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Assessing the current agreement status

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

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

Question 1

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

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

Answers to question 1

yes

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

no

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

Mu

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

Question 2

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

• The first suggestion:

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

• or the second suggestion:

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

Answers to question 2

first suggestion

second suggestion

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

Neither

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

---

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Questions raised by Rexxs

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

Question 3

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

yes

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

no

1. There is a separate section in this Wikipedia article already devoted to unsafe abortions.[1] Do other medical articles discuss how the procedure is frequently botched in underdeveloped countries? Even if that's a normal thing in medical articles, I feel that we already have a section in this article for such info.[2]Anythingyouwant (talk) 17:26, 14 June 2010 (UTC)

   Unsafe abortion is closely linked to the legality and accessibility of abortion, rather than simple resource availability (a point made in numerous sources). Thus the issue takes on a dimension beyond that of, say, a "botched" appendectomy in a developing country. MastCell ^Talk 20:56, 14 June 2010 (UTC)

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

Question 4

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

yes

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

no

Question 5

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

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

yes

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

no

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

Relevance of comparing to childbirth

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I'd suggest a read of:

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

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

Worldwide

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

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

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

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

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

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

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

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

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

The difference birth makes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

LMP?

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

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

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

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

Removal from the lead paragraph

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

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

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

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

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

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

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

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

Lead

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

Facts first, or qualifications first?

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

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

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

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

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

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

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

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

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

Organized and moved some content to subpages

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

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

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

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

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

Pic removal

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Placenta previa

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

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

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

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

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

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

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

Then, your sources are convincing:

1. 2003, admits in intro that previous studies have been inconclusive, then reports on study with 600 subjects
2. MayoClinic, rare but serious risk
3. Denmark, 1999, huge study checking only for pre-term, post-term, after abortion(s)
4. 2003, review showing strong and plausible association and a dose-response relationship indicating causality
5. 1980 in JAMA, concludes "that multiple induced abortions do increase the risk of subsequent pregnancy losses"

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

You don't see that Paul:

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

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

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

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

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

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

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

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

Top pic

I've reverted per WP:BRD. By restoring what was in the article earlier today, I hope I didn't inadvertently do too much. Doc James, would you like to start by discussing which pic you think should go at the top and why?Anythingyouwant (talk) 02:43, 16 June 2010 (UTC)

You have removed half a dozen current references. Therefore I have restored them. If you disagree with specific changes discuss them.

I have also fixed the formatting on a number of images.Doc James (talk · contribs · email) 03:24, 16 June 2010 (UTC)

Nope, you're now edit-warring to remove lots of material that has been in this article for months or years, and edit-warring to insert your new POV material. Please see WP:BRD. I'm not going to undertake the kind of persuasion that you have declined to engage in.

I also won't edit-war about this. I have already seen at the fetus article that Wilipedia rules mean little at articles like this. I've had my say, now do as you please. Cheers.Anythingyouwant (talk) 03:37, 16 June 2010 (UTC)

It is unclear if you even read the changes I made. Removing half a dozen references to the peer reviewed literature and a number of updated references with out mentioning why is a little strange. Please be selective in what you do.

You have missed the discuss part as you have not given any reason for the above. You have also not mentioned the improved formatting of the images or the movement of the some the material regarding the abortion debate to the appropriate subpage.

Would you please outline the POV material you say I added?Doc James (talk · contribs · email) 03:41, 16 June 2010 (UTC)

Discuss comes after revert, and I'd be glad to discuss things in any order you like, as long as revert comes first.Anythingyouwant (talk) 03:51, 16 June 2010 (UTC)

You have not discussed you just reverted all changes. This is not how it is done. Most of the changes are completely non controversial and improved the page. Most are completely self explanatory.Doc James (talk · contribs · email) 03:55, 16 June 2010 (UTC)

I've given several examples of why I find your bold edits problematic, and I've offered to discuss them one-by-one with you if we can get past the "R" in "BRD". But since we are never going to get past the "R" I don't feel the need to give you an elaborate "D". Cheers.Anythingyouwant (talk) 04:06, 16 June 2010 (UTC)

Culwell

As discussed above, an editor has overhauled this article, while declining to accept a revert while discussion occurs. I suppose that it will now be necessary for me to obtain consensus to remove material, which is the opposite of how Wikipedia is supposed to work.

The lead of this article now cites an article by Culwell et al. The four lead authors are from the International Planned Parenthood Federation, which is a pro-choice organization. Are people opposed to letting readers know this in our footnotes? If so, then I may bring this up at WP:RS; while information about authors' affiliations should not necessarily be required in the footnotes, it should be allowed.

Additionally, citing an article like this which costs $31.00 via the internet seems unnecessary, unless no free source is available on the internet. So, I intend to bring up at WP:V whether verifiability would be enhanced by requiring editors who cite material like this to first determine whether a free reliable source is available on the internet (and if so to cite that instead, or additionally).Anythingyouwant (talk) 01:57, 24 June 2010 (UTC)

In reverse order, I'll see your WP:V and raise you a WP:PAYWALL! As for Culwell: is the content itself disputed? if so, we shouldn't include it in the first place. Do you have a better source? If you don't like the source, but don't dispute the content, you are more then welcome to find another source, but if the content is fine, then locating redundant sourcing seems almost trivial/moot. I mean, I'd encourage you to find another source, but if you aren't disputing the content in the first place, I don't think it is worth fussing over here on a talk page. If other editors want to help find sources that say the same thing that are either free and/or not affiliated with controversial(?) organizations, then that's great, but I don't think that would be a good use of my person time. Sorry ;) Finally, do you have evidence their affiliation or political views affected their research? Did they declare a conflict of interest? (I'll help you out since I have full access to the text, under the header "Conflict of interest" it says The authors declare no conflict of interest.) Is there reliable sources responding to this article in regards to affiliation and/or conflict of interest? If not, then there is no reason for me to support including a footnote saying they are pro-choice (if that is the case). It seems like well poisoning, and very suspicious. It's like a disclaimer, and I have no idea what the disclaimer would be implying (that their research should be questioned because they are in league with Satan??) If reliable sources don't make the connection somehow, it is inappropriate for us to do it. I'd welcome 3rd opinions from any of the various message board you mentioned above!-Andrew c ^[talk] 02:26, 24 June 2010 (UTC)

Andrew c, first of all, I am disappointed but not surprised that you don't seem to care whether this Wikipedia article has been overhauled without consensus, and that these edits were edit-warred back into the article. This is against WP:BRD, but entirely consistent with practice at this particular article. By the way, your own comments about Hitler and Conservapedia ought to be removed from this talk page per WP:Not a forum (or at least Godwin's law).

Anyway, regarding Culwell, I never said that a $31.00 reliable source shouldn't be used here. I just said that maybe an editor who wants to use it should check whether there's an alternative reliable source that's free on the internet. WP:V says: "The principle of verifiability implies nothing about ease of access to sources: some online sources may require payment, while some print sources may be available only in university libraries." Maybe this statement ought to be modified as suggested above.

Further regarding Culwell, I know that some of what's cited in this article to Culwell is disputed. For example, there's a huge controversy about whether the number of abortions in the USA shot upward when Roe v. Wade was decided. That in itself may not necessarily mean that Culwell should be omitted, but certainly the present wording in our article is slanted.

And further still regarding the Culwell article, the authors declared no conflict of interest, but also declared their employment at Planned Parenthood. If this were an article by a bunch of NRLC employees I would feel exactly the same way: their affiliation may not be required in our footnotes, but it ought to be allowed for the benefit of Wikipedia readers. So I think it's an excellent issue to bring up at WP:RS.Anythingyouwant (talk) 02:59, 24 June 2010 (UTC)

Your objection to the authors' affiliation with Planned Parenthood is fairly easily addressed. The fact that making abortion illegal does not decrease abortion rate is virtually unanimous among scholarly sources, and is not unique to PP. If you'd prefer, we could cite the World Health Organization (e.g. PMID 20085681: "Legal restrictions on safe abortion do not reduce the incidence of abortion. A woman's likelihood to have an abortion is about the same whether she lives in a region where abortion is available on request or where it is highly restricted.") MastCell ^Talk 04:31, 24 June 2010 (UTC)

I am reluctant to research this issue, or argue about it, because the article is developing ass-backwards, so to speak. An editor edit-wars huge changes to the article, disregarding consensus, BRD, and the rest, and this shifts the burden to anyone who disagrees with the huge changes.

Whether you meant to or not, MastCell, you've just cited an article which is available on the internet for free.[12] Hurray! So, it would be a much better source than the $31.00 source by Planned Parenthood that is now cited in the lead.

On the other hand, the point at issue is highly disputed. The source that you cite does not say that its conclusions are "virtually unanimous among scholarly sources" as you assert. In fact, it's hard to see where the source you cite even gets its conclusions from. The issue here is what happens in a single country when abortion is made illegal, and I don't see what can be learned from comparing different countries while they do not change their laws; different countries that have very similar laws may have very different abortion rates due to cultural and other factors.

I'm not going to spend much time researching this, because the cart is before the horse. But glancing briefly at online sources, I find....

“With the introduction of legal abortion on demand through the 1974 abortion act, the abortion rate [in Singapore] rose sharply...." Population policies and programmes in Singapore, page 58 (2005).

“[M]any women were having abortions before abortion was legalized, but...the numbers increased, perhaps by about a third [in New York].” Decoding abortion rhetoric: communicating social change, page 203 (1994).

"The legalization of abortion in the United States is well known to have led to changes in reproductive behavior. Birthrates declined by about 5-8% as a consequence of abortion legalization." Did Abortion Legalization Reduce the Number Of Unwanted Children? Evidence from Adoptions (2002).

The pro-life camp chimes in here.

Legalization of abortion makes it safer and cheaper, so it would be almost nonsensical if it did not increase the abortion rate. Some scholars say that legalization of abortion in the US resulted in a tenfold increase in the number of abortions. See Syska, Hilgers & O'Hare, An Objective Model for Estimating Criminal Abortions and Its Implications for Public Policy, in New Perspectives on Human Abortion 178 (Hilgers, Horan & Mall eds. 1981).

I could find lots more sources, and better ones too, but I'm very disenchanted with the way this editorial process is going. Spinning wheels is a drag. But not as much of a drag as the lead of this article, which is biased.Anythingyouwant (talk) 07:34, 24 June 2010 (UTC)

I'm happy to have a source-based discussion. Secondary sources that are recent and global in scope seem to conclude that abortion rate is not affected by the legality of the procedure:

• WHO 2007: "Legal restrictions on abortion do not affect its incidence."
• PMID 17933648 (Lancet 2007): "The findings presented here indicate that unrestrictive abortion laws do not predict a high incidence of abortion, and by the same token, highly restrictive abortion laws are not associated with low abortion incidence. Indeed, both the highest and lowest abortion rates were seen in regions where abortion is almost uniformly legal under a wide range of circumstances." Secondary source coverage of this study from the New York Times: Legal or Not, Abortion Rates Compare.
• Guttmacher 2009: "Legal restrictions on abortion do not affect its incidence." (I suppose one could try to disqualify Guttmacher as a "pro-choice" source, although they keep the best statistics on abortion in the US).

One should probably be cautious in asserting a single country's experience as a rebuttal to these unequivocal global conclusions. It cannot be said with any certainty that abortions "rose" after Roe v. Wade, since a large number of illegal abortions pre-Roe were obviously unreported due to the fear of legal consequences. Clearly, the rate of reported abortions, and those amenable to surveillance, rose - but that's not the same thing. It's unclear how the baseline incidence of abortion pre-Roe was determined, when reporting involvement in an illegal abortion could lead to criminal prosecution.

