Talk:Birth control/GA3

GA Review
The edit link for this section can be used to add comments to the review.''

Reviewer: Hildabast (talk · contribs) 23:26, 12 July 2013 (UTC)

I've started the process of reviewing this article. I've not been involved with this article previously. (talk) 23:26, 12 July 2013 (UTC)

The lists below are being added to incrementally as I go through the article. It is close to being ready, but there are some things that are needed first.

Things to address to be a GA

 * Needs a few sentences on birth-spacing, contraception after birth (including lactation)
 * We state "Birth control also improves child survival in the developing world by lengthening the time between pregnancies.[6] In this population outcomes are worse when a mother gets pregnant within eighteen months of a previous delivery.[6][96]" already. We discuss breast feeding both with respect to how it decreases fertility and what birth control is safe "progestin-only pills may improve menstrual symptoms and can be used by breast-feeding women as they do not affect milk production." Will add some about contraception after birth. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:08, 13 July 2013 (UTC)
 * Looking at my notes about this, it came about because the phrase is used in the introduction, and then never again. This happened because I'd skimmed it, then did some searching within text. I thought it would save time, but I think it's going to waste your time instead. I should go through the whole thing carefully before making comments. Hildabast (talk) 21:57, 16 July 2013 (UTC)


 * The table in methods needs to be right as it will influence people's beliefs: many are listed as being worse with perfect use - it would be a good idea to check each number again too, since it looks as though something went wrong there.
 * I do not see any in the table that are listed as worse with perfect use? Can you clarify. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:08, 13 July 2013 (UTC)
 * Groan - it was me - I transcribed some backwards when cross-checking between table and text. Hildabast (talk) 21:57, 16 July 2013 (UTC)
 * Yes I rephrase a lot of stuff to avoid issues of plagiarism. Thus some of the terms are not entirely standard. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:44, 26 July 2013 (UTC)


 * Needs to refer to peri-menopausal issues: when birth control is no longer needed, menopause for women who've been on the pill for decades. Although this could wait for FA too. Shouldn't be held up over just this. — Preceding unsigned comment added by Hildabast (talk • contribs) 17:13, 13 July 2013 (UTC)
 * Added paragraph on special populations to the lead that addresses this. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:24, 14 July 2013 (UTC)


 * IUDs: I'll make additional specific remarks here, but a major problem is that it describes the North American situation only, in terms of what kind there are. The WP on intrauterine contraceptive devices down in the text shows there are other types and shapes, and the German WP has a good picture of the commonly used copper-gold T-shaped device with filament removal strings (that list bit is a translation of the description). That one is so widely used, it needs a mention and picture.
 * Have added the image here  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:17, 13 July 2013 (UTC)
 * The WHO document just discusses the two general types. While there are three general types per here  the inert form is hardly used anymore and thus IMO need not be mentioned in this overview article. All the copper and hormone IUDs are T shaped so the description given in this article would apply to the issue globally.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 13:00, 14 July 2013 (UTC)
 * No, sorry, that's wrong. If you look at the German WP page, or even the English WP, you'll see they talk about other types. Here's a Cochrane review of frameless (which isn't a T) versus framed (which is a T). Here are the various Gynefix IUDs in Belgium, and in Germany. Note there's also the multiload in those links (that just wasn't the subject of that review). Here's the Copper-7 and the multiload at a medical expo in Germany. I'm not sure if the companies that couldn't sell their copper-7s in the US went on to sell them internationally, but that would be normal, too. Here you can buy a German-manufactured multiload off Alibaba. I'm not saying that the T-shaped isn't the dominant one - only that it is not the only one. The IUD-specific WP pages make that clear too. Hildabast (talk) 21:57, 16 July 2013 (UTC)
 * Yes you are indeed correct. I have changed it to "usually small't"-shaped devices". THe less common shapes can be dealt with on the subpage. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 08:07, 17 July 2013 (UTC)


 * Consider including links to the 3 relevant WHO Reproductive Health Library instructional videos (laparoscopic tubes, vasectomy and IUD insertion).
 * IMO these videos would be best on the subpage dealing with the specific technique in question. Rather than within an overview article. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:55, 13 July 2013 (UTC)

Things that could be addressed now or in future to make it better than GA

 * The table in methods should be based on strong evidence, that can be updated as knowledge improves
 * Most of it is based on this textbook which is reffed in the heading of the table. We can switch it over to the MMWR  which I have done mostly.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:04, 13 July 2013 (UTC)

GA Review 2
Firstly, I'd like to acknowledge that I've had no role in creating or editing this article. This is an important article and I'm glad to see that it's at a stage where GA is considered. LT90001 (talk) 03:36, 31 August 2013 (UTC)

General Comments
I would like to make some general comments and then delve into specifics.


