Talk:Medical abortion/Archive 1

Proposed Infobox for individual birth control method articles
Let's all work on reaching a consensus for a new infobox to be placed on each individual birth control method's article. I've created one to start with on the Wikipedia Proposed Infoboxes page, so go check it out and get involved in the process. MamaGeek (Talk/Contrib) 12:28, 14 June 2006 (UTC)

Is there any information regarding whether chemical abortions have inherent risks on feritility at all? If so, this would be very useful information to include in the article. yo me to dog. i feel ya. —Preceding unsigned comment added by 207.4.39.2 (talk) 14:25, 7 April 2008 (UTC)

Move to Medical abortion
At Talk:Mifepristone, in the thread "'chemical abortion' vs. 'medical abortion'", User:69.208.181.213 pointed out that "chemical abortion" is a colloquial term used primarily in ideologically-orientated discourse. The term used in medical literature to refer to drug-induced abortions is "medical abortion." For evidence of the difference in usage, see the thread above for a Google/PubMed search term comparison composed by anon, or the Ontario Consultants on Religious Tolerance article "Non-Surgical, Medically Induced Abortions." I will thus be moving this article from Chemical abortion to Medical abortion. -Severa (!!!) 18:23, 22 December 2006 (UTC)


 * re: "chemical abortion" vs. "medical abortion"
 * "Chemical abortion" in most emphatically not a "colloquial term" like "the Pill".
 * "Chemical abortion" is a POV term used in some pro-life (anti-abortion) propaganda not in "ideologically-orientated discourse".
 * "Chemical abortion" has never been used in the medical literature to refer to "medical abortion".
 * "Septic chemical abortion" has only been used in three articles (1969, 1975, 1991) in the medical literature in reference to illegal septic chemical abortions that were self-induced with soap, Lysol, or hypertonic sucrose.
 * the Ontario Consultants on Religious Tolerance article Non-Surgical, Medically Induced Abortions is not a reliable source. It is a personal essay (one of almost 4,000) by Bruce A. Robinson, a retired electronics/computer engineer and agnostic Unitarian in Ontario on his personal website run with the assistance of four friends (an atheist, a Christian, a Wiccan, and a Zen Buddhist) and supported by banner ads.
 * 69.208.165.209 21:35, 16 October 2007 (UTC)

QUESTION :  WHAT IS THE PERCENTAGE OF RISK FOR FUTURE FERTILITY AFTER MEDICAL ABORTION? ANY RISK IF THE MOTHER HAS TAKEN CONTRACEPTIVE PILLS AFTER BECOMING PREGNANT? —Preceding unsigned comment added by 122.169.14.64 (talk) 13:04, 22 July 2008 (UTC)

Stub
Since May 2008 there has been a tag asking for somebody to source this article. After more than six months I have removed those statement that still have not been attributed. As this leaves hardly any info left I added a stub-tag. Please if you feel the need to restore unsourced material I ask you to review policy regarding WP:NOR, WP:V and WP:RS. Actually please place refs in the article since there is no way of knowing what is and what is not OR. Nomen Nescio Gnothi seauton 19:17, 4 February 2009 (UTC)

Improving the article
The Abortion article is currently 89 kB in size, and needs to move more toward a summary style. I've suggested on its talk page that this article should be one of the "daughter" articles that it summarises.

To that end, I'd suggest that the structure used in the Featured Article Sertraline be adapted for use here: Although I'd recommend that a Controversy section be confined to any controversies specifically concerning the drugs used, as the main Abortion article and Abortion debate already cover less specific controversies as well as the sociological aspects.
 * History
 * Indications
 * Adverse effects
 * Mechanism of action
 * Pharmacokinetics
 * Interactions
 * Controversy

I've put a couple of sources that may be useful in expanding the article below. Perhaps other editors can add further sources? --RexxS (talk) 15:56, 9 June 2010 (UTC)
 * This is a medical procedure, not a drug, strangely MEDMOS doesn't have a suggested structure for that (medical procedures).--Nutriveg (talk) 16:30, 9 June 2010 (UTC)
 * The procedure for medical abortion is the administration of two drugs, which is why I suggested that template would be suitable. I'd be very happy to discuss a different structure if you had one in mind? or even better to discuss at WT:MEDMOS a new section for medical procedures. --RexxS (talk) 17:08, 9 June 2010 (UTC)

=
This article needs info on what to expect after taking the drugs. — Preceding unsigned comment added by 71.174.20.160 (talk) 04:25, 18 February 2013 (UTC)

Complications are uncommon and easy to treat
I have added a sentence at the beginning of the "Health risks" section emphasizing that health risks from medical abortion are very low; complications from medical abortion are uncommon (2 to 3 patients per hundred require further treatment, which is almost always simple and safe) and easy for a doctor to treat. With a reference. Goblinshark17 (talk) 22:24, 14 September 2014 (UTC)

