Talk:Abortion/Archive 24

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We're mentioned on The Atlantic Online

An August 1, 2006 article by Marshall Poe, "A Closer Look at the Neutral Point of View (NPOV)," explores the concept of NPOV by examining the proceedings of this article between May-October 2005. -Severa (!!!) 09:19, 11 August 2006 (UTC)

Wow, that's interesting to read, almost sureal. Thanks for the link. --Andrew c 13:58, 14 August 2006 (UTC)

Would placing an {{onlinesource2006}} tag on this page be appropriate or not in this instance? I am not entirely certain as to whether this qualifies as having used the article as a "source." -Severa (!!!) 14:17, 14 August 2006 (UTC)

At the very least we should at least put a suggestion up at Wikipedia:Wikipedia Signpost, if not make a write up ourselves.--Andrew c 16:08, 14 August 2006 (UTC) Looks like someone already posted a link to the story [1], however I'm not sure if anything came of it.--Andrew c 16:11, 14 August 2006 (UTC)

Minority Abortions

Why is there no mention of the fact that Blacks & Hispanics are much more likely to have an abortion than white women. Since 1973 14 million Black fetuses & 10 million Hispanic fetuses have been aborted. This has altered the percent of black population of the US by -4%. —The preceding unsigned comment was added by 4.224.123.74 (talk • contribs) 00:37, 24 August 2006.

Hmm I'm not sure of the relevancy here even if this statement that's being made is true. You seem to be implying that 'Blacks and Hispanics' are more likely to have an abortion because of their ethnicity (or any number of situational factors attributed to their ethnicity) of which I don't see conclusive proof of. Even if such proof could be rendered different demographics in different parts of the world will inevitably have different abortion rates but including merely one ethnic group (or any specific group) does not bring a greater understanding of the subject and seems to lean towards racism to me.--Artificialard 05:16, 26 August 2006 (UTC)

I think he's referring more towareds the increase in abortions among minorities as a result of unfavorable economic hardships left over from more racist times, rather than an increase somehow based compleatly on the color of one's skin. Homestarmy 02:40, 7 September 2006 (UTC)

menstrual extraction?

...how come there's nothing on menstrual extraction/the women's self-help movement performing them for each other, etc? (i didn't read the whole archives--maybe this is covered somewhere?) http://www.fwhc.org/selfhelp.htm Cindery 01:11, 29 August 2006 (UTC)

That sounds increadibly dangerous, and not just because the goal is to kill an unborn baby either.... Homestarmy 22:49, 30 August 2006 (UTC)

i think the complication rate is comparable to/lower than surgical abortion. the big difference is that it's performed earlier than surgical abortion (2wks vs 8wks gestation).

http://www.prochoice.org/education/resources/surg_history_overview.html

but, whether or not it can have complications is separate issue from whether or not it's significant enough practice/significant enough in history of abortion to mention. it seems it was pretty common in US in late 60s/early 70s at least, and still is in bangladesh (perhaps elsewhere?). i haven't done a lexis search on the legalities yet, which would be another facet. it seems that it is legal for nonprofessionlas to perform menstrual extraction for menstrual hygiene, but illegal to perform it for abortion unless medically certified. (That would be practicing medicine without a license.) but, only a medical professional can determine pregnancy absolutely, according to law. so there is a legal loophole, whereby menstrual extraction in case of suspected pregnancy is legal, because even if the practitioner isn't licensed to practice medicine, they aren't licensed to determine pregnancy either, so they can't be culpable. i think the laws vary by state, also--virginia recently tried to pass a law regarding medical practitioners/menstrual extraction--prohibiting them from performing menstrual extraction without first doing a pregnancy test. i don't think it passed. (that's a third issue--menstrual extraction can be/is performed both by medical practitioners and lay people. it uses the same soft karman cannula as vacuum suction abortion/similar procedure). Cindery 00:33, 31 August 2006 (UTC)

Just because something is legal doesn't make it safe, and i'd say sticking implements into...ah...very private places in other people's bodies with basically the training of reading a few web pages ranks fairly low on the safety scale. Homestarmy 00:36, 31 August 2006 (UTC)

Just because something's unsafe doesn't make it non-existent. Cindery's original question was not "Is menstrual extraction a good idea?", but "Why isn't it mentioned in the article?", if I'm reading correctly. -GTBacchus^(talk) 00:39, 31 August 2006 (UTC)

Oh, my mistake, sorry. Homestarmy 00:40, 31 August 2006 (UTC)

yeah, i did mean not is it safe? but, should it be mentioned? i think they could both be discussed. i think there's maybe 4 aspects to it that could be included in short paragraph of article: 1)history/incidence/commonality of practice 2) safety 3) legalities 4) DIY feminism. (i wouldn't have one--i'd be too paranoid about air bubbles and infection, but other people make other choices:

http://slingshot.tao.ca/displaybi.php?0086015 Cindery 00:49, 31 August 2006 (UTC)

It sounds like you have a good idea what needs to be there and how to provide good citations for it - why not go ahead and edit the article, and see what happens? -GTBacchus^(talk) 01:04, 31 August 2006 (UTC)

...it looks like i missed that it is slightly mentioned in surgical abortion section--it is also called "manual vacuum aspiration"--but MVA and EVA were conflated. they actually are a little different--MVA can be performed much earlier, doesn't require cervical dilation...i'm not sure that inserting info about women's self-help/all the legal issues/history of ME would be good there--would disrupt the coherence of that paragraph. it seems like a short paragraph about ME would fit better elsewhere, but i'm not sure exactly where...any ideas? Cindery 02:20, 31 August 2006 (UTC)

Moving of two "Death" topics

There is a specific sub-page reserved for the discussion of this article's first paragraph: Talk:Abortion/First paragraph. If you are looking for either of the two recent "Death" threads, I have moved them, so please check there. Thanks. -Severa (!!!) 05:52, 6 September 2006 (UTC)

Abortion and mental health

Hi! I would like to propose the following changes to the "Mental health" -chapter of the abortion article:

Firstly, I would like to make the following amendment to the beginning of the third paragraph:

"According to a study by Reardon and Cougle published in British Medical Journal in 2002, the risk of clinical depression is higher for women who have an abortion compared to those who give birth although the pregnancy is unwanted. The prior psychiatric states of the 421 women included in the study were controlled."

I know Severa considers all studies by Reardon biased since Reardon is against abortion. However, since the article I'm referring to has been published in British Medical Journal, I assume it ought to be fairly reliable. Furthermore, the authors of the APA briefing paper (the source of the statements that abortion may improve reported mental well-being and cause less depression than continuing an unwanted pregnancy, and that adverse reactions are most strongly influenced by pre-existing negative factors) are pro-choice, but I don't think the paper can be dismissed as irrelevant just because the authors happen to have an opinion. I think most people have an opinion on this issue, so if just the fact that the conductor of a study has an opinion makes the study biased, we might as well exclude all mentions of studies from the entire article.

The study by Adler, Ozer and Tschann stating that abortion yields positive outcomes, when the alternative is unwanted pregnancy, referred to in the APA briefing paper, is a study on adolescents experiencing unwanted pregnancies, not women in general. Since giving birth to a child is naturally more stressful for an adolescent than for an adult, and since the majority of women experiencing abortions are adults, this may bias the results. In addition, it appears to be a study primarily on short-term effects of abortion on mental health. Since abortion-related depression may arise even a decade after the actual event, I don't think one can draw the conclusion that abortion causes less depression than unwanted pregnancies based on this.

On the other hand, the study of Reardon and Cougle isn't conclusive proof for abortion causing more depression than continuing an unintended pregnancy, so in my opinion both the APA briefing paper and Reardon and Cougle's study ought to be mentioned, if this Wikipedia article is meant to be neutral.

Sedondly, I would like to reformulate the rest of the third paragraph as follows:

"On the other hand, according to an APA briefing paper on the impact of abortion on women, elective abortion may on the contrary cause less depression than carrying an unwanted pregnancy to completion, although it is also sometimes reported as an additional stressor. This paper also suggests a link between elective abortion and improvement in reported mental well-being, and that adverse emotional reactions to the procedure are most strongly influenced by pre-existing psychological conditions and other negative factors. In cases in which abortion has been denied, it can have a negative, long-lasting outcome for both women and their families. "

This formulation contains the same facts as the original version, but eliminates the need of three separate references one after another, all pointing to the same article.

Thirdly, I would like to continue the sentence about the Finnish study with ": for women who had chosen abortion the risk of suicide was more than five times higher than for women who had given birth." That would be a minor amendment which would give the reader a far better picture of the results of the study. "A statistical correlation" doesn't say much - practically all published studies contain statistical correlations.

Mkaksone 20:05, 6 September 2006 (UTC)Mkaksone

Last year, it was decided that an article on fetal pain, published in the Journal of the American Medical Association — no less prestigious than the BMJ, I'd think — was inappropriate due to the association of two of its authors with NARAL (see Archive 13, "Fetal Pain"). WP:RS notes that bias in a source might be subtle but that it is nonetheless an important consideration. Everyone has an opinion on this subject, of course, but that doesn't mean that a person's views couldn't present a conflict of interest. I have never read anything to suggest that the author of the APA briefing paper is a pro-choice activist, because I've never encountered an actual name, beyond the APA itself. You will need to provide a source to verify this claim if we are to give it due consideration.