Most of the arguments supporting the WHO position are based on comparisons between abortion rates in "legalized" vs. "restrictive" countries (they are no different). Additionally, there has been a well-described liberalization of abortion laws globally over the past several decades (PMID 18957353), which has coincided with global decreases in abortion rate - a finding suggesting that legal status is not a major determinant of abortion rate. MastCell ^Talk 23:31, 24 June 2010 (UTC)

As evidenced by the comments above, there are reliable sources taking a variety of positions on this. It's not our job to decide what the truth is, and proclaim it in the lead. Like I said, my inclination is just to throw up my hands and let you do whatever you want with this article. Are admins required to be evenhanded, or is it acceptable to be passive in the face of edit-warring for a particularly sympathetic POV?Anythingyouwant (talk) 23:47, 24 June 2010 (UTC)

It's our job to provide up-to-date syntheses of relevant information from reputable expert sources, which is sort of where I was going with the citations I listed. Your question seems designed as a rhetorical attack rather than an honest inquiry, but since you ask... I'm in an editorial role at this article. It would be inappropriate for me to take an admin role, since I'm involved in ongoing content disputes. As an editor, I'm trying to model what I think is correct behavior in such disputes - that is, I'm not participating in any edit wars that develop; I'm limiting myself to 1RR at most; I'm trying to address reasonable concerns on the talk page, while drawing a distinction between productive discussion and enabling unreasonable obstruction; and I'm striving to ignore obvious provocation. MastCell ^Talk 00:27, 25 June 2010 (UTC)

My question is sincere, and the question stands. You and other admins get involved now and then In administrative proceedings regarding this article, so I'm just wondering if there is any kind of "code of conduct" or "honor code" or the like for admins. Even assuming that all the admins who watch this article have been amply justified in the actions they've taken, I'm curious about the actions not taken, and whether there is any obligation not to overlook violations. This was not meant as a vague hypothetical question. This article was massively overhauled recently, via edit-warring, and against policy, and I've mentioned some of what I consider pro-choice-slanted edits within that overhaul.

Anyway, regarding this particular material in the lede, it is: "The frequency of abortion is, however, similar whether or not access is restricted." Basically, this is equivalent to saying: "Whoever wants to restrict abortion is either deluded or merely wants to kill women.". I suggest the material be removed until there is consensus for how it should be dealt with later in the article. I've already removed it once, so I'm not going to do so again. This stuff in the lede does not reflect any of the sources I mentioned; as far as I can tell, this stuff is not based on studying a single country's before-and-after-legalization statistics, and that ought to be mentioned in this article if we want to neutrally address this issue.Anythingyouwant (talk) 03:15, 25 June 2010 (UTC)

Editors can read all they like about administration elsewhere. This is not the talkpage for discussing it. The appropriate response to your disagreement with a statement is to verify the sources cited. If there are none, the appropriate response is to request citation, usually by the use of {{cn}}. It is not to create absurd paraphrasures. Editors can have principled disagreements without maligning each others' positions. One can acknowledge that the opposite side in the debate has good intentions but different priorities. Both sides in this debate want less abortions done, but while one side believes that they can and should approach that goal by restricting legal access, the other believes they can and should do so by education on and promotion of better contraception. Neither "merely wants to kill women" and the allegation of such is simply irresponsible and should be retracted. LeadSongDog come howl! 16:43, 25 June 2010 (UTC)

I never said that either side wants to kill women, so I have nothing to retract. Which side do you think I accused of that? If you want to edit the lede to say that one side believes the number of abortions can be reduced by restricting access, please do. The lead currently says such a thing is impossible.Anythingyouwant (talk) 16:55, 25 June 2010 (UTC)

No, you didn't say either side wants to kill women, you equated the existing statement in the lede to a position which clearly differs from its intent. In any case if you did not wish your words to have that interpretation, I urge you to revise them to something that will be less likely to be mistaken as such. I believe the lede correctly reflects the published research that indicates the bans have been ineffective. That does not mean those laws haven't reduced access to legal abortion, but rather that by making access illegal for some they have in the process making it more dangerous, difficult or expensive for others. My use of the word "legal" was intentional and it carried meaning that you disregarded. LeadSongDog come howl! 18:30, 25 June 2010 (UTC)

I have no idea what the intentions were behind the recent edit-warred changes to the lede. The effect of those changes is that this article now declares that people who wish to reduce abortions by legally restricting access are attempting the impossible, though they would succeed in making abortion less safe and more dangerous to womens' lives. That's an accurate characterization of what the edit-warred lead now says, in my honest opinion, and this disregards a substantial body of reliable sources, while reducing the NPOV of this article's lede.

As for what Wikipedia policies may or may not say about whether edit-warrng should be treated consistently regardless of POV, I was asking where at Wikipedia this ought to be addressed, so that I can go there. But never mind, I'll figure it out.

Also, if I overlooked any word you used, then I apologize.

I am going to step back from this article and talk page for awhile, due to the atmosphere here. I may remove it from my watchlist. So, please feel free to contact me at my talk page if you have further concerns. Thanks, and I hope you'll consider my comments in this section in the NPOV spirit n which they were offered. Cheers.Anythingyouwant (talk) 18:49, 25 June 2010 (UTC)

In reply to the as evidenced by the comments above, there are reliable sources taking a variety of positions on this, I just want to reiterate a comment made by MastCell: One should probably be cautious in asserting a single country's experience as a rebuttal to these unequivocal global conclusions. And perhaps we should repeat the Lancet conclusion: Indeed, both the highest and lowest abortion rates were seen in regions where abortion is almost uniformly legal under a wide range of circumstances. Finding 2 possible exceptions to the rule does not mean the rule is no longer valid. I mean, those global overview studies could be wrong, but I don't find the (basically) anecdotal evidence sufficient to discount those sources. I think we'd need to find a source on par with those others, yet with different conclusions. That said, we could consider rephrasing the sentence to make it clear that there are exceptions? -Andrew c ^[talk] 01:19, 25 June 2010 (UTC)

It's not clear to me that there are exceptions. The belief that the US abortion rate "rose" after Roe v. Wade seems founded on iffy statistical approaches and a misunderstanding of American abortion surveillance. See (for example) Wetstein 1996; using an autoregressive model, he concluded:

...when controlling for the increasing trend [in abortion] already at work, and the apparent leveling off at average around 1978, the Roe variable did not have a positive effect on the national abortion ratio... These findings from national data contradict popular claims about the impact of Roe v. Wade. Conventional wisdom tells us that Roe was the catalyst for a substantial increase in abortions in the United States. Yet time series analysis demonstrates that Roe did not significantly alter the trend in abortion utilization in this country, at least when examining the aggregate data.

The use of abortion data reported to the Centers for Disease Control may be inappropriate for measuring the true levels of abortion nationally. In the years prior to Roe, only states that had legalized abortion were providing data to the federal government. Thus, the data represent only reported legal abortions prior to 1973. The vast majority of unreported, illegal abortions are not included in the time series.
Therefore, the increase in abortions and abortion rates in the wake of Roe may represent better reporting of the real abortion rate. This might also explain the plateau of abortions and abortion rates around 1980. In essence, more systematic reporting of abortion by the states may have revealed the true abortion rate in the US only around the 1979-1980 period.

Sorry for the lengthy quote, but I think a direct quantitative approach is a useful counterpoint to the vaguer and more oblique assertions in the sources cited by Anythingyouwant above. MastCell ^Talk 06:13, 25 June 2010 (UTC)

I suspect that multiple factors come into play when examining the effect of legalisation. From what I find in the literature, it seems certain that availability of reliable contraception is the biggest single factor affecting the abortion rate globally. I see that a BBC news article (not a scholarly source, but normally reliable in reporting) says that the number of reported abortions in the UK rose sharply in the years immediately following legalisation (1967-1971) and has risen steadily since then - even taking into account the population increase. In a country where both contraception and abortion are generally freely available now, I would suspect that there may be an effect due to a increasingly relaxed attitude to abortion over 40 years, because the consequences of inadequate contraception have become less severe. This is pure hypothesis on my part, of course, so I would suggest looking for any studies that have examined such an effect before daring to add anything to the article. In summary, like MastCell, I believe the general conclusions of the WHO, but would caution that other confounding factors may need to be taken into account in any particular country. --RexxS (talk) 12:10, 25 June 2010 (UTC)

Assessing the current agreement status(2)

These three are excellent sources:

• A Lancet review from 1996: Kulczycki A, Potts M, Rosenfield A (1996). "Abortion and fertility regulation". Lancet. 347 (9016): 1663–8. doi:10.1016/S0140-6736(96)91491-9. PMID 8642962. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

When women ask about the safety of abortion it is also worth pointing out that in developed countries, mortality associated with childbirth is 11 times higher than that for safely performed abortion procedures and 30 times higher than for abortions of up to 8 weeks gestation

• A medical text from 2005 National Research Council (U.S.). Panel on Transitions to Adulthood in Developing Countries (2005). Lloyd, Cynthia B. (ed.). Growing up global: the changing transitions to adulthood in developing countries. Washington, DC: National Academies Press. p. 215. ISBN 9780309095280. OCLC 57529038.

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

• A 2003 journal article Yanda K, Smith SV, Rosenfield A (2003). "Reproductive health and human rights". International journal of gynecology and obstetrics. 82 (3): 275–283. PMID 14499974. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

The availability of safe, affordable abortion

services in any country is determined by the legal status of induced abortion, compounded with how laws are interpreted.Thus, a country with strict policies could have an exception for the life of the mother, while one with liberal laws could place a series of restrictions w19x.When abortion is legal, available, and carried out under modern aseptic conditions, mortality is extremely low; abortion is one of the safest surgical procedures w17x.Deaths from obstructed labor and abortion are extremely rare in the United States and other developed countries, where mortality per 100 000 abortions is 0.2–1.2 w18,20x.Studies of medical abortion since the 1980s in Europe and in 2000 in the United States, in addition to studies in various other countries, have shown the method to be extremely effective and significantly safer than

childbirth.

These can be summarizes: The risk of abortion in developed countries is less than 1 in 100,000 per procedure making it significantly safer than pregnancy and childbirth.—Preceding unsigned comment added by Jmh649 (talk • contribs)

Agree

1. Doc James (talk · contribs · email) 18:01, 15 June 2010 (UTC)
2. I would still prefer to cite actual numbers for childbirth, to make the absolute and relative risks clearer. But this text at least accurately and honestly conveys the content and emphases that are consistently presented in the scholarly literature. MastCell ^Talk 18:51, 15 June 2010 (UTC)
3. LeadSongDog come howl! 19:13, 15 June 2010 (UTC)
4. Agree. I also think that, as when dealing with any low risk, stating absolute risk is pereferable to stating a relative risk. SHEFFIELDSTEEL^TALK 20:22, 15 June 2010 (UTC)
5. That summary is okay, except that you don't need to say "pregnancy", and it also needs to be mentioned that the risk of childbirth is itself low (per Lloyd 2005). I agree with omitting lots of numbers, and they can be explicitly put in a footnote, or in the wikilinked article about childbirth.Anythingyouwant (talk) 20:29, 15 June 2010 (UTC)
6. Disagree, because the sentence is not good English. By itself, the phrase "The risk of abortion" is much more about having an abortion than about the risk of complications (including death) associated with having an abortion. See? V (talk) 19:09, 18 June 2010 (UTC)

Suggestion based on the so far most commonly agreed suggestion

I fell sad about this newly created suggestion when we had a former one which five people agreed in its basic form, so we could evolve from that taking those editors opinion into account. But I'll take this new section as an opportunity to present that earlier suggestion with the improvements suggested there. With that I expect we can get more support than that former one and this newly created discussion section fits any purpose.--Nutriveg (talk) 18:58, 15 June 2010 (UTC)

From the following medical book

• National Research Council (U.S.). Panel on Transitions to Adulthood in Developing Countries (2005). Lloyd, Cynthia B. (ed.). Growing up global: the changing transitions to adulthood in developing countries. Washington, DC: National Academies Press. p. 215. ISBN 9780309095280. OCLC 57529038. In representative developed countries, the risk of dying (from abortion) is no more than 1 in 100,000 procedures, lower than the relatively low risks associated with pregnancy and childbirth in these countries (The Alan Guttmacher Institute, 1999)

Suggested text

"In developed countries the maternal death rate from abortion is below 1 in 100,000 procedures, lower than the rate for childbirth and general pregnancy, which is already low."

Agree

1. Nutriveg (talk) 18:58, 15 June 2010 (UTC)
2. Anythingyouwant (talk) 20:38, 15 June 2010 (UTC) I don't see a problem with this.