Timing of misoprostol
Removed sentence citing single primary source study of vaginal misoprostol regimens:"A 2007 study found that administering mifepristone and misoprostol simultaneously was as safe and effective as administering misoprostol 24 hours after the mifepristone.[9] 9. Creinin MD, et al. (April 2007). ' Mifepristone and misoprostol administered simultaneously versus 24 hours apart for abortion: a randomized controlled trial '. Obstetrics & Gynecology 109 (4): 885–894."per: • Harwood, Bryna (May 6, 2014). " First trimester medication abortion (termination of pregnancy) ". Waltham, Mass.: UpToDate."Choosing a regimen Common regimens — There are two protocols that are most common in the United States (table 4): • US Food and Drug Association (FDA)-approved/manufacturer-recommended regimen – Mifepristone (600 mg orally), followed 48 hours later by misoprostol (400 mcg orally). Both medications are administered by a clinician. • Alternative regimen, referred to as the evidence-based regimen – Mifepristone (200 mg orally) administered by a clinician, followed 24 to 72 hours later by misoprostol (800 mcg buccally) administered either by a healthcare provider or self-administered in a nonclinical setting, typically the patient’s home. This regimen has varied slightly over time. Misoprostol Timing — The interval from mifepristone to misopristol is 48 hours in the FDA/manufacturer regimen and 24 to 72 hours in the evidence-based regimen. Extending the interval to 24 to 72 hours does not appear to impact efficacy. Intervals from mifepristone to misopristol of less than 24 hours appear to be less effective [19,46]. There are no data on misoprostol administration more than 72 hours after mifepristone. 19. Wildschut H, et al. (January 19, 2011). ' Medical methods for mid-trimester termination of pregnancy '. Cochrane Database of Systematic Reviews (1): CD005216. 46. Wedisinghe L, Elsandabesee D (April 2010). ' Flexible mifepristone and misoprostol administration interval for first-trimester medical termination '. Contraception 81(4): 269–274. Summary and Recommendations • The regimen approved by the US Food and Drug Administration (FDA) and recommended by the manufacturer consists of mifepristone (600 mg orally) followed 48 hours later by misoprostol (400 mcg orally). We prefer an alternative regimen (referred to as the evidence-based regimen), which includes mifepristone (200 mg orally) followed 24 to 72 hours later by misoprostol (800 mcg buccally). (See 'Common regimens' above.)" Bobigny (talk) 18:54, 20 October 2014 (UTC)

Contraindications: a comment on ectopic pregnancy
I have added a comment to the CONTRAINDICATIONS section, explaining that although mifepristone abortion is contraindicated in cases of ectopic pregnancy, methotrexate is used to treat early ectopic pregnancy medically, provided the fallopian tube has not ruptured. I don't know why the WHO pamphlet the article refers to fails to mention this. I have backed this up with a reference to a study, and with referral to Wikipedia's own articles on methotrexate and ectopic pregnancy. Goblinshark17 (talk) 07:05, 9 September 2014 (UTC)


 * This article is about medical abortion (i.e. the medical termination of an intrauterine pregnancy), not medical treatment of ectopic pregnancy. The cited source for this article's "Contraindications" subsection, the WHO's  Frequently asked questions about medical abortion  is about medical abortion, not medical treatment of ectopic pregnancy. Medical treatment of ectopic pregnancy is not referred to in the medical literature as "medical abortion". Bobigny (talk) 18:46, 20 October 2014 (UTC)


 * That's not entirely true. Ectopic pregnancy is still pregnancy, with a live human embryo, and some ob/gyn profs in lectures and ordinary conversation refer to its termination as abortion.  Spontaneous self-termination of tubal pregnancy is called "tubal abortion" (see https://www.inkling.com/read/obstetrics-gynecology-beckmann-7th/chapter-19/ectopic-pregnancy ).  Furthermore, opposition to abortion by some religions such as the Catholic Church includes strict rules on how an ectopic pregnancy must be treated in order to avoid directly killing the embryo, which is considered abortion (i e methotrexate is forbidden, and so is direct surgical killing of the embryo which is medically desirable as it can be done without damaging the fallopian tube.  The Catholic-approved way to treat tubal pregnancy is: the fallopian tube, or at least the part of the fallopian tube containing the embryo must be removed intact.  This damages the woman's future fertility, but you don't directly kill the embryo; its death is a side-effect of your life-saving operation, which is regrettable but not forbidden by the Church.  See for instance http://www.ncbcenter.org/page.aspx?pid=940 also http://www.cuf.org/2004/04/ectopic-for-discussion-a-catholic-approach-to-tubal-pregnancies/ The latter source specifically refers to the killing of the ectopic embryo as "abortion", twice.)  More to the point, the distinction between "termination" and "abortion" is a semantic quibble, and the article without my paragraph asserts that ectopic pregnancy is a contraindication for medical termination, which is not true, it is not a contraindication for medical termination using methotrexate, and readers need to know that.  And I cited a perfectly good source besides the WHO pamphlet. Goblinshark17 (talk) 02:55, 22 October 2014 (UTC)


 * I see you also removed my sentence in the "regimens" section stating that the methotrexate regimen protects the patient from possible undiagnosed ectopic pregnancy. Your "edit summary" called this sentence "medically inaccurate"; however, it is not medically inaccurate, but true.  It is also important for the reader, who may be a woman trying to choose a regimen, to know.  The sentence is also supported by the source I cited, which indicates that methotrexate is used routinely to treat ectopic pregnancies.  The fact that the source doesn't mention the phrase "medical abortion" is irrelevant.  Not all sources need to explicitly mention the title of the article in which they are cited!  Goblinshark17 (talk) 04:00, 22 October 2014 (UTC)

Image of medical abortion at 10 weeks gestational age
I removed the image of an "Almost completed medical abortion” at 10 weeks gestational age because it was not representative of most medical abortions. In Sweden in 2014, 55% of medical abortions were performed at ≤ 7 weeks gestational age, and 85% of medical abortions were performed at ≤ 9 weeks gestational age. In the United States, almost all medical abortions are performed at ≤ 9 weeks gestational age.  In Republican Governor John Kasich's Ohio, which has the most extreme anti-medical abortion restrictions in the United States, a law went into effect on February 4, 2011 making it a felony (punishable by a fine of up to $5,000, and/or up to 1½ years in prison, and/or suspension or revocation of a license to practice medicine) for a physician to perform a medical abortion beyond 7 weeks gestational age.  The image was especially unrepresentative and misleading because the introduction of medical abortion has been responsible for a shift towards abortions being performed at earlier gestational ages. Bobigny (talk) 17:52, 18 March 2016 (UTC)

Revisions and edits to reflect new/updated sources, changes in medical procedures, and advances in medical knowledge.
I have updated this information based primarily on the World Health Organization's 2014 guidance, as well as medical advances and new developments in Canada and the USA. The earlier version had outdated information about methods, contraindications, and prevalence. I have updated most of the references as well, as there have been numerous published studies on best regimens and outcomes that change some of the information. Although that information was accurate 4-8 years ago, it was no longer current. With the increased use of medical abortion, there are new sources of information, so I have also updated the external links.

