Talk:Abortion/Archive 37

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Archive 35

Assessing the current agreement status

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

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

Question 1

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

"In representative developed countries, the risk of dying (from abortion) is no more than 1 in 100,000 procedures, lower than the relatively low risks associated with pregnancy and childbirth in these countries (The Alan Guttmacher Institute, 1999)"

Answers to question 1
yes

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

no

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

Mu

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

Question 2

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

The first suggestion:

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

or the second suggestion:

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

Answers to question 2

first suggestion

second suggestion

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

Neither

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Questions raised by Rexxs

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

Question 3: Do you agree that the section on Health risks should address the issues of developing countries with at least as much weight as developed countries?
yes

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

no

There is a separate section in this Wikipedia article already devoted to unsafe abortions.[1] Do other medical articles discuss how the procedure is frequently botched in underdeveloped countries? Even if that's a normal thing in medical articles, I feel that we already have a section in this article for such info.[2]Anythingyouwant (talk) 17:26, 14 June 2010 (UTC)
Unsafe abortion is closely linked to the legality and accessibility of abortion, rather than simple resource availability (a point made in numerous sources). Thus the issue takes on a dimension beyond that of, say, a "botched" appendectomy in a developing country. MastCell ^Talk 20:56, 14 June 2010 (UTC)

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

Question 4: Do you agree that the section on Health risks should address the issue of increasing rate of mortality from abortion as the pregnancy progresses?
yes

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

no

Question 5: Do you agree that the following text addresses the issues related to health risks of abortion better than the proposal above?

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

yes

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

no

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

Relevance of comparing to childbirth

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I'd suggest a read of:

Ronsmans C, Graham WJ (28 September 2006). "Maternal mortality: who, when, where, and why". Lancet. doi:10.1016/S0140-6736(06)69380-X.

LeadSongDog come howl! 20:57, 14 June 2010 (UTC)

Worldwide

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

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

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

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

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

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

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

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

We've spent a lot of time arguing about the precise wording about abortion risk in the developed world (which seems a bit silly, since ample sources exist to handle it in a short paragraph). But don't take that to mean that there is no interest in discussing the risk of unsafe abortion - in fact, the pathetic under-representation of such material was one of the major factors that motivated me to attempt a rewrite. MastCell ^Talk 17:43, 14 June 2010 (UTC)

The difference birth makes

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

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

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

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

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

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

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

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

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

That's multiply incorrect. First of all, most American states (38) have laws against elective third-trimester abortion ([5]). These laws have exceptions only for the life and (rarely) the health of the mother. You're also incorrect about their frequency - third-trimester abortions are extremely rare in the US. They constitute ~0.01% of all abortions in the US (according to Fox News). There are about 100 performed annually in the US (for comparison, there are about 400-600 lightning strikes per year in the US). The only sense in which late-term abortions are "common" in the US is as a talking point in the political debate. MastCell ^Talk 00:20, 12 June 2010 (UTC)

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

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

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

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

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

LMP?

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

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

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

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

Removal from the lead paragraph

I've reverted this edit [6] as it was made without consensus and apparently without reading either the preceding sentence or the source. Compare the edit summary with the source's summary... In recent years, more countries experienced a decline in legal abortion rates than an increase, among those for which statistics are complete and trend data are available. The most dramatic declines were in Eastern Europe and Central Asia, where rates remained among the highest in the world. The highest estimated levels were in Armenia, Azerbaijan and Georgia, where surveys indicate that women will have close to three abortions each on average in their lifetimes. The U.S. abortion rate dropped by 8% between 1996 and 2003, but remained higher than rates in many Northern and Western European countries. Rates increased in the Netherlands and New Zealand. The official abortion rate declined by 21% over seven years in China, which accounted for a third of the world's legal abortions in 1996. Trends in the abortion rate differed across age-groups in some countries. I trust that this revert will meet either with consent or discussion, rather than an edit war. SHEFFIELDSTEEL^TALK 15:00, 15 June 2010 (UTC)

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

I think the information should be kept, since many countries were mentioned, but it should be updated at least, since the trend has inverted: Among the 46 areas that reported data consistently during 1996--2006, decreases in the total reported number, rate, and ratio of abortions were attributable primarily to reductions before 2001. During 2005--2006, the total number and rate of abortions increased--Nutriveg (talk) 16:50, 15 June 2010 (UTC)

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

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

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

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

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

Facts first, or qualifications first?

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

Unsafe abortion: the preventable pandemic [7]
Induced abortion: an overview for internists [8]

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

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

I didn't see this before because the section title was not clear. We should follow the same order used by the source "legal abortion in industrialised nations has emerged as one of the safest procedures in contemporary medical practice",[9] So I disagree with your change.--Nutriveg (talk) 14:12, 16 June 2010 (UTC)

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

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

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

"in developed countries" is qualifying "abortion (procedure)", not "safest procedures in contemporary medical practice" which already carries a qualifier in itself "in contemporary medical practice". So the qualifier should be placed closer to the object of qualification, in the same order is the one used by the indicated source: "legal abortion in industrialised nations has emerged as one of the safest procedures in contemporary medical practice",[10]--Nutriveg (talk) 15:09, 18 June 2010 (UTC)

Lead

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

Organized and moved some content to subpages

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

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

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

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

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

Pic removal

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

They however do have an ultrasound image supposedly showing Jesus Christ [11]. Definitely fair and balanced. Doc James (talk · contribs · email) 20:34, 16 June 2010 (UTC)

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

Placenta previa

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

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

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

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

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

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

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

Then, your sources are convincing:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

You don't see that Paul:

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

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

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

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

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

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

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

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

More reliable references

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

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

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

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

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

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

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

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

(edit conflict) If it's any help:

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

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

(edit conflict)Reading what you posted.

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

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

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

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

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

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

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

Yanda

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

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

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

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

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

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

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

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

Having most additions of references I have added in an attempt to solve the ongoing debate removed I have posted at WP:3RR [12]. I will stop further editing of the main article / looking for references until this matter is resolved. I see no reason to search the literature in this environment. BTW that sentence is based on 6 excellent sources and the information is in all 6 of the sources. Doc James (talk · contribs · email) 21:40, 9 June 2010 (UTC)

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

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

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

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

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

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

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

Cites cleaned up

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

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

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

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

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

I checked the text of those references:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

First suggestion by Nutriveg

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

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

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

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

Arbitrary break 1

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

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

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

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

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

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

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

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

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

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

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

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

Exactly about what source? RexxS said:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

8. see 6

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

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

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

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

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

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

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

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

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

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

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

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

Another source

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

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

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

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

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

Rephrasing my earlier suggestion

Earlier I've said:

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

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

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

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

So this is the new proposed version:

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

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

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

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

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

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

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

So you want to replace the sentence:

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

with:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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