WP:NPOV#UW is also of concern here. This is a top-tier article, and, as such, much of what is written here is a summary of other relevant articles; we must be selective in what we convey and do it briefly. But, if you stress the specific findings of one study, while omitting those of another, you are creating undue weight. We would need to cite hard numbers in both case or otherwise an addition like this would in no way be a move toward neutrality. -Severa (!!!) 23:25, 6 September 2006 (UTC)

Hi, Severa! You asked for the source of my information regarding the pro-choice stand of the authors of the APA briefing paper. Naturally, I don't know the names of the authors any better than you do, since they don't stand anywhere for some reason. I don't think I need names to know it, though. I know the authors are pro-choice, because they say so themselves. Read the end of the APA briefing paper. The authors clearly state they believe in free access to legal abortion for women. As a matter of fact, if you take a closer look at the website, the entire text is written by the public policy office, as a briefing of the APA's stand on abortion and an explanation as to why it is pro-choice. But as I said, I don't think an article can be considered irrelevant just because of its authors' opinions, and if the article in the Journal of the American Medical Association was rejected merely on the basis that the authors were pro-choice, I think that's unfair.

As for your other concern, I'm all for adding hard numbers to the mentions of the other studies as well. I think it would improve this section considerably - for instance, I'd like to know how big the differences in outcomes of adolescents who aborted and adolescents who chose to give birth were, or the differences in reported mental well-being before and after abortion, or get some more details regarding the study of Russo and Zierk in 1992, the source referred to by the APA briefing paper as the study indicating negative emotional reactions to abortion are most strongly influenced by pre-existing negative factors. If presented briefly, these numbers wouldn't significantly prolong the article while giving the reader a notably better picture of the results of the studies. I would have suggested adding these numbers as well, but they don't stand in the APA briefing paper. I don't think we should report all studies inexactly just because no exact numbers are even given in one of our sources. I searched for the articles by Adler et al. and Russo and Zierk referred to by the paper via PubMed, but I only managed to find an abstract of the study by Adler et al., and not even that of the study by Russo and Zierk. But if you manage to find some exact numbers regarding the results of these studies, please add them.

I agree no study should be given excessive stress in an article like this, but as it is, the Finnish study is reported in a way which doesn't give the reader any picture at all of the results - as I said, all studies generally need to present "a statistical correlation" in order to be published in the first place. But if you think my suggestion stresses the Finnish study too much, how about this formulation: "According to one study, the risk of suicide is more than five times higher for women who have chosen an abortion than for women who have given birth. " This formulation is actually shorter than the original version, while being far more informative and precise.

Mkaksone

...i strongly support the deletion of the APA position paper in favor of citing actual studies readers can link to under "verifiability." they should be able to form their own opinions-- instead of being spoon-fed interpretations so heavily slanted they read like a press release. (i particularly do not think it should be cited twice in a short paragraph). Cindery 09:21, 7 September 2006 (UTC)

Multiple, ibid-style citation was required to resolve confusion, when a user removed content because he did not understand that the entire paragraph was derived from the source listed at the end. Thus each sentence was cited individually to avoid future misunderstanding. -Severa (!!!) 20:45, 8 September 2006 (UTC)

Severa! I’ve done some additional reading, and it appears you were right and I was wrong – it seems it might indeed be possible opinions could present a conflict of interest in some cases. I searched for information about the leading authors of the studies the APA briefing paper referred to, i.e. Nancy Adler and Nancy Russo, on Google and found the following:

Nancy Russo is openly pro-choice – in one quote, she even talks about the agenda of pro-choice researchers, apparently including herself in this category. (See [[2]]) (NOTE: The neutrality of this article is debatable, since other websites suggest its author is against abortion, and I suspect the quote is incorrect or at best inaccurate. Even so, I think Russo's position on the issue becomes fairly clear.)

As for Nancy Adler, I eventually did manage to find a name connected to the APA briefing paper – according to this article [[3]], Nancy Adler herself is the lead author. As a matter of fact, this document [[4]] shows she and Nancy Russo were both involved with the same division of APA. And all but two of the studies referred to in the entire APA briefing paper have Adler or Russo as the leading author, or are written by “Prochoice Forum of Division 35” – a division of APA. What a funny coincidence.

And of course, both Russo and Adler seem to constantly get results that show no significant increase in depression rates of women who have experienced an abortion compared to women who have continued an unwanted pregnancy, and dismiss any studies pointing to the contrary, just as Reardon, who is against abortion, seems to display a tendency to do the opposite.

I’m disappointed. I really thought research was supposed to be about making science, not about proving oneself right. One would think researchers could at least pretend not to be pro-choice researchers, or pro-life researchers, but simply researchers investigating the facts, without any underlying agenda.

It unfortunately seems pretty apparent certain researchers actually do let their opinions interfere with their work. Consequently, in my opinion we shouldn’t add the study by Reardon to this article after all, and in addition we should delete the parts of the article that are based merely on the APA briefing paper and a separate article by Russo, in other words this part of the article would be deleted:

“Data on the incidence of clinical depression, mental illness, post-traumatic stress disorder, and suicide in association with abortion remain inconclusive.

Some studies have suggested a link between the elective termination of an unwanted pregnancy and an improvement in reported mental well-being. Elective abortion may reduce the occurrence of depression in cases of unwanted pregnancy, as compared to cases in which the pregnancy has been carried to completion, but it is also sometimes reported as an additional stressor. The majority of evidence would seem to indicate that adverse emotional reactions to the procedure are most strongly influenced by pre-existing psychological conditions and other negative factors. ”

In addition, I guess the parts based on the APA briefing paper in the Post-abortion syndrome article should be deleted as well.

I didn’t find any information indicating the authors of the Finnish study would be pro-choice or pro-life activists, and the author of the study conducted in New Zealand is actually pro-choice – according to his own words he published the results (despite the warnings of his fellow pro-choice researchers who thought it would just get him caught up in the debate) only because he thought it would have been dishonest to conceal the findings just because he didn’t like them. (See [[5]]) Consequently, I think we can safely include these studies in the article.

As for the study indicating negative effects for women and their families after the woman has been refused an abortion, I don’t know who the authors are since the link leads to a “File not found” –site. Also, the link to the study of the effects of miscarriage on depression obviously leads to the wrong site. If someone knows where these sites actually are, could this person please correct the links to lead to the right places?

Mkaksone 09:40, 8 September 2006 (UTC)Mkaksone

...i think the "data on the incidence...remain inconclusive" sentence is an objective assessment, and should stay. based on "the majority of the evidence," i agree that whether or not depresssion was an underlying condition is also an accurate/objective summary. (but the APA position paper is not a good citation for that claim). and again, the APA position paper should go--it's a didactic, biased, unauthorative synthesis with a press-release overtone/thrust. i do support the inclusion of the underlying studies it cites to make the balanced case that data is indeed "inconclusive." Cindery 16:45, 8 September 2006 (UTC)

That's all right with me, if we decide to start accepting studies whose authors have strong personal opinions on the issue, but if that's the case I see no reason to exclude Reardon either. Or the article Severa was talking about earlier, the one excluded because of the membership of an author in a pro-choice group. We could either exclude all such studies, or we could accept them, but I think we should do one or the other. Severa? What do you think?

One thing about the sentence "data on the incidence...remain inconclusive". No matter whether the assessment is objective or not, it isn't included in the article that it's referred to - the article by Schmiege and Russo states only that data on the incidence of clinical depression remains inconclusive, saying nothing of mental illness, post-traumatic stress disorder, or suicide. It's a minor error, but I think it wouldn't hurt to correct it. Mkaksone 17:18, 8 September 2006 (UTC)Mkaksone

...i just want to clarify for the purpose of discussion that there is a difference between studies and interpretations of studies. (i.e, the APA paper is not a study but an interpretation of selected studies.) study bias in individual studies comes up a lot in other articles/the outside world, and is primarily concerned with financial conflicts of interest (i.e., when the author(s) of a study received money from the drug company whose drug is favorably reviewed in the study). the professional ethical standard of medical journals is not to reject the studies, but to require disclosure of all potential conflicts of interest. i think reporting potential bias/conflicts of interest matters when a single study is included, and the findings of the study have not been reproduced elsewhere. if resercahers with no potential conflict of interest to disclose have also made similar findings, the potential COI is not so relevant to report. disclosing all the potential biases in studies re mental health and abortion doesn't seem necessary, as long as the conclusions presented here reflect "inconclusiveness," which imples that there is no consensus and invites readers to investigate studies/potential biases on their own.--i.e., the studies may be affected by bias, but our presentation of them is not affected by bias; does not favor one bias over the other.

re depression does not cover suicide, etc: perhaps a more inclusive term would be helpful, one that absorbs all the negative sequelae. Cindery 17:52, 8 September 2006 (UTC)

sorry, Mkaksone, that i overlooked two other points you made: i agree that reardon should be included, and that "statistical correlation" is vague/euphemistic/weasel worded, and the summary should cite numbers. Cindery 19:16, 8 September 2006 (UTC)

WP:RS is clear on the issue of source bias. Obviously, we cannot audit the personal opinions of an author, but we can verify that he or she does not have any connections which might present a conflict of interest. For instance, a study questioning the negative health effects of cigarettes authored by a smoker wouldn't be an issue, but such a study from a someone with proven ties to the tobacco lobby would raise questions. Thus, the precedent here is that sources which are written by those who have been involved in pro-life or pro-choice advocacy, or have connections to such advocates, require special consideration. In the case of the JAMA study, its lead author had once provided legal work for NARAL [6], and Reardon has been involved in the pro-life movement. [7]

Of course, such bias concerns could be resolved with prefacing. However, given the fact this is a top-tier article, which is largely in the business of summarizing other articles, we must remain concise. There is only so much prefacing we can add before the article would become burdened by it. Thus, it is probably better to just sidestep problematic studies entirely, and leave them to more targetted articles where there would be room to fully address any concerns.