I am still verifying some of the details in this article, and will post that as soon as possible. I will be fixing the two outdated external links.

Thank you to all the authors and contributors to this entry. I did my utmost to preserve your structure and text, focusing on the medical information. Please let me know if you find any items in this article that would benefit with additional information. Lakshmi Singh LPSingh (talk) 21:48, 25 September 2017 (UTC)

External links modified (January 2018)
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Misnamed
Both chemical abortions and surgical abortions are medical abortions, so suggest renaming. -Inowen (nlfte) 22:18, 22 September 2018 (UTC)

Editing
As part of the WikiEdu Project, my group and I will be making the following proposed changes to this page in an effort to improve its content and readability. We will updating the content so that it reflects the most recent guidelines and evidence from the literature.

1. Reorganize sections to follow ‘Surgeries and Procedures’ template. Add pharmacology section as well Medical uses Contraindications risks/complications Technique Pharmacology recovery/rehabilitation History (e.g., when it was invented) Society and culture (include legal issues, if any) Special populations Other animals - may not include this if not enough resources

2. Update info with the following guidelines: WHO 2012 Guidelines Safe abortion: technical and policy guidance for health systems 2012 http://apps.who.int/iris/bitstream/handle/10665/70914/9789241548434_eng.pdf;jsessionid=DC15A0CF765FF012EFD9A480A87AF014?sequence=1 Clinical practice handbook for safe abortions 2014 (to facilitate practical application of 2012 guidelines) http://apps.who.int/iris/bitstream/handle/10665/97415/9789241548717_eng.pdf?sequence=1

3. Clean up & reorganize “Methods” section. Currently it is very wordy and not very clear. Jennyzhou4 (talk) 00:12, 17 October 2018 (UTC)

Dense, Oblique Explanation of How
The section on methods is dense, technical, and oblique. You can go to the individual wikipedia page of each drug, but that's even worse, since it will be about the drug itself and not how it is used in a medical abortion. Based on my (limited) understanding, medical abortions work in much the same way: the woman is given something which deprives the embryo of nutrients and kills it, and then she is given something to induce contractions, flushing it out. Some plain English explanation along those lines would greatly improve this article.

Craigthelinguist (talk) 06:20, 18 October 2018 (UTC)

Pharmacy Student Peer Reviews
Peer Review by Group 14:

1. Does the draft submission reflect a neutral point of view? If not specify Yes, the draft submission does reflect a neutral point of view. Some of the information that was added into the sections might be difficult for a person who doesn't have a very high level of education to understand though. It seems however that in terms of neutrality that the edits are neutral and not persuasive for any belief. Especially since medical abortion can be a issue surround with controversy I believe its important that the edits were kept neutral. I think the group did a great job staying neutral and providing information! Dmorovati91 (talk) 20:44, 7 November 2018 (UTC)

2. Are the points included verifiable with cited secondary sources that are freely available? If not specify

Overall, all information and studies are cited by credible sources, including guidelines from WHO and the National Abortion Federation which are created by health professionals and used by providers. For the section on "Contraindications" and "management of prolonged bleeding", the WHO source requires a login to access the PDF. However, I believe it is free for anyone who makes an account. This would be an extra step for someone who wants to read further into the resource. The organization of methods allows me to easily sort through the sources for each medication regimen and the citations include articles, guidelines, and books. However, the book used for these citations may require a cost to access either online or a hardcover. I was able to access it through our university's online library. Jessicali cp133 (talk) 21:36, 7 November 2018 (UTC)

3. Are the edits formatted consistent with Wikipedia's manual of style? If not, specify The edits are formatted consistently with Wikipedia's manual of style. The group did a great job of making the page easy to read and organized with including pertinent information under headers and titles. Also, the references are correctly inputed and even follow after punctuations within the text. Adding bullet points made it really easy to read, while keeping the format of Wikipedia's style!

4. Is there any evidence of plagiarism or copyright violation? If yes, specify

None so far - the group has done a great job at putting information in their own words. On a side note, the revisions made by our pharmacy peers for this article may be more useful for healthcare providers i.e. updating side effects, 1st vs 2nd line therapy considerations, etc. Henryhuang24 (talk) 04:07, 8 November 2018 (UTC)

Peer Review by Group 1:

1. Does the draft submission reflect a neutral point of view?

Neutrality is reflected throughout the article. Information provided in the article is mostly medical and empirical drug and medical data and thus is neutral. Statistics provided in the edits were cited and factual data without any opinion or narrative being pushed by the statistics. Because of the controversial viewpoints on this topic, the choice to exclude any religious or political sources and articles throughout was very well chosen. ChristopherOng (talk) 17:45, 8 November 2018 (UTC)

2. Are the points included verifiable with cited secondary sources that are freely available?

All the additions made by the authors are verifiable with credible sources that are correctly linked to their respective websites. The only corrections needed are the date format for the citations for C. Schreiber (one study) and E. Raymond (two studies). AilinKim (talk) 18:04, 8 November 2018 (UTC)

3. Are the edits formatted consistent with Wikipedia’s manual of style?

The edits formatted are consistent with Wiki's manual of style. The students used concise language, rearranged headings to improve page flow, added subheadings for different medications, removed redundancy, and incorporated lots of citation. The use of bulleted lists made it easier to view the information rather than reading plain paragraph. Ereca (talk) 18:33, 8 November 2018 (UTC)

4. Is there any evidence of plagiarism or copyright violation?

There appears to be no evidence of plagiarism or copyright violation. All content added was verifiable through citations to reliable sources. This group did a great job in adding citations to their sections. Citations range from randomized controlled trials in primary literature to reputable medical journals.