 * This article is comprehensive and that is great, however it's very hard to follow because terminology regarding failure rates and pregnancy rates and first-year pregnancy rates and effectiveness are constantly interchanged. If one term could be agreed upon (for example "first-year pregnancy rates") and used throughout the article, this would make it much more readable.
 * Good idea and change a bunch. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:18, 3 September 2013 (UTC)


 * This claim is made several times: “Condoms have the additional benefit of preventing sexually transmitted infections.[9]” In my understanding diseases such as pubic lice are often considered sexually transmitted, and not prevented by condoms. It might be more accurate to say that the majority of STDs are prevented.
 * Removed duplication in the lead leaving the wording "help prevent" Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:18, 3 September 2013 (UTC)


 * This article alternates between 'birth control' and 'contraception' terminology.
 * Yes we should only use contraception once in the lead but birth control otherwise as it is simplier. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:18, 3 September 2013 (UTC)
 * Looks good. LT90001 (talk) 08:22, 5 September 2013 (UTC)


 * "theoretical use" could be replaced with "best practice use" to standardise terminology when dealing with use in theory / vs. in practice.
 * Were was this term used? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:18, 3 September 2013 (UTC)
 * Oh, now it's disappeared! I was referring to the abstinence section, but now it's very clear. LT90001 (talk) 08:22, 5 September 2013 (UTC)

Lede

 * This statement "Contraceptive use in developing countries has decreased the number of maternal deaths by 40…" should move to the end of the lede, as there is additional information about the use and effectiveness of contraception there, and also the conventional structure is introduction -> methods/tools/procedures -> effectiveness /utility.
 * Sure Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:29, 3 September 2013 (UTC)


 * "Some people regard sexual abstinence as birth control", "some people regard" could be removed.
 * Removed "people" Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:29, 3 September 2013 (UTC)


 * Suggest: “In teenagers, pregnancies are at greater risk of poor outcomes (full stop). Comprehensive sex education and access to birth control decreases the rate of unwanted pregnancies in this age group.[12][13]”
 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:29, 3 September 2013 (UTC)


 * "After the delivery of a child (comma) a women (woman) who is not exclusively breast-feeding may become pregnant again as early as four to six weeks."
 * Done. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:29, 3 September 2013 (UTC)

Methods

 * When referring to the effectiveness of a method of contraception, this is given in at least four places: lede, introduction to methods, the table, and the section itself. Perhaps some trimming of the lede and introduction to methods section could decrease the redundancy and possibility for confusion.
 * No numbers are given in the lead (methods are only briefly compared to each other). The lead should also not contain anything that is not in the body of the text. We have the info summarized in a table. Will move some discussion from the lead of the methods section to the subsections. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:42, 3 September 2013 (UTC)


 * "While all methods of contraception carry some risk, the risk is less than that of pregnancy.[24]" meaning of 'risk' is unclear. I thought pregnancy was an effective method of contraception? (against a second pregnancy)
 * Clarified risk to "potential adverse effects" This is referring to stuff like blood clots and death. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:38, 3 September 2013 (UTC)


 * Sentence "In those with specific health problems, certain forms of birth control may require further investigations.[30] " should be moved to top of paragraph, as it gives some context to the paragraph's topic.
 * Agree Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:38, 3 September 2013 (UTC)

Hormonal

 * First para: formats -> forms.
 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:57, 3 September 2013 (UTC)


 * do not -> neither (neither/nor)
 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:57, 3 September 2013 (UTC)


 * "however, the risk is less than that associated with pregnancy" I don't think this is relevant in this article about contraception.
 * When one looks at the risks of any medication one must compare it to a control group. The control group is not a non pregnant state but a potentially pregnant state. Thus the comparison to the risk that occur in pregnancy is key (pregnancy increase both the risk of blood clots and the risk of death in the mother). This refutes those who argue against birth control as it can cause blood clots. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:57, 3 September 2013 (UTC)
 * Whether or not I agree with this point won't affect the article quality, so I'm willing to demur. LT90001 (talk) 07:55, 5 September 2013 (UTC)


 * "not associated with an increased risk of blood clots" perhaps could be worded "whislt not increased with an increased risk of blood clots in veins, there is a slight increase in the risk of blood clots in arteries." As you do go on to state there is a risk of arterial thromboembolism.
 * Clarified. Progestin only BC other than the injectable version may be used. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:57, 3 September 2013 (UTC)
 * Yep, I note that this paragraph has changed and reads much clearer. LT90001 (talk) 07:55, 5 September 2013 (UTC)

Barrier

 * "Globally condoms" -> "globally, condoms"
 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:15, 3 September 2013 (UTC)