The American Psychological Association is far from being an advocacy group, and, aside from a public policy recommendation based on its interpretation of the weight of scientific evidence, [8] I am not aware that the APA has any connection to either side of the abortion movement. We would need a source to establish the fact that there is a conflict of interest, because, unfortunately, the perception of one is not evidence in itself. The APA would certainly be no less invested in policy recommendations than Reardon's think tank The Elliot Institute. Also, describing the APA as "didactic" is odd, given that David Reardon's doctorate was in Social Sciences, not Medicine or Psychology.

I also see no basis for removing the APA's conclusion because it is a "synthesis" of the results of multiple studies. The 2003 NCI workshop and Joel Brind's meta-study, both the product of such informational "synthesis," are referenced in the "Breast cancer" sub-section without issue.

If Russo, as an individual author, has connections to the pro-choice movement, this would be an issue. Unfortunately, though, if we exclude her findings, we won't be left with much of a section. The remaining section would present a negative, one-sided picture of the abortion-mental health issue, which would be a far worse violation of NPOV. The solution, thus, would be to list a study's author(s) and note any potential bias if it is deemed appropriate. The study bias precedent does indeed have a one-size-fit-all, class detention effect which makes nuanced decisions difficult. -Severa (!!!) 19:51, 8 September 2006 (UTC)

conflict of interest v. bias

WP:RS is clear on the issue of source bias. Obviously, we cannot audit the personal opinions of an author, but we can verify that he or she does not have any connections which might present a conflict of interest. For instance, a study questioning the negative health effects of cigarettes authored by a smoker wouldn't be an issue, but such a study from a someone with proven ties to the tobacco lobby would raise questions.

i think you are mistakenly conflating bias with conflict of interest. conflict of interest (as in examples of drug companies or tobacco lobby funding research) refers to finacially motivated bias. opinion bias is generally agreed to potentially exist in every study--hence the gold standard is the double-blind controlled placebo study. "consensus" is even more problemmatic viz bias, as it can be taken to mean that something has been decided once and for all, but is in fact subject to change based on new information (as in the case of idiopathic disease and psychological distress subject to great individual and contextual variation). i see no precedent in WP:RS establishing that potential opinion bias in and of itself renders a study irrelevant. (the professional ethical standards of medical journals--i.e., the outside world which wikipedia is supposed to reflect) do not exclude studies from publication for potential opinion bias (but they hold double-blind controlled studies, reproduced/reproducible evidence, and peer review in higher esteem than a single study.)

the problem with the APA position paper is that it is exactly that--a position paper, clarifying the political position of the APA (it is not an authoritative objective synthesis of the studies to date; although it pretends to be one). i would say that it will never be possible to absolutely determine by empirical evidence that there is a causal relationship between an event and a reaction, for the same reason that psychology is not a hard science:individual variation is too great and too paradoxical. assertions regarding associations between depression and abortion will no doubt continue indefinitely and inconclusively. hence studies--biased or not--from both sides should be included to reflect that there is no agreement, including russo and reardon. APA presents false objective consensus, which is different than a potentially biased study.

re the rearrangement of first sentence in section: a problem throughout the "mental health" section is that post-abortion syndrome, depression, and other adverse psychological effects are not distinguished in the point-counterpoint. (meaning: all studies which examine and find depression are not therefore asserting post abortion syndrome exists). Mkaksone is correct that depression/suicide are different findings. the Russo studies didn't really address depression, but "self-esteem." there are pro-life assertions that "post-abortion syndrome" exists, but those have not been mentioned or included (which is necessary for a point-counterpoint about whether it exists and who thinks so). "data is inconclusive" is NPOV; i'm not so sure about "negative feelings about reproductive choices"--vague and weasel-worded, this article is about abortion--and immediate mention of "PAS" as though it were the inclusive summary of the issues at hand, when it is not. Cindery 21:15, 8 September 2006 (UTC)

I suggest you read through the archives to understand why this is the current wording. The original text read as: "Some women will experience negative feelings as a result of elective abortion." This was carefully worded to acknowledge the fact that, regardless of whether studies refute or support the assertation that abortion is generally a detriment to mental well-being, some women will report negative feelings as a result of having terminated their pregnancy. [9] However, another user complained that this phrasing was "weaseling," in light of the fact that women can also regret childbirth. The sentence you believe to be weasel-worded was in fact the product of an attempt to avoid weasel-wording. [10] :-Severa (!!!) 22:40, 8 September 2006 (UTC)

that in no way means it is not weasel-worded now. and prior consensus is always subject to criticism/debate/change. i think the "data is inconclusive..." is a far superior lead (also previously in the article) and that "some women..." is flabby, vague, superfluous. Cindery 22:51, 8 September 2006 (UTC)

I agree the APA briefing paper is biased. Severa, the problem with this paper isn't the fact that it's a synthesis of multiple studies. The problem is the fact that the articles it has chosen to quote contain almost exclusively articles by either Adler or Russo, or "Prochoice Forum, Division 35". It also quotes a report of "Centers for Disease Control and Prevention", but the statistics attributed to it are about abortion rates and risk of death, not about the effects of abortion on mental health. A study by Zabin, Hirsch and Eberson (investigating the impacts of abortion on adolescents like the study by Adler et al. quoted earlier) is the only study presented in the entire report on the impact of abortion on the mental health of women, aside from studies of Adler and Russo. I find the decision to quote almost exclusively studies of two authors more than a little surprising, if the APA briefing paper had indeed been meant to be an objective synthesis of the studies on this issue.

As mentioned previously, I happened to find out that, interestingly enough, Adler is herself the leading author of the APA briefing paper, and the links I presented earlier show that Russo was for instance the person who the APA referred Throckmorton to when he asked them for a comment on a mental health and abortion related issue and that Russo and Adler have been involved with the same APA division. Writing a paper claiming to tell what "well-designed studies of psychological responses following abortion" indicate and then quoting almost exclusively one's own studies doesn't seem to me like an objective way to write a synthesis, to say the least.

Mkaksone 22:35, 8 September 2006 (UTC)Mkaksone

i hadn't noticed that adler was author of both synthesis and study synthesized-i agree that utterly shreds the credibility of APA paper viz any claims of objectivity or peer review. it is not only a position paper, it is a self-published position paper, in which the author favors her own study... Cindery 23:18, 8 September 2006 (UTC)

"unilateral blanking"

automatic reverting without addressing the discussion (see above) is edit warring, and you are up to 2 reverts in as many hours...this is clearly not "stable" content as it is currently the subject of discussion/re-edit/reverting. "PAS" again, does not encompass all of the studies referred to in the section, and should not be referred to in the first sentence as if it did. Cindery 21:56, 8 September 2006 (UTC)

On the contrary, Cindery, you are the one whose editing behavior is questionable, as you are removing content which has been in the present article in a relatively unaltered form for nine months without explanation or agreement. -Severa (!!!) 22:13, 8 September 2006 (UTC)

try to keep a "cool head"--reverting more than once without discussion indicates a problem. :-)

content is not being "removed," an uncited, weasel-worded sentence has been removed, and another not removed at all but moved down in the paragraph to signify that while the PAS debate exists, it is not conflatable with all the conflicting studies on abortion/mental health.

content is no longer "stable" once it's justifiably contested--corrections/adjustments are welcome whenever in wikipedia (as with diff between MVA and EVA and cervical dilation...) "but that mistake has been there for a year!" is not an argument for keeping a typo, for example. Cindery 22:24, 8 September 2006 (UTC)

WP:Vandalism

"Do not place dispute tags improperly, as in when there is no dispute, and the reason for placing the dispute tag is because a suggested edit has failed to meet consensus. Instead, follow WP:CON and accept that some edits will not meet consensus." So what, exactly, is the rationale behind this? -Severa (!!!) 00:10, 9 September 2006 (UTC)

accuracy dispute

i was trying to post terms, but there was an edit conflict while you personally attacked me with a vandalism accusation. you may not remove dispute tags while a dispute is unresolved.

the studies referred to in the mental health section do not make arguments for the existence of "post abortion syndrome." "post abortion syndrome" is a term used for example, here: [11]

the debate about whether or not "post abortion syndrome" exists is separate from inconclusive data about whether or not negative psychological sequelae can ensue from abortion, and should not define the discussion in the section in the lead sentence, as it is not at issue in the studies.

equating all studies which find that depression, suicide etc. can ensue from abortion with "the existence or not" of a defined nosological category advocated by none of the scientists who have performed the included studies is an example of a straw man argument. if, for example, all of the studies advocated that PAS should be a defined term, based on their findings, then an appropriate summary in the lead sentence would be "some say it should be in the DSMV, but it is not." since none advocate this, framing the discussion in terms of PAS in the lead sentence is inaccurate.—The preceding unsigned comment was added by Cindery (talk • contribs) 20:21, 8 September 2006.