AnnChen17 (talk) 17:55, 8 November 2018 (UTC)

A new section on the "reversal" controversy
I have added a short new section on the current controversy over whether mifepristone abortion can be reversed by administering progesterone to the patient. A real study, with correct controls and double-blind administration is finally underway. HandsomeMrToad (talk) 23:52, 18 April 2019 (UTC)

NPOV section headings
A section on complications was misleadingly and alarmingly entitled "Recovery and rehabilitation"; also, a section on what happens during a non-surgical abortion was misleadingly and judgementally entitled "Commital". I am fixing both, and adding more of the most common complications. HandsomeMrToad (talk) 23:54, 18 April 2019 (UTC)

UPDATE: Reviewing the article, I see that the "complications" I have added are already listed in another section. Sorry, my error, overlooked it. I'm removing the redundant and moving the part which is not redundant (on managing bleeding) to the "Side-effects" section since this part is about managing a side-effect. HandsomeMrToad (talk) 23:57, 18 April 2019 (UTC)

proposed edit on lead
I suggest editing the first sentence to say: A medical abortion, also known as medication abortion, occurs when pills are used to induce an abortion. The recommended regimen consists of a combination of medications, starting with mifepristone followed after at least a day by misoprostol. (ref = Medical management of abortion. World Health Organization,. Geneva, Switzerland. ISBN 9241550406. OCLC 1084549520, p 24) When mifepristone is not available, misoprostol may be used. Rationale for suggestion: major, recent citation added; also defines method by what it is (pill based abortion), as opposed to what it is not (non-surgical abortion). Also statement saying it's called "abortion pill" is not validated/cited.

I also suggest adding a section on "history" and putting that last sentence currently in the lead section--about RU 486--into that history section.Purplemountain1 (talk) 01:47, 12 September 2019 (UTC)

Proposed edit to section titled "Chemical/physiological mechanisms"
In line with Wikipedia:Manual of Style/Medicine-related articles#Drugs, treatments, and devices, I propose changing the title of this section to Pharmacology.--Purplemountain1 (talk) 21:41, 12 September 2019 (UTC)

Methods
Per the Wikipedia:Manual of Style/Medicine-related articles#Drugs, treatments, and devices, the "methods" section does not belong. I suggest first integrating content relevant to the article into other sections, and then deleting this section. For starters, I suggest deleting the following, which is outdated and different from the newer information now listed in the "medical uses" section: "The World Health Organization recommends the combined use of mifeprostone followed by misoprostol for pregnancies of gestational age 9 weeks or less. This combination consists of 200 mg mifeprostone followed by 800mcg of misoprostol to be taken within 24–48 hours. The misoprostol can be administered in the clinic or at home. For pregnancies that are 9–12 weeks of gestational age, the WHO recommends the initial 200 mg mifeprostone dose to be followed by 800mcg misoprostol administered vaginally, which can be repeated every three hours up to 4 total doses. In this case, the misoprostol must be administered in the clinic.[11]"Purplemountain1 (talk) 20:15, 24 September 2019 (UTC)

Contraindications
Dear Fellow Wikipedians, In line with the comment under "side "effects" regarding undue weight to each one in this vertical format, I suggest rewriting the contraindications and basing them on an updated systematic review to say instead: "Medical contraindications to mifepristone are rare and include ectopic pregnancy, intrauterine device in place, chronic corticosteroid use, adrenal failure, bleeding disorder, and allergy to mifepristone.(ref Medical management of first trimester abortion, SFP and ACOG, Contraception 2014 (89) 148-161). Misoprostol is contraindicated in women who are alllergic to it. Many studies excluded women with severe medical problems such as heart and liver disease or severe anemia.Purplemountain1 (talk) 19:31, 26 September 2019 (UTC)

side effects
Hello fellow Wikipedians, Currently the side effects are listed vertically. This gives heavy, perhaps undue, weight to each one. Information in this section is also internally repetitive. I suggest deleting repeated information, deleting the list, and instead inserting the following which includes a citation from a discussion of side effects in a review/guidelines by the American College of Ob-Gyn and the Society of Family Planning, 2014: "Most women will have cramping and bleeding heavier than a menstrual period.[1] Nausea, vomiting, diarrhea, headache, dizziness, and fever/chills are also common. Misoprostol taken vaginally tends to have fewer gastrointestinal side effects. Nonsteroidal antiinflammatory medications such as ibuprofen reduce pain with medication abortion.Purplemountain1 (talk) 17:57, 26 September 2019 (UTC)


 * I also propose changing the title of this section to Adverse Effects. That is still consistent with the Wikipedia:Manual of Style/Medicine-related articles#Drugs, treatments, and devices, and given that complications are within this section, it seems more appropriate. I also suggest putting in a subheadling called complications, so that side effects are separated from complications. That would make it more clear.--Purplemountain1 (talk) 17:23, 10 October 2019 (UTC)


 * I plan to add additional information and citations about complications associated with medical abortion at or under 9-10 weeks pregnancy. Specifically: Complications following medical abortion with mifepristone and misprostol under 10 weeks pregnancy are rare; according to two large reviews, bleeding requiring a blood transfusion occurred in 0.03-0.6% of women, and serious infection occurred in 0.01-0.5%.(Chen 2015; Raymond 2013)--Purplemountain1 (talk) 17:50, 10 October 2019 (UTC)

History
I suggest adding more content and a citation to the section on history. Specifically I would like to add: "Mifepristone was initially approved in China and France (need date); in 2000, the United States Food and Drug Association approved mifepristone followed by misoprostol for abortion through 49 days. Purplemountain1 (talk) 15:13, 24 September 2019 (UTC)


 * I plan to add the following additional information to the history section: In 2016, the United States FDA updated mifepristone's label to support usage through 70 days gestation. from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf--Purplemountain1 (talk) 17:56, 10 October 2019 (UTC)

