason why the issue deserves extensive coverage here. In the third place, the safety of legal abortions is in marked contrast to the dangers from illegal abortions, which are a major cause of maternal mortality in countries that ban abortion. I don't think you're going to get a consensus of editors to reduce the coverage of safety.

Nor is it likely that a consensus of editors will agree that safe is the wrong term. But if you want, we could have a simple yes-or-no RfC on whether or not safe and safety, as used in this article, are the correct terms. NightHeron (talk) 21:24, 6 January 2022 (UTC)

@NightHeron: From what I have gathered reading the referenced "medical studies" the stated purpose was to provide lawmakers with information to make laws. So from the get go this is political. The research is also only focused on death not complications. So saying the risk of dying from getting an abortion from a legit doctor is 1 in 100,000 is ok. Stating that 35 out of 1,000 women have complications and need to return to the doctor is also true, does that seem "safe" the risk is 3,500 times greater, but you won't die so it is safe? So again What is SAFE? That is why I don't like using the term safe and would prefer the term "Risk of X out of Y times". As far as overweighting the lead with "safety" I have Zero problem with a sentence stating the risk is x out of y for procedures performed in a "legit" location vs risk of x2 out y2 for illicit procedures. Then in the safety section (should change to Risks) talk about what the risks are and how "safe" it is compared to other procedures.

I think And RFC would be appropriate on the term safe, that is a good idea. Tepkunset (talk) 15:28, 7 January 2022 (UTC)

Flawed Data

The article on abortion states that abortion is 14 times safer than childbirth, which is something I'd like to address. The website cited for this claim Raymond and Grimes is very misleading. Visit this website to learn more; https://www.hli.org/resources/abortion-really-safer-childbirth/ — Preceding unsigned comment added by 69.246.86.82 (talk) 05:11, 2 December 2021 (UTC)

Please take a look at our reliable sources policy. An advocacy source like HLI can't be used to counter a peer-reviewed medical journal article. Firefangledfeathers 05:15, 2 December 2021 (UTC)

This concern is related to broader issue that "risk" is employed in inconsistent manners in the article. Another problem with the 14x safer claim is that American statistics are inherently less complete than European ones from countries with single-payer health care systems. The 14x safer claim relies on American statistics, while it would be better to use studies relying on European statistics instead. It would not be necessary to use a survey article, since the medical content policy has a carve out for pregnancy-related articles; content can be supported by individual studies instead.--Epiphyllumlover (talk) 15:37, 11 December 2021 (UTC)

What "carve out for pregnancy-related articles" are you referring to? Can you give a link to the relevant Wikipedia "carve out" policy? Thank you. NightHeron (talk) 15:54, 11 December 2021 (UTC)

The general principle remains that higher quality sources, when they exist should be used instead of lower quality sources. This is why European-derived safety data is preferable to American. For the carve out, my previous comment was

Pregnancy has a carve out to the general rule you discuss. The table at Wikipedia:Biomedical_information#The_best_type_of_source says "As these are often overlooked areas, check every type of source." For Causes, Mechanism, and Diagnosis I agree the journal article is insufficient. (The journal article contained some psychological speculation about possible causes for why some women undergo subsequent abortions. In accord with the table, I did not summarize that in the paragraph.)

Pregnancy outcome statistics falls under "Pregnancy" in the table and the journal qualifies for the article as a kind of "every type of source". Also cross reference Wikipedia:Identifying_reliable_sources_(medicine)#Biomedical_journals; such journals are not forbidden and the guideline states, "Any text that relies on primary sources should usually have minimal weight, only describe conclusions made by the source, and describe these findings so clearly that any editor can check the sourcing without the need for specialist knowledge. Primary sources should never be cited in support of a conclusion that is not clearly made by the authors". Also consider that the journal article itself is not the "basis" for the content; rather Medicaid is the basis.

Abortion as a topic is a subset of the topic of pregnancy.--Epiphyllumlover (talk) 20:38, 12 December 2021 (UTC)

First of all, abortion is a subset of the topic of health and medicine, and so Wikipedia policies such as WP:MEDRS apply. In the second place, in the table you link to the relevant line is Outcomes, where it says Look for review articles for statistics, and textbooks for general information. The line for "populations" (where pregnant women, children, and the elderly are examples) would apply to related demographic or sociological information, not the medical outcomes of continuing or terminating pregnancy. If you dispute that, I would suggest that we ask for help in resolving this sourcing issue at WP:WikiProject Medicine. NightHeron (talk) 23:37, 12 December 2021 (UTC)

Wouldn't the study of Medicaid data count as related demographic or sociological information? It looks at lifetime behavior patterns among a large population.--Epiphyllumlover (talk) 19:57, 7 January 2022 (UTC)