Note how I neither refered to you as a vandal nor removed your tag. I merely refered to a WikiPolicy page. Generally, tagging an article is regarded as last resort in an editorial dispute, not a first resort. Specifically, a tag is is usually placed when debate between several editors fails to yield a solution and has reached an impasse. Tags are obstrusive and distracting to readers and thus placing them in an article is not something which is to be done lightly or preemptively.

"Post-abortion syndrome" is a term used by Wikipedia as the title for an article. If you have an issue with the term, it should be addressed on Talk:Post-abortion syndrome, not here. Nowhere does the section attempt to equate findings on depression, suicide, etc. with this proposed syndrome. It merely states that there is debate over whether post-abortion mental health effects warrant an individual nosological classification, and, then, goes on to note that PAS is not a mental disorder listed in two prominent diagnostical manuals. You might infer that therein PAS is being equated with other conditions (depression, substance abuse, suicidal tendencies, etc.), but this, in and of it itself, does not constitute a factual dispute. The underlying facts, discussed above, are not in dispute. -Severa (!!!) 01:08, 9 September 2006 (UTC)

...you immediately lobbed an inappropriate vandalism accusation (and demanded an explanation)-- so quickly i couldn't even post terms on talk page right after tagging the section. remember again, to "keep a cool head." i reminded you not to remove the tag because you've been set on "automatic revert" rather than "editorial discussion." moreover, this is becoming a two-person argument, not an editorial dispute per se, which is partly why i affixed the tag--the discussion should be noticed and commented on other editors (who may also be readers of the article).

post-abortion syndrome is a wikipedia article which does not address the broader category of mental health and abortion, but "post abortion syndrome." i do not dispute that the term exists--on the contrary, i have repeatedly asserted that it does.

the accuracy dispute does not refer to the existence of the term--it refers to the straw man use of the term in the lead sentence of the "mental health" section. none of the studies in the section which report negative findings advocate use of the term. Cindery 01:35, 9 September 2006 (UTC)

I haven't had the time to read all the talk page discussion yet, but I think citing the actual studies, instead of the general overview from the APA, seems like an improvement to me. However, I think we may need to watch out for being a bit meticulous by citing each individual study in such detail. (or not, I'm torn. at the very least, I'd say we shouldn't add any more specific details) Regardless, it seems like both paragraphs need topic sentences to give a brief overview/connect the studies, and to perhaps explain the contrast between the two 'sets' of studies. something like "On one hand, a number of studies have shown abortion to have neutral or postive effects on mental health in some patients..." "On the other hand, a number of other studies have shown a correlation between abotion and depression/suicide/etc in other patients". Something along those lines leading in each paragraph? Maybe we don't need the "on one hand/other hand" part, but you get my drift. I'll review the discussion and comment more later.--Andrew c 02:11, 9 September 2006 (UTC)

The tag placed states the following: "The factual accuracy of this article or section is disputed." It has not been conclusively established precisely what facts are in dispute. What is being questioned is the manner in which the facts are being presented, not the accuracy of the facts themselves, and thus the use of this tag is inappropriate. -Severa (!!!) 02:34, 9 September 2006 (UTC)

i think it is appropriate to give other editors time to contribute to what is now a long complicated discussion; you do not WP:OWN the article. the terms of ther factual accuracy dispute have been carefully explained several times now. Cindery 02:49, 9 September 2006 (UTC)

Perhaps my "examination" of the situation is unsatisfactory, but a quick check and run-through of all the citations for that section checks out perfectly normal, and un-biased publications on a psychologist journal (or something along those lines).

If you're actually referring to the subject of whether or not such sources are valid and trust-worthy... that argument could probably be extended to everything within the article. --Talv 20:45, 9 September 2006 (UTC)

(note: this is the version Talv read/is referring to: "Some women experience negative feelings as a result of their reproductive choices. In the case of abortion, whether this phenomenon warrants a general diagnosis, or even classification as an independent syndrome, is debated by an extreme minority. [39] Post-abortion syndrome is listed in neither the DSM-IV-TR nor the ICD-10. Data on the incidence of clinical depression, substance abuse, post-traumatic stress disorder, anxiety and suicide in association with abortion remain inconclusive. Women who suffer from conditions listed in the DSM-IV following an abortion--such as depression, anxiety, stress, substance abuse and suicidal behavior--do not need a diagnosis of "post abortion syndrome" to be treated for those conditions.") Cindery 17:56, 10 September 2006 (UTC)

the section has been adjusted since the beginning of the dispute--i added a citation to support that any medical source believes that PAS should have its own classification--there was none before. (and the qualifier that this is the "extreme minority" of medical opinion). so now i suppose the accuracy dispute revolves around whether the extreme minority medical view should be in the first sentence (framing the section) or if it should be moved further down in the paragraph to a place of more appropriate emphasis. Cindery 21:02, 9 September 2006 (UTC)

I think its like one of those issues that comes up on Big Bang and Evolution. Because the article is about a scientific POV, views that are nearly non-existent within the scientific community are given proper weight, which is to barely mention them at all. If we are to follow this precedent, we probably shouldn't mention PAS in the opening, and simply keep it as an aside somewhere. ON the otherhand, part of this article covers the social/political debate where PAS may be a more common view. Perhaps it belongs in another section? Anyway, just some thoughts.--Andrew c 21:51, 9 September 2006 (UTC)

i think andrew's suggestion that a debate outside of the medical/scientific community does not belong in this section is a good one. perhaps "PAS" can go in abortion debate article or section. "framing" abortion and mental health in terms of a debate not addressed by medicine/science/the studies cited in the section does a disservice the section, to objectivity, to NPOV. i noticed also in the talk archives for this article that the original intent of framing this section in terms of "PAS"--based on a paucity of participants and discussion--was to counter a single editor who started the "PAS" article... Cindery 04:39, 10 September 2006 (UTC)

I don't quite understand why the section that discusses the theory of post-abortion syndrome can't be linked to the main article. Because of the reason that article got started, or its creator? You gladly have my blessing to adapt that article as you see fit. In the meantime, that section of this article deals with the "extreme-minority viewpoint", and I see that as the only reason it's immediately addressed. I'll refrain from adding back the link for the moment, but I don't understand why you object to it. As for moving it to a different section...maybe. I personally think it's fine where it is (though, yes, it should be noted as a minority viewpoint), but if we can reach a faster consensus by moving it, all the better. -Umdunno 05:26, 10 September 2006 (UTC)

...saying "see PAS" implies that mental health section is summary of PAS article, which it is not (nor has anyone ever claimed it was until 2 hours ago.) Cindery 05:48, 10 September 2006 (UTC)

It is inaccurate to claim that the some proposed health effects of abortion are not debated outside of the medical community. Such issues do not exist in a some sort of vacuum which precludes consideration and input from the laity. In fact, the "Suggested effects" sub-section begins, "There is controversy over a number of proposed risks and effects of abortion." The "Breast cancer" summary section also happens to conclude:

" Most medical professionals agree with the recent prospective studies that conclude no abortion-breast cancer association, and the ABC issue is seen by some as merely a part of the current pro-life "women-centered" strategy against abortion. Nevertheless, the subject continues to be one of mostly political but some scientific contention."