Medical uses edits
I suggest editing this section by deleting what is there now and instead putting in: "Medical abortion is indicated in people who want to use medications to end a pregnancy. Mifepristone followed by misoprostol for abortion is considered both safe and effective throughout a range of gestational ages. For medical abortion prior to 12 weeks gestation, the WHO recommends mifepristone 200 mg orally followed 1-2 days later by misoprostol 800 mcg bucally, vaginally, or sublingually; misoprostol may be repeated to maximize success. If mifepristone is not available, the WHO recommends misoprostol 800 mcg bucally, vaginally, or sublingually.Purplemountain1 (talk) 19:40, 18 September 2019 (UTC)
 * , I think you should think about the terminology you're using and whether it's appropriate to a general audience. Many people probably could not define bucally or sublingually. Elysia (Wiki Ed) (talk) 20:01, 18 September 2019 (UTC)
 * , Thank you Elysia (Wiki Ed). That is really helpful feedback. I will simplify the language. How about ...misoprostol 800 mcg inside the cheek, under the tongue, or in the vagina....Purplemountain1 (talk) 20:31, 18 September 2019 (UTC)


 * I also propose adding to this section: "For medical abortion at or after 12 weeks gestation, WHO recommends mifepristone 200 mg by mouth (orally), followed 1-2 days later by misoprostol 400 mcg under the tongue, inside the cheek, or in the vagina. (citation: WHO Med Management of abortion page 25) Misoprostol may be repeated every 3 hours until successful abortion is achieved.Purplemountain1 (talk) 03:26, 19 September 2019 (UTC)
 * , I think that using the more accessible language is better, as long as meaning isn't lost! As for your second proposed addition, that all looks fine to me. Elysia (Wiki Ed) (talk) 18:21, 19 September 2019 (UTC)
 * Per the Wikipedia Manual of Style Medicine, the "medical use" section should contain information on efficacy. Therefore I propose adding the following content and new citations to this section: "According to a systematic review of 33,846 women across 20 studies, the success rate of mifepristone followed by misoprostol through 10 weeks pregnancy is 96.6%. Reference: Chen, M. J., & Creinin, M. D. (2015). Mifepristone with buccal misoprostol for medical abortion: A systematic review. Obstetrics & Gynecology, 126(1), 12-21. According to a systematic review of 12,829 women across 42 studies, the success rate of misoprostol alone for first trimester abortion is 78%." reference: Raymond, E., Harrison, M, & Weaver, M. (2019). Efficacy of misoprostol alone for first-trimester medical abortion: A systematic review. Obstetrics & Gynecology, 133, 137-147. This contains information updated form what is currently in the methods section. I also propose deleting the outdated success rate information from the "methods" section.Purplemountain1 (talk) 20:08, 24 September 2019 (UTC)
 * The Medical Use section currently combines different regimens and different gestational ages, which is confusing. It would be clearer to divide it into sub sections: through 12 weeks and at/after 13 weeks is in line with studies and guidelines mentioned in this section.--Purplemountain1 (talk) 18:22, 10 October 2019 (UTC)
 * This section still needs information about success rates for medical abortion at or after 13 weeks. I suggest adding: For medical abortions at or after 13 weeks with recommended regimens of mifepristone followed by misoprostol, the mean time to abortion after starting misoprostol is 6-8 hours, and approximately 94% will abort within 24 hours after starting misoprostol.(Kapp 2007; Abbas 2016; Borgatta 2011) When mifepristone is not available for medical abortion at or after 13 weeks, misoprostol may still be used though the mean time to abortion after starting misoprostol will be extended compared to regimens using mifepristone followed by misoprostol.--Purplemountain1 (talk) 18:44, 10 October 2019 (UTC)

Society and Culture as new section
I suggest adding a new section titled Society and Culture. This would be in line with Wikipedia: Manual of Style/Medicine, content section on Drugs, treatments, and devices. Then in this section, I suggest adding the line: "The legal and political setting should support people's access to evidence-based medical care, including medical abortion. Purplemountain1 (talk) 19:28, 18 September 2019 (UTC)

So Wikipedia is stating as fact the political goals of the World Health Organization?Deepfrieddough (talk) 13:09, 26 September 2020 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 27 September 2018 and 14 December 2018. Further details are available on the course page. Student editor(s): Jennyzhou4, Latallah1212, Katertotz, Nhituta. Peer reviewers: AilinKim, AnnChen17.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 03:45, 17 January 2022 (UTC)

Research results section(?)
There's an ongoing prospective observational study happening currently in Greece looking at the efficacy and safety of mifepristone combined with sublingual misoprostol second-trimester medical abortions. I think it would be useful information to show how the regimens have been developed over time - is this something anyone else would like to see added to the article? Kazamzam (talk) 16:31, 24 June 2022 (UTC)


 * While it sounds interesting, I don't know what WP:MEDRS says about discussions of the evolution of standard medical practices or procedures. But if it is allowed I'd say it would imporove the article. --- Avatar317 (talk) 21:04, 26 June 2022 (UTC)
 * Is the study finished?  Is there a link you can provide to the study?  Noleander (talk) 02:13, 27 June 2022 (UTC)
 * @Noleander - not that I'm aware of. The study wrapped in 2021 but the results I mentioned were published in March 2022 and seem preliminary. I'm keeping an eye on it, will update when there's something to report of substance. But, of course, it's a relatively small study (13 women included in the initial analysis), so TBD on the external validity. Kazamzam (talk) 21:11, 4 July 2022 (UTC)

Why is there a “needs update” note next to the statement “Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage”?
Does it belong there? Why is it there? I really don’t see how the fact that medical abortion is an alternative to surgical abortion could “need an update”... It just is. VictimOfEntropy (talk) 21:39, 5 July 2022 (UTC)


 * No ... in my opinion, I don't think it should be there.  It was put there by some editor a couple of months ago.  They seem to be saying that the existing citation is out of date, or at least needs to be reviewed to make sure it is still accurate.   I don't feel comfortable removing it because it was put there after I re-wrote the lede section; so it is most appropriate if someone else removes it. Noleander (talk) 23:29, 5 July 2022 (UTC)

Rename article to "Medication abortion"?

 * The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion. 

The result of the move request was: No consensus. It is clear that the current name remains the most common name, but the supporters find reasonable support in the following caveat in WP:COMMONNAME: "Ambiguous or inaccurate names for the article subject, as determined in reliable sources, are often avoided even though they may be more frequently used by reliable sources." It doesn't seem clear whether the intended meaning of "medical" in this context would be comfortably understood by the article's traffic.