Comment

The most commonly agreed suggestion is Doc James' above, having 5 agreements (3 with reservations) versus 1 disagreement. Talk:Abortion#second suggestion had 5 in favour (4 with reservations) versus 2 against, and was phrased ("If you answered yes to question above or didn't answered that question") to exclude those (including me) who disagreed with the first question. It would be better to try to find consensus based on Doc James' suggestion, addressing the comments there. --RexxS (talk) 19:51, 18 June 2010 (UTC)

The answer to this misplaced commentary is on the discussion section below.--Nutriveg (talk) 21:15, 18 June 2010 (UTC)

Other suggestions

---

You're not assessing the current status, you're making a new proposal and asking for "votes". And I see this as problematic when you created this discussion when the former one which you and four other users basically agreed (about the second suggestion) was still in discussion and the few opposing voices didn't clearly express their concerns in a way that those opinions could be properly addressed.

The sources don't consistently say "significantly safer", the only one who does so is one about a specific procedure: Medical abortion which indeed has lower rate of maternal mortality, at least in the US, even than abortion itself. Your suggestion also fails to qualify the risk of general maternal death which is low, giving the impression that risk is somewhat considerable. --Nutriveg (talk) 18:23, 15 June 2010 (UTC)

A huge number of reliable sources consistently make clear that abortion is significantly safer than childbirth (many are listed on this talk page). If you either do not understand that or are unwilling to acknowledge it, then I think it's a waste of time to continue this circular discussion, because you are ignoring the reality of available sources. MastCell ^Talk 18:49, 15 June 2010 (UTC)

MastCell, safer is an interpretation, an analysis. When the compared subjects are different (one group performing abortion and other group of pregnant women not performing abortion) such analysis requires epidemiological criteria, for example by searching for possible confounding factors (like income, age, education status, access to health care, regional issues, ...) often misrepresented by a single number and verifying statistical significance after those factors were adjusted. Sources consistently present "lower data rates", so presenting that as an analysis (safer) is WP:SYNTH and WP:UNDUE. Beyond the point of uncharacterizing the actual maternal death from childbirth and general pregnancy, which the sources support as "low" so further breaking WP:NPOV. --Nutriveg (talk) 19:02, 15 June 2010 (UTC)

We don't need another lecture on your personal ideas about epidemiology. We need a commitment to actually respect available sources, instead of making up frivolous and idiosyncratic reasons to reject them. It not WP:SYN, because numerous high-quality sources explicitly compare abortion to childbirth and conclude that the former is safer. If you don't understand that, then my time is better spent finding ways to limit the damage you cause rather than talking in circles. MastCell ^Talk 20:59, 15 June 2010 (UTC)

Turning "lower data rate" into "safer", using a claim about a "specific procedure" (medical abortion) to apply to "all procedures" is WP:SYNTH. My points about epidemiology were to show how you're doing the "science in between" by yourselves.--Nutriveg (talk) 21:19, 15 June 2010 (UTC)

Do you see the numerous sources explicitly using the word "safer"? If yes, then you should be clear that it is not WP:SYN to say it's safer. If no, then, well... MastCell ^Talk 21:38, 15 June 2010 (UTC)

Do you? From DocJames quotes above, I only see in Yanda using the word "safer" in a phrase that talks about medical abortion, the others talk about mortality rates. If such source is out there that claim is not consistent--Nutriveg (talk) 22:15, 15 June 2010 (UTC)

Since I'm a bit tired of watching you move the goalposts, I'd like you to do a bit of the legwork. Start on this page with #Safer_than_childbirth, perhaps scroll through to #More reliable references, peruse eMedicine, UpToDate, this review from Annals, Grimes 2006, and so forth. Then please come back and let us know whether you see any sources stating explicitly that abortion is safer than childbirth. MastCell ^Talk 22:42, 15 June 2010 (UTC)

I agree the sources are good and relevant but disagree with the summary: "These can be summarizes: [This makes no grammatical sense] risk of abortion in developed countries [this sounds like it means risk of abortion occurring, I assume it means risk of death caused by an abortion] is less than 1 in 100,000 per procedure [the sources don't seem to support this statement "the risk of dying is no more than 1 in 100,000" and "where mortality per 100 000 abortions is 0.2–1.2 (emphasis added)] making it significantly safer than pregnancy [significantly is not stated in the snippets] and childbirth [no objections]." Guest9999 (talk) 18:48, 15 June 2010 (UTC)

I can't find "safer" in the "Annals" article. I can't further check "Grimes,2006" but it's a US centric primary study. I can see UptoDate uses US data (citing grimes, the same author of Annals btw), oh wait there's something about "safer" in eMedicine but the author (Suzanne Trupin) owns a [clinic that provides abortion since 1973, not reliable and certainly WP:UNDUE to give such exposition to a POV (safer) supported by a minor number of sources, let's keep lower mortality rate, then everyone is happy and no Wikipedia policy (WP:SYNTH and WP:NPOV) had to be breached.--Nutriveg (talk) 00:03, 16 June 2010 (UTC)

(the comment below was moved from the space reserved to the suggestions Nutriveg (talk) 19:43, 15 June 2010 (UTC))

Comment I find the wording a little choppy. I do not think we need to state maternal death rate twice. Doc James (talk · contribs · email) 19:24, 15 June 2010 (UTC)

I reworded that to address your concerns.--Nutriveg (talk) 19:48, 15 June 2010 (UTC)

Why not just pregnancy rather than general pregnancy. And below has one l not two :-) People already realize that the mortality is low from child birth repeating "already low" at the end I think is not needed.Doc James (talk · contribs · email) 20:03, 15 June 2010 (UTC)

Abortion is pregnancy management, the woman needs to be pregnant to perform an abortion, childbirth is also associated with pregnancy. The association is defined in the WHO definition of maternal death. So "general" is necessary to represent the general data. But I can remove that if that's your only problem.

The already low is to qualify the risk of general maternal death which is low, so the reader can balance the actual risk. Such term was used by sources in the same context, was in the last most approved suggestion, AIW also expressed direct concerns about it several times.--Nutriveg (talk) 20:24, 15 June 2010 (UTC)

I need to remember that Wikipedia:Polling is not a substitute for discussion so I expect the same way of respect for raised concerns as I didn't further use a majority position before to ignore those few opposing voices despite their silence over the problematic parts of the source supported text.

I can only laugh when seeing so much votes to something like this:

"The risk of abortion in developed countries is less than 1 in 100,000 per procedure (...)"

that doesn't even say what that risk is about.--Nutriveg (talk) 20:48, 15 June 2010 (UTC)

Agree and fixed that.Doc James (talk · contribs · email) 21:24, 15 June 2010 (UTC)

I reverted because you already received votes for that and don't know which term "maternal death", "death", "of abortion death in early stages of pregnancy", "risk of death from medical abortion" was presumed by those "careful" voters.--Nutriveg (talk) 21:29, 15 June 2010 (UTC)

The collaborative approach is to discuss concerns with editors, and evolve the proposal into something which will gain more support. Reverting another editor's good faith attempt to improve a proposal... really isn't constructive. This sort of thing can leave other editors feeling that it would be easier to work here without your input. SHEFFIELDSTEEL^TALK 21:39, 15 June 2010 (UTC)

That's your interpretation, you can't change a question after you received votes after it. Such conclusion ("significantly safer") was extracted from a phrase about medical abortion, by the quoted text, so it's not clear where that came from, as Guest9999 also pointed. Other editors have insisted several times that lower risk was about early abortion. DocJames can't decide by himself.--Nutriveg (talk) 21:49, 15 June 2010 (UTC)

I tell you what. Why don't you specify exactly which hoops you want all the other editors to jump through, in order to produce a proposal that you will accept, and we can take it from there. SHEFFIELDSTEEL^TALK 22:08, 15 June 2010 (UTC)

If WP:SYNTH, mainly, and WP:UNDUE were taken out of the game we would be playing fair. I've done several suggestions and addressed many concerns, so that's not me who is lacking effort towards a good solution here.--Nutriveg (talk) 22:22, 15 June 2010 (UTC)

Actually, there's no need for any of this silliness. I just realised that we actually have consensus support for Jmh649's proposal at the top. The fact that one editor does not recognise that consensus, for whatever reason, does not stand in the way of improving the article. I'll start a new proposal addressing the concerns of those editors who've made productive suggestions above, and get confirmation of support for it. Moving forward, and all that. SHEFFIELDSTEEL^TALK 13:41, 16 June 2010 (UTC)

Silliness is you that rejected my second suggestion lacking any arguments that could be addressed is now the one defining consensus, when that former suggestion had a similar degree of approval. There are two editors above disagreeing with DocJames suggestion, clearly pointing their reasoning, I hope your new proposal addresses those issues.--Nutriveg (talk) 13:48, 16 June 2010 (UTC)

(un-dent) The more I look, the more it seems that there's no consensus that the article text needs changing at all. SHEFFIELDSTEEL^TALK 14:05, 16 June 2010 (UTC)

This article was earlier protected in the middle of changes to this very sentence, so it could be previously discussed, if you think that version is the better one, please suggest it as everyone else did with their suggestions.--Nutriveg (talk) 14:22, 16 June 2010 (UTC)

(text below was moved from Talk:Abortion#Suggestion based on the so far most commonly agreed suggestion: )--Nutriveg (talk) 17:17, 18 June 2010 (UTC)

I'm not sure the reader would always conclude, from reading that, that the "which is already low" applies only to developed countries. So, I think the above sentence needs to have "in those countries" appended to it. V (talk) 04:54, 18 June 2010 (UTC)

Objectivist, we can make that change if AIY that voted on that version so far doesn't disagree with that.--Nutriveg (talk) 17:17, 18 June 2010 (UTC)

Answer to misplaced commentary

Doc James suggestion had three disagreements: me, Guest9999 and Objectivist, and that phrase as it was has no meaning. Wikipedia is also based in WP:Consensus so counting votes and giving weights to them is also meaningless. I raised my problems with Doc James suggestion and was expecting them to be addressed. SheffieldSteel promised a new suggestion, but he never proceeded with that.--Nutriveg (talk) 20:37, 18 June 2010 (UTC)

Doc James did address your concern - see the edit summary? But you reverted it, on the basis that "you already received votes for that", even though you disparage voting as meaningless. It is totally disingenuous to complain that someone didn't address your objection, when you removed their attempt to do so. How is that conducive to seeking consensus? You need to start being constructive instead of destructive of any attempt to reach a consensus you don't like. Drop the stick. --RexxS (talk) 21:27, 18 June 2010 (UTC)

I didn't said to have just "one" objection, my major objections are those of WP:SYNTH and WP:UNDUE as explained in this whole discussion section. About the meaning issue, those "voters" have voted on a phrase that had no meaning and so couldn't even be evaluated by careful readers. Doc James only realized that after that phrase had already received its five votes so giving a specific meaning at that time, by his own desire, was no longer a viable solution.--Nutriveg (talk) 21:49, 18 June 2010 (UTC)

The objections of SYNTH and UNDUE have already been dismissed as patent nonsense. What is the purpose of discussion? Is it to reach a consensus? If so, how does reverting the change from "The risk of abortion" to "The risk of death from abortion" help us to approach consensus?—Preceding unsigned comment added by RexxS (talk • contribs)

I've argumented about those problems so I'm still expecting the other part to address those problems in the same way, either by recognizing and fixing those problems or explaining why those arguments are not correct, not simpling dismissing those real issues as "patent nonsense". That revert was made to don't misrepresent those votes, as already explained at that time.--Nutriveg (talk) 22:26, 18 June 2010 (UTC)

Why would any volunteer editor carry on addressing your concerns, when you thwart their efforts to do do? SYNTH and UNDUE are clearly nonsensical objections, and simply accusing good faith editors of that doesn't move the discussion forward. We've already agreed that "voting is meaningless" - this isn't a battle of the votes, so how are you going to get closer to consensus by preventing an editor from improving their suggestion? --RexxS (talk) 22:51, 18 June 2010 (UTC)

I've been collaborative explaining that reasoning and expect the same level of discussion instead of simple being qualified as "patent nonsense", "nonsensical objections" and such. I've seem much more assumptions of bad faith against me than an argumentative discussion here.--Nutriveg (talk) 23:04, 18 June 2010 (UTC)

Ok, I'll do my best to demonstrate good faith. As I see your objections, they seem to be that:

1. "has a lower mortality rate" means something different from "is safer" – which I'm already discussing with you;
2. failure to mention that the risk of general maternal death which is low – which I'd agree should be addressed;
3. arriving at "is safer" from "has lower data rates [of mortality]" is WP:SYNTH – which MastCell seems to have refuted above by referring to previous discussions where sources were found.