Post-abortion syndrome is a good foundation upon which to base our summary. We should concentrate of summarizing this article, as was done with Abortion-breast cancer hypothesis, instead of trying to reinvent the wheel as we are doing now. After all, why is there is no drive to divorce discussion of the potential of a correlation between abortion and breast cancer from that of the "ABC hypothesis?" -Severa (!!!) 05:02, 10 September 2006 (UTC)

...the scientific studies in the ABC article find for and against breast cancer. the studies in the mental health section find for and against mental health (not for and against PAS). Cindery 06:36, 10 September 2006 (UTC)

There is no suggestion that PAS is linked to or dependent upon other disorders. This is your own assessment of the section; we will need clear evidence and a definitive reason to justify the exclusion of PAS — a suggested psychological condition related to abortion — from the "Mental health" sub-section. Otherwise, it would be little more than POV-forking. If it is still your opinion that distiction between "Post-abortion syndrome," which is itself ill-defined, and other disorders is insufficient, then perhaps the solution would be to propose the creation of a Abortion and mental health article. Circular arguments are not going to produce a solution and are just going to distract us from addressing other parts of the article. We have generously let your tag remain for two days, but it is an obtrusive and unsightly presence, and is not justified given the fact that your concerns are ones of context, not of factual accuracy. Tags are not to be misused as leverage in editorial disputes and thus it should be removed. -Severa (!!!) 07:26, 10 September 2006 (UTC)

you are making edits regarding disputed content claiming consensus you don't have; you are adamantly defending your own original wording/straw man argument against all reasonable arguments WP:OWN and you are personally attacking people WP:NPA who don't disagree with you by calling them sockpuppets and vandals. again, try to keep a cool head and see what consensus emerges. maybe you need a break. Cindery 08:25, 10 September 2006 (UTC)

Also, please note the to-do list, which contains many tasks which as-of-yet remain incompleted. Endlessly rehashing already-completed sections is counterproductive and hampers progress on this article. -Severa (!!!) 05:20, 10 September 2006 (UTC)

"prior consensus"

the "PAS" article does not equal the scientific or medical studies on mental health and abortion, which is what is summarized in the section. "PAS" gets exactly seven hits on pubmed, only one of them current (the one i included--in which a whole two doctors advocate for the term). that's an "extreme minority."

below, i have posted your previous summary of why the section should be framed in terms of "PAS." the problem with the discussion below is that neither of you is arguing WP:RS--you are arguing your own opinions against the perceived threat of a pro-life website + pro-lick and his PAS article. the decision that "the real bone of contention" is whether PAS exists is just your opinion of what the heart of the matter is based on one editor and a website--it is not based on a reliable source, or any of the studies summarized in the section. the "debate" you refer to appears to have been a debate between you and two or three other people vs. pro-lick and his PAS article.

from the talk archives:

"Mental health changes

The original:

Some women will experience negative feelings as a result of elective abortion. However, whether this phenomenon is significant enough to warrant a general diagnosis, or even classification as an independent syndrome (see post-abortion syndrome), is a subject that is debated among members of the medical community.

"Pro-lick's version:

"Negative mental impact as a result of elective abortion is considered unproven. This phenomenon has been generally referred to as post-abortion syndrome."

The original version "covers all bases," and, thus, I believe it should be kept. Some women will regret abortion, or be pained by it, as many come to regret decisions such as dropping out of high school or having an extramarital affair. It's callous and dismissive to label such emotions as "unproven," even unintentionally, and even if such campaigns as Silent No More are little more than alarmist efforts intended to ban abortion through the self-interested manipulation of human suffering. The real bone of contention herein is whether abortion is in general deleterious to mental health and whether this effect warrants classification as an independent syndrome. I'm reverting the opening paragraph in this interest. -Severa ?? | !!! 04:11, 27 March 2006 (UTC)

Obviously some women are going to be unhappy about having an abortion. In fact, even those relieved by the termination of an unwanted pregnancy may well be unhappy that they got pregnant in the first place and had to have an abortion. This isn't the issue. The issue is whether there's some sort of PTSD-like syndrome associated with abortion. It has been claimed by anti-choice advocates to exist, but there's no credible evidence and we have to make that clear. Perhaps we can split the difference between these two paragraphs. Alienus 04:25, 27 March 2006 (UTC)" —The preceding unsigned comment was added by Cindery (talk • contribs) 05:48, 10 September 2006.

Mental health and PAS

I think Andrew c's suggestion to add "On one hand"/"On the other hand" topic sentences to the two paragraphs is a good idea. As it seems no one else has anything against it either, I'll add these sentences to the beginning of both paragraphs.

As for the PAS issue, I think Cindery's addition "Women who suffer from conditions listed in the DSM-IV following an abortion--such as depression, anxiety, stress, substance abuse and suicidal behavior--do not need a diagnosis of "post abortion syndrome" to be treated for those conditions." and the mention that there are two doctors who think that PAS should have its own classification clarified the section considerably and should be re-added. Right now, this paragraph appears to be confusing - Severa's comment "After all, why is there is no drive to divorce discussion of the potential of a correlation between abortion and breast cancer from that of the "ABC hypothesis?"" makes this clear. "The potential of a correlation between abortion and breast cancer" and "the ABC hypothesis" are synonyms. Post-abortion syndrome and depression/suicide/etc occurring post-abortion are not. The discussion whether there's a relationship between mental health problems and abortion, and the discussion whether there's an independent set of mental symptoms specific to abortion that should be classified as post-abortion syndrome, are different issues. For instance, miscarriage is known to increase the risk of depression and suicide, but that doesn't mean there should be a separate nosological category called "post-miscarriage syndrome". Neither are there, as far as I know, any syndromes called "post-rape syndrome" or "unemployment-syndrome" or "post-death-of-family-member-syndrome", but that doesn't mean these events couldn't be related to subsequent mental health problems.

I think the issue primarily discussed in the Mental health -section is whether or not abortion in itself is related to subsequent mental health problems. The discussion whether the symptoms exhibited by some women after abortion constitute an independent syndrome is another discussion. The discussions are related and I agree the suggestion to classify certain mental symptoms occurring after an abortion as "post-abortion syndrome" could be mentioned in this section, but not as if this discussion was synonymous to the general discussion on mental health problems related to abortion. Therefore, I support the re-addition of the clarification originally added by Cindery.

Mkaksone 07:09, 10 September 2006 (UTC)Mkaksone

I've modified the section to include a description of PAS from its own article. I have also broken the paragraphs and prefaced the second one in a manner which I hope resolves any unintentional conflation. -Severa (!!!) 08:36, 10 September 2006 (UTC)

no, what you changed does not at all make Mkaksone's observation that one need not be diagnosed, for example, with "post-miscarriage syndrome" to be treated for depression following a miscarriage; nor does it make clear that a separate nosological category/lack thereof is not considered a pressing issue in the medical community. per consensus, i have undone your revert to make those things clear. i believe that is a fair compromise, as what we are still primarily discussing is whether PAS belongs in the lead sentences(s) or not, i.e., should frame a neutral presentation of the studies to date regarding abortion and mental health. Cindery 20:21, 10 September 2006 (UTC)

PAS not main article

I'm fairly new here but I have been following this discussion closely. I offered one minor edit and was immediately personally attacked. Mumblio 08:03, 10 September 2006 (UTC)

Wow. Not sure what section of this page to add my notes to, since three sections seem to revolve around the same topic. I have been recently involved in a somewhat exhausting revision of Planned Parenthood#Controversy and criticism, which is why I haven't been around. I won't question the majority of the new revisions until I've had a chance to thoroughly go over them. But, looking at the current revision (by Mumblio), I note the total lack of linkage to post-abortion syndrome. I understand de-linking it as the mainarticle (although I haven't closely scrutinized the citations--yet), but removing it entirely is more than a little extreme. PAS is currently a well-written, appparently well-cited article, and it deserves to have the chance to speak for itself. It should be mentioned and wikilinked in the Mental Health section. Apologies if I am retreading old arguments; I have not had time to read the entire discussion and accompianing edit log--since it is about three pages long. Doesn't 3RR apply? Especially on such a heavily disputed page? --BCSWowbagger 05:28, 11 September 2006 (UTC)

Addendum: Hm. While I was writing this, I caught an edit conflict where Cindery dealt with some of those very issues I mentioned. I preserve my post as originally written for historical purposes. --BCSWowbagger 05:28, 11 September 2006 (UTC)

WP:3RR

continually and immediately reverting, severa, especially without discussion and against a consensus compromise, might be considered disruptive edit warring even though you stop at 2 every day. Cindery 05:17, 11 September 2006 (UTC)

"The Three-revert rule (or 3RR) is an official policy which applies to all Wikipedians. 3RR violations are reported here.

The policy states that an editor must not perform more than three reversions, in whole or in part, on a single Wikipedia article within a 24 hour period. This does not imply that reverting three times or fewer is acceptable. In excessive cases, people can be blocked for edit warring or disruption even if they do not revert more than three times per day.

Protected

I've protected the page in light of recent edit-warring. I am not going to block anyone for 3RR at this time, call it a amnesty if you may. Please discuss the changes instead of edit-warring with each other. If there is any signs of edit-warring after this page is unprotected I'll not hesitate to block the involved party/parties for any violations. --WinHunter ^(talk) 09:42, 11 September 2006 (UTC)

why the page is protected

[12]

Mental Health: Starting from Scratch

Okay. We've been protected. I think this is a signal that we should start over. We should scratch the whole mental health section as written and rewrite it here. When it's done, we can get a de-protect, but, now that we're stuck where we are, we might as well be sure we get it right before we open it up again. At the same time, we can put the recent edit war, and the personal issues contained therein, behind us, because it doesn't matter anymore. (This will also give me a chance to catch up on the entire issue. Sneaky me.  ;))

To that end, I just spent the last hour reading the Talk logs from 9/8 through 9/11--which, I note, is 37 pages long, double-spaced in Microsoft Word.