Note also that both sides acknowledge that there is a trend where the proposed title is coming more into use recently, which might complicate further RMs on the matter. — Ceso femmuin mbolgaig mbung, mellohi! (投稿) 04:44, 12 July 2022 (UTC)

Medical abortion → Medication abortion – What do editors think of renaming the article from "Medical abortion" to "Medication abortion"? Google search result-count suggests that "Medical abortion" is slightly more commonly used, but "Medication abortion" is also heavily used.

It seems clear that the current title, "Medical abortion" is potentially very confusing, because surgical abortions are also "medical" - at least to any layman. My understanding is that "medical abortion" became more commonly used because, within the community of medical experts, the word "medical" suggests medicine or drugs ... so that explains how that term originated. But Wikipedia is an encyclopedia for _everyone_ and since there are two phrases that are both commonly used, it seems better to use the term that is more understandable & less ambiguous.

Historical search trends of the two phrases (in USA) are:
 * https://trends.google.com/trends/explore?date=today%205-y&geo=US&q=%22Medical%20abortion%22
 * https://trends.google.com/trends/explore?date=today%205-y&geo=US&q=%22medication%20abortion%22

Since both phrases are heavily used, it seems better to use the one that is more clear & less ambiguous to the layman. Thoughts? Noleander (talk) 02:19, 27 June 2022 (UTC) — Relisting. — Ceso femmuin mbolgaig mbung, mellohi! (投稿) 02:58, 4 July 2022 (UTC)


 * Also, many of the important sources that use one phrase or the other, acknowledge the existence of the other phrase. For example the Cleveland clinic website uses the phrase “medical abortion”, but very early on acknowledges the other term, as in “A medical abortion (or medication abortion) …”. Noleander (talk) 11:49, 27 June 2022 (UTC)


 * oppose current name is much more common see trends  and ngrams —blindlynx 14:04, 27 June 2022 (UTC)
 * Yes, Google stats show that "Medical abortion" is more widely used, but the same statistics also show that over the past five years, the usage of "Medical abortion" is declining, and usage of "Medication abortion" is increasing. WP:TITLE says that when two or more names are used for something, other factors should be considered (WP:Article_titles) including  Recognizability, Naturalness, Precision, Concision, and Consistency.    "Medication abortion" is seems to be superior to "Medical abortion" in at least three of those five criteria (Recognizability, Naturalness, Precision) ... and a tie in the other two (Concision, and Consistency). Noleander (talk) 18:25, 27 June 2022 (UTC)
 * The difference between usage is still an order of magnitude making the current tile the clear WP:COMMONNAME. There is no way to tell when or if that will change (see WP:CRYSTALBALL). I fail to see how the proposal meets the precision or naturalness criteria —blindlynx 19:35, 29 June 2022 (UTC)


 * * Support - 1) MAJOR sources for this info, like the Guttmacher Institute call it "Medication abortion"
 * 2) (Agree with Noleander) Wikipedia is written for the layperson, and I agree that to the layperson "medical" is confusing...isn't anything having to do with a doctor medical? After all, they have MD degrees, right?  That's a Doctorate of Medicine? --- Avatar317 (talk) 23:58, 27 June 2022 (UTC)


 * Oppose - medical abortions are so named because to delineate from surgical abortions which involve surgical interventions. Avatar317's proposal that 'anything having to do with a doctor is medical' is incorrect. A procedure, abortion or otherwise, is medical because it is performed by a medical practitioner, i.e. a nurse-practitioner, a midwife, a physician's assistant, etc. The distinction between medical and surgical goes beyond abortion, such as medical vs. surgical asepsis or medical vs. surgical jaundice. We should also be wary of using a term that may be more common in the US - for example OHIP, the Alberta Health Services, the UK NHS, the Australian government's HealthDirect.gov.au site uses the term medical abortion, etc. On PubMed, the term 'medical abortion' (in quotes) pulls up 61 results, whereas 'medication abortion' has only 5. Similarly, Google Scholar has roughly 28,000 results for medical abortion to 3400 for medication abortion. I get the impetus for this but I don't think it's necessary for understanding, consistent with common usage, or helpful for readers. Instead of changing the term, I think a brief etymology section immediately following the lede would be helpful to more clearly delineate between the two. Kazamzam (talk) 12:23, 28 June 2022 (UTC)
 * So then (mifeprestone + misprostol) is only "medical" because of its politically controlled legal status. If it were over-the-counter, it would no longer be "medical", like Plan B. --- Avatar317 (talk) 04:21, 30 June 2022 (UTC)
 * I don't doubt that there's a technical distinction in the field between medicine and surgery, but by the common definition of the word "medical" (for example, Merriam-Webster or Cambridge English Dictionary) it means "relating to or concerned with physicians" - and all surgeons are physicians although not all physicians are surgeons. And it's use is definitely widespread - for example, surgeries are performed at UCLA Medical Center.  In the same way that the article title recommendations specify that articles should use the common name for a species instead of the scientific name (it gives the example of "Guinea Pig" being preferred over "Cavia porcellus") wouldn't it make more sense to use the common definition of the word rather than a technical definition that the average person is not aware of? FearlessLingonberry (talk) 14:54, 30 June 2022 (UTC)
 * First of all, I would be shocked if the 'average' person didn't under the meaning of the word 'medical'. Heteroskedasticity (a very powerful word on the Scrabble board) is a technical and complex term that most people would not understand; medical is not.
 * Secondly: medical abortion is the most commonly used term for this process. It is not an unfamiliar Latin name, it is a current term widely used in majorpublicationsthat are read by a generalaudienceof laypeople, not simply in the realm of academics. It is also a term used by health care providers and I think it is important to be consistent in that respect as well. I have also seen English media outside of the US use medical abortion much more frequently so I think it is pertinent to say that we avoid a US-centric perspective. We have an immediate reference to medication abortion in the lede sentence - I personally consider this to be sufficient for the 'medication abortion' supporters. I don't have much else to say on the topic so however this goes I will continue to support and contribute to the page. Kazamzam (talk) 15:55, 30 June 2022 (UTC)
 * I posted a notice of this discussion on the Talk:Abortion page because it seems that many more editors see and contribute to that article and so hopefully that will bring more discussion here. I agree, whatever people's decision on the name won't change my attitude towards the topic. --- Avatar317 (talk) 21:16, 30 June 2022 (UTC)