 * "Male condoms and the diaphragm with spermicide have similar typical use first-year failure rates (15% and 16%, respectively), with perfect usage of the condom being more effective (2% first-year failure vs 6%).[15] Condoms have the additional benefit of helping to prevent the spread of sexually transmitted infections such as HIV/AIDS.[9]" just to reiterate, this is where it starts to get confusing with pregnancy/failure rates first-year is and isn't mentioned, and also the STD prevention thing I mentioned above.
 * Okay added "some STIs". Adjusted the working of the first bit. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:15, 3 September 2013 (UTC)

IUDs

 * First sentence "which is" is redundant
 * You sure? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:23, 3 September 2013 (UTC)


 * Statement "They are a form of long-acting reversible contraception, and the most effective type of reversible birth control.[51]" is confusing. In the table you state that implanon is the most effective (0.05%). In the text you state that the most effective methods are surgery (which you state is somewhat reversible)
 * Surgery is not considered a reversible form of contraception. But agree and removed. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:23, 3 September 2013 (UTC)


 * You state here "As of 2007, IUDs are the most widely used form of reversible contraception, with more than 180 million users worldwide.[59] " but then state "The most common method in the developed world is condoms and oral contraceptives, while in Africa it is oral contraceptives and in Latin America and Asia it is sterilization"
 * Sterilization is not deemed to be reversible and thus is out of the calculation.
 * This leave the situation were in the developed world condoms and the pill are first and second followed by the IUD in third. In the developing world sterilization is first but out of the equation. Condoms are used in Africa but not so much elsewhere. Overall IUDs are the most common reversible method because 2.5 billion people live in India and China were usage is high. Thus globally in all countries the IUD is most. Can send you the table if you want. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:23, 3 September 2013 (UTC)
 * How interesting! Would love to have a look. LT90001 (talk) 07:58, 5 September 2013 (UTC)

Sterilisation

 * "Short term complications are less likely from a vasectomy than a tubal ligation.[15] " does not provide any information about the likelihood or type of side-effects.


 * Added details. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:58, 4 September 2013 (UTC)


 * "Some women regret the decision: about 5% over 30 years old, and about 20% under 30 years old.[15]" no time period or definition for 'reget' is given. "Regret following sterilization in men is less common comma at less than 5% comma with risk factors including younger age, an unstable marriage, and young children or no children.[61]" perhaps could be written -> "Whilst men are less likely to regret sterilsation than women (<5%), younger men, those with young or no children, or men with an unstable marriage were more likely to regret the procedure.""
 * The ref does not define a time period. The studies have looked at up to 28 years afterwords. http://www.ncbi.nlm.nih.gov/pubmed/16413851 Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:58, 4 September 2013 (UTC)
 * Doesn't read that well. Suggest: "This decision may cause regret in some men and women. Of women who over 30 years old who have undergone hysterectomy, about 5% regret their decision, as compared with 20% of women under 30 years old." and -> "In contrast, less than 5% of men are likely to regret sterilization. Men more likely to regret the sterilisation are younger, have young or no children, or have an unstable marriage.[64] In one survey of men who had undergone vascetomy who have previously had children, 9% stated they would not have had any children if they were able to do it over again.[65]" LT90001 (talk) 08:20, 5 September 2013 (UTC)
 * Changed the first bit. The 9% is of parents who have had children. Not necessarily those who have had a vasectomy. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:08, 5 September 2013 (UTC)


 * "In one survey of those who have children, 9% stated they would not have children again if they were able to do it over again.[62]" Not sure what you mean here. In parents who have vascectomies, 9% wish they had it earlier?
 * Of people who have kids 9% wish they hadn't. Clarified. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:58, 4 September 2013 (UTC)
 * Hah, surprised it's that low! (said with a grain of salt) LT90001 (talk) 08:20, 5 September 2013 (UTC)


 * "In women the desire for a reversal is often due to a change in spouse.[63]" due to -> associated with
 * Changed. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:58, 4 September 2013 (UTC)


 * " Rates of success in fathering another child are between 38 and 84%" (in one year or in total); being lower overall ("overall" is a tautology here) in those in which a greater time has passed from the original procedure.[64]
 * Lifetime. Adjusted the working. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:58, 4 September 2013 (UTC)


 * "Sperm extraction followed by in vitro fertilization may also be an option in men.[65]" suggest move to article about vascectomy as this is a bit too much detail (birth control -> contraception -> sterilisation -> reversal of sterilisation -> strategies to mitigate).
 * Just one sentence. This is separate from reversal. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:58, 4 September 2013 (UTC)
 * Fair enough. LT90001 (talk) 08:20, 5 September 2013 (UTC)