To wit, the problems here seem mostly to be a question of framing:

• Where should post-abortion syndrome be mentioned, if at all?
  • Lead sentence?
  • First paragraph?
  • Own paragraph?
  • Buried in another paragraph?
  • Not at all?
• How should PAS be discussed? (Several revisions mentioned it only to say that it is not DSM/ICD-listed.)
• How heavily should the fact that PAS is a minority view be emphasized?
  • Factual Dispute: How much of a minority view is it? Is it accepted only by an "extreme minority," by "somewhat less than a majority," or, more likely, somewhere in between?
• What exactly is PAS, and can studies showing increased rates of suicide, anxiety, etc. among post-abortive women be said to support the PAS hypothesis?
• This is an older issue, but still: What sources should be used? Is the current source list a valid one? A brief list of current sources:
  • Against adverse mental health effects:
    • Stotland, "The myth of the abortion trauma syndrome." Journal of the American Medical Association (JAMA)
    • Emerson/Hirsch/Zabin, "When urban adolescents choose abortion: effects on..." Family Planning Perspectives
    • Russo/Zierk, "Abortion, childbearing, and women." Professional Psychology
    • Russo/Schmiege, "Depression and unwanted first pregnancy: longitudinal cohort study." British Medical Journal
      • Note: Should we have two studies co-authored by the same person? It doesn't seem like a big deal, but worth mentioning nonetheless.
  • Supporting adverse mental health effects:
    • Gissler/Hemminki/Lonnqvist, "Suicides after pregnancy in Finland, 1987-94." British Medical Journal
    • Gomez/Zapata, "Diagnostic categorization of post-abortion syndrome." Actas Esp Psiquitr
    • Reardon/Cougle, "Depression and unintended pregnancy in the NLSY." Journal of Child Psychology & Psychiatry
  • Unrelated to PAS hypothesis:
    • Ferguson/Horwood/Ridder, "Depression Risk Increased After Miscarriage." Journal of Child Psychology & Psychiatry
      • Note: This study is improperly cited right now. Not part of the dispute, but something to fix.

It seems to me that, if we can answer these basic questions, we should be able to compose a new Mental Health section in a relatively short time. I hope this synthesis of all the content-related issues in this dispute (so far) will be of help. Sadly, I can not at the moment answer the very questions I have posed (re-posed, I suppose), as dinner has just been called. Mwaha. Burgers and fries, I smell. She's a good cook. Yum. --BCSWowbagger 22:36, 11 September 2006 (UTC)

...starting over is a great idea. but, the studies you have listed do not support/not support "PAS." the studies find or don't find DSM-IV disorders such as depression, suicide, anxiety, etc.

a neutral presentation of the scientific studies to date which find or do not find these DSM-IV disorders would be good. after that, a mention that pro-life/pro-choice advocacy groups debate something called "PAS" --which is not much of an issue in the scientific medical comminity--would be appropriate.

the obvious problem with "PAS" is that it implies that every woman who has an abortion will therefore have PAS. prolifers assert that PAS exists. pro-choicers say it does not, and counter that PAS is not in the DSM-IV. the medical community doesn't care if PAS is in the DSM-IV or not, because they don't need a separate diagnosis to treat people for depression/suicide etc. both sides use and abuse the scientific studies about mental health, not PAS and the DSM-IV classification status for their side--prolifers use studies which find for depression to support that PAS exists, prochoicers use the lack of DSM-IV classification to claim that PAS is a "pseudoscience" (did you notice that that is how it is classified at the bottom of the PAS article? or the bitter arguments/edit wars about leaving "pseudoscience" category attached to it?)

a discussion of the non-scientific debate between advocacy groups re a fad term should not define a neutral account of the scientific studies, but should merely be mentioned briefly towards the end.

Cindery 23:26, 11 September 2006 (UTC)

Cindery: tabs are important. ;) Seeing your point, I agree that calling the sources "supporting/opposing PAS hypothesis" depends on one's agreeing that "studies showing increased rates of suicide, anxiety, etc. among post-abortive women can be said to support the PAS hypothesis." I have altered my headings accordingly. I think I begin to understand your sentence about a woman not "needing" a PAS diagnosis for treatment, but it is a poorly worded one, seeming, from my POV, to pointlessly bash the PAS hypothesis, depending on how one connote's "need" (I think).

With the majority--in fact, pretty much all--of your analysis, I am inclined to agree. I would note that it is important, I think, that PAS, even if relegated away from the top paragraph (which would seem to be a justified measure), should be referred to as the main topic of a short paragraph towards the bottom of the section, which would basically say that some in the pro-life/medical community interpret the various inclinations to DSM-IV disorders in post-abortive women as indicating an entirely separate syndrome, referred to as post-abortion syndrome. Slipping in the word nosological would be appropriate, I think, but I don't know what it means. :)

Otherwise, what we (well, you guys, since I wasn't around) had going was a section with fairly good content that was being bogged down in the details of sentence placement and structure. Once there's been further commentary and consensus on the treatment of PAS, as well as any other issues anyone would like to bring up, we should be able to forumulate a new section with relative ease. --BCSWowbagger 03:05, 12 September 2006 (UTC)

• BCS, just quick note of clarification re "women do not need a diagnosis of PAS to be treated for depression, anxiety..."--that was not meant to bash PAS, but to defuse the use of PAS as a straw man argument. (i.e, the previous verison if the opening only said "however, PAS is not listed in the DSM-IV or the ICD 10." which implied, i think, that therefore depression, anxiety, substance abuse etc cannot occur after an abortion; PAS is utterly pseudoscience, doesn not pertain to DSM-IV disorders at all. the sentence was meant to clarify that the medical establishment has not refused to adopt PAS as a term not because women do not ever suffer from DSM-IV disorders after an abortion, but because doctors don't need additional terminology to treat women for those disorders. so yes, there is an overlap between idea of PAS and DSM-IV disorders. to say, "PAS is not in the DSM-IV, {therefore is is pseudoscience}" denied the overlap. the sentence only meant to point out the overlap, and defuse the implications of "it is not listed in the DSM-IV." (so no, it doesn't need to be in a new paragraph further down re pas.)

Cindery 04:35, 12 September 2006 (UTC)

Sorry it took me all day to get to this. I spent way too much time dealing with 75.3.50.41. I fully understand the purpose of your sentence ("Women who suffer from such conditions following an abortion do not need a diagnosis of "post-abortion syndrome" to receive treatment for them.")and your intent. I assumed good faith and read it over until I got the point. But, the first time I read it, I thought it was going for something like this: "Of course, the actual real-world women who suffer from real psychological conditions don't need some academic debate about so-called "post-abortion syndrome;" what they need is sane doctors who will treat the diseases women have instead of self-rightgeously moralizing about them." I can see that that isn't what you meant, but I think the sentence needs cleanup to avoid suggesting that interpretation. I also understand the implications of the way the other phrase was worded: "However, PAS is not listed in the DSM-IV." That made it sound like it was surprising or deeply contentious or even unjust that PAS wasn't so listed. So we need to make it clear that PAS is pseudoscience (there is no objection to this--right? Right?). I still think PAS is notable enough to merit a short paragraph--probs one sentence, two max--in this section. So, here's the structure I propose:

I. Statement that data concerning the effects of abortion are inconclusive -- short, to the point, lists only alleged DSM-IV disorders; no mention of PAS.

II. Current paragraph about alleged positive/neutral effects -- as long as needed, but no longer

III. Current paragraph about alleged negative effects -- ditto

IV. Mention of PAS and how it fits into this framework -- this would require careful NPOV combing, but would separate the issue from the rest of the paragraph, thus bringing a certain protection to it.

V. Current final paragraph, about birth and postpartum depression -- possibly flip with paragraph #4?

I look forward to your commentaries. --BCSWowbagger 01:52, 13 September 2006 (UTC)

...i have no objections to that structure, and even think that the article in its previous form--with a few new sentences about PAS inserted after the studies, before mention of miscarriage/pregnancy--would be fine/matches your suggestions. let's see what other people think. Cindery 02:28, 13 September 2006 (UTC)

would look like this:

"Data on the incidence of disorders such as clinical depression, substance abuse, post-traumatic stress disorder, anxiety and suicide in association with abortion remain inconclusive.

Some studies have shown abortion to have neutral or positive effects on the mental well-being of some patients. A 1989 study of African-American teenagers who sought pregnancy tests in Baltimore, Maryland found that the level of stress and anxiety, from the time of the test until two years later, of those who had an abortion did not differ from that of those who had not been pregnant at all or who had carried their pregnancy to term.[39] Another study in 1992 suggested a link between the elective termination of an unwanted pregnancy and later reports of positive self-esteem; it also noted that adverse emotional reactions to the procedure are most strongly influenced by pre-existing psychological conditions and other negative factors.[40]Termination, as compared to completion, of an undesired first pregnancy was not found to directly pose the risk of significant depression in a 2005 study.[41]

Other studies have shown a correlation between abortion and negative psychological impact. A 1996 comparative analysis of the suicide rates among postpartum and post-abortive women in Finland found that suicide is more common after a miscarriage and especially after an induced abortion than in the general population.[42] Additional research in 2002 reported that the risk of clinical depression was higher for women who chose to have an abortion in comparison to those who opted to carry to term — even if the pregnancy was unwanted.[43] Another study in 2006, which used data gathered over a 25-year period in Christchurch, New Zealand, found an increased occurrence of depression, anxiety, suicidal behavior, and substance abuse among women who had previously had an abortion.[44]

(a few sentences about PAS)

Miscarriage, or spontaneous abortion, is known to present an increased risk of depression in women.[45] Childbirth can also sometimes result in maternity blues or postpartum depression."