Links for the above references:
 * https://www.ontario.ca/page/what-ohip-covers
 * https://albertahealthservices.ca/info/Page14011.aspx
 * https://www.nhs.uk/conditions/abortion/
 * https://www.healthdirect.gov.au/abortion#legal


 * Support - it seems Kazamzam's point there is about what "medical" means in a hospital setting, but as has already been expressed, we muggles don't understand the term that way. "Medication abortion" doesn't seem to be incorrect in any way, but is less confusing than "medical" for the layman—i.e., the overwhelming majority of the Wikipedia-using population. "Medical abortion" sounds like it's in contrast to a miscarriage (a spontaneous abortion). Hppavilion1 (talk) 00:44, 29 June 2022 (UTC)


 * To confirm that I have understood your position: because laypeople ("laypeople") might misunderstand an extremely frequently used term that operates in the established binary distinctions of medical and surgical, we should use a less commonly used term that doesn't seem to be widely used outside of the U.S. and is infrequently used in government context and scholarly research. Isn't the point of Wikipedia to be instructional and encyclopedic - I'd rather punch up than down, so to speak. Or instead we could throw in 3 to 5 sentences explaining the difference between a surgical and medical procedure, and then get on with the body of the content. I would much rather work on improving the article itself than split hairs over the title, particularly given that the term medication abortion is mentioned in the very first sentence and all the appropriate/necessary redirects are in place. Kazamzam (talk) 03:33, 29 June 2022 (UTC)
 * I generally agree with your comment "Isn't the point of Wikipedia to be instructional and encyclopedic - I'd rather punch up than down, so to speak." but in THIS case I feel that the academic name is stupid, confusing and should be discontinued. Like how they finally changed "Munchausen syndrome" (totally non-descriptive, and not even named after a discoverer) to "Factitious disorder imposed on self".  Part of my reason for arguing this is that I'd like to see the term changed in ALL the related articles in the Abortion space, and would like some consensus rather than lots of arguments if I start doing that. --- Avatar317 (talk) 01:26, 30 June 2022 (UTC)


 * Comment: American College of Obstetricians and Gynecologists suggests to use the term “Medication abortion”: ACOG Guide to Language and Abortion


 * Term to Avoid - Clinical Explanation - Use Instead
 * “Chemical abortion” - This is a biased term designed to make medication abortion sound scarier than the safe, effective medical intervention it is. - “Medication abortion” --- Avatar317 (talk) 01:20, 30 June 2022 (UTC)


 * Support - current events have caused the likelihood of abortions outside professional licensed medical care to return to the realm of reality for the large part of the enwiki readership, causing the term "medical abortion" to become highly ambiguous when it wasn't before; and per Avatar317's ACOG usage guide. Dan Ratan (talk) 03:54, 1 July 2022 (UTC)
 * Oppose Per Kazamzam's arguments - Medical vs. Surgical is a common delineation in all areas of medicine and doesn't imply a hospital setting. The balance of current usage on my assessment, both in lay, professional, and research settings appears to support the status quo. It looks like this balance might be shifting, in the US at least, but WP reflects current usage generally rather than trying to influence change, or even using the term that might be deemed more informative or 'correct' (which I would argue is actually "medication-induced abortion" rather than "medication abortion" - as "medication" is not an adjective). |→ Spaully ~talk~ 09:33, 1 July 2022 (UTC)
 * The induction is implied, since otherwise it is a "spontaneous" abortion. --- Avatar317 (talk) 21:29, 2 July 2022 (UTC)
 * I think you miss the point - as medication is not an adjective, "medication abortion" on first reading looks like it is referring to an abortion of medication, only the absurdity of this leads to mentally inserting the omitted "induced" to make it work grammatically. |→ Spaully ~talk~ 19:51, 4 July 2022 (UTC)
 * Weak Oppose It does seem the balance lies with "medical abortion", but "medication abortion" certainly seems to be gaining ground. I am not really opposed to either option, and am opting more for wait-and-see.  I am not troubled by laymen - the medical vs. surgical distinction is sufficiently well-known to people (laypeople do see doctors and surgeons in their lives, it is not such an obscure or esoteric distinction as some make to want it sound).  To be honest, I am also a little uncomfortable with the term "medication", as that term has implications about remedying or curing a "disease", so feels a little POVish.  "Pharmaceutical abortion" would be more neutral, but it is just not as widely used.  Certainly any confusion about the term "medical" can be clarified in the first sentence (ps "Non-surgical abortion" seems to be another term in use, although not nearly as much either of the other two.) Walrasiad (talk) 05:26, 4 July 2022 (UTC)

Walrasiad, you are the only one inserting bias here. The objective fact of the matter is that pregnancy causes bodily harm to women, and medication exists to treat and prevent bodily harm. Carrying a pregnancy to term (in the U.S., a developed country with modern hospitals) is 75 times more likely to kill a woman than inducing an abortion with mifepristone and misoprostol is, and continued pregnancy is infinitely more likely to cause nonfatal damage to her body that impairs her quality of life as well. If people were concerned with caring for the people who are here instead of continuing the species, then induced abortion would be universally recognized as the appropriate medical approach to every pregnancy, as pregnancy (whether you like it or not) is a harmful condition that doctors would all seek to cure in order to protect the health of women. VictimOfEntropy (talk) 17:40, 5 July 2022 (UTC)