I'm happy to discuss with you any of the above, as long as we agree that we're looking for common ground on which to improve Doc James' suggestion. Would you like to discuss the points about citing actual numbers for childbirth (MastCell); including the absolute risk for MMR (SheffieldSteel); not mentioning "pregnancy" and omitting lots of numbers (Anythingyouwant); improving the phrase "The risk of abortion" (Objectivist) at the same time? --RexxS (talk) 23:58, 18 June 2010 (UTC)

My major problems are with WP:SYNTH: advancing "lower maternal mortaltity" as "safer", and applying to general abortion something specific about medical abortion. And with WP:UNDUE giving undue representation to a claims supported only by minor sources or, the possible risk of giving more (comparative) representation to an issue than the sources themselves, which mention the issue shortly. There's problem number 2 that is definitely an issue but I think it would better to deal with the WP:SYNTH issue first. After that both versions would look the same so it shouldn't have a need to choose a version to work from.--Nutriveg (talk) 02:02, 19 June 2010 (UTC)

How about "The risk of complications associated with abortion is less than 1 in 100,000 per procedure, in developed countries, making it significantly safer than pregnancy and childbirth." However, didn't someone say that in the most medically advanced countries, the risks are about the same? (On the other hand, I'm not sure I can believe such a claim; the rate-of-occurance of ectopic pregnancies should be about the same everywhere, regardless of the medical development level, and those are always dangerous.) V (talk) 13:43, 19 June 2010 (UTC)

Advancing a position to make a conclusion saying it's safer when the reliable sources don't (consistently) make such conclusion is WP:SYNTH. Giving undue balance to a claim made by few problematic (country specific, primary or unreliable) sources is WP:UNDUE. By the sources presented here so far I don't support the use of the word "safer".--Nutriveg (talk) 13:53, 19 June 2010 (UTC)

Sorry, you are quibbling. Have you never been asked in school to write a description of something, using a source, but in your own words? Phrases such as "less dangerous" or "less risky" are legitimately synonymous with the word "safer"! No "synthesis" there at all! (Synthesis is adding Fact A and Fact B to reach Conclusion C, but to simply describe Fact A in synonymous words is not to do synthesis, at all. V (talk) 06:40, 20 June 2010 (UTC)

It occurs to me to show you an example of Genuine Synthesis: Consider the concept of a Malthusian Catastrophe. This event, generally a 99% drop in a population due to lack of food and/or food-associated resources, is sometimes dismissed as being applicable only to mere animal populations, because humans are too smart for it to ever happen to them. Anyone claiming such a thing is dead wrong, however, because the archeological evidence on Easter Island clearly shows that the Polynesian population there once reached a maximum of about 20,000, and then they cut down the last tree on the island (mostly used as firewood and to make fishing boats), and when the Europeans discovered the place a couple centuries later, the total population was about 200 --a 99% drop from the maximum, entirely consistent with humans suffering a Malthusian Catastrophe. Note that if someone deliberately acts to promote the death of 99% of a population, that person will be called "genocidal". Next, it is observed that Island Earth is having its resources stripped relentlessly, to the extent that there have been plenty of warnings over the past several decades about a likely global Malthusian Catastrophe for humanity. Desertification, and growth of cities, are cutting into the total farmland available. Fish stocks worldwide are in obvious decline. Forested regions much larger than the total area of Easter Island disappear every month. And the world human population continues to grow, partly at the behest of opponents of abortion. Can we therefore conclude that every so-called "pro-lifer" actually has a genocidal agenda, with the goal of encouraging 99% of humanity to die in a global Malthusian Catastrophe, no matter how many abortions they have to oppose, to increase the odds of that happening? Nutriveg, it is very obvious that you don't know the meaning of "synthesis" at all! V (talk) 07:03, 20 June 2010 (UTC)

I don't see your point, we are not in "school" here, we just cite sources. I don't know which "school" you have been but this is a medical claim so we try to use medical standards, where words are used to better represent the state of evidence, and in "med school" advancing such position would represent a fail and shame, like for those vaccine scientits.

Did you wrote all that just to give a synthesis example? Maybe this case doesn't fit your definition of synthesis, since other source (or methodology) was not used to advance that position but editor interpretation. Anyway that's still WP:OR--Nutriveg (talk) 17:13, 20 June 2010 (UTC)

We do indeed cite sources, and we also quote them in limited fashion, per the "Fair use" copyright rules, and the rest of the time, we describe source-information in our own words. The school exercise involves learning to not plagiarize. So, if a source describes percentanges of complications associated with such things as pregnancy and abortion or childbirth, then it is not synthesis at all to sum up the data in a few words, if all the pieces of the data are in a single source. Synthesis in Wikipedia involves piecing a conclusion from multiple sources, got it? Since we do provide the reader with the source material, it is easy for the reader to verify the editors'-own-words description of the data, that was written into a Wikipedia article. V (talk) 18:25, 20 June 2010 (UTC)

If you think that WP:SYNTH doesn't apply, fine, but WP:OR applies anyway:

"Articles may not contain any new analysis or synthesis of published material that serves to advance a position not clearly advanced by the sources"

Advancing that something is safer, from sources that simple present distinct data rates is original research.--Nutriveg (talk) 21:46, 20 June 2010 (UTC)

False. Wikipedia fully allows simple conclusions to be stated when they are obvious in the data. I don't need a source to say that 1+1=2, and I don't need a source to say "If A, then B obviously follows, when B happens to indeed obviously-to-anyone follow A. For example, in the 1800s people working with the material known as "felt" typically used certain mercury compounds in processing that material. There also is considerable data (more recent than the 1800s) indicating that working with mercury compounds can cause various mental illnesses. Finally, a major use of felt in the 1800s was in the manufacture of hats --and in those days people making various goods also tended to themselves work with the raw materials when it wasn't super-difficult. (Some blacksmiths made all their own iron from ore, but most did so only seldom.) It was normal for a hat-maker to also make the felt. Therefore a Wikipedia article that mentions this information, appropriately sourced, can also mention that in the story "Alice in Wonderland" (written in the late 1800s), the person called the "Mad Hatter" was almost certainly given that name exactly because of widespread tales/knowledge (in the 1800s) about hat-makers becoming mentally unstable, even though at the time nobody knew why. SO, if it is obvious to anyone seeing the source data that abortion is safer than childbirth in most developed countries, then any Wikipedia article referencing that data can plainly say it. V (talk) 05:16, 21 June 2010 (UTC)

This is a medical claim, so we follow medical criteria, where there's difference in making an analysis (as described in the section below) and presenting actual data.--Nutriveg (talk) 12:41, 21 June 2010 (UTC)

Really? Then where is that statement in the Wikipedia guidelines, equivalent to the WP:Synth or the WP:OR that you so readily presented in your above failed arguments? V (talk) 13:43, 21 June 2010 (UTC)

The head of WP:OR says Wikipedia editors shouldn't perform analysis, like to say something is safer based on raw data (about two distinct groups). WP:MEDRS presents the guidelines about the use of sources to support medical claims. Welcome to Wikipedia.--Nutriveg (talk) 22:19, 21 June 2010 (UTC)

But when you read the rest of WP:OR, you find these two qualifications:

• "A and B, therefore C" is acceptable only if a reliable source has published the same argument in relation to the topic of the article.

So when Laube compares the maternal mortality rate from abortion with the overall MMR for the US, he opens the gate for any of us to make the same comparison for data from other countries.

• A primary source may only be used to make descriptive statements that can be verified by any educated person without specialist knowledge.

So any of us is free to use primary data on MMR to say that "1 is lower than 9" - unless somebody thinks you need specialist knowledge to make that claim. --RexxS (talk) 23:50, 21 June 2010 (UTC)

Not to mention, WP:MEDRS specifically says to "Summarize Scientific Consensus" --which is exactly what you, Nutriveg, are opposing here. V (talk) 04:58, 22 June 2010 (UTC)

RexxS, you're mixing the discussions in another thread. Me and Objectivist are discussing another issue (safer). Laube is a single source, it's primary since it doesn't point its sources, it doesn't say is lower, it just presents those two distinct data rates, so a experienced reader (which has an idea of the data distribution) would be able to infer something about it.

Your interpretation of that phrase from WP:SYNTH is incorrect: ""A and B, therefore C" is acceptable only if a reliable source has published the same argument in relation to the topic of the article. In that phrase the "same argument" other source is using is "A and B, therefore C", it doesn't allow you to mimic scientific work using D (alike A), or E (alike B) to conclude F.

Objectivist, consensus has nothing to do with the "analysis" mentioned in WP:OR and there's no "Scientific Consensus" saying it's safer, reliable sources don't say that at all.--Nutriveg (talk) 14:46, 22 June 2010 (UTC)

There is far more in the way of agreement/consensus that abortion is safer than childbirth in most developed countries, than there is disagreement. Can you present just one RS paper stating that abortion is less safe in those countriese? V (talk) 15:06, 22 June 2010 (UTC)

Burden of the proof is for those supporting a claim. In this case: "consensus (is) that abortion is safer than childbirth". Reliable sources only present different data, they don't advance such position "safer". Please read the section below if you didn't understand that yet.--Nutriveg (talk) 15:26, 22 June 2010 (UTC)

You are quibbling again. If abortion is not safer than birth in most developed countries, then there should be some RS that says so. Since you are the one claiming that the available data does not support Wikipedia editors reaching the conclusion that abortion is safer than birth in those countries, you are the one who must present that data!!!! V (talk) 22:16, 22 June 2010 (UTC)

I'm not saying it's not safer and I definitly don't want to include such information (not safer) in the article, but WP:BURDEN is for those trying to include information (safer). Abortion may be safer but we are limited by the sources. Please take a moment and read Wikipedia policies and guidelines, that way we could have a much more productive discussion.--Nutriveg (talk) 22:40, 22 June 2010 (UTC)

Sorry, your "broken record" mode doesn't cut it, either. The Wikipedia guidelines do in-essence say that editors can state the obvious in any article, period. And in this case the data obviously indicates that abortion is safer than childbirth in many countries. Q.E.D. V (talk) 03:52, 23 June 2010 (UTC)

For some reason that still eludes me, at least one editor finds a semantic distinction between "safer than" and "a lower mortality rate than". Fine. Let's simply state the rates without making any comparison. This has gone on way too long and burned way too many electrons for a petty semantic issue. LeadSongDog come howl! 16:21, 22 June 2010 (UTC)

But... our article said safer for a long time, and had 3 sources [13]. These sources (at least Grimes and Henshaw) specifically used the word "safer". This isn't some junk we are making up, but something found in reliable sources. Multiple editors dug up even more sources after protests from a single user. I have no idea what the heck you guys have been arguing about for the last couple weeks, and I have no idea why you let it go on for so long. We have citations that clearly use the word safer. SO much so that the RCOG uses the word and comparison in their guidelines. This is a non-issue to me, and I have no idea how so much talk page has been wasted on this nonsense. How can it be OR, when it is our sources making the comparison and using the word "safer"??? Jeez Louise! -Andrew c ^[talk] 16:36, 22 June 2010 (UTC)

June 15th, looks like MastCell reached the same conclusion as I, yet that didn't quell debate. I don't see any valid objections, and I think the consensus is clear. I'd urge Nutriveg specifically to drop this issue, and for everyone to move on. -Andrew c ^[talk] 16:38, 22 June 2010 (UTC)

Thank you Andrew, I'd be happy to move on – but not at the expense of letting one editor dictate both the content of the page, and just as importantly, the methods we use to reach consensus where that content is contended. We will just bog down at the next issue while we have an editor dismissing sources, such as an up-to-date medical textbook (Laube, 2009), published by a respected publisher as a "primary source" - it's hard to draw any conclusion other than it's because it makes the very comparison he doesn't want to see in text. We also simply won't make progress while we accept the pushing of contrived versions of Wikipedia polices. Imagine how we will be hamstrung if we can't say something as obvious as "1 is lower than 8" because we can't find a source making that exact comparison, even though the literature is littered with reliable sources making the same argument in relation to the topic of the article. - note the selective emphasis of part of a guideline in the earlier reply to push an idiosyncratic interpretation. It is time to end this nonsense, and I'd be happy to hear how others propose to do that. --RexxS (talk) 17:53, 22 June 2010 (UTC)

If we (meaning LeadSongDog, Andrew c, RexxS, and myself) are agreed about an accurate representation of sources, and Nutriveg is the sole opposition, and we have made strenuous efforts to reach an acceptable consensus but have failed because of what we feel are unreasonable demands and interpretations, then personally I think it's reasonable to move ahead with implementing language that we believe is appropriate.