This structure is fine with me. What would those few sentences about PAS be? Any suggestions? Mkaksone 09:41, 13 September 2006 (UTC)Mkaksone

Where's the bit about abortion having a positive effect on mental health in some cases? KillerChihuahua^?!? 09:43, 13 September 2006 (UTC)

KillerChihuahua, the "positive" effect refers to later reports of positive self-esteem by women who had earlier experienced an abortion in a study by Nancy Russo and Kristin Zierk in 1992.

As for the section on PAS, would this be an acceptable formulation:

"The existence of post-abortion syndrome (PAS), an independent set of mental symptoms associated with abortion that would warrant a general diagnosis or classification as an independent syndrome, is currently considered a possibility by two doctors. The psychopathological symptoms attributed to post-abortion syndrome are similiar to those of post-traumatic stress disorder, but have also included, "repeated and persistent dreams and nightmares related with the abortion, intense feelings of guilt and the 'need to repair'". PAS is listed in neither the DSM-IV-TR nor the ICD-10."

Maybe the last sentence should be excluded, if BCSWowbagger still thinks it makes it sound like PAS ought to be listed? But I think the mention that it's considered a possibility by two doctors should make it clear enough that this is not the case. What do the rest of you think?

Mkaksone 10:49, 13 September 2006 (UTC)Mkaksone

...i think that the previous version of the article--framed in terms of PAS--purported to be only a scientific/neutral account which excluded prolife/prochocie arguments, but actually was a stealth POV-pushing of the pro-choice view. for example, the statement that PAS is "debated" did not tell us who debated it, but did imply that the debate was scientific. pointing out that in the scientific/medical community, two doctors/an extreme minority think PAS should have a separate DSM-IV classification clarified the "debate" in a way consistent with what the terms of the section were supposed to be--science only; no biased unscientific opinions.

andrew's point that PAS is debated by the advocacy groups is true, i think. since we would be making it clear--by separating PAS from the studies--that the studies/the PAS debate are different things, i think it would be ok to find citations from each side which define the opposing views in the cultural/political pro-life/pro-choice debate re PAS? (the first three google hits on PAS seem to be pro-life websites. one of them could be cited, and the APA citation could be the counterpoint. it could also be mentioned that the medical community has addressed PAS in a minor way, by providing two citations for that--the "two doctors," and the JAMA article? Cindery 17:31, 13 September 2006 (UTC)

...the pro-life/pro-choice advocacy arguments re PAS seem to be:

• Pro-choice advocates argue that since the 80s, the pro-life movement has "framed its arguments in terms of health because it has failed to convince others that abortion should be illegal on moral grounds alone." i.e., PAS is just a political tactic in the fight to overturn roe v. wade. in addition, they allege that the diagnostic criteria are intentionally and broadly vague, to include as many post-abortive women as possible within its description, making it appear universal/epidemic/de facto causally-related. [13]

• pro-life advocates counter that the main critic of PAS is the APA, which is biased and "pro-abortion," and therefore refuses to accept/consider that PAS exists strictly for political reasons. they also claim that PAS takes time to emerge, and that the studies the APA cites to debunk PAS are based only on very short-term evaluations of post-abortive women, who are likely to be experiencing temporary feelings of relief-- only to have delayed traumatic/negative responses later. [14]

1) are these summaries complete and/or accurate and do they need to be modified/should they be shorter or longer? 2) are the arguments too complicated/would they take up too much room/ might they still be better suited to the "abortion debate"? 3) it seems that this debate was a lot more relevant in the 80s--is that more or less true? does mentioning it in a section which is supposed to be a very selective summary imply that it is a more current controversy than it actually is/give it undue weight? Cindery 20:43, 14 September 2006 (UTC)

Hmm... lots of discussion since I've been gone. First, I for the most part like the formulation above. I think saying, "two doctors consider XYZ to be possible" would be inaccurate--two doctors have published a study on it, and there's no way of telling how many doctors were persuaded by it. So I think "small minority" or, better yet, "tiny minority," would be most appropriate (for whatever reason, "extreme" minority sounds too strong to me). I have no problem with the final sentence about its listing in the DSM-IV. It was the earlier use of the "however" to introduce it that seemed to imply a pro-life POV.

Now, with the rest of this, with the discussion of PAS as a debate issue--are we talking about adding this into Mental Health or a different section of the article, which does not deal so exclusively with health issues? And, if this *is* going into a different section, are we ready to request unprotection? It's somewhat embarassing that we've been locked so long, especially since we were featured on Nightline two nights ago.

.*pause*

.*remembers he forgot to mention that* *rushes off to make another post*--BCSWowbagger 21:13, 14 September 2006 (UTC)

...it does seem like giving both sides of the advocacy debate would give undue weight/take up too much room. the problem with moving it to the abortion debate article is that--while the "polarization" section mentions a variety of platforms for the debate--it sticks to the legal platform. the polarization section could be modified to include health as a platform, and address the "suggested effects" from the health sections of the main abortion article, where it could deal with the "debate" aspect of PAS. if no one objects to that, Mksasone's version + BCS' suggestions could go into the mental health section (which would appear as below) and we would be done. Cindery 22:06, 14 September 2006 (UTC)

"Data on the incidence of disorders such as clinical depression, substance abuse, post-traumatic stress disorder, anxiety and suicide in association with abortion remain inconclusive.

Some studies have shown abortion to have neutral or positive effects on the mental well-being of some patients. A 1989 study of African-American teenagers who sought pregnancy tests in Baltimore, Maryland found that the level of stress and anxiety, from the time of the test until two years later, of those who had an abortion did not differ from that of those who had not been pregnant at all or who had carried their pregnancy to term.[39] Another study in 1992 suggested a link between the elective termination of an unwanted pregnancy and later reports of positive self-esteem; it also noted that adverse emotional reactions to the procedure are most strongly influenced by pre-existing psychological conditions and other negative factors.[40]Termination, as compared to completion, of an undesired first pregnancy was not found to directly pose the risk of significant depression in a 2005 study.[41]

Other studies have shown a correlation between abortion and negative psychological impact. A 1996 comparative analysis of the suicide rates among postpartum and post-abortive women in Finland found that suicide is more common after a miscarriage and especially after an induced abortion than in the general population.[42] Additional research in 2002 reported that the risk of clinical depression was higher for women who chose to have an abortion in comparison to those who opted to carry to term — even if the pregnancy was unwanted.[43] Another study in 2006, which used data gathered over a 25-year period in Christchurch, New Zealand, found an increased occurrence of depression, anxiety, suicidal behavior, and substance abuse among women who had previously had an abortion.[44]

The existence of post-abortion syndrome (PAS), an independent set of mental symptoms associated with abortion that would warrant a general diagnosis or classification as an independent syndrome, is currently considered a possibility by a tiny minority of the medical establishment. The psychopathological symptoms attributed to post-abortion syndrome are similiar to those of post-traumatic stress disorder, but have also included, "repeated and persistent dreams and nightmares related with the abortion, intense feelings of guilt and the 'need to repair'". PAS is listed in neither the DSM-IV-TR nor the ICD-10."

Miscarriage, or spontaneous abortion, is known to present an increased risk of depression in women.[45] Childbirth can also sometimes result in maternity blues or postpartum depression."

People this has been blown to a granderous extreme. We already have a section entitled "Health Issues", logically following, anything large-scale, noteworthy health issue should be placed there. As for the factual accuracy, someone needs to just compile a concise list of "speculated" mental issues resulting from abortion, write them, insert them, cite them, and be done with it. Look at the two preceding paragraphs: Fetal Pain and Breast Cancer. Those are debated down to the bone. I haven't been following this argument down to the T but I'm sincerely wondering what the issue over this "Factual Accuracy" is. No matter what link you provide it isn't going to be 100% factually accurate because no one but these independant studies proport such findings. --Talv 02:26, 16 September 2006 (UTC)

I'm confused-- is the section directly above fine with you, or do you have objections to it? Cindery 03:29, 16 September 2006 (UTC)

Are we referring to above me in the Talk Page here? I haven't read the entire thing. But are you referring to the article where by the "section directly above" is about Fetal Pain and Breat Cancer? No, I don't have objections to those. --Talv 11:20, 16 September 2006 (UTC)

I agree that this is more than a little too much effort and craziness put into a single section, but isn't that how all edit wars go? It's been blown out of proportion, but now it's been made better. I would, however, agree with Talv that we are not being as concise as we could be. Giving it another look, I think we should remove the prefacings of the various studies (which, admittedly, are already pretty concise)--if anyone cares enough, they'll look it up, but, as an encylopedia, we really only need to involve ourselves with the studies' conclusions. Also, the phrase "termination of an unwanted pregnancy" and its variations should be replaced with the more concise, "abortion" or "elective abortion." So, I propose:

"Data on the incidence of disorders such as clinical depression, substance abuse, post-traumatic stress disorder, anxiety and suicide in association with abortion remain inconclusive.