 * @VictimOfEntropy I have no idea where your statements in response to @Walrasiad's decidedly neutral comments are coming from, and they are inappropriate in terms of WP:AFG and WP:Aspersions. Additionally, mandated induced abortion for all pregnancies, also known as forced sterilisation, is recognized as a crime against humanity. This extreme statement is also not related to the discussion topic at hand. Your strong feelings on the need for legal abortion access, which I share, do not make it okay for you to put words into other editors' mouths or make baseless accusations. I encourage you consider that we are, ideally, all here for the same purpose of providing accurate and reliable information about abortion, and this is about building consensus for improving the article rather than espousing views on the topic. As stated at the top of the page: this is the talk page for discussing improvements to the article, this is not a forum for general discussion of the article's subject. Kazamzam (talk) 19:19, 5 July 2022 (UTC)
 * Walrasiad was making the baseless and inflammatory claim that simply using the term “medication abortion” to describe an abortion done with medication is somehow “POVish”. I have no idea where *your* statements about mandated abortion and forced sterilization (which are two separate things, despite the fact that you’re conflating them) are coming from considering that I *never* said anything about either of those things and they are not at all related to any of the discussion topics at hand and I was only explaining what should be obvious about what the universally accepted appropriate medical recommendations would be in a world that prioritized women’s health as doctors are supposed to do instead of the continuation of the species (which, objectively, is inherently harmful to women’s physical health, as pregnancy takes a huge toll on a woman’s body and always does physical damage to it) after addressing the objective fact that unwanted pregnancy is indeed a harm that is remedied with abortion and that saying so is not “POVish” as Walrasiad claimed at all. VictimOfEntropy (talk) 19:50, 5 July 2022 (UTC)
 * Kazamzam, I never made any “extreme statements”. You are doing what you’ve baselessly accused me of, making extreme statements which are entirely unrelated to the topics at hand and apparently meant to cast aspersions at me. Stating the objective fact that carrying a pregnancy to term always causes harm to a woman’s body and that that harm could be prevented with abortion and that abortion is a medical procedure that could be performed with medical instruments or medication is not in any way “extreme”. You don’t get to describe something as “extreme” just because you don’t like it, even though it’s true, and you don’t get to take issue with someone pointing out the bias of another editor when it’s not based on anything which is true but merely their personal preference for the childbirth over abortion, despite the medical implications. VictimOfEntropy (talk) 19:57, 5 July 2022 (UTC)
 * Saying that all pregnancies should be aborted is an extreme position that does not relate to the topic of renaming this article . It ignores and denies the agency of people who want to be pregnant, who want to have children, and who are capable of making up their own minds about what they want to do with their own bodies, should they choose to continue a pregnancy. You have no what the "universally accepted appropriate medical recommendations in a women that prioritized women's health", but I imagine they would involve respecting the desires of someone who wants to be pregnant, wants to have a child, and is capable of making that decision! It also ignores the fact that people do "inherently harmful" things to their bodies every single day (drinking alcohol, smoking, using drugs, not exercising, exercising too much, etc.). Many people who have abortions go on to have children in the future, by choice.
 * Your comment on 'the continuation of the species' is immaterial here. If you agree with the position of the Voluntary Human Extinction Movement, that's fine but, again, it does not relate to the topic of renaming this article . I have no interest in continuing this conversation, or bothering everyone watching this page. Please keep your future points to the limits of this discussion, not to the topic of the page, or your personal feelings on it, or take it over to your talk page. Kazamzam (talk) 00:34, 6 July 2022 (UTC)

I’m torn on this question, as “medical abortion”, in my experience and evidently supported by all gathered data, does seem to be the most commonly used term for mifepristone-misoprostol abortions, but I agree with Spaully that “medication-induced abortion” would be the most accurate term to describe the result of a mifepristone-misoprostol regimen, especially when you consider the fact that both of those medicines and other medications that are recognized as abortifacients are also used to treat other conditions unrelated to pregnancy (although some of them may also be caused by pregnancy).

However, the word “abortion” is understood to mean both the miscarriage of a pregnancy *and* a procedure done to deliberately induce the miscarriage of a pregnancy, and it seems to be more commonly used as the name of a procedure. Medical abortion contrasts with surgical abortion, and medication abortion contrasts with vacuum aspiration abortion. It’s not necessary to specify “induced”, and would actually narrow the definition too much, because both the procedure itself and the result of it are referred to as an abortion. So it’s not just inducing an abortion, it’s an abortion done by medication.

I have to support Noleander’s name change proposal, as long as it doesn’t conflict with Wikipedia policies on using page names that might not be as widely-used as other names for the same thing. “Medication abortion” does seem like the best and most accurate description for every aspect of the article. It’s important to keep “medical abortion” on the article, though, in the place where “medication abortion” currently is, I’d say. VictimOfEntropy (talk) 18:43, 5 July 2022 (UTC)

*Not moved - Doesn't look like the requisite consensus is gonna happen. Trends clearly show "Medication abortion" gaining on "Medical abortion" in news & medical community. Probably will catch up in a couple of years, and can reconsider the new name for this article then. Noleander (talk) 22:58, 7 July 2022 (UTC)
 * Kindly let the closer do their work. >>> Extorc . talk  12:05, 11 July 2022 (UTC)


 * Oppose per Blindlynx - Ngrams clearly show that sources use Medical Abortion much more often then Medication abortion which has only gained some usage in the last few decades.
 * Also to suggest that slowly medical abortion is becoming ambiguous and will be overtaken by other forms of usage is WP:CRYSTALBALL >>> Extorc . talk  12:04, 11 July 2022 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
 * Oppose - 1) medical abortion is more common, 2) it is pretty well understood that what most people think of first when the word "abortion" is used is a surgical procedure, so "medical" here is easily understood in the same context as "medical treatments" vs "surgical treatments" in cancer cases, 3) "medication abortion" is worse than wrong, it is ridiculous. It sounds as silly as "scalpel appendectomy" would. --User:Khajidha (talk) (contributions) 18:55, 11 July 2022 (UTC)