We've made extensive efforts to accommodate Nutriveg's objections. However, one editor cannot be allowed to indefinitely stall progress with increasingly arbitrary obstructions (see WP:IDIDNTHEARTHAT). If Nutriveg continues to disagree with our collective interpretation of policy in this instance, then it would seem incumbent upon him/her to further pursue dispute resolution, for instance by soliciting additional outside input. That's how I would handle it, anyway. I agree that this has gone on long enough, and that beyond a certain point, humoring unreasonable objections turns into enabling obstructionism. MastCell ^Talk 18:25, 22 June 2010 (UTC)

LeadSongDog, I understand you don't like the "safer" discussion to continue, and would have no problem using the "lower mortality rate" and other editors (MastCell, RexxS) previously agreed with that. But "Objectivist" expressed disagreement and I was addressing his concerns.

Andrew c, since then we have reviewed many sources, and the word safer was rarely used in a worldwide context. If I recall correctly only the owner of an abortion clinic uses that, and without attributing the source. Yourself said that wouldn't join this source discussion, where we searched and discussed those sources. So now it sounds strange for me you came up here ignoring the discussion of the sources presented so far, making it sound like they used such word.

RexxS, in my commentary I dismissed Laube for the purpose you want to use it, together with you interpretation of [[WP:SYNTH]

MastCell, I'm probably the one more interested in accurate representing reliable sources, but that doesn't stop other people from saying the same thing while pushing for WP:OR at the same time, like the ongoing discussion with RexxS where he wants to use MMR as it was that data that based the author's conclusion. We can make progress if people demonstrate that purpose and we continue from the moment we last reached consensus, except for "Objectivist" opinion until later today, which was about using "lower mortality", not "safer". But if others until silent or agreeing users, show up just to ignore the progress we have made so far, and those points we have reached consensus and want to start discuss from the beginning like Andrew source discussion above, or want to use a catharsis moment to exclude another editor, like you're doing, it's unlikely we will reach progress that way. So what we need more is that the current editors collaborate instead of advertising the chaos or ignoring the points we have already reached consensus.--Nutriveg (talk) 22:33, 22 June 2010 (UTC)

MastCell's comment on 22:42, 15 June 2010 (UTC) seems to discredit your claim about the sources not using "safer". Does everyone else here agree with Nutriveg's assessment of the newer sources? (I checked the original sources that were in the article for years, and at least 2 of the 3 use the word "safer", but obviously so much has changed in the last decade, those sources are inaccurate and useless anyway). Also, I didn't know that owning an abortion clinic discredited someone from publishing peer reviewed/scholarly papers. That's like someone arguing that a Christian is automatically disqualified from publishing scholarly information about the historical Jesus (I work on those articles, and some people do try to make that claim!) Reviewing the past 4 days of conversation above, I don't think it's accurate to characterize the discussion as a group of editors working together to reach a consensus compromise. It seems like nonsensical arguing over basic policy points, and multiple editors accusing you of obstructionism, "quibbling", thwarting, etc. If I am mistaken, and everyone was working well with you to reach a compromise, I apologize, and I'll let your progress continue. I fail to see any "progress". I'm just going to back away and agree with MastCell that others are welcome to stop enabling obstructionism any time they wish.-Andrew c ^[talk] 23:17, 22 June 2010 (UTC)

Andrewc, my last discussion with MastCell, that worldwide secondary sources don't consistently use the word "safer" was in 19 June in the section just below Talk:Abortion#Proper use of secondary sources.

I'll take the opportunity to answer your question about that source using the same answer:

"eMedicine doesn't provide the source for that claim, so its unlikely to be classified as secondary, and the eMedicine author owns a clinic that execute abortions since 1973. Such claim is not consistently supported by the other sources that only mention "lower maternal mortality", so it would be at best WP:UNDUE to use those claims."

To summarize, the source has many problems and, beyond that, it would be undue to use that single problematic source to support a claim not supported by secondary sources.

In 19 June 2010, MastCell said: "I would be fine with a statement comparing the mortality rates of abortion and childbirth without using the word "safer". That looks like consensus about something.

So next time you decide to show up, check better what we had discussed after you decided to leave ("I don't have much time to contribute to this") when you were last asked to join the source discussion ("if you're still interested about the outcome of that discussion, I ask you to express your opinion").---Nutriveg (talk) 02:16, 23 June 2010 (UTC)

Let's be clear. I agreed to not use the word "safer" because I want this ridiculous waste of time to end. Not because I think your objections are reasonable (I don't), but because you are clearly so heavily invested that I'm looking for the path of least resistance and least damage to the article. I'm still not sure it was the right call - I'm a little concerned about enabling an endless stream of obstructionism, and this latest round of arguments substantiates that concern.

It doesn't make sense to disqualify a source because it's written by someone who performs abortions. Presumably, the people who are experts on the technique and risks of abortion are those who perform them. If a surgeon had never removed an appendix in his life, would you consider him a serious authority on the risks of appendectomy? MastCell ^Talk 03:57, 23 June 2010 (UTC)

Proper use of secondary sources

Most of the problems related to this maternal mortality from abortion versus from general causes (including childbirth) is how to represent that difference, most of the secondary sources just compare those different mortality rates as such "lower mortality rate" but a significant number of wikipedia editors want to advance that position and use the word "safer" instead, supported only by a few country specific or unreliable sources.

The reason we prefer to use secondary sources is not because they carry a more reliable nature, from being better peer/editorial reviewed than primary sources, but because they "(summarize) one or more primary or secondary sources, usually to provide an overview of the current understanding of a medical topic". We do not use secondary sources because their original claims carry more truth (which some here often call "facts") but because they better represent the "varying viewpoints". So it doesn't make sense to pick a (country specific or unreliable) secondary source that use the contradictory word "safer" (without even citing the sources it has based to make such claim) when that doesn't better describe what all the secondary sources are commonly saying "lower mortality rate". So the choice of a source to reference a text is not one of who "carries more truth" (or is believed to be more "factual") but which one is more consistent with all the others, in this case, so far, (Lloyd, 2005) is the one which better fits that need.--Nutriveg (talk) 18:18, 18 June 2010 (UTC)

English is a language rich in variety. It is that very fact that allows editors to summarise multiple reliable sources in order to create an article suitable for an encyclopedia. An editor who reads "A has a lower mortality rate than B" and writes "A is safer than B" is not guilty of WP:SYNTH, but is paraphrasing to avoid plagiarism and to make it simpler for a lay person to read. If you think that such a paraphrase is over-simplification, say so, but don't expect editors to accept that "safer" is somehow "contradictory" of what all of the sources say. --RexxS (talk) 19:07, 18 June 2010 (UTC)

It's not a matter of the English language but one of science. Epidemiology is the science that deals with such comparative analysis, when Wikipedia editors do such science by themselves they're doing WP:SYNTH. Unfortunately the editors doing such science don't have no idea about that otherwise they would have long recognized the problem.--Nutriveg (talk) 19:55, 18 June 2010 (UTC)

When you quibble over "is safer" versus "has lower mortality rate", then it is a question of language, not science. You've already acknowledged seeing Yanda use "safer" in an edipemiological analysis – or is that not science because he's talking about medical abortion? If you find yourself the only editor who thinks there's a significant difference between the two phrases, and make unsubstantiated attacks on other editors, it may be time to drop the stick and move on to more productive discussions. --RexxS (talk) 20:15, 18 June 2010 (UTC)

Understanding the problem with Yanda phrase is just one of language:

"Studies of medical abortion since the 1980s in Europe and in 2000 in the United States, in addition to studies in various other countries, have shown the method to be extremely effective and significantly safer than childbirth."

She makes clear in the beginning that the phrase is about medical abortion, she makes that even clear by mentioning "the method". Abortion is not a method but a procedure, medical abortion is a method. Applying something said about a specific method to the whole procedure is WP:SYNTH. If my argument about WP:SYNTH wasn't enough for you, in the US at least, maternal mortality from "medical abortion" is lower than "surgical abortion".

I would have dropped my point if the users so far supporting the "lower mortality rate between two distinct groups of people means safer" argument, so far RexxS and MastCell (which clearly said such thing) had some degree of knowledge about Scientific control to know how absurd is the WP:SYNTH conclusion they're proposing.--Nutriveg (talk) 21:06, 18 June 2010 (UTC)

So now it's the difference between "procedure" and "method"?

• procedure: 1. a way of acting or progressing in a course of action, esp an established method - Collins English Dictionary (quoted here)
• procedure: 1. A particular method for performing a task. Synonyms: (method): algorithm, method, process, routine – Wiktionary
• method: 3. The procedures and techniques characteristic of a particular discipline or field of knowledge - Collins English Dictionary (quoted here)

So what you're saying is that it's ok to use the word "safer" for a method, but not for a procedure? --RexxS (talk) 21:47, 18 June 2010 (UTC)

If you can't even interpret that phrase then we really have a problem here. Medical abortion is the subject of the phrase, it's mentioned twice one as "medical abortion" and other as "the method".

If you still fail to understand "method" as "medical abortion" maybe you should go to the text and read the next phrase: "Surgical abortion remains the primary method of abortion, though medical abortion accounts for 40% of all procedures"--Nutriveg (talk) 22:17, 18 June 2010 (UTC)

So what you're saying is that although you accept that we can say "medical abortion is safer", we can't say that "abortion is safer", but we can say "abortion has a lower mortality rate"? Can you see how ridiculous that sounds? --RexxS (talk) 22:40, 18 June 2010 (UTC)

I agree that the source says "medical abortion is safer", but I don't know how that compare to other sources comparing both since we have been so far looking for sources about Abortion not Medical abortion.

I definitely agree we can cite "abortion in developed countries has a lower maternal mortality rate than childbirth" since that has been consistently supported by sources. However I disagree with saying it's "safer" because that's WP:SYNTH since those rates talk about distinct groups of people and such comparison could only be done after statistical adjustment by an external source!--Nutriveg (talk) 22:57, 18 June 2010 (UTC)

Thank you - that is helpful, and I sincerely mean that. Would it be correct to say that you would accept we can say "abortion in developed countries has a lower maternal mortality rate than childbirth", but we can't say "abortion in developed countries is safer than childbirth", because the two statements have different meanings? --RexxS (talk) 23:07, 18 June 2010 (UTC)

They do have different meanings, that is very clear to those with knowledge of the science that should support such statements. We should mention the first phrase because it has been consistently supported by the reliable updated sources presented so far, while the later was supported by only a few country-specific or unreliable ones. And such second phrase doesn't contradict the claims supported by the first one, while the inverse is not necessary true.--Nutriveg (talk) 23:17, 18 June 2010 (UTC)

Thank you again, could you then put your finger on what the difference between the meanings is? --RexxS (talk) 00:12, 19 June 2010 (UTC)

Lower mortality data rate means there's lower mortality between two different groups of people (where those two groups may or not share similar characteristics).

Safer, in the mortality context, would mean something like this: in two statistically identical groups, abortion and childbirth, where a control group (no pregnancy) would also be used, there's lower mortality (per procedure) in the abortion than in the childbirth group and such difference is statistically significant even after elimination of possible confounding factors. Several such epidemiological studies are performed/reviewed and they reach similar conclusions. At that point it would be classified as "probably safer". While/after other scientists would try to identify the mechanism that could justify the difference, relying on scientific knowledge and laboratory studies, when they agree between themselves and with the epidemiological studies, then that would be classified as "safer". That's what I understand by "safer".--Nutriveg (talk) 01:20, 19 June 2010 (UTC)

Well, the authors of UpToDate and eMedicine understand is that abortion is "safer" than childbirth. Generally, their understanding counts for more than yours or mine. Nonetheless: do I understand correctly that you would be OK with a statement comparing the risks of death from abortion and childbirth, as long we do not use the word "safer"? MastCell ^Talk 04:38, 19 June 2010 (UTC)

UpToDate, uses US data, eMedicine doesn't provide the source for that claim, so its unlikely to be classified as secondary, and the eMedicine author owns a clinic that execute abortions since 1973. Such claim is not consistently supported by the other sources that only mention "lower maternal mortality", so it would be at best WP:UNDUE to use those claims.