Behavioural

 * Suggest move "The withdrawal method, ... however, is poor.[66]" to the part about withdrawal to ensure there is no duplication or minor contradiction (as there is now)


 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:28, 4 September 2013 (UTC)


 * Suggest remove statement in Fertility awareness: "They are used by about 3.6% of couples.[68] " No comparative % rates are provided in other methods regarding use. If retain, suggest add "worldwide"
 * Added global. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:21, 5 September 2013 (UTC)


 * "between 1 " -> "1%"
 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:28, 4 September 2013 (UTC)


 * Abstinence "compared to" -> "as compared with" (sorry, little bit of a grammar stickler)
 * Thanks and done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:28, 4 September 2013 (UTC)


 * "Non-penetrative sex and oral sex are also sometimes considered contraception" I think the intended meaning is "Additionally, to some teenagers the meaning of 'sex' may not include non-penetrative or oral sex". If I read this sentence literally, some teenagers think that oral sex is a method of preventing pregnancy: that is, prior to coitus, will have oral sex as a method of preventing pregnancy.
 * Clarified. Not entirely sure I understand. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:28, 4 September 2013 (UTC)
 * I still feel this is unclear. Perhaps you could add 'deliberate' to highlight the unspoken part about the motivation for non-penetrative sex, eg. "Deliberate non-penetrative sex without vaginal sex, or deliberate oral sex without vaginal sex, are sometimes considered methods of birth control." LT90001 (talk) 08:13, 5 September 2013 (UTC)
 * Sure Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:21, 5 September 2013 (UTC)


 * Lactation. statement "it is 98% effective in the six months following delivery.[84] " is inconsistent, as you have used one year or lifetime as the cutoff for effectiveness in other sections of this article, so this stat can't be used comparatively.
 * Yes this is one required exception. It is only effective for 6 months. It cannot be used up to a year. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:28, 4 September 2013 (UTC)


 * Sentence "In those who are exclusively breastfeeding, about 10% begin having periods before three months and 20% before six months.[85]" seems to be superseded by the comments on effectiveness above it.
 * Not sure what you mean? If one has a period it is no longer the LAM. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:28, 4 September 2013 (UTC)
 * The lactation section reads quite clearly now. LT90001 (talk) 08:13, 5 September 2013 (UTC)


 * Emergency. Another confusing stat: " 70% effective (pregnancy rate 2.2%) " So... the earlier readings about effectiveness are not the number of couples at one year who are not pregnant as compared with a couple having unprotected sex?
 * With emergency contraception one is looking at a single sexual encounter and not a year as use. EC is not used for an entire year. Have adjusted the wording.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:28, 4 September 2013 (UTC)
 * Yep, on reflection I think the confusing thing was that the pregnancy rate following a single sexual encounter is unstated, so I'm not quite sure what to make of the stated pregnancy rate. LT90001 (talk) 08:13, 5 September 2013 (UTC)
 * Added that bit in. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:21, 5 September 2013 (UTC)


 * "All methods have good safety and minimal side effects.[89]" suggest remove 'good safety', this is quite ambiguous
 * Minimal side effects is enough agree. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:28, 4 September 2013 (UTC)

Effects.

 * "In the developing world (comma) birth control secondary to (due to) there being fewer dependent children and thus more women participating in the workforce.[8]
 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:31, 4 September 2013 (UTC)


 * "for a C-section as of 2012" -> Caesarean section (or inter-wiki link)
 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:31, 4 September 2013 (UTC)

Prevalence
Very interesting section.
 * "Avoiding sex when fertile " could be reworded as "abstinence" in consideration of above sections
 * Abstinence is a more complicated word. Prefer to keep words simpler for translation purposes among others. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:41, 3 September 2013 (UTC)


 * Fair enough. LT90001 (talk) 07:45, 5 September 2013 (UTC)

Society and culture

 * "Effects required of governments include " -> "Governments are often required by ? to..." whether governments are forced to or voluntarily adopt measures is a little ambiguous here.
 * Adjusted wording. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:49, 4 September 2013 (UTC)


 * "If governments fail to do this it may put them in breach of binding international treaty obligations.[119]" should some obligations be noted?
 * Adjusted wording. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:49, 4 September 2013 (UTC)

Research

 * "Between 25 and 75% of males would use hormonal contraception if it was available for them.[141][108] -> sexually active males (?)
 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 14:41, 3 September 2013 (UTC)

Conclusion
This review satisfies the Good Article review criteria (WP:GACR) and has undergone a review process. With no objections, I have re-promoted it to GA status. With an annual estimated readership of 540,000, thanks to and previous editors for producing such an important and comprehensive article. LT90001 (talk) 10:31, 6 September 2013 (UTC)