Some studies have shown abortion to have neutral or positive effects on the mental well-being of some patients. A 1989 study of pregnant teenagers found that, counting from the beginning of pregnancy until two years later, the level of stress and anxiety of those who had an abortion did not differ from that of those who had not been pregnant at all or who had carried their pregnancy to term.[39] Another study in 1992 suggested a link between elective abortion and later reports of positive self-esteem; it also noted that adverse emotional reactions to the procedure are most strongly influenced by pre-existing psychological conditions and other negative factors.[40]A 2005 study concluded that abortion of an undesired first pregnancy did not directly pose a risk of significant depression.[41]

Other studies have shown a correlation between abortion and negative psychological impact. A 1996 study in Finland found that suicide is more common after a miscarriage and especially after an induced abortion than in the general population.[42] Additional research in 2002 reported that the risk of clinical depression was higher for women who chose to have an abortion in comparison to those who opted to carry to term — even if the pregnancy was unwanted.[43] A New Zealand-based study conducted between 1970 and 2006 found an increased occurrence of depression, anxiety, suicidal behavior, and substance abuse among women who had previously had an abortion.[44]

The existence of post-abortion syndrome (PAS), an independent set of mental symptoms associated with abortion that would warrant a general diagnosis or classification as an independent syndrome, is currently considered a possibility by a tiny minority of the medical establishment. The psychopathological symptoms attributed to post-abortion syndrome are similiar to those of post-traumatic stress disorder. PAS is listed in neither the DSM-IV-TR nor the ICD-10."

Miscarriage, or spontaneous abortion, is known to present an increased risk of depression in women.[45] Childbirth can also sometimes result in maternity blues or postpartum depression."

That's a wee bit shorter, but not as much as I'd hoped. I note that I this clause: but have also included, "repeated and persistent dreams and nightmares related with the abortion, intense feelings of guilt and the 'need to repair'. This seems somewhat wordy and probably an unnecessary detail, but I know there might be NPOV objections to its removal. Other than that... I think we're ready to ask for an unprotect, after the longest protection of abortion in my memory. --BCSWowbagger 19:51, 16 September 2006 (UTC)

I think the clause but have also included, "repeated and persistent dreams and nightmares related with the abortion, intense feelings of guilt and the 'need to repair'. ought to be included, since it clarifies how post-abortion syndrome is claimed to differ from ordinary post-traumatic stress disorder.Mkaksone 08:01, 17 September 2006 (UTC)

If we want to shorten this section further, perhaps we should remove the mentions of the places where the studies indicating abortion has a negative effect on mental health were conducted, as was done for the previous paragraph. Besides, the current version telling in what country the 1996 and 2006 studies were conducted, but not where the "additional research" in 2002 was conducted might cause the misunderstanding that it was also conducted in Finland like the study mentioned before it. Mkaksone 08:09, 17 September 2006 (UTC)

...it's fine with me--but there is a minor error re the first study which makes it sound a little confusing. it didn't study "pregnant teenagers," it studied girls who got pregnancy tests. (then it compared the ones who turned out to be pregnant vs. the ones who didn't, and the ones who carried to term vs. the ones who didn't.) Cindery 20:45, 16 September 2006 (UTC)

Another minor error - the New Zealand-based study wasn't conducted between 1970 and 2006, but used data gathered over this time period. Mkaksone 08:15, 17 September 2006 (UTC)

Comments:

1. Overall, support the rewrite.
2. The improved mental health was sourced by more than the Russo/Zierk study. Which references are you planning to use?
3. Concur that listing where the studies were done is uncessisarily verbose. Suggest putting locale in ref not in body.
4. The New Zealand study is badly flawed, see [15].

   KillerChihuahua^?!? 09:44, 17 September 2006 (UTC)

The improved mental health was sourced by more than the Russo/Zierk study. Which references are you planning to use? ...there are three studies which make positive findings, and they are listed first. Cindery 21:32, 17 September 2006 (UTC)

Would this version be acceptable?

"Data on the incidence of disorders such as clinical depression, substance abuse, post-traumatic stress disorder, anxiety and suicide in association with abortion remain inconclusive.

Some studies have shown abortion to have neutral or positive effects on the mental well-being of some patients. A 1989 study of teenagers who got pregnancy tests found that, counting from the beginning of pregnancy until two years later, the level of stress and anxiety of those who had an abortion did not differ from that of those who had not been pregnant at all or who had carried their pregnancy to term.[39] Another study in 1992 suggested a link between elective abortion and later reports of positive self-esteem; it also noted that adverse emotional reactions to the procedure are most strongly influenced by pre-existing psychological conditions and other negative factors.[40]A 2005 study concluded that abortion of an undesired first pregnancy did not directly pose a risk of significant depression.[41]

Other studies have shown a correlation between abortion and negative psychological impact. A 1996 study found that suicide is more common after a miscarriage and especially after an induced abortion than in the general population.[42] Additional research in 2002 reported that the risk of clinical depression was higher for women who chose to have an abortion in comparison to those who opted to carry to term — even if the pregnancy was unwanted.[43] A study based on data gathered between 1970 and 2006 found an increased occurrence of depression, anxiety, suicidal behavior, and substance abuse among women who had previously had an abortion.[44]

The existence of post-abortion syndrome (PAS), an independent set of mental symptoms associated with abortion that would warrant a general diagnosis or classification as an independent syndrome, is currently considered a possibility by a tiny minority of the medical establishment. The psychopathological symptoms attributed to post-abortion syndrome are similiar to those of post-traumatic stress disorder, but have also included, "repeated and persistent dreams and nightmares related with the abortion, intense feelings of guilt and the 'need to repair'.. PAS is listed in neither the DSM-IV-TR nor the ICD-10."

Miscarriage, or spontaneous abortion, is known to present an increased risk of depression in women.[45] Childbirth can also sometimes result in maternity blues or postpartum depression."

Mkaksone 06:53, 18 September 2006 (UTC)

Approve, and, given above reactions, I'd say we have consensus--or are at least able to work out any remaining problems without an edit war. Requesting unprotect so we can do this. --BCSWowbagger 00:45, 19 September 2006 (UTC)

Everything looks good (although I wasn't quite sure what to read, I read all possible samples, and they all look fine). The PAS snippets need to be tidied up with grammar, however, but that is obvious. --Talv 00:20, 22 September 2006 (UTC)

new zealand study

first of all, KC, nowhere does it say in the pro-choice editorial from an australian newspaper that the NZ study is "badly flawed." secondly, the NZ study is not flawed--the criticism that it did not study reasons for depression such as 1) difficulty paying for an abortion 2) lack of social/emotional support for making a decision is cancelled out by the fact that the study controlled for multiple conditions, including family support, etc. moreover, the study covered women over a 25 year period--in which multiple confounding factors could be accounted for. of all the studies included here, the NZ studied the largest number of women for the longest time, with the greatest number of confounding factors and the blindest controls. also, the lead scientist is pro-choice, and claimed that he did not expect to find the conclusions he found, but did the ethical thing and reported what he actually found anyway. (as a side point, if we were only going to include studies in which the alleged pro-choice/pro-life bias of the scientist supposedly influenced their findings, the NZ study would be the only one standing. and its significance as the longest study with the blindest controls is not adequately made clear in the current or prior versions of the mental health section. but i don't think it's that important-- i stand by the argument that psych is a soft science, and there is no definitive empirical means by which to determine that an event causes a reaction, and that therefore studies from both sides which give an overall impression of "inconclusive" is NPOV and...rational.) Cindery 21:24, 17 September 2006 (UTC)

I agree. For instance the study by Zabin, Hirsch and Emerson on the African-American teenagers didn't control for any pre-existing conditions, and the study by Russo and Zierk only controlled "childbearing and resource variables", and when these variables were controlled, it was only found that "neither having 1 abortion nor having repeat abortions had an independent relationship to well-being" - in other words, no relationship to a positive outcome could be found after these variables were controlled. Consequently, the conclusion drawn from this study that abortion would have a positive impact on mental well-being is actually rather questionable. But I support presenting studies from both sides in the article in order to keep it neutral. Mkaksone 06:41, 18 September 2006 (UTC)

My recollection was that the Nz study was flawed; as Cindery put it they are all flawed to one degree or another, which given the multiple factors involved is probably a reasonable position.

My two cents: we have that there is no consensus (i.e., studies are inconclusive); that different studies have found different results (more depression, less depression, no difference, with no difference in the lead when other factors are ruled out - that is supported by the cites, yes?); as long as we cite the best sources we can find, then I support unprotection. KillerChihuahua^?!? 10:17, 18 September 2006 (UTC)