If you didn't read my suggestions so far I'm ok in citing the data as it is "lower maternal mortality". I don't agree is using the word safer by the explained reasons.--Nutriveg (talk) 12:24, 19 June 2010 (UTC)

I've read and now understand your explanation, and I can see how we have had a problem in communication. As a matter of good faith, I fully accept that you have a very precise definition of "safer", but I hope that you can accept that it is an idiosyncratic use of the word, not shared by many. That's not a criticism, merely an observation that different people can read different meanings into the same word.

Another point: Having discussed this with a real life friend who has lived in the US, I'm informed that the phrase "abortion is safer than childbirth" carries connotations that the phrase "abortion has a lower mortality rate than childbirth" does not, and that the connotations are much more significant to some than a difference in meaning. It seems that the first phrase carries with it an implied endorsement of the pro-choice position. I don't pretend to understand the strength of feeling in the pro-choice/pro-life division, but if that is actually part of your objection, then I'd support you on those grounds alone: there's no need to use phraseology that carries "baggage" when a neutral phrase is available. Disclaimer: Those positions have little or no currency where I live, and I have no desire to promote either on Wikipedia. --RexxS (talk) 14:56, 19 June 2010 (UTC)

If I Google abortion "safer than childbirth", the first 2 pages of hits are virtually all pro-life websites making (largely incorrect) assertions about the dangers of abortion. So I wouldn't say that "safer than childbirth" is a pro-choice talking point. It seems more correct to say that the pro-life lobby considers it very important to make abortion seem dangerous (based on the search engine results).

However, I appreciate RexxS' desire to avoid unnecessary conflict. I would be fine with a statement comparing the mortality rates of abortion and childbirth without using the word "safer". Perhaps such language should be discussed here to avoid edit-warring? MastCell ^Talk 19:08, 19 June 2010 (UTC)

Yes there is not the same controversy surrounding this procedure outside the United States. I am not sure what the objects are to this wording but if it because it carries more significance I am sure we can figure out something that works for everyone.Doc James (talk · contribs · email) 06:47, 20 June 2010 (UTC)

Arbitrary break 2

Well, since that problem looks to have been resolved between the editors so far objecting that earlier suggestion then what would be the problem with:

• "In developed countries the maternal death rate from abortion is below 1 in 100,000 procedures, lower than the rate for childbirth and general pregnancy, which is already low."

--Nutriveg (talk) 17:19, 20 June 2010 (UTC)

It's a reasonable starting point. My quibbles are that it's very vague and innumerate, and does not describe the risk of childbirth in either relative or absolute terms, thus leaving a reasonably sophisticated reader to wonder. I would rather specify either the relative risk of childbirth compared to abortion, or the absolute risk (and leave the reader to compare using their own metrics). This is typically the approach taken by reliable sources.

Also, the writing is a bit awkward (too many comma-separated clauses), and the word "low" is repeated too often. Also, "general pregnancy" should be removed, since it's vague (what is "general" pregnancy?) and the risk in question is associated specifically with childbirth. MastCell ^Talk 18:18, 20 June 2010 (UTC)

May I try? A possible simple and direct reword:

• "In developed countries, fewer than one woman dies per 100,000 abortions; this is lower than the already low rate of maternal deaths in childbirth in these countries."

(This moves the word maternal nearer to childbirth, where I feel it belongs. A 14-year-old aborting in the first 8 weeks is hardly a maternal person.) Hordaland (talk) 18:56, 20 June 2010 (UTC)

What sources would you suggest to cite for these two suggestions? --RexxS (talk) 19:48, 20 June 2010 (UTC)

MastCell, The risk of maternal mortality from childbirth or pregnancy is described as "low", as by the source. I don't think it would be easy to find the number you want since the data is usually collected as maternal mortality as defined by WHO/ICD, which is readily available, instead of that other you're looking for.

This article is about abortion, this sentence is about abortion mortality, there's no need to display childbirth or pregnancy mortality numbers, otherwise that would be WP:Undue. Only few sources cite a number.

The mention of "general pregnancy" is because both childbirth and abortion is pregnancy, so there's a need to differentiate. Sources cite childbirth, pregnancy or both, not just childbirth.

Hordaland, your suggestion looks OK, I just need to check how many sources cite just pregnancy. Maternal was used by WHO definition of maternal mortality, that's about any gestational age. Citing woman may sound abortion is sex-selective to an unaware reader, but since the number is very low and maternal mortality is mentioned afterward I don't think that would be a problem.

Rexxs, so far Lloyd,2005 is a secondary source that supports both suggestions.--Nutriveg (talk) 20:00, 20 June 2010 (UTC)

The figure that MastCell suggests to include is easy to find for 2005 from WHO: 9 maternal deaths per 100,000 live births (although Lloyd incorrectly uses "risk" to describe both of these ratios). --RexxS (talk) 20:36, 20 June 2010 (UTC)

Which source says that? From what you say that number is for maternal death, by the WHO definition which I'll paste here since so far some are still failing to understand:

"the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes"

That doesn't include only deaths from childbirth procedure, but to many causes, including abortion. That MMR number doesn't use childbirth procedures or number of pregnancies to calculate the ratio, but the number of live births. While the abortion numbers use the number of procedures to calculate the ratio. See the problem again of comparing different groups? --Nutriveg (talk) 21:20, 20 June 2010 (UTC)

The source is http://www.who.int/whosis/mme_2005.pdf p.16. That's the maternal mortality ratio as defined by the WHO as I understand it. Lloyd says "In representative developed countries, the risk of dying (from abortion) is no more than 1 in 100,000 procedures, lower than the relatively low risks associated with pregnancy and childbirth in these countries" - if the "relatively low risks associated with pregnancy and childbirth" isn't MMR, what is it? Obviously there are two different groups, since one outcome precludes the other. Lloyd makes the comparison, not me. --RexxS (talk) 22:55, 20 June 2010 (UTC)

How about:

• "The risk of dying from abortion in developed countries (less than 1 in 100,000 procedures) is lower than maternal mortality from pregnancy and childbirth (9 per 100,000 live births) in those countries"

to make it clear what is being compared? --RexxS (talk) 23:17, 20 June 2010 (UTC)

(edit conflict)Yeah as expected, that number is not just about childbirth, as by Hordaland suggested text, it includes other causes of maternal death (including abortion), it's not just about different causes but also using a different ratio: not procedure, not pregnancies. Obviously the sources had more data than you, they weren't relying simple in WHO, that was necessary to calculate how many of those registered maternal deaths were caused by abortion so they probably had an idea about other numbers involved, where they had shown no effort to describe those numbers more than necessary or to be "exact", even if you understand the other number, less than 1 as "exact". I repeat, we shouldn't cover this issue more than the sources themselves.--Nutriveg (talk) 23:25, 20 June 2010 (UTC)

RexxS, as explained that's original research, you're using a number not used by the source itself, the second number includes the first, the chosen developed countries are different, the ratio is different, the years are different (7 years at least), description "from pregnancy and childbirth" don't match the definition, you don't know what data was used to compare... Are you still not convinced that we shouldn't do WP:OR no matter how much some editors want that "the source should have said that".--Nutriveg (talk) 23:43, 20 June 2010 (UTC)

I used the number supplied by another reliable source for MMR, what wrong with that? The years are the same (2005). The second number does include the first - that's clear from the definition of MMR, but it's the same comparison that Lloyd makes. The words "from pregnancy and childbirth" are the ones Lloyd used, and you've already pointed out that's what the WHO definition covers. Lloyd did the comparison, not me; I have to accept the conclusions of a reliable source, not try to work out whether they are valid or not. I strongly believe we shouldn't do OR, but that's not what I've done. I've only used the same arguments that the reliable sources do. --RexxS (talk) 00:26, 21 June 2010 (UTC)

You're assuming the WHO data was the raw data used by the researcher who had the same limitation as you (of not having detailed data), which is clearly not the case since they had maternal mortality data from abortion for the same "representative developed countries" which the author call "these countries". Lloyd,2005 is a secondary source, while you're a wikipedia author giving another meaning to primary data. This is WP:OR and it's sad how you don't recognize that.--Nutriveg (talk) 01:31, 21 June 2010 (UTC)

Well, no. Lloyd is talking about MMR, isn't she? What do you think she's talking about? --RexxS (talk) 01:36, 21 June 2010 (UTC)

Would:

• "In developed countries, deaths occur in less than 1 in 100,000 abortions, versus the relatively low maternal mortality ratio of 9 per 100,000 live births."

be clearer? --RexxS (talk) 02:07, 21 June 2010 (UTC)

If you don't care to read the text, Lloyd says:

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

It talks about "pregnancy and childbirth" it doesn't talk about MMR or would make sense to mention it since that also includes deaths from abortion, it's obvious to anyone that first number would always be lower than the second and that phrase wouldn't be meaningful. The source had data you don't have, otherwise it wouldn't be able to distinguish deaths from abortion from other causes of maternal mortality, the source decided it was not important to publish those numbers, maybe because it just got an rough idea of that number. Please accept that and respect WP:DUE and WP:OR.--Nutriveg (talk) 13:21, 21 June 2010 (UTC)

But I'm not the one who has decided that when Lloyd uses the word "risk", she means "maternal death rate" - you are! Look at your suggestion from above:

• "In developed countries the maternal death rate from abortion is below 1 in 100,000 procedures, lower than the rate for childbirth and general pregnancy, which is already low."
• ""In representative developed countries, the risk of dying is no more than 1 in 100,000 procedures lower than the relatively low risks associated with pregnancy and childbirth in these countries (The Alan Guttmacher Institute, 1999)" added for comparison (my emphasis) --RexxS (talk) 23:38, 21 June 2010 (UTC)

Why do you think you can accuse me of OR, when you're the one who made the interpretation of what the source said? --RexxS (talk) 15:31, 21 June 2010 (UTC)

"Maternal death" is the normalized term for the death of a women while/after pregnant, the definition is linked I just used the technical definition. "Rate" is just a word meaning amount, it can omitted from the phrase if you will.

On the other hand "Maternal Mortality Ratio (MMR)" is a measure defined by the WHO. Its name is derived from "maternal death" but that's a different term which a very specific meaning. You interpreted those two terms as if they had the same meaning, but they don't, the second just derives from the first.--Nutriveg (talk) 22:08, 21 June 2010 (UTC)

Nice try, but that's just bluster. You made the connection between "risk" and a completely imprecise term: "maternal death rate". We all know how "maternal death" is defined (and it is obviously not what Lloyd is referring to), but there's no definition of "maternal death rate". There's no such thing as a "normalised term" in MEDMOS either. I am equally free to make the connection between "risk" and "maternal mortality ratio" - MMR does exist, as it's defined by WHO and has a section in Maternal death on Wikipedia. On the other hand, anyone familiar with the topic will know that "maternal mortality rate" is defined by the WHO to be "Number of maternal deaths in a given period per 100,000 women of reproductive age during the same time-period" - a completely different thing and impossible to be confused with MMR.

Now let's move forward: you make an assumption about what Lloyd means by "risk"; I make another assumption about what Lloyd means by "risk". So either withdraw your accusation about OR (because if I'm guilty, then you are), and we'll thrash out which wording better reflects what Lloyd said; or withdraw your suggestion because it's OR (and I'll do the same), and we can agree that Lloyd is not suitable because "Article statements generally should not rely on unclear or inconsistent passages nor on passing comments. Passages open to multiple interpretations should be precisely cited or avoided." (WP:No original research). Make your mind up. --RexxS (talk) 23:38, 21 June 2010 (UTC)

You're making me sound like I strongly support the use of the word "rate", which I clearly pointed above I don't. I'm not pushing a "term": "maternal death rate". They are just two distinguish terms that were put together by chance "maternal death" and "rate". We can change "rate" back to "risk" if you think that's so different. But you can only make me laugh when you say Lloyd wasn't "obviously" talking about maternal death. I just used the medical standardized term (maternal death) for such event (death of a pregnant woman). What do you want to justify with such absurd arguments? That you're free to make WP:OR by presuming the data used by the authors to conclude the risk is lower. No you're not.

I rephrased mine and Horland suggestions to replace the word "rate" with "risk" so I expect you to abandon those WP:OR intentions and we could move on just following the sources.

• "In developed countries, the risk of a women dying from abortion is fewer than 1 per 100,000 procedures; this is lower than the already low risk of maternal deaths in childbirth in these countries."
• "In developed countries maternal death risk from abortion is below 1 in 100,000 procedures, lower than the risk for childbirth and general pregnancy which is already low."

-Nutriveg (talk) 15:19, 22 June 2010 (UTC)

Nutriveg, I too had a good chuckle when I saw your attempts to do anything to avoid the fact that Lloyd is talking about MMR. Please understand that Wikipedia is not the place to start inventing your own terms: first "maternal death rate", now "maternal death risk". "Maternal death" is an event, a single datum point; while the other three defined terms are statistical measures of its prevalence. Maternal mortality ratio is the number of deaths per 100,000 live births. Maternal mortality rate is the number of deaths per 100,000 women of reproductive age. Lifetime risk of maternal death is the probability of dying from a maternal cause. Those are three different metrics, and they are the ones the rest of the world uses - the "medical standardised terms" in fact. There is absolutely no need to start inventing our own ill-defined terms in an effort to avoid having numbers that can be used. I expect you to acknowledge that your suggestion contains more WP:OR than mine did, and to abandon Lloyd as a source because of its lack of clarity. Then we can indeed move on to summarising the unambiguous sources. --RexxS (talk) 17:19, 22 June 2010 (UTC)

While it might not have been so cited, "maternal mortality rate" is defined here and more generally here on MedTerms, at MedicineNet.com for what it's worth. LeadSongDog come howl! 19:12, 22 June 2010 (UTC)

Thank you, LSD - that definition coincides with the WHO definition of "maternal mortality ratio" (Maternal Mortality in 2005, p.5), where they provide a different definition of "maternal mortality rate". Our article on Maternal death also has a section on Maternal Mortality Ratio (MMR) and provides the same definition. I think that the lesson here is to stick with terms that are unambiguous where possible, and to prefer terms that have a single definition where there is a choice (even it it does mean we have to figure out which one the sources are referring to). --RexxS (talk) 20:09, 22 June 2010 (UTC)

RexxS, the source was not talking about MMR. MMR includes all causes of death (including abortion) while he had detailed numbers (deaths caused by abortion). Don't you see how meaningless would be to say F (which is the sum of the positive numbers A, B, C and D) is higher than A?

LeadSongDog, I think you can get a better source than that website reviewed in 1998. The combination of words ""maternal mortality" + "rate" was just a coincidence I made while rephrasing the sources and carries no other meaning, like RexxS implying it was another term "Maternal Mortality Ratio (MMR)" (which you can surely find better sources for that). And was using that number as the one used by the authors to make the "lower mortality" conclusion.

RexxS "Maternal Mortality Ratio (MMR)" derives from "maternal death" not the opposite.--Nutriveg (talk)

Nutriveg, don't you see that your example is precisely the reason that we should give the absolute numbers, since the reader can then clearly see that B+C+D is much bigger than A ("7 is much more than 1, just as 8 is much more than 1", in this case). It would be deceptive to omit the fact that MMR is often a magnitude of order greater than the equivalent ratio due to abortion. It is utterly bizarre to create an undefined term ""maternal mortality" + "rate" and ascribe it to a source, and then to accuse me of WP:OR!! As for the derivation, I've patiently explained to you that MMR is the number of maternal deaths per 100,000 live births several times; you should be able to see by now that MMR is not the same thing as maternal death, and that Lloyd was was talking about the ratios, not the total number of events, or even "lifetime risk of maternal death" (both of which would be meaningless in that comparison). You're the one who's "rephrasing the sources", so answer the question: When you were rephrasing, what did you think Lloyd mean by "risk"? --RexxS (talk) 00:07, 23 June 2010 (UTC)

We don't do original research here choosing our own numbers and putting them together just because that sounds better. The authors were writing about abortion mortality and used childbirth/pregnancy mortality just to say how low it was. They had no intention of strictly assessing risk of childbirth versus abortion, they just gave a rough idea, that's probably because they didn't cite numbers. It's WP:Undue to over represent that specially by adding WP:OR. There are many things that carry a higher mortality risk than abortion. We don't need to cite them all, we don't need to detail them all, I don't see why you're making childbirth such a special case.

I pointed MMR problems: on one side (of the deaths) it includes deaths from many causes including abortion (so, naturally a higher number), on the other side (of the cases) it counts only live births not all pregnancies (so a lower number). Just to point how problematic WP:OR can be. But you don't need to convince me that's a good comparison, we just cite the sources here and sources saying mortality is lower don't use such number, specially one you choose yourself.

I don't see why you're creating so much problem about the use of those two words together, that was merely accidental, carries no specific meaning when put together, except for careless readers looking for information by themselves instead of relying on the provided sources, which mistook "Maternal Mortality Ratio", a WHO defined statistic, with "maternal death rate". Even when the interlink provided, by marking only "maternal death", shows that's simple a medical term next to a word, "rate", used merely to describe "1 per 100000" (a rate). Where that word can be suppressed, inverted "rate of maternal mortality", replaced with "risk" and I won't make a problem about that change, right in the opposite, I immediately suggested a change to address your concerns when you expressed it.

On the other hand you continue to pushing for the use of your WP:OR

Answering your question Loyd used "risk of dying" and "risks" I interpret that second word "risks" was short for the first term "risk of dying", where the plural "risks" was used because it was about two things "pregnancy and childbirth".--Nutriveg (talk) 01:52, 23 June 2010 (UTC)

Moving on towards a baseline version

After all these discussions we have had so far, recently I only saw a couple people disagreeing with the last suggested version and they only wanted to "add more" to that version ("include numbers" or add "safer" instead of "lower mortality risks"), without rejecting that version as inappropriate. Since it's impossible to find a perfect version at first try, we need to move on towards a baseline version we can work from instead of going backwards everytime a new person joins this discussion. That said I'll move on and be bold adding the Hordaland (changed) suggestion to the article.--Nutriveg (talk) 19:10, 24 June 2010 (UTC)

There's no consensus for the version added to the article. Get consensus by proposing changes here before you modify text and remove reliable sources. --RexxS (talk) 20:56, 24 June 2010 (UTC)

Just posting to second this request. We've had enough bold edits and reversions for a while. Let's discuss the problems and find a good compromise. SHEFFIELDSTEEL^TALK 21:05, 24 June 2010 (UTC)

Well, if no one opposed Horland suggestion and other editors only wanted to add more, then there was consensus about a starting point. If you think otherwise please say what's the problem with that version by itself, not how you think it could be better.--Nutriveg (talk) 11:49, 25 June 2010 (UTC)

If you want to start from scratch, why not revert back to the version that was in the article for years: Early-term surgical abortion is a simple procedure which is safer than childbirth when performed before the 21th week.[31][32][33] But really, why even do that? Removing any reference to the comparison because you guys have some minor quibbles is disruptive. It appears there has been some progress, scores of news sources, and more data added. I see no reason to remove that outright simply because one person doesn't like some minor aspect. Discuss whatever changes you feel need to be made here, and keep working on improving it. You don't get to blank the section just because an edit you tried didn't work out. Maybe take it as a minor set back, but keep working on it. -Andrew c ^[talk] 20:12, 25 June 2010 (UTC)

I don't want to start from scratch but from a version that everyone agrees and addresses the presented problems of WP:OR and WP:UNDUE under the context of all the recent worldwide sources about the subject that were presented here.

The version that so far better fitted that purpose was the Hordaland (changed) suggestion, and so far no one said what was the problem with that version by itself (not how it could be better by adding more). I've waited more than two days and no one said what that problem was, so I'll take this as a consensus that no one think it has a problem by itself, since no one said what would be that problem, so I'll perform that edit using it.

No version is better because of how old it is but because of consensus. If we don't reach an agreement about a version then this issue shouldn't be mentioned in the article at all.--Nutriveg (talk) 16:00, 27 June 2010 (UTC)

Incorrect. The previous version is by default the consensus version. I support the version proposed above by Andrew c. If you can't get sidespread support for a change, do not make it. It's been days since I advised you to read and understand what consensus means. You've had plenty of time by now. SHEFFIELDSTEEL^TALK 18:07, 27 June 2010 (UTC)

• Per a request at WP:RFPP I have fully-protected the article for seven days. If you arrive at a consensus in the meantime use the {{editprotected}} tag to indicate that you wish to amend the article. TFOWR 18:36, 27 June 2010 (UTC)
  • This is a bit ridiculous. One editor - Nutriveg - insists on edit-warring against any number of others who disagree with his ideas. He's been blocked twice for this in the past couple of weeks, and this is now the second time he's landed this article in full protection (incidentally, despite its controversial status, the article hadn't previously required full protection for almost 2 years until Nutriveg arrived). I'm kind of tired of seeing the article end up protected because of one clearly disruptive editor, and the next time something like this happens I think my time (and probably all of ours) is better spent figuring out how to deal with this disruption rather than continuing to repeat this unproductive cycle. MastCell ^Talk 20:07, 27 June 2010 (UTC)
    • My apologies. I felt that discussion might be encouraged if further reverting was impossible. SHEFFIELDSTEEL^TALK 20:14, 27 June 2010 (UTC)
      • Is there a version that the majority here support? Maybe people could post diffs of the ones they like best? Or can you all finish discussing your differences and come up with a new version you all can agree upon? I mean, what is the state of this discussion? Is it close to completion? Has it stalled? Does it need additional input (RFC)? It's hard for someone like myself to jump in and help because of all the prior discussion, you know? -Andrew c ^[talk] 20:43, 27 June 2010 (UTC)
        • Well Andrew, you can see the problem as well as any of us. I'll be blunt. If I reply to Nutriveg's refusal to accept any source other than Lloyd, or correct his interpretations of that source, we end up in endless talk page arguments with continual IDIDNTHEARTHAT from Nutriveg. I took note of your request to stop enabling his obstruction, and stopped replying. The result of that is Nutriveg declared that he has consensus and put his preferred version in the article: back to edit-warring. If you feel that we've already discussed sources long enough, then let's find a neutral third party to start a content RfC or mediate the dispute. While Nutriveg continues campaigning to slant the article to put abortion in the worst possible light, we'll find no resolution through discussion here. --RexxS (talk) 21:45, 27 June 2010 (UTC)
          • One option that might make sense at this point is outlined in WP:SHUN. Perhaps we should discuss what we think is the most appropriate text, brainstorm a few alternatives, put them up for revision on the talk page, etc. If Nutriveg raises a novel concern that has not been discussed to death, then we address it - once. If he raises the same concern again in a way that doesn't take on board the response in a meaningful way, then we ignore him. That way, he's still able to have a constructive voice here, but we remove his ability to single-handedly obstruct and derail any form of progress on this page. MastCell ^Talk 04:09, 28 June 2010 (UTC)

This diff restores the version that (I think) contains all the sources that editors want to see cited, including the Lloyd reference that Nutriveg wants to use. I believe that this best represents the former (and thus the default) consensus version of this text, and I haven't seen any real support for changing it. Remember, consensus can exist even if one editor refuses to accept it. SHEFFIELDSTEEL^TALK 22:04, 27 June 2010 (UTC)

I realise that my previous comment was somewhat short of constructive, and for that I apologise. For anyone else thinks it may be of value, I'll outline the key points that I think the opening paragraph of a section on the 'Health risks of abortion' should contain (in this order):

• Unsafe abortion is a serious risk to a woman's health (both mortality and morbidity)
• Unsafe abortions occur predominately in non-developed countries
• The MMR of unsafe abortion is estimated at 340 per 100,000 procedures
• The rate of long-term damage or disease from unsafe abortion is in excess of 10% and may be as high as 35%
• Safe abortion is one of the safest procedures in medicine
• Safe abortions occur predominately in developed countries
• The MMR of safe abortion is less than 1 per 100,000 procedures
• Although in developed countries the MMR of childbirth is low (around 8 per 100,000 births), the MMR of safe abortion is even lower
• The MMR of safe abortion increases as the pregnancy progresses

I'm quite prepared to cite the multiple sources that expound those points, but I thought I'd ask first whether any others think the time is right to overhaul that entire paragraph, with a view to ensuring that it accurately covers the whole topic that it purports to do? --RexxS (talk) 22:49, 27 June 2010 (UTC)

SheffieldSteel, there's no such thing as an earlier change has more consensus, specially when the article was protected just after that change was made, because of that change. You saying that change has consensus is deceptive, and it's more deceptive when you use such argument to revert and protect the article. You saying you didn't "seen any real support for changing it" is a LIE! There was a long discussion on this talk page that you were aware of.

It was SheffieldSteel continued edit warring and protection request that lead to this protection. Ignoring the discussion process

I presented Hordaland suggestion, and so far NO ONE have said what's the problem with that version. The only thing I'm seeing here is people that just don't like it without saying what's the problem with that version, but only what they want to add more. And I'll continue to understand that version has consensus unless some one says what is the problem with that version by itself, and then after that, we can discuss what we can add more to this article.

MastCell, your WP:SHUN proposal is hilarious, you people already removed other parties against your POV (out of Wikipedia) by misuse of administrative tools, now you that to remove me from this discussion.--Nutriveg (talk) 12:59, 29 June 2010 (UTC)

If you believe there has been admin abuse, please report it at WP:AN. This is not the place for that discussion. Next, can you post a diff for the "Hordaland suggestion" so that those just joining the discussion can see your proposal. So far it appears SheffieldSteel is the only one who posted a diff to a version they prefer. If you have one as well, perhaps we can compare and contrast the two, and work out a compromise based on those two. If we stick to working on content, we can probably get some progress here. If we get boggled down in interpersonal junk, then that's not going to lead anywhere (again, any legitimate complaints should be raised at the respective noticeboards).-Andrew c ^[talk] 13:43, 29 June 2010 (UTC)

I don't expect to have a discussion based on diffs, but on arguments. The version I'm supporting wasn't one that someone silently made to the article and others are trying to impose by reverting, ignoring the lots of problems discussed about that change in the talk page, specially about the use of old, country-specific and unreliable sources, the misrepresentation of those sources by WP:OR and WP:UNDUE, and the version reached by the discussion process, represented in the sections above, where those problems of misrepresentation were discussed.

I'm not supporting a final version but one we can commonly agree and start from it. The proposed version was the result of a discussion process where me, Anythingyouwant (a user with 31,000 edits that leaved Wikipedia because to those abuses), RexxS, DocJames, MastCell, the parts more involved in the discussion (not the ones who show up here once and while, ignoring what was discussed so far, only to exarcebate the discussion) had agreed about the use of "lower mortality", after we have reviewed the worldwide sources, and Horland proposed a version based on that agreement, which no one so far disagreed about that version itself, where the only change, in a proactive way, due to RexxS concers about the use of the word "rate" instead of "risk" was that word change. I'm not going to cite diffs, people are not stupid to don't be able to see that change, and if they have such a narrow view they probably won't be able to see the whole discussion process that leaded to that Horland suggestion and shouldn't join this discussion at all.--Nutriveg (talk) 14:25, 29 June 2010 (UTC)

I agree that SheffieldSteel's diff represents a reasonable starting point for further work on this section. I also agree with the list of information points that RexxS provided - while there might be a few minor tweaks, I think he's summarized the key points that the section should convey. I would add to his list that we should detail specific complications of abortion, as well as complication rates in both the "safe" and "unsafe" settings. MastCell ^Talk 17:28, 29 June 2010 (UTC)

Well, we are not discussion discussing "the whole section" but the abortion mortality point in the head of this discussion section, so we could add more to that, we don't expect to start from the end. If you don't say what's the problem with that Horland suggestion by itself (not what you want to add to it) I'll understand there's no disagreement about it and so it remains as a consensual starting point, instead of SheffieldSteel change, which carries several problems extensively discussed in this talk page (old, country-specific and unreliable sources and the misrepresentation of those sources by WP:OR and WP:UNDUE)--Nutriveg (talk) 17:43, 29 June 2010 (UTC)

I will happily address any comments or suggestions that Hordaland has. I think there's been some progress, in that editors have suggested a starting version as well as a list of key points for inclusion. If you wish to help make progress, then constructive content suggestions are welcome. However, I think patience is exhausted with your attempts to dictate the terms of discussion. Other comments? MastCell ^Talk 18:06, 29 June 2010 (UTC)

It's the "Horland suggested text", a text that so far received no expressed disagreement and so has consensual approval by all involved editors since unexpressed arguments don't count. Ignoring that a consensual discussion process takes into account the position of all involved parties, taking into account only those who share the same POV of yours can only result in the failure that accompains such unilateral discussions.--Nutriveg (talk) 18:41, 29 June 2010 (UTC)

Sheffield suggestion

Can anyone make a short, concise reply to why Sheffield's diff isn't a good starting point? And if you want, you can expand on things you'd change, but is there any significant reason why that version cannot sit in the article while we work out the other stuff? -Andrew c ^[talk] 18:10, 29 June 2010 (UTC)

About the first sentence the provided mortality number (between 0.2–1.2 per 100,000) is a range instead of average and doesn't give an idea of the data distribution within that range, secondary worldwide sources consistently support the less/no more than 1 per 100,000 number.

About the second sentence " In comparison, by 1996, mortality from childbirth in developed countries was 11 times greater". A balantaly mistake is that the source that support such text doesn't use the same number of the early sentece, which make such sentece absurd by comparing different numbers.

Further that text is based on a single old source, it's 1996, where we need to remember is using even older data since currently the WHO releases maternal mortality data with a delay of at least 2 years. So, a 14 years old source, doesn't fit "Look for reviews published in the last five years or so, preferably in the last two or three years." While we have updated sources that fit that need, like (Lloyd, 2005) supporting Horland and also mine suggestions already presented in this talk page.

That claim is primary since it doesn't cite it's sources. Such number (11) isn't presented by any former source. We prefer to use secondary sources not because their authors carry more reliabilty to make original claims but because they should fairly describing the varying viewpoints of existing sources.

That claim was made by the source as a way to convince unsure women: "When women ask about the safety of abortion it is also worth pointing out that in developed countries, mortality associated with childbirth is 11 times higher than that for safely performed abortion procedures". By such context it's biased. Those numbers also don't carry scientific rigour since they were cited in a phrase that was addressed to the lay public.

That number is not used by later secondary sources, that only use the word lower. So its use is WP:UNDUE

That text by using that (division-by-zero) number misrepresents the mortality risks of childbirth in those countries which is low as stated by (Lloyd, 2005).--Nutriveg (talk) 19:41, 29 June 2010 (UTC)

So the answer to my first question is "no"? Sorry, TL;DR. -Andrew c ^[talk] 21:38, 29 June 2010 (UTC)

The current text is not a particularly good starting point because it ignores the fact that 99% of maternal deaths occur outside developed countries, thus failing WP:UNDUE. The whole paragraph needs updating and revision to cover all the issues. I'd leave it stand for now, since fiddling with the current text is less productive than working on expansion. --RexxS (talk) 22:54, 29 June 2010 (UTC)

Andrew c, that wasn't short enough for you? It's not my problem if some want to start from a version that has so many problems. That's why the Horland suggestion fits as a simple but consensual version we can start from.--Nutriveg (talk) 23:18, 29 June 2010 (UTC)

We have the data presented for the developed world and I do not think it should be removed just expanded. I will work on data for the developing world in a couple of weeks when I am back from holidays. Doc James (talk · contribs · email) 23:23, 29 June 2010 (UTC)

Perhaps RexxS could provide us with some links to sources? The bulleted list above seemed quite promising, though I felt it was lacking a MMR for childbirth in developing countries, which I think would give readers a complete picture of the relative risks. SHEFFIELDSTEEL^TALK 23:25, 29 June 2010 (UTC)

I'd be happy to, if you'd give me a little time to assemble them; I'd also like to bring up sources to cover MastCell's comment about complications from abortion (which are many times the mortality). The 2005 estimates for MMRs are given by the WHO at http://www.who.int/whosis/mme_2005.pdf (p.16) as 9 per 100,000 live births in developed countries, and it is dwarfed by the MMR for developing countries at 240 per 100,000. The table there makes interesting reading. --RexxS (talk) 23:55, 29 June 2010 (UTC)

I wanted to address MastCell's request that we also 'detail specific complications of abortion, as well as complication rates in both the "safe" and "unsafe" settings', but the impression I got from the reading I did today was that specific complications of abortion are fundamentally different between surgical and medical abortion, so I'd suggest they would be better detailed in the Physical health section which immediately follows, while the overview (complication rates) can be dealt with in the introductory paragraph that we are discussing. Please let me know if you prefer a different approach. I've re-laid out the points, with the above additions and numbered them for ease of reference in discussion:

1. Unsafe abortion is a serious risk to a woman's health (both mortality and morbidity)
2. Unsafe abortions occur predominately in non-developed countries
3. The MMR of unsafe abortion is estimated at 340 per 100,000 procedures
4. The rate of long-term damage or disease (instead of complication rate?) from unsafe abortion is in excess of 10% and may be as high as 35%
5. Safe abortion is one of the safest procedures in medicine
6. Safe abortions occur predominately in developed countries
7. The MMR of safe abortion is less than 1 per 100,000 procedures
8. Although in developed countries the MMR of childbirth is low (around 8 per 100,000 births), the MMR of safe abortion is even lower
9. The MMR of safe abortion increases as the pregnancy progresses
10. The complication rate of safe abortion increases rapidly with stage of pregnancy

While I was reading, I noted the following passages/data as illustrative of the key points above. I suspect I may have missed some things that I read, but I can repeat the exercise if required for particular points:

• Lloyd 2005: "Mortality and morbidity related to pregnancy and childbirth (particularly in sub-Saharan Africa and South Asia, where levels of early childbearing remain high) and as a direct consequence of unsafe abortion across all developing regions remain among the most significant risks to young women's health." (p.5)
• Lloyd 2005: "Maternal deaths are those that occur during pregnancy and up to 42 days after birth. About 80 percent of these are due directly to maternity; the most common cause is hemorrhage, followed by sepsis and complications of unsafe abortion ..." (p.191);
• WHO 2005: "A total of 99% of all maternal deaths occur in developing countries, where 85% of the population lives. More than half of these deaths occur in sub-Saharan Africa and one third in South Asia. The maternal mortality ratio in developing countries is 450 maternal deaths per 100,000 live births versus 9 in developed countries."
• WHO 2003: "Globally, approximately 13% of all maternal deaths are due to complications of unsafe abortion." (p.7)
• WHO: The table on p.16 of MMRs by region
• Mazza 2004: "Complications from unsafe abortions account for approximately 40% of maternal deaths wordwide. (Roston & Armstrong 1989)"
• Smithyes 2008: "Almost 20 million unsafe abortions occur annually, virtually all in the developing world." (is the Institute of Development Studies (IDS) a WP:RS for this?)
• Shah 2009: "Each year 42 million abortions are estimated to take place, 22 million safely and 20 million unsafely. Unsafe abortion accounts for 70,000 maternal deaths each year and causes a further 5 million women to suffer temporary or permanent disability." (70,000/20,000,00*100,000 = 350 is the arithmetic, although I think I may have used slightly older figures from the WHO to get the 340 in my list)
• Sokol, 2007 (quoted by Nutriveg): "In developed countries, the mortality rate from legal, induced abortion in the first trimester is less than 1 in 100,000 procedures, making the procedure safer than pregnancy and childbirth."
• Lloyd 2005: "In representative developed countries, the risk of dying is no more than 1 in 100,000 procedures, lower than the relatively low risks associated with pregnancy and childbirth in these countries"
• Laube 2009: "(United States) Risk of death from abortion during the first 2 months of pregnancy is less than 1 per 100,000 procedures, with increasing rates as pregnancy progresses (versus 7.7 maternal deaths per 100,000 live births)." (p.150)
• Gaufberg, eMedicine 2010: "(United States) Complication rates according to gestational age at the time of abortion are as follows: 8 weeks and under - Less than 1%; 8-12 weeks - 1.5-2%; 12-13 weeks - 3-6%; Second trimester - Up to 50%, possibly higher"

Please understand, I'm not suggesting actual article text at this stage. I just urge interested editors to look at the sources I've listed and see if you get the same impression of what is key (and how much of it is sourceable). I'm happy to discuss the weight each of the points should have, as many others have a better overview of this topic than I. But I hope that others will review my choices of quotes from the material I've suggested - there's obviously a lot more in the sources above than I can summarise here, and I don't want to be seen as "cherry-picking" my quotes. I hope there's some value in my efforts in helping others to write what ought to be the introduction to Health risks of abortion. --RexxS (talk) 20:36, 30 June 2010 (UTC)